tailieunhanh - báo cáo hóa học:" Effect of adaptive abilities on utilities, direct or mediated by mental health?"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa học đề tài : Effect of adaptive abilities on utilities, direct or mediated by mental health? | Peeters et al. Health and Quality of Life Outcomes 2010 8 130 http content 8 1 130 HEALTH AND QUALITY of life outcomes RESEARCH Open Access Effect of adaptive abilities on utilities direct or mediated by mental health Yvette Peeters1 Adelita V Ranchor2 Thea PM Vliet Vlieland3 Anne M Stiggelbout1 Abstract Background In cost-utility analyses gain in health can be measured using health state utilities. Health state utilities can be elicited from members of the public or from patients. Utilities given by patients tend to be higher than utilities given by members of the public. This difference is often suggested to be explained by adaptation but this has not yet been investigated in patients. Here we investigate if besides health related quality of life HRQL persons ability to adapt can explain health state utilities. Both the direct effect of persons adaptive abilities on health state utilities and the indirect effect where HRQL mediates the effect of ability to adapt are examined. Methods In total 125 patients with Rheumatoid Arthritis were interviewed. Participants gave valuations of their own health on a visual analogue scale VAS and time trade-off TTO . To estimate persons ability to adapt patients filled in questionnaires measuring Self-esteem Mastery and Optimism. Finally they completed the SF-36 measuring HRQL. Regression analyses were used to investigate the direct and mediated effect of ability to adapt on health state utilities. Results Persons ability to adapt did not add considerably to the explanation of health state utilities above HRQL. In the TTO no additional variance was explained by adaptive abilities A R2 .00 b .02 in the VAS a minor proportion of the variance was explained by adaptive abilities A R2 .05 b .33 . The effect of adaptation on health state utilities seems to be mediated by the mental health domain of quality of life. Conclusions Patients with stronger adaptive abilities based on their optimism mastery and self-esteem may .

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