Impact of physical activity and selected relaxation techniques on the quality of life of female patients with irritable bowel syndrome

Patients with irritable bowel syndrome (IBS) have significantly impaired quality of life (QoL). We investigated the presence of dysfunctional cognitions, anxiety, and depression symptoms and their impact on daily symptoms and QoL in a large IBS cohort. A total of 268 IBS patients (Rome II criteria, age 18 to 65 y) were included. Patients completed a 2-week daily symptom diary. The Short Form-36 was used to score QoL. The 31-items Cognitive Scale for Functional Bowel Disorders (CSFBD) and the Hospital Anxiety and Depression Scale (HADS) were used to analyze the psychological factors. Possible anxiety and depression disorders were present in 30% and 22% of IBS patients, respectively. Patients with anxiety and depression had significantly higher mean symptom scores, impaired QoL, and higher CSFBD scores (P<0.01). Physical and mental QoL were both affected by depression (HADS-D) and dysfunctional cognitions (P<0.01). Only physical QoL, not mental QoL, was affected by referral type (hospital setting vs. community based; P<0.01). Only mental QoL was affected by anxiety (HADS-A) (P<0.01). Dysfunctional cognitions independently of anxiety and depression influenced QoL and IBS symptoms. In this IBS cohort, dysfunctional cognitions independently influence physical and mental QoL and symptom severity. Presence of possible anxiety and depression disorders resulted in higher symptoms, lower QoL, and higher CSFBD scores. The results point toward an important role of psychological factors, especially dysfunctional cognitions on QoL and symptom scores in IBS patients.

This study investigates the efficacy of and gender differences in exercise therapy in patients with malignant lymphoma undergoing chemotherapy. Twenty-six patients (13 men, 13 women) received physical therapy (based on the Borg Scale 13) during hospitalization. Physical function was measured using grip and knee extension strength, 6-minute walking distance, and body composition; nutritional status assessed via Mini Nutritional Assessment (MNA®); and serum albumin levels analyzed. Fatigue was evaluated using the Brief Fatigue Inventory, and health-related quality of life was assessed with the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36v2). The analysis of all patients indicated that the right grip strength, skeletal muscle mass, skeletal muscle index, and leg muscle mass significantly decreased, whereas the serum albumin level, MNA® score, and scores of many items of the SF-36v2 significantly increased after chemotherapy. In a gender-specific analysis, only men showed significant declines in the skeletal muscle mass and skeletal muscle index, and improvement in the MNA® score after chemotherapy. In the SF-36v2, there were significant improvements in general health and physical component summary scores among men, and general health and mental component summary scores among women. Exercise therapy at a Borg Scale intensity of 13 may not prevent muscle mass decline in patients with malignant lymphoma, especially male patients. In addition, this study revealed that there is a gender difference in the effect of exercise therapy on quality of life. Thus, gender should be considered in exercise therapy for patients with malignant lymphoma.

BackgroundThe level of physical activity (PA) among patients with coronary heart disease (CHD) living in Chinese communities who do not participate in cardiac rehabilitation programs and the factors contributing to patient maintenance of PA are unclear.ObjectiveThis cross-sectional study, guided by the Transtheoretical Model, evaluated (1) the maintenance of PA in Chinese patients with CHD 12 months after hospital discharge and (2) the demographic, clinical, and psychological characteristics associated with maintenance of PA.MethodsA total of 1162 patients completed 6 questionnaires at 12 months posthospitalization to assess their maintenance of PA, stage of change, symptoms of depression and anxiety, and health-related quality of life and sleep.ResultsOnly 40% of patients with CHD maintained regular PA 12 months after hospital discharge. Walking was their primary PA. Thirty-seven percent of patients reported no intention of having regular PA. Male sex (odds ratio [OR], 1.69), awareness of PA's cardiac benefit (OR, 4.12), a history of regular PA before the cardiac event (OR, 6.08), history of chronic disease (OR, 1.43), mild depressive symptoms (OR, 1.40), moderate and severe depressive symptoms (OR, 0.41), smoking (OR, 0.54), and years of CHD (OR, 0.96) were related to maintenance of regular PA. Patients with CHD who maintained regular PA had better quality of life and sleep (P < .001) and fewer unplanned clinic visits (P = .001) and cardiac cause readmissions (P = .012) and reported fewer declines in PA capacity (P < .001).ConclusionsWalking is the most common form of PA 12 months posthospitalization among patients with CHD in China. Patient education and counseling about the cardiac benefits of PA, taking into account stage of change, are important considerations to improve maintenance of PA.

Objective To investigate the influence of gender and psychosocial parameters on the quality of life in patients with irritable bowel syndrome(IBS). Methods Out-patients from Jan to Oct 2008 in the Department of Gastroenterology at the First Affiliated Hospital of Nanjing Medical University were enrolled. Based on Rome teria IBS was diagnosed. Interviewed by a GI physician with questionnaire of demographic data,Zung self-rating anxiety and depression scale(SAS/SDS) and IBS-specific quality of life(IBS-QOL) questionnaire. Results 452 patients were diagnosed as IBS according to Rome Ⅲ criteria. IBS was more common in female. In male, anxiety and depression scales were significantly increased( t =7. 191、6. 459 ,P ＜ 0. 01 ) and the scale of IBS-QOL was significantly decreased ( t =9.119, P ＜ 0.01 ) in female IBS patients. In IBS patients, IBS-QOL scales were negatively associated with the anxiety and depression scales(P ＜0. 01 ). Conclusion These results suggest that there were gender differences in psychological status and quality of life in IBS patients,and difference psychological status based on gender should influence the quality of life of patients with IBS. Key words: Irritable bowel syndrome; Gender; Psychology; Quality of life

Is Video-Assisted Thoracic Surgery Lobectomy Better? Quality of Life Considerations

BackgroundReduced quality of life (QoL) is often the main problem for patients with irritable bowel syndrome (IBS). This study aimed at finding predictors of reduced physical and mental quality of life (QoL) accessible for intervention.MethodsConsecutive patients with IBS (according to the Rome II criteria) visiting a general practitioner were included in a prospective cohort study and followed up for 6−9 months. At the last visit, information about sociodemographic characteristics, abdominal complaints, QoL and a range of physical and mental comorbidities were collected. Physical and mental QoL were measured with the generic QoL instrument Short Form-12 Physical Component Score (SF-12 PCS) and Short Form-12 Mental Component Score (SF-12 MCS) respectively. The normal scores are 50. This cross-sectional study used data from the last visit.ResultsOut of 208 patients included in the cohort study, 149 (female/male: 105/44) with a mean age of 52 years (SD 15.3) were available for the analyses. Physical and mental QoL were reduced, the mean SF-12 PCS and SF-12 MCS scores were 38.4 (SD 11.9) and 45.0 (SD 11.3) respectively. The main independent predictors of low SF-12 PCS and SF-12 MCS were subjective health complaints and organic diseases, and affective disorders respectively. The severity of IBS symptoms was of minor clinical importance.ConclusionsTo help patients with IBS and reduced QoL, treatment should focus on QoL and not on relief of IBS symptoms. The different causes of reduced physical and mental QoL make an individually directed treatment necessary.

We aimed to assess the influence of anxiety and depression on the physical and mental quality of life (QoL) in patient with chronic obstructive pulmonary disease (COPD) and caregiver dyads, detect the simultaneous effect of anxiety and depression of each partner on the other's QoL and determine the dyadic patterns. A cross-sectional descriptive design was used. The actor-partner interdependence model estimated by structural equation modeling was used for the dyadic analysis. Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and 12-Item Short-Form Health Survey (SF-12) were used to measure depression, anxiety and QoL, respectively. Eighty COPD dyads were enrolled in the study. Patients presented higher depression symptoms and poorer physical and mental QoL than their caregivers, whereas comparable levels of anxiety were found in patients and caregivers. The model exploring the effects of depression and anxiety on mental QoL found that patients' depressive symptoms negatively influence their mental QoL, and caregivers' anxiety and depression symptoms negatively impact their mental QoL. The model exploring the effects of anxiety and depression on physical QoL detected one statistically significant actor effect with patients' depressive symptoms negatively influencing their physical QoL, and two partner effects with caregivers' anxiety worsening patients' physical QoL and caregivers' depression improving patients' physical QoL. The results suggest that caregivers' psychological distress influences caregivers' mental QoL and patients' physical QoL. Therefore, health-care professionals should assess and treat anxiety and depression in both members of the COPD dyad to improve their QoL.

BackgroundIrritable bowel syndrome (IBS) is a prevalent functional disorder of the gastrointestinal (GI) tract, often accompanied by depression and sexual dysfunction. Depression and IBS may share similar pathophysiological mechanisms, making it essential to understand them for effective treatment. This study aims to compare the state of sexual function, depression, and quality of life in IBS patients experiencing depression with that of healthy subjects.MethodsIn this cross-sectional study, three groups of 49 individuals each were included: patients with irritable bowel syndrome (IBS), patients with depression without symptoms of IBS, and healthy individuals attending university internal clinics in Hamedan city. All patients were sexually active. Quality of life was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, depression severity was measured using the Beck Depression Inventory (BDI), female sexual function was evaluated using the Female Sexual Function Index (FSFI), and male sexual function was assessed using the Male Sexual Health Questionnaire (MSHQ). Data were analyzed using the Chi-square test and analysis of variance.ResultsThe study compared depression scores, quality of life, and sexual performance among three groups: irritable bowel syndrome (IBS) patients, patients with depression, and a control group. Results showed that depression scores were significantly higher in the IBS and depression groups compared to the control group. Quality of life scores did not significantly differ between IBS and depression groups but were lower in both compared to the control group. Sexual performance, both in men and women, differed significantly across all groups. The relationship between quality of life and depression in IBS patients was inverse (r=-0.71, P = 0.001), while depression negatively correlated with sexual performance in men (r=-0.550, P = 0.001). Conversely, higher quality of life and better sexual performance showed a positive relationship in men (r = 0.335, P < 0.001). Based on the findings of the current study, it could be said that depression is significantly higher in IBS patients and depression is not the only intervening factor in the low sexual quality of IBS patients. Other factors such as physiological symptoms, medication side effects, and psychological stressors also contribute to causing sexual dysfunction in these IBS patients.

Self-Administered Cognitive Behavior Therapy for Moderate to Severe Irritable Bowel Syndrome: Clinical Efficacy, Tolerability, Feasibility

Acupuncture has been used to improve the quality of life (QoL) of patients in clinical settings. However, the effect of acupuncture on QoL in patients with irritable bowel syndrome (IBS) remains unclear. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of acupuncture on the QoL of patients with IBS. PubMed, Cochrane Central Register of Controlled Trials, Embase, and Web of Science were screened from inception to September 2023. RCTs published in English comparing acupuncture with sham acupuncture, usual care, pharmacological interventions, or other therapies were analyzed for QoL in patients with IBS. The primary outcome was QoL and secondary outcomes were the IBS-symptom severity scale (IBS-SSS) and abdominal pain. The Cochrane Collaboration recommendations were used to assess the risk of bias. Fourteen articles with 2,038 participants were included. The pooled result showed acupuncture can significantly improve the QoL of patients with IBS compared to the conventional treatment (MD = 6.62, 95% CI, 2.30 to 10.94, P<0.001, I2 = 72.45%). Additionally, acupuncture was superior to other interventions in relieving the symptoms' severity of IBS (MD = -46.58, 95% CI, -91.49 to -1.68, P<0.001, I2 = 90.76%). Nevertheless, acupuncture was not associated with abdominal pain reduction (MD = -0.35, 95% CI, -0.91 to 0.20, P = 0.21, I2 = 0.00%). Lower adverse events were observed in the acupuncture group. Thus, the quality of this study was relatively high. The meta-analysis showed that acupuncture improves QoL and symptom severity in patients with IBS and that the optimal parameters for acupuncture to improve QoL in patients with IBS are 30 minutes of acupuncture per session, less than or equal to five sessions per week, and a 4-week course of treatment. However, more high-quality clinical trials are needed to provide stronger evidence.

To evaluate the quality of life (QoL) of patients with Chagas disease (CD) and the association between QoL domains and several clinical, socioeconomic and lifestyle characteristics of this population. Cross-sectional observational study conducted from March 2014 to March 2017 including a total of 361 outpatients followed at Evandro Chagas National Institute of Infectious Disease, Brazil. QoL was assessed using the Portuguese shorter version of the original WHO Quality of Life questionnaire (WHOQOL-BREF). Information about clinical CD presentation, presence of comorbidities, functional class, previous benznidazole treatment, socioeconomic profile and lifestyle was also obtained. Environment and physical domains presented the worst QoL scores, while the social relationship domain presented the highest score. Multivariate regression analysis demonstrated that variables independently associated with QoL were functional class, sex, clinical presentation of CD, sleep duration, schooling, physical activity level, smoking, income per capita and residents by domicile. The low socioeconomic status and the physical limitations imposed by the disease presented an important impact on the QoL reduction among CD patients, especially on environment and physical domains. Strategies to improve QoL among CD patients should be tailored and consider many different variables to maximise improvements not only of patients' physical but also of their mental health.

Irritable bowel syndrome (IBS) has been effectively treated with acupuncture, but the significance of quality of life, depression, and anxiety in the assessment of IBS patients has received little consideration. This study examined the impact of acupuncture on depression, anxiety, and quality of life in IBS patients. PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), EMBASE, China Science and Technology Journal Database (VIP), Chinese Biological Medical (CBM, SinoMed) Database, and the Wan Fang Database were among the electronic databases from which relevant randomized controlled trials (RCTs) were systematically retrieved between their inception and July 2023. The outcomes included adverse events, total response rate, anxiety, and symptoms of depression, as well as quality of life. In this study, the heterogeneity, publication bias, standardized mean difference (SMD), and risk ratios (RR) with 95% confidence intervals (CI) were estimated. In this study, 29 RCTs including 3114 participants for analysis (treatment group, 1730; control group, 1384) were included. Compared to other therapies, acupuncture significantly improved the quality of life (SMD = 0.61, 95% CI = [0.26, 0.96], P < 0.001) and alleviated anxiety (SMD = - 0.72, 95% CI = [- 1.76, 0.32], P = 0.18) and depression (SMD = - 0.74, 95% CI = [- 1.18, - 0.3], P < 0.001) in IBS patients. A statistically significant improvement was recorded in their quality of life, and they also displayed fewer symptoms of depression. The total response rate (RR = 1.18, 95% CI = [1.12,1.25], P < 0.001) indicated that acupuncture significantly affected IBS treatment in comparison to other methods. Subgroup analysis of primary outcome indicators revealed that acupuncture demonstrated better results regardless of the duration of intervention and was more effective than Western medicine or sham acupuncture. In addition to the total response rate (I2 = 0%), the other three outcome indicators showed significant heterogeneity (I2 > 50%). No publication bias was noted in RR (P < 0.05); however, a significant publication bias was observed in quality of life (P > 0.05). Acupuncture can enhance the quality of life and relieve anxiety and depression in patients with IBS with apparent safety; however, a large number of high-quality RCTs are still needed.

Quality of life in patients with multiple sclerosis: A study with patients and caregivers

Background: Depression, a known comorbidity in coronary heart disease (CHD), is associated with adverse cardiac events, mortality, symptom burden, physical limitation, and poor quality of life (QOL). Evidence has shown that depression impedes self-care behaviors including, physical activity. Similarly, regular physical activity has been shown to lessen depressive symptoms and improve cardiovascular health. However, there is limited research to determine whether depressive symptoms mediate or moderate the association between physical activity and overall QOL in the older adult population living with chronic CHD. Hypothesis: Depression mediates the positive association between physical activity and QOL. Depression is a moderator of physical activity and QOL. Objectives: 1) To determine the direct effect of depressive symptoms on physical activity and QOL; 2) to investigate the mediating effect of physical activity and depressive symptoms on QOL; and 3) to test the moderating effect of depressive symptoms on physical activity and QOL. Methods: This cross-sectional study collected 20-year follow-up survey data from 126 survivors from the Heart and Soul prospective cohort study of people living with CHD. Mediation testing was conducted using the steps described by Baron and Kenny. Results: Physical activity significantly predicted QOL ( β =.133, p =.02) and significantly predicted depressive symptoms ( β =-.1918, p =.0002); depressive symptoms significantly predicted QOL( β =-0.762, p &lt;.0001). After depression was added to the model, the relationship between physical activity and QOL was no longer significant, indicating a mediating effect. The average causal mediation effect was statistically significant (.1463, p =.0002). Depression was not a moderator of physical activity and QOL (p&gt;.05). Conclusions: This study demonstrated that depression mediated the effect of physical activity on QOL. The findings underscore the importance of addressing physical activity and depressive symptoms in interventions to improve the overall well-being and quality of life of individuals living with chronic CHD.

INTRODUCTION: Irritable bowel syndrome (IBS) is a highly prevalent functional bowel disorder characterized by abdominal pain and change in bowel habits. IBS represents a significant public health problem because of its substantial reduction of quality of life (QoL) and increased healthcare cost. There is a significant paucity of data regarding gender-based QoL measures. Therefore, we report here results of a prospective study on gender based QoL measures in outpatients with IBS conducted at a single tertiary care center. METHODS: We prospectively enrolled adult outpatients with IBS (N = 72) and non-IBS patients (N = 181) based on a validated Rome III criteria questionnaire. Electronic medical records were reviewed, and demographic data were collected. Validated IBS-specific QoL (IBSQoL 34-item instrument) and general QoL (Veterans RAND-12, VR-12) questionnaires were completed by the study sample. Statistical analyses of data were performed using Chi-square, Fisher's exact, and two-samples t-test. RESULTS: The proportion of female IBS patients (N=44; 61%) was not different (P = 0.35; Table 1) from female non-IBS patients (N = 99; 55%). Other demographics, including BMI, marital status, smoking and insurance status were also comparable between these 2 groups, but IBS patients were younger (45 vs 51 yrs; P = 0.01, Table 1). Female and male subgroup analysis within both the IBS and non-IBS samples showed all similar demographic characteristics (age, BMI, smoking, marital and insurance status; data not shown). QoL in IBS subjects was highly significantly reduced as compared with non-IBS subjects both using the VR-12 and the IBSQoL instruments (Tables 2 and 3 and data not shown). In IBS patients, QoL (by VR-12) was significantly lower in males (P = 0.02) as compared to females in MCS (P = 0.02), but not in PCS (P = 0.07; Table 2). Male IBS patients scored significantly lower in the IBSQoL instrument than females in 2 of 8 domains (dysphoria and interference) and in the overall score whereas no gender differences were noted within the non-IBS sample (Table 3). The greatest IBSQoL reduction occurred in the food avoidance domain without gender disparity. CONCLUSION: IBS patients suffer from substantial impairment of QoL. This gender-based study is the first to demonstrate lower QoL scores in male IBS patients as compared to females in specific domains of validated general QoL and IBS-specific QoL instruments. Gender disparities demonstrated in this study were not associated with differences in age, BMI, and other demographics.