Browsing by Subject "Quality of Life"
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Item Association of Pain Sensitivity with Outcome Measures for Quality of Life, Functional Ability and Current Pain Intensity in Chronic Low Back Pain(2021-05) Doud, Ronnie L.; Sumien, Nathalie; Licciardone, John C.; Kearns, Cathleen; Phillips, Nicole R.Pain sensitivity, as measured by the self-reported Pain Sensitivity Questionnaire (PSQ), was investigated using data from the PRECISION Pain Research Registry. Outcome measures for quality of life, functional ability, and current pain intensity were found to be significantly associated with PSQ Total in participants reporting chronic low back pain, even when controlling for age, sex, race, ethnicity, smoking status, and body mass index. Higher reported pain sensitivity correlated with reported higher pain intensity, lower quality of life, and increased physical disability.Item Changes in Healthcare Utilization and Charges Among Supportive Housing Residents Enrolled in a Health Coaching Program(2019-05) Chhetri, Shlesma; Spence-Almaguer, Emily; Walters, Scott T.; Stockbridge, Erica L.; Aryal, SubhashThe effectiveness of self-management programs on healthcare use outcomes is an active area of research with inconsistent results. This study was the first to evaluate changes in healthcare utilization (including hospital encounters, inpatient visits, outpatient visits, and emergency visits) and charged amounts among supportive housing residents enrolled in a health coaching program. We utilized retrospective longitudinal medical claims data and a qualitative examination of participants' perceptions of the program's influence on their healthcare use. Zero-inflated negative binomial model and log-gamma models were used to assess change in count variables and charged amounts respectively. Although participants reported a positive impact of the program on their overall quality of life through improved health self-management strategies, the analysis of claims data showed no significant change in healthcare use and charged amounts in all analyses spanning 12 months prior to 24 months post enrollment. These findings may potentially demonstrate the success of health coaching programs in stabilizing healthcare utilization among individuals who otherwise might have increased their healthcare use over time. During interviews and focus groups, participants also shared personal and systems level challenges that influenced their healthcare use. The inclusion of a control group in future analyses would help measure the actual impact of health coaching on healthcare utilization measures among supportive housing residents with high health needs.Item Investigating the Complex Relationship Between Adverse Childhood Experiences and Oral Health-Related Quality of Life(2017-05) Kabani, Faizan A.; Lykens, Kristine A.Dental caries is one of the most common chronic disease in children and continues to be a significant global public health concern. Evidence indicates that chronic diseases, and adverse childhood experiences (ACEs), have destructive impacts on overall quality of life, health outcomes, and health care expenditures. The ACE investigation identified cumulative dose-response relationships between ACEs and development of diverse health and social consequences later in life. Research is scarce on investigating causal pathways to facilitate contextualized public health interventions addressing this seismic threat. Data was utilized from the 2011-2012 National Survey of Children's Health, inclusive of ages 1-17 for dentate status. The dependent variables identified untreated oral health care needs and preventive dental utilization. The key independent variable, ACEs, included exposure to parental death, parental divorce, parental incarceration, mental health illnesses, domestic violence, neighborhood violence, and racial discrimination. Exogenous variables included age, sex, race/ethnicity, number of children in household, socioeconomic status proxies, health insurance status, and presence of special health care needs. Path analysis, a special subcomponent of structural equation modeling was utilized to explore direct, indirect, and mediating causal pathways. The data, when adjusted for complex survey design, proportionately represents children in the United States. The results of the adjusted logistic regressions revealed ACEs demonstrating varying magnitudes of significance across diverse racial and ethnic profiles. Exposures to parental divorce and parental death particularly exhibited critical magnitudes of influence. Adjusted path analyses demonstrated alternative family structures contributing a mediating role between ACEs and oral health-related quality of life (OHRQoL). In keeping with the Pareto Principle, exposure to certain ACEs, namely parental divorce and parental death, potentially introduces more profound social and health-related consequences later in life. Moreover, invocation of Occam's razor, can assist in theorizing that exposure to alternative family structures (i.e. via parental divorce and/or parental death) initiate a concatenated deteriorating domino effect sequela of secondary ACEs. Therefore, contextualized interventions should prioritize psychotherapeutic child, marriage, and family counseling services improving the home, as an enabling environment, to potentially minimize detriments of ACEs on OHRQoL.