In this study we focus on the personal characteristics, particularly anxiety and optimism. The effect of psychological characteristics has also been often evoked, but still warrants further exploration. According to the original conceptual model of Wilson reviewed by Ferrans, characteristics pertaining to both the individual and the environment can have an impact on the five major domains of HRQOL, namely biological and physiological factors, symptoms status, functional status, general health perceptions, and overall HRQOL.
Worried about are reasons optimism. professional#
level of education, professional activity…) have been clearly identified in the literature. Some determinants of HRQOL such as gender, type of disease, age or socio-demographic characteristics (e.g. For our proposed model, we considered only the influence at the individual level. The McLeroy model indicates five levels of influence: (a) intrapersonal factors (characteristics of individual such as personality traits, knowledge, attitudes, behavior, self-concept, skills, etc.), (b) interpersonal factors (formal and informal social support systems, including the family, work group, and friendship networks), (c) institutional factors (social institutions, organizations such as schools and healthcare facilities), (d) community factors (relationships among institutions and informal social networks in a defined area), and (e) public policy (local, state, and national laws and policies). The conceptual framework for our study is a variation on Broffenbrenner’s ecological model, proposed by McLeroy, and explains the multiple levels of influence on health outcomes at both individual and environmental characteristics in HRQoL. Thus, chronic diseases can generate psychological distress and can be associated with a lower HRQOL. Patients affected by chronic disease have a particular profile, due to their recourse to regular care and the necessity to adapt to their disease, and this can have consequences on HRQOL assessment. HRQOL as an indicator provides essential information to the clinicians to estimate the efficiency of their therapeutic and preventive actions.
Contrary to optimism, it seems essential to evaluate trait anxiety in future studies about HRQOL, since it could represent a confounding factor.įor the follow-up of chronic diseases, it is necessary to develop indicators that can easily be assessed, such as the measure of the health-related quality of life (HRQOL), which is governed by specific guidelines for implementation. Furthermore, an interaction existed between the trait anxiety and optimism for some dimensions of SF36. Optimism and trait anxiety appeared to be significantly correlated with HRQOL. In this model, interaction between anxiety and optimism was significant for the Social Functioning dimension (p = 0.0021). It increased with increasing level of optimism (p < 0.006) in the model for all dimensions of SF36 except the Role Physical dimension. In the model 3, assessing the effect of both anxiety and optimism on HRQOL, and their interaction, the HRQOL score for all dimensions of the SF36 increased when the level of anxiety decreased (p < 0.0001).
The HRQOL score increased for all dimensions of SF36 between 15,8 and 44,5 when the level of anxiety decreased (p < 0.0001) for the model 1, assessing the effect of anxiety on HRQOL and increased for all dimensions of SF36 between 3.1 and 12.7 with increasing level of optimism (< 0.0001) in the model 2 assessing the effect of optimism on HRQOL. In this study, 1529 patients were included in three participating hospitals and there existed wide diversity in the chronic diseases in our population. We studied the effect of each trait on HRQOL separately, and simultaneously, taking account of their interaction in 3 models, using an ANOVA. Six months after hospitalization, patients completed a generic HRQOL questionnaire (SF-36), and the STAI and LOT-R questionnaires to evaluate optimism and trait anxiety. Using cross-sectional data from the SATISQOL cohort, we conducted a multicentric study, including patients hospitalized for an intervention in connection with their chronic disease. We aimed to study the effect of this factor on health-related quality of life (HRQOL) of patients after a hospitalization in relation with their chronic disease.
However, the effect of optimism and trait anxiety remains controversial and they are rarely studied simultaneously. The impact of psychological factors is often taken into account in the evaluation of quality of life.
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