Knowledge Item:
CA-Quality of Life and Health-42
Trends in Quality of Life Over the Course of the Treatment
Episode Part VIII–Maximum Change and Related Factors
For patients who were assessed at
least two times, the rate of change in total quality of life was
examined. The highest level at which quality of life can be maintained
is examined over time to both characterize the entire sample and to
study differential rates for various types of clients seen at different
projects. Overall, about 62% of the patients had improved or maintained
quality of life–as defined as quality of life that either increased
from baseline or was maintained at 100% of the baseline rate. The
maintained quality of life is encountered for periods of many years in
the treatment populations of these projects. Particularly for
disenfranchised patients, quality of life significantly changed in a
positive way throughout the program and changes in the order of
magnitude of 25-50% over periods of several years were not uncommon.
Further analyses given in Knowledge
Items: CA-Quality of Life and
Health-37, -43,
-50, -51,
and -39, as well as Knowledge
Items: CA-Medical Outcomes-11, -12,
and -13 show
additional analyses that confirm that the projects with wrap-around
comprehensive psychosocial services, supplementing basic medical
services, tend to maintain the patient at the same or an increased
quality of life for a longer time, and with a greater ratio of
improvement, than just medical services. The additional Knowledge Items
use alternate statistical designs and models with different factors
"controlled," but the different methods of assessing the
relative effectiveness of these different types of service models in
achieving improved quality of life for the patients all point out the
importance of integrated psychosocial or "wrap-around"
services.
Percentage of
Patients Who Have Improved Quality of Life Above Baseline Over the
Course of Treatment
Percentage of
Patients with Sustained or Improved Quality of Life Over the Course of
Treatment
Mean Ratio of
Highest Quality of Life Score to Baseline Over the Course of Treatment
(Ratio > 100 is Improvement) Over the Course of Treatment
More Information:
CHAID and CHAID Diagram
Mean Days Quality
of Life is Maintained at or Above Baseline Level
[Note: This is a "raw" mean that does not
control for whether the patient was still in the program on the last day
when data were collected. More complete analyses which do correct for
this issue are shown in the "survival at the same degree of quality
of life" curve given below.]
More Information:
Survival
Function or Survival Curve
Likelihood of
Keeping a Patient at or Above the Baseline Quality of Life Level
Controlling for Initial Level of Quality of Life and Participant
Demographic Factors
In
interpreting this Knowledge Item, and all others in this section on Quality
of Life and Health, remember that the ratings of quality of life,
symptom impact, and healthcare utilization are based on patient self
reports.
Knowledge Item Citation: Huba, G. J., Melchior, L. A., Panter, A. T., and the HRSA/HAB SPNS Cooperative Agreement Steering Committee (1998-2001). Knowledge Item:
CA-Quality of Life and Health-42 from
HRSA/HAB's SPNS Cooperative Agreements on Innovative Models of Care, The Measurement Group Knowledge Base on HIV/AIDS Care, Online at www.TheMeasurementGroup.com.
Last Updated:
March 25, 2005; data through June 15,
1999; analyses conducted February - June 2000.
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Knowledge Base Citation: The Knowledge Base and
this Knowledge Item were designed and authored by G.
J. Huba, Ph.D.; in collaboration with Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; and the staff of The Measurement Group. Cite this work as
"Huba, G. J., Melchior, L. A., and Panter, A. T. (1998 - 2001). The Measurement Group Knowledge Base on HIV/AIDS
Care. On the World Wide Web: http://www.TheMeasurementGroup.com."
Questions or
Comments:
Contact The Measurement
Group.
Use of Knowledge Base
Information: Acceptable Uses and
Limitations.
Collaborators from
Participating Projects: Cooperative
Agreement Steering Committee 1999.
Participating
Projects: This Knowledge Base is based on
the service delivery experiences of 27 Cooperative Agreement Projects on Innovative Models
of HIV/AIDS Care. These projects and the Evaluation and Dissemination Center
which produced this Knowledge Base were funded by the Health
Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) as Special Projects of National Significance (SPNS)
between 1994 and 1999. Click the Model Programs button
above for descriptions of the projects that contributed to this specific
Knowledge Item, a list of
key staff, and project grant numbers.
Why This Evaluation was
Conducted: Editorial.
More Information: Design
of this Knowledge Base.
Recommended Citation
Format for Web Materials: American
Psychological Association Publication Manual Section, Revised 2001.
Work on the Knowledge Base and the
cross-cutting evaluation was supported in part by Grant Number 5 U90 HA 00030-05 from the
Health Resources and Services Administration (HRSA), HIV/AIDS Bureau's (HAB) Special Projects of National Significance
(SPNS). The contents of this Knowledge Base are
solely the responsibility of The Measurement Group and do not necessarily represent the official
views of HRSA or HRSA/HAB's Special Projects of National Significance
nor may they represent the positions of the individual grantees whose
projects are included in the cross-cutting evaluation.
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