Evaluation of the Effectiveness of the Smart Post-Discharge Elderly Health Management Platform for Older Patients' Health-Related Quality of Life: A Cluster Randomised Controlled Trial.

Impact of Comorbidities on Health-related Quality of Life in Nontransplant Eligible Patients With Newly Diagnosed Multiple Myeloma.

Hepatitis C treatment and quality of life – You can’t always get what you want, but you might get what you need

Health-related quality of life (HRQOL) is a health outcome that has seen a growing interest in physical activity research. The Short-Form Health Survey (SF-36) is the most widely used HRQOL instrument in physical activity research. The purpose of this study was to perform a systematic review and meta-analysis of reliability coefficients on the SF-36 HRQOL assessment applied in physical activity research so as to assess the generalizability of HRQOL measurement reliability. A separate meta-analysis was performed for each HRQOL domain (physical and mental). A total of 87 effect sizes were analyzed in this study, 44 for the physical health domain and 43 for the mental health domain. The effect sizes were strong and significantly different from zero for both physical health (ES = .90 [95% CI: .88, .92], p< .001) and mental health (ES = .90 [95% CI: .89, .91], p< .001) domains. These findings show that both HRQOL scales of the SF-36 assessment are reliable across a wide variety of physical activity studies.

Health-related quality of life (HRQOL) represents a central outcome following hip fracture surgery. This study examined whether psychological resilience and other factors predict HRQOL. In this prospective longitudinal study, patients ≥60 years undergoing hip fracture surgery in southern Taiwan were consecutively recruited. HRQOL was measured by the 36-item Short Form Health Survey (SF-36) and psychological resilience by the 10-item Connor–Davidson Resilience Scale (CD-RISC-10). Both tools were administered at admission prefracture (at admission, based on recall), and at 6 and 12 weeks postoperatively. Changes and predictors of HRQOL within 12 weeks were analyzed using generalized estimating equations. Generalized estimating equations were used to analyze changes in these and predictors of HRQOL within 12 weeks after surgery. Among 50 participants (mean age 72.1 ± 9.6 years; 58% female), psychological resilience (CD-RISC-10) showed no significant changes across baseline, 6 weeks, and 12 weeks postoperatively, whereas HRQOL (SF-36 total, physical, and mental health domains) declined at 6 weeks but returned to baseline by 12 weeks (SF-36: b = −9.19, P < .001; physical health domain: b = −5.29, P < .001; mental health domain: b = −3.90, P = .001). Higher prefracture CD-RISC-10 scores significantly predicted better SF-36 total, physical, and mental health domains (all P < .001), whereas a hospital stay ≥8 days was associated with lower SF-36 and its mental health domain. In conclusion, psychological resilience supports postoperative HRQOL, underscoring its relevance as a perioperative care target. Larger, long-term studies are warranted to confirm these effects and elucidate their sustained impact.

ABSTRACTLittle is known about health-related quality of life (HRQoL) after stroke in Chinese populations. We conducted the present study to evaluate HRQoL after stroke in a group of Chinese patients. We followed 114 patients diagnosed with a first-ever stroke for 2 years. The HRQoL at discharge, 1 year poststroke, and 2 years poststroke was evaluated with the Medical Outcome Short Form 36. After a 2-year follow-up, there were 92 (88.5%) survivors. All eight domains of the HRQoL had the lowest scores at discharge, greatly improved over the first year after discharge, and showed continuous improvement. The HRQoL of patients after stroke significantly improved in two mental health domains (social function and mental health) and all four physical health domains 2 years after discharge. However, patients with stroke still had significantly lower scores in every domain than an age-matched reference group even 2 years after discharge. Age, sex, and activities of daily living were associated with HRQoL in the mental or physical domain in patients with stroke. Our results suggest that HRQoL greatly improved 2 years after discharge in patients with stroke. This study also confirmed the usefulness of the HRQoL assessment for prognosis evaluation in patients after stroke. Further studies from Chinese populations are still warranted.

Insulin resistance is a metabolic abnormality that underlies Type 2 diabetes, the metabolic syndrome and cardiovascular disease, but it may also be associated with more global health deficits. This study assessed associations of insulin resistance with health-related quality of life (HRQoL) in different domains of physical and mental health in a large elderly population study. Cross-sectional data of 1212 participants from the Hertfordshire Cohort Study were analysed. Insulin resistance was assessed by the homeostatic model assessment (HOMA-IR), and HRQoL was measured using the SF-36 health survey. Poor HRQoL was defined by a score lower than the sex-specific 10th percentile of each scale, and logistic regressions yielded odds ratios in relation to the HOMA-IR scores. Subsequent analyses adjusted for the influence of age, smoking, alcohol consumption, social class, BMI, coronary heart disease and depression. Results showed an increase in poor HRQoL with an increase in HOMA-IR scores for physical functioning (OR = 2.29; CI: 1.67-3.13), vitality (OR = 1.45; CI: 1.05-2.00), and general health (OR = 1.62; CI: 1.19-2.21). In men, but not in women, associations with physical functioning were independent of confounding variables. The results indicate that insulin resistance is associated with poor HRQoL in domains of physical health, but not in domains of mental health.

Informal caregivers who provide home-based care frequently experience stress and burden that adversely affect their health-related quality of life (HRQOL). To evaluate the efficacy of the Further Enabling Care at Home (FECH+) program for the HRQOL of caregivers of older adults discharged home from the hospital. This multicenter, parallel, 2-group randomized clinical trial, with blinded baseline and outcome measurements, was conducted at 3 hospitals in 2 states in Australia. Recruitment took place between August 2020 and July 2022, and follow-up was performed for 12 months after hospital discharge. Participants were dyads of caregivers and patients. Eligible caregivers were aged 18 years or older who provided informal home-based care at least weekly for a patient aged 70 years or older. Caregivers were enrolled when their patient was discharged from the hospital. Dyads were randomly assigned to either the intervention or control group. Data analysis followed an intention-to-treat approach. Caregivers in the intervention group received the FECH+ program, structured nurse support of 6 telephone calls over 6 months after the patient's discharge plus usual discharge care. Caregivers in the control group received usual care alone. Primary outcome was caregivers' HRQOL 6 months after discharge, which was measured using the Assessment of Quality of Life 8-Dimension (AQOL-8D). Secondary outcomes were caregivers' HRQOL 12 months after discharge as well as preparedness to care (measured using the Preparedness for Caregiving Scale), self-efficacy (measured using the Caregiver Inventory), and levels of strain and distress (measured using the Family Appraisal of Caregiving Questionnaire) at 6 and 12 months after discharge. Baseline and outcome measurements were administered by telephone at 3, 6, and 12 months after discharge. A total of 547 dyads (caregivers: 405 females [74.0%], mean [SD] age, 64.50 [12.82] years; patients: 296 females [54.1%], mean [SD] age, 83.16 [7.04] years for the intervention group and 83.45 [7.20] years for the control group) were included in the intention-to-treat analysis. There was no significant difference in caregivers' HRQOL between the 2 groups at the primary time point of 6 months (difference in AQOL-8D score, 0.01; 95% CI, -0.02 to 0.03; P = .62) after hospital discharge. In this randomized clinical trial, the FECH+ program-a nurse telephone support intervention for caregivers of older adults after hospital discharge-did not significantly improve caregivers' HRQOL at 6 months after discharge compared with usual care. Additional examination is warranted into improving caregivers' HRQOL at the time of their patient's hospital discharge. Australian New Zealand Clinical Trials Registry Identifier: ACTRN12620000060943.

OBJECTIVES:To explore associations between the physical, cognitive, and mental post-intensive care syndrome (PICS) health domains with changes in health-related quality of life (HRQoL) following ICU admission.DESIGN:A longitudinal prospective multicenter cohort study.SETTING/PATIENTS:Patients (n = 4092) from seven Dutch ICUs.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:At ICU admission, 3 and 12 months post-ICU, patients completed validated questionnaires regarding physical health problems, cognitive health problems, mental health problems, and HRQoL. Composite scores were created for the physical health domain (physical problems and fatigue) and mental health domain (anxiety, depression, and post-traumatic stress disorder). Adjusted multivariable linear regression analyses were performed, including covariables (e.g., patient characteristics, disease severity, pre-ICU HRQoL, etc.) to explore associations between the physical, cognitive, and mental health domains of PICS and changes in HRQoL at 3 and 12 months post-ICU. At 3 months (n = 3368), physical health problems (β = –0.04 [95% CI, –0.06 to 0.02]; p < 0.001), cognitive health problems (β = –0.05 [95% CI, –0.09 to –0.02]; p < 0.001), and mental health problems (β = –0.08 [95% CI, –0.10 to –0.05]; p < 0.001) were negatively associated with changes in HRQoL. Also, at 12 months (n = 2950), physical health problems (β = –0.06 [95% CI, –0.08 to –0.03]; p < 0.001), cognitive health problems (β = –0.04 [95% CI, –0.08 to –0.01]; p < 0.015), and mental health problems (β = –0.06 [95% CI, –0.08 to –0.03]; p < 0.001) were negatively associated with changes in HRQoL.CONCLUSIONS:PICS symptoms in the physical, cognitive, and mental domains are all negatively associated with changes in HRQoL at 3 and 12 months post-ICU. At 3 months, PICS symptoms in the mental domain seem to have the largest negative associations. At 12 months, the associations of PICS in the mental and physical domains are the same. This implies that daily ICU care and follow-up care should focus on preventing and mitigating health problems across all three PICS domains to prevent a decrease in HRQoL.

To assess the prospective relationship between obesity and health-related quality of life, including a novel assessment of the impact of health-related quality of life on weight gain. Longitudinal, national, population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study, with surveys conducted in 1999/2000 and 2004/2005. A total of 5985 men and women aged ≥ 25 years at study entry. At both time points, height, weight and waist circumference were measured and self-report data on health-related quality of life from the SF-36 questionnaire were obtained. Cross-sectional and bi-directional, prospective associations between obesity categories and health-related quality of life were assessed. Higher body mass index (BMI) at baseline was associated with deterioration in health-related quality of life over 5 years for seven of the eight health-related quality of life domains in women (all P ≤ 0.01, with the exception of mental health, P>0.05), and six out of eight in men (all P<0.05, with the exception of role-emotional, P=0.055, and mental health, P>0.05). Each of the quality-of-life domains related to mental health as well as the mental component summary were inversely associated with BMI change (all P<0.0001 for women and P ≤ 0.01 for men), with the exception of vitality, which was significant in women only (P=0.008). For the physical domains, change in BMI was inversely associated with baseline general health in women only (P=0.023). Obesity was associated with a deterioration in health-related quality of life (including both physical and mental health domains) in this cohort of Australian adults followed over 5 years. Health-related quality of life was also a predictor of weight gain over 5 years, indicating a bi-directional association between obesity and health-related quality of life. The identification of those with poor health-related quality of life may be important in assessing the risk of future weight gain, and a focus on health-related quality of life may be beneficial in weight management strategies.

BackgroundAdherence to a gluten-free diet (GFD) and food insecurity (FI) may influence health-related quality of life (HRQOL) in individuals with celiac disease (CD). This study aimed to investigate the association between adherence to a GFD, FI, and HRQOL in individuals with CD.MethodsThis cross-sectional study included 97 adults (mean age: 34 ± 9 years) diagnosed with CD. The participants were on a GFD for more than 6 months. Sociodemographic characteristics and medical history were assessed. Adherence to a GFD, FI, and HRQOL were assessed using validated questionnaires.ResultsMost participants (73%) adhered to a GFD, and 62% were experiencing FI. Individuals with CD faced difficulty in accessing GF foods due to the high cost (90%) and limited availability (79%). The mean overall HRQOL score was 60. Scores on the physical and mental health domains were 69 and 47, respectively. Adherence to a GFD was significantly associated with FI (P = 0.02), while there was no association between adherence to a GFD and HRQOL measures (P > 0.05). Participants facing FI had lower scores in emotional well-being and mental health domains, and overall HRQOL (P < 0.05).ConclusionsThe findings of the present study demonstrate that FI influences adherence to a GFD, and that FI is associated with HRQOL in terms of both emotional well-being and mental health.

The aim of this study was to evaluate the changes in health-related quality of life in patients with coronary heart disease according to age, gender, and treatment method. The study enrolled 167 patients after acute myocardial infarction (MI), percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG). The mean age was 59.3 years; there were 71.9% of males. General health-related quality of life was measured using the SF-36 questionnaire. Patients were examined at the beginning of rehabilitation and after 6-, 12-, 18-, and 24-month follow-up. Effect sizes were computed to assess the changes in health-related quality of life over time. Health-related quality of life significantly improved at 6 months, but improvements did not continue over time. The largest effect size was seen in the pain domain. Effect sizes were greater in the physical health domains among male patients and among female patients in the mental health domain. With regard to age, effect sizes were greater in the physical functioning domain among older patients. With regard to treatment method, at baseline, the CABG patients had the poorest health-related quality of life; however, the largest effect sizes were seen in this group. Health-related quality of life improved over 2 years; the greatest improvement was seen at 6 months. Males better improved on the physical component summary domain; there was no significant improvement in the mental component summary domain in males and females. Older patients improved better on the physical activity and physical component summary domains. Changes in health-related quality of life were related to treatment method.

Assessment of Health-Related Quality of Life in Adults Hospitalized with Sickle Cell Disease Vaso-Occlusive Crisis

Background: The impact of rheumatoid arthritis (RA) on health-related quality of life (HRQoL) in older adults remains incompletely characterized, particularly regarding sex-specific patterns and the relative contribution of physical and mental health domains in later life. Methods: We conducted an observational cross-sectional case-control analysis including adults aged ≥65 years. A total of 180 patients with RA (65.6% women) were compared with 195 age- and sex-matched control subjects. HRQoL was assessed using the Short Form-12 (SF-12) questionnaire, generating Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Analyses were stratified by sex. Associations between HRQoL domains and clinical variables were examined using correlation analyses and sex-specific multivariable linear regression models. Effect sizes (Cohen's d) were calculated to quantify the magnitude of between-group differences. Results: Women with RA showed significantly lower SF-12 physical (PCS) and mental (MCS) component scores than men with RA, indicating a greater impairment in overall HRQoL. Women also exhibited higher functional disability, as assessed by the Health Assessment Questionnaire (HAQ), and higher disease activity, as assessed by DAS28. In sex-stratified case-control comparisons, men with RA showed lower SF-12 PCS scores, while MCS scores were comparable to those of the age-matched male controls. In contrast, women with RA exhibited significantly lower PCS and MCS scores compared to age-matched female controls. In multivariable analyses, distinct sex-specific patterns were observed. In women with RA, HAQ emerged as the only independent determinant of PCS, whereas DAS28 was the sole independent determinant of MCS. In men with RA, PCS was independently associated with DAS28, whereas MCS was independently associated with HAQ. Effect size analyses indicated consistently small impairments in both physical and mental HRQoL domains in women, whereas in men, the impact was small and largely confined to the physical domain. Conclusions: In older adults with RA, HRQoL impairment is sex-dependent and domain-specific, with women experiencing a more pronounced and generalized reduction in both physical and mental health compared with men. Sex-specific differences in the relative contribution of disease activity and functional disability highlight the need for a differentiated interpretation of patient-reported outcomes in this population. A domain-specific and sex-aware assessment of HRQoL may enhance the clinical evaluation of older patients and provide a more comprehensive understanding of disease burden beyond inflammatory activity alone.

e19038 Background: Health related quality of life (HRQoL) is associated with excess morbidity and mortality after cancer diagnosis. While a growing body of research indicates that sexual minority women (lesbian and bisexual women; SMW) experience greater risk for cancer diagnoses and cancer-related mortality, there is a paucity of evidence describing HRQoL in this population. This is a critical omission as assessment of sexual orientation differences in HRQoL may inform clinical interventions to improve health and survival of SMW after cancer diagnosis. This study examined associations between sexual orientation and HRQoL domains among female cancer survivors. Methods: Data from the 2013-2018 National Health Interview Survey (NHIS) was pooled. HRQoL was defined using individual indices across physical health, mental health, social, and financial domains. The association between sexual orientation and individual indices of HRQoL was assessed using weighted multivariable logistic regression analyses. Results: The sample included 97909 heterosexual, 1424 lesbian, and 1235 bisexual women who reported a cancer diagnosis. Sexual minority women were more likely to be college graduates (p &lt; 0.001) and employed (p &lt; 0.001); however, they had higher rates of being uninsured (p = 0.01) than their heterosexual counterparts. Reproductive cancers—including breast, ovarian, cervical, and uterine—accounted for 51% of cancer diagnoses in heterosexual women and 57.2% in SMW (p = 0.06). Sexual minority and heterosexual women had more similarities than differences in individual indices of HRQoL; however, several pertinent differences were noted. Specifically, SMW had higher odds of moderate (OR 1.46 [1.01-2.13]) and severe psychological distress (OR 2.10 [1.17-3.77]); chronic health conditions, including COPD (OR 1.72 [1.06-2.80]) and heart disease (OR 1.93 [1.32-2.83]); financial concerns about retirement (OR 1.36 [1.01-1.83]); food insecurity (OR 2.13 [1.23-3.68]), and severe food insecurity (OR 2.44 [1.28-4.67]). Conclusions: Sexual minority women with cancer diagnoses report worse indices of HRQoL. Poorer HRQoL may influence excess morbidity and mortality evidenced in these populations; however, future longitudinal studies are needed to assess prospective risk. Given our results, implementing interventions in the cancer setting to identify sexual minority patients in need of physical and mental health and financial services may reduce disparities.

FRI0058 Improvements in Health Related Quality of Life (HRQOL) Reported by Rheumatoid Arthritis (RA) Patients in a Randomized Controlled Trial [RCT] of Sarilumab [Mobility] that Met or Exceeded the Patient...