Objective: Both cognitive impairment and lower quality of life (QoL) are highly prevalent in individuals with spinal cord injury (SCI) compared to healthy controls. Despite a growing interest into...Show moreObjective: Both cognitive impairment and lower quality of life (QoL) are highly prevalent in individuals with spinal cord injury (SCI) compared to healthy controls. Despite a growing interest into understanding the association between cognitive impairment and QoL in SCI patients, the results of studies conducted to date are conflicting. Therefore, we conducted a meta-analysis to have a better understanding of this association in SCI patients. Data sources: EMBASE, PubMed, and PsychInfo were systematically searched for all eligible articles with a cut-off date of March 21st, 2023. Study selection: Studies describing SCI patients, in which an association between cognitive factors and QoL was measured using validated questionnaires. Data Synthesis: Of 1824 studies, eight met inclusion criteria, reporting on 39 individual correlations and involving total sample size of 1142 SCI patients. Given the limited number of studies examining the association between cognitive factors and overall QoL, our meta-analysis focused on emotional QoL, specifically depression and anxiety. The random-effects meta-analysis for the association between cognitive factors and depression, included seven studies and 24 correlations, and the association between cognitive factors and anxiety, included four studies and 15 correlations. Results: Overall cognitive impairment was not associated with increased depression (𝑟 = -.095; 95% CI = -.214, .024; p = .142). However, cognitive impairment was significantly associated with increased anxiety (𝑟 = -.239; 95% CI = -.360, -.119; p < .001). Subgroup meta-analysis revealed an association between impaired perceptual-motor function and increased depression (-.171; 95% CI = -.192, -.151; p = .006). Impaired executive function (-.209; 95% CI = -.415, -.003; p = .047) and language (-.510; 95% CI = -.639, -.381; p < .001) were associated with increased anxiety. Conclusions: While depression was generally not associated with cognitive factors, subgroup analyses revealed that there was an association with impaired perceptual-motor functions. For anxiety, a more general negative association was found. In more specific analysis, only impaired language and executive functions associated with anxiety. The results need to be interpreted with caution due to limitations such as high heterogeneity. Follow-up longitudinal research could explore the causality between cognitive factors and QoL in SCI patients.Show less
Introduction: This thesis focuses on Quality of Life as defined by Schalock. Research has been performed to see if different assessed parts of Quality of Life of residents at Ipse de Bruggen match...Show moreIntroduction: This thesis focuses on Quality of Life as defined by Schalock. Research has been performed to see if different assessed parts of Quality of Life of residents at Ipse de Bruggen match the amount of developmental goals aimed at these areas. How does quality of life appear in support plans at Ipse de Bruggen? Method: An assessment was made of current Quality of Life at Ipse de Bruggen. Following this developmental goals were collected and coded based on which part of Quality of Life they were part of. The results of the assessment and coding of developmental goals were then compared. Finally, the outcomes were verified using several interviews with behavioral experts working at Ipse de Bruggen. Results: The assessment of different components of Quality of Life greatly don't match the amount of goals put up on these areas. Noteworthy is how Social Inclusion scores lowest but also has few goals striving to improve this. Focus seems to lie on the area of Personal Development. This scores around the median. However, when compared with level of development. It is seen that Personal Development gets lower scores the lower the developmental level of the client. There have also been indications that these developmental goals don't seem to actually match the desired level of quality needed for effective use. Discussion: It can be concluded that developmental goals do not always match the assessed Quality of Life of clients. There seems to be a sort of hierarchy in this construct where certain components of Quality of Life have to be fulfilled first before attention can be switched to different aspects of this construct. There also seems to be insufficient knowledge of the definitions of aspects of Quality of Life under carers. More focus on schooling could be a solution to this. It is recommended to perform follow-up research to see if different parts of Quality of Life return in the way in people of different developmental levels. It is also recommended to further research the current quality of developmental goals in Ipse de Bruggen.Show less
Background: The aim of this study is to investigate differences in QoL between males and females visiting a memory clinic. Knowledge about determinants of QoL is limited, especially from patients'...Show moreBackground: The aim of this study is to investigate differences in QoL between males and females visiting a memory clinic. Knowledge about determinants of QoL is limited, especially from patients' own perspective. We examined whether there was a relationship between sex and QoL in patients in different stages and with different types of dementia taken together (total sample), whether this relationship existed within patient groups of specific stages or types of dementia separately and whether this relationship in the total sample was mediated by anxiety, depression, perceived severity, perceived susceptibility and/or coping style. Methods: In total, 375 patients aged between 32 and 82 years, who visited the memory clinic and who completed an 88-item self-reported questionnaire, were included in the study. Linear regressions were performed to assess the relationship between sex and QoL and whether stage and type of dementia affect this relationship. In addition, we performed mediation analyses to assess whether anxiety, depression, perceived severity, perceived susceptibility and/or coping styles mediate the relationship between sex and QoL. In all our analyses, age and education were added as covariates. We corrected for multiple testing using False Discovery Rate (FDR). Results: Sex was not associated with QoL (p = .160) in the total sample. Sex was also not associated with QoL within the different stages (CN p = .847, MCI p = .688 and dementia p = .688), or within different types of dementia (FTD p = .895, AD p = .809 and other types of dementia p = .895). Our mediation analyses showed that only anxiety was a significant mediator in the relationship between sex and QoL (p = .010). Conclusion: In our study, there was no relationship between sex and QoL. For patients trying to maintain or improve their QoL, it is important to be aware of the factors that play an important role in QoL.Show less
Objective: There is growing evidence that freedom of movement inside and outside the nursing home has a positive effect on the Quality of Life (QoL) of people with dementia. The participants in...Show moreObjective: There is growing evidence that freedom of movement inside and outside the nursing home has a positive effect on the Quality of Life (QoL) of people with dementia. The participants in this study were living in nursing homes with either ‘freedom of movement’ or ‘restricted movement’. The level of physical activity, QoL, and how these differed in the two nursing home situations was examined. Furthermore, it was tested whether there was a correlation between physical activity level and QoL for both nursing home situations. Method: A questionnaire with nine subscales was used to measure QoL for people with dementia (QUALIDEM). The Maastricht Electronic Daily Life Observation (MEDLO) tool was used to measure physical activity levels during social activities. Results: For this study 81 nursing home patients with dementia were included (mean age ‘restricted movement’, 84 years; 33 females [69%]; mean age ‘freedom of movement’, 83 years; 20 females [83%]). Both QoL and activity level data was available for six participants from the ‘restricted movement’ situation and thirteen participants from the ‘freedom of movement’ situation. No significant differences between the two situations for QoL and activity level were found. Also, no significant correlation was found between activity level and QoL for the two situations. As a consequence of this non-significant correlation, it was decided that the moderation by situation would not be tested. Conclusion: Participants did not show a difference in activity level or QoL between the two nursing home situations (‘freedom of movement’, ‘restricted movement’). A relation between activity level and QoL could not be confirmed for either nursing home situation. Additional research is needed with a sample size providing sufficient statistical power. Furthermore, mediation needs to be included in the hypothesized model with depression and activities of daily life (ADL) as mediators for QoL.Show less
