The mission of the Chronicity Areas of Excellence (AoE) is to advance and disseminate knowledge and to influence public policy related to living well with chronic health concerns.
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  1. Field testing the WHOQOL-100 in Canada. [Download]

    Title: Field testing the WHOQOL-100 in Canada.
    Creator: Molzahn, A. E.
    Description: The purpose of this project was to test the WHOQOL-100, an instrument for assessing quality of life (QOL), developed to facilitate cross-cultural comparison. The instrument was tested with a convenience sample of 144 people.The mean age of participants was 58 years and 41% were female.Test-retest reliability was .86 for the physical domain, .78 for the psychological domain, .91 for independence, .87 for social relationships, .77 for environment, and .60 for spirituality. Consistency reliability was .77 for physical, .79 for psychological, .89 for independence, .71 for social relationships, .80 for environment, and .89 for spirituality/ personal beliefs. Correlations of the various domains with other instruments, including the SF-36, the Self-Anchoring Striving Scale, and the Visual Analogue Scale for Pain, supported the convergent validity of the instrument.The instrument was able to discriminate between healthy and ill populations, providing support for construct validity.
    Subjects: measurement, quality of life
    Date Created: 2006
  2. Exercise programs for people with dementia [Download]

    Title: Exercise programs for people with dementia
    Creator: Forbes, D
    Description: Background In future, as the population ages, the number of people in our communities suffering with dementia will rise dramatically. This will not only affect the quality of life of people with dementia but also increase the burden on family caregivers, community care, and residential care services. Exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia. Study characteristics This review evaluated the results of 17 trials (search dates August 2012 and October 2013), including 1,067 participants, that tested whether exercise programs could improve cognition (which includes such things as memory, reasoning ability and spatial awareness), activities of daily living, behaviour and psychological symptoms (such as depression, anxiety and agitation) in older people with dementia. We also looked for effects on mortality, quality of life, caregivers' experience and use of healthcare services, and for any adverse effects of exercise. Key findings There was some evidence that exercise programs can improve the ability of people with dementia to perform daily activities, but there was a lot of variation among trial results that we were not able to explain. The studies showed no evidence of benefit from exercise on cognition, psychological symptoms, and depression. There was little or no evidence regarding the other outcomes listed above. There was no evidence that exercise was harmful for the participants. We judged the overall quality of evidence behind most of the results to be very low. Conclusion Additional well-designed trials would allow us to enhance the quality of the review by investigating the best type of exercise program for people with different types and severity of dementia and by addressing all of the outcomes.
    Subjects: Dementia, Motor Activity, Depression, Exercise Therapy, Cognition
  3. A qualitative study to explore patient and staff perceptions of intradialytic exercise [Download]

    Title: A qualitative study to explore patient and staff perceptions of intradialytic exercise
    Creator: Thompson, Stephanie
    Description: Background and objectives Randomized, controlled trials show that regular exercise is beneficial for patients on hemodialysis. Intradialytic exercise may have additional benefits, such as amelioration of treatment-related symptoms. However, the factors that influence the implementation of intradialytic exercise are largely unknown. Design, setting, participants, & measurements Individual semistructured interviews were conducted with a purposive sample of patients on hemodialysis who had participated in a pilot randomized, controlled trial on intradialytic exercise and dialysis staff that worked in the unit during the trial. The trial took place from July to December of 2014 and enrolled 31 patients. Interviews were conducted from April to December of 2014. Interview coding followed an inductive and broad-based approach. Thematic analysis was used to group codes into common themes, first individually and then, across staff and patient interviews. Results Twenty-five patients and 11 staff were interviewed. Three themes common to both groups emerged: support, norms (expected practices) within the dialysis unit, and the role of the dialysis nurse. The support of the kinesiologist enhanced patients’ confidence and sense of capability and was a key component of implementation. However, the practice of initiating exercise at the start of the shift was a barrier to staff participation. Staff focused on the technical aspects of their role in intradialytic exercise, whereas patients viewed encouragement and assistance with intradialytic exercise as the staff’s role. An additional theme of no time (for staff to participate in intradialytic exercise) was influenced by its low priority in their workflow and the demands of the unit. The staff’s emphasis on patients setting up their own equipment and enhanced social interaction among participants were additional themes that conveyed the unintended consequences of the intervention. Conclusions The kinesiologist-patient interactions and staff readiness for intradialytic exercise were important factors in the implementation of intradialytic exercise. Understanding how unit workflow and the personal values of staff can influence implementation may improve the design of intradialytic exercise interventions.
    Subjects: Quality of life, Exercise, Sensation, Dialysis, Perception, Humans, End-stage renal disease, Randomized Controlled Trials as Topic, Qualitative research, Hemodialysis
    Date Created: 2016
  4. Relocation of remote dwellers living with hemodialysis: A time trade-off survey [Download]

    Title: Relocation of remote dwellers living with hemodialysis: A time trade-off survey
    Creator: Tonelli, Marcello
    Description: Background There has been little research exploring the experience of dialysis therapy for people living in remote communities. Remote residence location has previously been associated with excess mortality in hemodialysis (HD) patients, suggesting that relocation to a referral center might improve outcomes. It is unknown whether patients view this approach as acceptable. Methods We studied 121 remote-dwelling chronic HD patients using the time trade-off method applied to hypothetical scenarios. Results Participants indicated that they would trade a median of 6 years of life in their current location (including current social supports) (95% CI 2.25–7) for 10 years of life in a referral center without any of their existing social supports (meaning they would be willing to forgo 4 years of life to remain in their current residence location). When current social supports were assumed to continue in both locations, people were only willing to forego a median of 2 years of life (95% CI 1–4) to remain in their current location. Older participants were much less willing to accept relocation than younger participants; the median time trade-off associated with relocation and without social supports was 2 years for participants aged <50 years, 3 years for those aged 50–69.9 years and 9 years for those aged ≥70 years. Conclusions Hemodialysis patients currently living remotely were willing to forgo much of their remaining life expectancy rather than relocate—especially among older participants. These findings suggest that decisions about relocation should be accompanied by discussion of anticipated changes in quality of life and life expectancy.
    Subjects: Health care services, Hemodialysis, Remote dwellers, End-stage renal disease
    Date Created: 2015
  5. Engaging Hope [Download]

    Title: Engaging Hope
    Creator: Duggleby, W.
    Description: This video reflects the hope experience of male spouses of women with breast cancer. It was funded by Canadian Breast Cancer Foundation - Prairies/NWT.
    Subjects: Hope