Improvement of Mental Health and Quality of Life of Patients after Radical Prostatectomy through Continuous Nursing Based on Internet Technology: A Retrospective Study.

Radical prostatectomy (RP) is a treatment method for prostate cancer (PCa). However, patients usually experience urinary incontinence and a reduction in quality of life after surgery. Seeking a nursing programme is necessary to improve the prognosis of patients undergoing RP. This study aims to explore the effect of the cluster nursing through empowerment education on patients with RP. The general data of 203 patients who underwent RP surgery from June 2021 to June 2023 were collected for a retrospective study. After excluding four patients who changed from RP to laparotomy during surgery, four patients with incomplete clinical data and three patients without normal communication ability, the remaining 192 patients were included in the study. The patients were divided into two groups in accordance with different nursing plans. In this study, 98 patients receiving the cluster nursing through empowerment education were set as the observation group (OG), and 94 patients undergoing routine nursing were included in the reference group (RG). The indicators of postoperative recovery, mental health status and life coping ability were compared between the two groups. The times to first exhaustion, to start eating, of first off-bed activity and of hospitalisation in the OG were shorter than those in the RG (p < 0.001). No significant difference was found in the total incidence of complications between the two groups (p > 0.05). Before management, no significant difference in the scores of Hospital Anxiety and Depression Scale (HADS) and Activity of Daily Living Scale (ADL) was observed between the OG and RG (p > 0.05). After management, the HADS and ADL scores of the two groups all decreased, and the OG showed a greater reduction in scores than the RG (p < 0.001). The cluster nursing through empowerment education can shorten the recovery time of patients after RP surgery and improve their living ability. This effect is beneficial to their mental health and can provide additional directions for the formulation of subsequent clinical nursing programmes.

Cognitive frailty and depression are prevalent among the elderly, significantly impairing physical and cognitive functions, psychological well-being, and quality of life. Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population. To evaluate the effects of exercise-cognitive dual-task training on frailty, cognitive function, psychological status, and quality of life in elderly patients with cognitive frailty and depression. A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023. Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care. Frailty, cognitive function, balance and gait, psychological status, and quality of life were assessed before and after the intervention. After the intervention, the frailty score of the observation group was (5.32 ± 0.69), lower than that of the control group (5.71 ± 0.55). The Montreal cognitive assessment basic scale score in the observation group was (24.06 ± 0.99), higher than the control group (23.43 ± 1.40). The performance oriented mobility assessment score in the observation group was (21.81 ± 1.24), higher than the control group (21.15 ± 1.26). The self-efficacy in the observation group was (28.27 ± 2.66), higher than the control group (30.05 ± 2.66). The anxiety score in the hospital anxiety and depression scale (HADS) for the observation group was (5.86 ± 0.68), lower than the control group (6.21 ± 0.64). The depression score in the HADS for the observation group was (5.67 ± 0.75), lower than the control group (6.27 ± 0.92). Additionally, the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group, with statistically significant differences (P < 0.05). Exercise-cognitive dual-task training is beneficial for improving frailty, enhancing cognitive function, and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.

Urinary incontinence (UI) is a common complication after radical prostatectomy (RP). It has a great influence on the postoperative quality of life of patients. This study aims to explore the clinical efficacy of low-frequency electrical pulse acupoint stimulation combined with pelvic floor muscle exercise in the treatment of UI after RP. The clinical data of 129 patients with UI after receiving RP in our hospital from July 2020 to July 2023 were retrospectively analysed. A total of 65 patients who received pelvic floor muscle exercise from July 2020 to January 2022 were set as the reference group. Of these patients, four were excluded, resulting in the inclusion of 61 cases. A total of 64 patients who received low-frequency electrical pulse acupoint stimulation combined with pelvic floor muscle exercise from February 2022 to July 2023 were classified into the observation group. Of these patients, four were excluded, and 60 cases were finally included. SPSS 23.0 was used to analyse the use of urine pads, recovery time of urinary control and improvement of urination in the two groups. Before treatment, no significant difference existed in the use of urine pads, urination condition, maximum flow rate, maximum cystometric capacity, maximum urethral closure pressure, abdominal leak point pressure and scores on Short-Form-36 Health Survey (SF-36) in both groups (p > 0.05). After treatment, the observation group had significantly lower use of urinary pads, urination frequency and leakage times; Significantly shorter recovery time of urinary control (p < 0.05); And significantly higher maximum flow rate, maximum cystometric capacity, maximum urethral closure pressure, abdominal leak point pressure and SF-36 scores than the reference group (p < 0.05). The combination of low-frequency electrical pulse acupoint stimulation and pelvic floor muscle exercise can improve clinical symptoms, shorten the recovery time of urinary control and improve urodynamics and quality of life in patients with UI after RP.

BackgroundKinesiophobia is simply defined as a fear of movement and physical activity.It can be seen in patients as a result of any injury, which results in pain or a fear...

Non-alcoholic fatty liver disease (NAFLD) is often thought of as clinically asymptomatic. However, many NAFLD patients complain of fatigue and low mood, which may affect their quality of life (QoL). This may create a barrier to weight loss and hinder the achievement of NAFLD therapy goals. Our study aimed to evaluate the QoL in NAFLD patients vs. healthy volunteers, and to analyze likely influencing factors. From March 2021 through December 2021, we enrolled 140 consecutive adult subjects (100 NAFLD patients and 40 controls). Overall, 95 patients with NAFLD and 37 controls were included in the final analysis. Fatty liver was diagnosed based on ultrasonographic findings. We employed 36-Item Short Form Health Survey (SF-36) to evaluate QoL, Hospital Anxiety and Depression Scale (HADS) to identify anxiety and/or depression, and Fatigue Assessment Scale (FAS) to measure fatigue. NAFLD patients had significantly lower physical component summary scores, as well as significantly higher HADS-D scores, compared with the control group (Mann-Whitney U criterion = 1140.0, p = 0.001 and U = 1294.5, p = 0.022, respectively). Likewise, fatigue was more common in NAFLD patients (χ2 = 4.008, p = 0.045). Impaired QoL was significantly associated with fatigue (FAS score ≥ 22, p < 0.001) and depression (HADS-D ≥ 8, p < 0.001). In conclusion, NAFLD patients had significantly poorer QoL vs. controls, in particular with respect to the physical component of health. Impaired QoL may be associated with fatigue and depression, and together they may interfere with increased physical activity and lifestyle modifications in patients with NAFLD.

Sirs, We read with interest the article by Turco et al.1 The authors are the first to demonstrate within a paediatric population, a significantly higher prevalence of functional gastrointestinal disorders (FGIDs) in patients with coeliac disease adhering to a gluten-free diet compared to age-matched controls. We would like to provide a further novel insight into another important aspect of the relationship between FGIDs and coeliac disease. We recently undertook a cross-sectional survey using the short-form 36-Item Health Survey (SF-36) to evaluate quality of life in adult patients with coeliac disease and in controls.2 We also used the ROME II Criteria and the Hospital Anxiety and Depression Scale (HADS) to evaluate the prevalence of irritable bowel syndrome (IBS) within these two groups, with the aim of determining the impact, this may have on quality of life and psychological well-being. Two hundred and twenty-five patients (25% male, mean age 53 years) with adult coeliac disease and 348 age- and sex-matched controls were enrolled into the study. The prevalence of IBS within the cohort of coeliac patients was 22% and 6% within the control group. The presence of concomitant IBS was identified as an independent risk factor that reduced the quality of life in patients with coeliac disease (P ≤ 0.0001). Although Turco et al. are correct to suggest that we do not as yet understand the mechanisms of why FGIDs are seen in the context of coeliac disease, nevertheless asking adult coeliac patients about the presence of IBS-type symptoms may allow an opportunity for an intervention that could potentially have a positive impact on their quality of life. Declaration of personal and funding interests: None.

The objective of this study was to assess the effect of infliximab on depression, anxiety and quality of life in patients with active ankylosing spondylitis (AS). In this 6-week longitudinal study, 16 patients with AS were assessed. Active disease as defined by BASDAI ≥4.0 was sought for inclusion. Infliximab was administered 5mg/kg at 0, 2weeks and 6weeks. Collected data included age, sex and date of onset of rheumatologic disease. Activity of disease was measured using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Biological activity was evaluated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). ESR and CRP were assessed at baseline and day 42. The Hospital Anxiety and Depression scale (HADS), Beck Depression Inventory (BDI) and 36-item Short Form Health Survey (SF-36) were used to evaluate anxiety, depression and quality of life. BASDAI, SF-36, HADS and BDE were assessed prior to the initial infliximab dose and at 2nd, 14th and 42nd day. Seven (43.8%) AS patients had depression scores above the cut off value for both the HADS depression (HADS-D) and BDI and 4 (25 %) had high HADS anxiety scores at baseline. Significant time effect for BDI and HADS-D scores were observed. Although significantly lower BDI scores were found after first, second and third infusions of infliximab, compared to initial score, the significant decrease in HADS-D appeared after second and third infusions. A significant time effect for HADS-anxiety scores were found as well. All of the subscales of SF-36 improved significantly during the course, with an exception of role emotional, for which the difference approached to the significance. The change in BASDAI scores and CRP and ESR, in the treatment process, were not correlated with the change in depression and anxiety scores. Infliximab which is an anti-TNF-α drug, may be effective in the treatment of depression accompanying AS. Possible implications for the treatment of major depressive disorder were discussed, as well.

The quality of life for patients with advanced cancer declines, tending to deteriorate further as they approach the end of their lives. This retrospective study aimed to evaluate the potential benefits of incorporating early palliative care into routine care for patients with advanced or metastatic bladder cancer. A total of 97 patients with advanced or metastatic bladder cancer from January 2022 to May 2024 were included. Amongst them, 46 received routine treatment and early palliative care (observation group) and 51 received routine treatment only (control group). Assessments using Functional Assessment of Cancer Therapy-General (FACT-G), Brief Pain Inventory (BPI), Cancer Fatigue Scale (CFS), Hospital Anxiety and Depression Scale (HADS) and Family Satisfaction with Advanced Cancer Care-2 (FAMCARE-2) were conducted before and at 3 and 6 months after initiating early palliative care. Generalized estimating equation analysis was used for statistical analysis. The indicators in the observation group showed improvement within 6 months after initiating early palliative care. Notably, the quality of life in the observation group significantly improved over this period (p = 0.013), whereas changes in pain scores were not statistically significant in either group (p > 0.05). The level of fatigue in the observation group decreased to its lowest point at 6 months (p = 0.001), whereas changes in fatigue levels in the control group were not significant (p > 0.05). Compared with the control group, the observation group experienced a significant reduction in depression and anxiety levels within 6 months (p < 0.001). The nursing satisfaction in the observation group increased over time, with statistical significance (p = 0.006). Notably, significant interaction effects were observed between time and group, particularly in fatigue and psychological distress. Early palliative care improves quality of life and reduces fatigue and psychological distress in patients within 6 months, without notable changes in pain scores. Integration of early palliative care into routine management is recommended to enhance patient well-being and satisfaction.

Objective To investigate the clinical effect of pelvic floor muscle training (PFMT) combined with neuromuscular electrical stimulation (NMES) on patients with pelvic organ prolapse (POP). Methods A total of 150 patients with POP who were treated in Xuzhou Central Hospital from June 2015 to April 2018, were chosen as research subjects. They were divided into observation group (n=80) and control group (n=70) according to random digits table method. Patients in observation group were treated with PFMT combined with NMES, while patients in control group were only treated with PFMT. Quality of sexual life was evaluated by Pelvic Organ Prolapse /Urinary Incontinence Sexual Questionnaire Short Form (PISQ)-12. Quality of life (QoL) of patients was evaluated by Mos 36-Item Short form Health Survey. The pelvic floor muscle strength of patients was evaluated by neuromuscular stimulation therapy apparatus. The anxiety and depression of patients were evaluated by Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). The degree of POP of patients was evaluated by abdominal ultrasonography. The related indexes above mentioned before treatment and until one year of treatment of POP patients were compared intra-group or inter-group by t test or chi-square test. The study was carried out with the approval of Ethics Committee of Xuzhou Central Hospital (Approval No. 20150056). All patients had informed consent to the study. Results ① Comparison of quality of sexual life: PISQ-12 score of POP patients who had sexual life after treatment in observation group until one year of treatment was (24.5±8.0) scores, which was higher than that of (19.7±8.2) sores before treatment in observation group who had sexual life after treatment, also higher than that of (20.6±7.1) sores of POP patients in control group until one year of treatment, and the difference was statistically significant (t=8.326, P=0.037; t=7.422, P=0.042). ② Comparison of QoL: the score of physiological function (PF), role physiological (RP), bodily pain (BP), general health (GH), physical component summary (PCS), vitality (VT), social functioning (SF), role emotional (RE), mental health (MH) and mental component summary (MCS) of POP patients in observation group until one year of treatment were (88.0±13.4) scores, (91.9±22.6) scores, (98.4±22.6) scores, (88.1±9.5) scores, (90.8±21.7) scores, (92.1±19.6) scores, (91.6±18.5) scores, (92.1±21.6) scores, (91.2±27.4) scores and (91.9±14.5) scores, which were higher than those of (71.6±8.5) scores, (76.9±9.5) scores, (73.8±12.1) scores, (69.4±8.6) scores, (79.1±10.3) scores, (76.8±10.4) scores, (75.5±11.7) scores, (78.6±9.5) scores, (75.2±11.6) scores and (80.1±7.3) scores in control group until one year of treatment, and the differences were statistically significant (t=8.805, 9.537, 8.643, 10.335, 8.036, 8.605, 9.060, 8.254, 8.814, 8.541, all P<0.001). ③ Comparison of pelvic floor muscle strength: the proportion of grades of pelvic floor muscle strength of Ⅲ+ Ⅳ+ Ⅴ of POP patients in observation group until one year of treatment was 90.0%, which was higher than that of 44.3% in control group until one year of treatment, and the difference was statistically significant (χ2=12.652, P=0.011). ④ Comparison of anxiety and depression conditions: the score of HAMA and HAMD of POP patients in observation group until one year of treatment were (7.4±2.1) scores, (8.1±3.1) scores, which were lower than those of (10.3±2.3) scores, (10.1±3.1) scores in control group until one year of treatment, and the differences were statistically significant (t=5.170, P=0.041; t=5.352, P=0.039). ⑤ Comparison of degree of POP: the distance from bladder neck to baseline and from cervix to baseline of POP patients in observation group until one year of treatment were (0.71±0.62) cm, (1.5±0.8) cm, which were longer than those of (0.14±0.74) cm, (1.1±0.6) cm in control group until one year of treatment; the hiatus area of levator ani muscle of POP patients in observation group was (18.2±2.8) cm2, which was less than that of (22.5±4.9) cm2 in control group, and all the differences above were statistically significant (t=3.275, P=0.039; t=3.073, P=0.046; t=3.770, P=0.043). Conclusions PFMT combined with NMES for treatment of POP can improve the quality of sexual life, QoL and pelvic floor muscle strength of patients, also reduce the severity degree of POP, and relieve anxiety and depression. Key words: Pelvic organ prolapse; Electric stimulation; Pelvic floor, muscle tissue; Pelvic floor muscle training; Quality of life; Anxiety; Depression; Comparative effectiveness research; Female

Current Prostate Cancer Treatments: Effect on Quality of Life

Quality of life (QOL) has become an important area to address. The most commonly used QOL tool in oncology is the European Organization for Research and Treatment of Cancer QOL measure (EORTC QLQ-C30). The aim of this study is to examine the reliability and validity of this widely used questionnaire in Turkish language. A total of 114 cancer patients were recruited in this study. The internal consistency of the subscales, concurrent validity between EORTC QLQ-C30 version 3.0 and Short Form-36 (SF-36), the correlations between the subscales of EORTC QLQ-C30 and Hospital Anxiety and Depression scale-Anxiety (HADS-A), and Hospital Anxiety and Depression scale-Depression (HADS-D) were also evaluated. Cronbach's alpha-coefficient for multi-item scales ranged from 0.56 to 0.85, with emotional functioning having the highest Cronbach's alpha-coefficient. General health/QOL subscale was correlated significantly with all other subscales. Modest correlations were found between relevant subscales of SF-36 and EORTC QLQ-C30 scales indicating good convergent validity. Although score of emotional functioning subscale was significantly correlated with HADS-A, no correlation was found with HADS-D. The correlations between general health/QOL and HADS-A and HADS-D were significant though Pearson's coefficients were below 0.4. The EORTC QLQ-C30 version 3.0 is a reliable and valid instrument and suitable for measuring the QOL in cancer patients in Turkey.

Background and Aims Haemodialysis (HD) is associated with a decline in physical capacity, quality of life (QoL), and the emotional well-being of the patient. Evidence suggests that physical exercise provides benefits to lifestyle, prevents muscle loss, enhances mood, and alleviates symptoms associated with renal disease. Given these benefits, assessing the impact of an intradialytic exercise programme on emotional well-being, health-related QoL, and HD-related symptoms is essential. This study aimed to investigate the effects of such a programme on physical fitness, emotional response, health-related QoL in patients undergoing HD and symptoms associated with renal disease. Method Clinical trial with convenience sampling. The patients included in the study participated in an individualised intradialytic exercise programme, which lasted for 5 months with a frequency of 2 days per week, supervised by exercise professionals. Pre- and post-intervention assessments included the Hospital Anxiety and Depression Scale (HADS), the 12-Item Short-Form Health Survey (SF-12) for health-related QoL, and the Edmonton Symptom Assessment System (ESAS). IBM SPSS Statistics for Windows, Version 29.0.2.0 (Armonk, NY: IBM Corp), was used to analyse the collected data. The significance level was set at P &amp;lt; 0.05. Results A total of 71 patients undergoing HD participated in the individualised intradialytic exercise programme. Of these, 37 patients (52.1%) were under 65 years old (mean age 65.6 ± 15.5 years), 43 patients (60.6%) were male, and 25 patients (35.2%) were immigrants. The mean duration of time on HD was 4.9 ± 4.4 years. Regarding the Charlson Comorbidity Index, 40 patients (56.3%) had a score of less than 8, with an overall mean score of 7.1 ± 2.8. The results of the HADS scale showed improvements in anxiety scores pre- and post-intervention (from 4.5 to 4.0; P = 0.013) and also in depression scores (from 8.6 to 7.6; P = 0.006) (HADS, Table 1). The physical and mental components of health-related QoL, as measured by the SF-12, also showed a significant improvement (P &amp;lt; 0.001) (SF-12, Table 1). Regarding the symptoms measured by the ESAS questionnaire, pain, depression, drowsiness, appetite, and sleep improved following participation in the exercise programme (ESAS, Table 1). No significant differences were observed in symptoms related to fatigue, nausea, anxiety, well-being, and shortness of breath. Conclusion Participation in intradialytic exercise leads to improvements in both physical symptoms related to renal disease, as well as enhancing mental health and overall health-related QoL. Incorporating intradialytic exercise programmes should be considered an important component of comprehensive care for patients undergoing HD.

Background: Degenerative lumbar spine disease is a prevalent cause of chronic low back pain that significantly impairs daily function and quality of life. While conservative management is the first line of treatment, many patients ultimately require instrumented lumbar spine surgery. However, postoperative outcomes vary considerably, with emerging evidence suggesting that preoperative psychological factors such as anxiety, depression, and pain catastrophizing may influence recovery. The SAP-LD (Scale for Anxiety and Pain in Lumbar Degeneration) study was designed to assess the prognostic role of these psychological and physical parameters in surgical outcomes. Methods: This prospective observational study enrolled 70 adult patients with degenerative lumbar spine pathology scheduled for instrumented surgical treatment at the University of Brescia and ASST Spedali Civili di Brescia between March and December 2024. Preoperative assessments included demographic, clinical, and radiologic data along with validated scales: the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scale (HADS). Follow-up evaluations were performed at 45 days and at 6 months, and statistical analyses were conducted using correlation tests, ANOVA, and regression modeling. Results: The demographic analysis of the 70 enrolled patients shows a balanced gender distribution (38 females, 34 males) with a mean age of 61 years (range 23–81). The educational level distribution indicates that the majority of patients (44.29%) have a secondary education level, while 35.71% have a tertiary education level. Regarding employment status, 50% of the patients are retired or not working. Patients with clinically significant anxiety and/or depression showed higher levels of perceived pain, pain catastrophizing, and disability at baseline. These patients reported significantly worse scores on the Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Oswestry Disability Index (ODI). The Oswestry Disability Index (ODI) demonstrates a clinically significant improvement (reduction) in disability between the preoperative period (t0) and the 45-day follow-up (t2), with the median decreasing from 39.00 to 13.00. However, there is a partial regression at the 6-month follow-up (t3), with the median increasing to 27.00. For the SF-36 Health Survey, the General Health subscale shows an improvement between t0 and t2 (median increasing from 55.00 to 60.00), followed by a slight decrease at t3 (median 55.00). Similar patterns are observed in most other subscales, with initial improvement followed by partial regression. The Pain Catastrophizing Scale (PCS) shows a substantial reduction in catastrophizing between t0 and t2 (median decreasing from 16.00 to 3.00), followed by an increase at t3 (median 11.00), though still below baseline levels. Pain intensity as measured by the Visual Analogue Scale (VAS) shows a significant reduction at t2 (median decreasing from 5.00 to 3.00), but increases again at t3 (median 6.00), even exceeding the preoperative level. For the Hospital Anxiety and Depression Scale (HADS), no significant differences were observed across time points, with values indicating mild symptoms throughout the study period. Correlation analyses confirmed that higher preoperative anxiety and depression scores were predictive of poorer postoperative outcomes. Specifically, higher HADS scores at baseline are associated with higher ODI scores (increased disability) at all time points (p = 0.002), higher VAS scores (increased pain) at all time points (p = 0.015), and lower scores on SF-36 subscales, particularly Emotional Well-being (p = 0.00023) and Social Functioning (p = 0.002). Higher PCS scores at baseline are associated with higher ODI scores at all time points (p = 0.001), higher VAS scores at all time points (p = 0.008), and lower scores on SF-36 subscales, particularly Pain (p = 0.00023) and Physical Functioning (p = 0.04254). The mixed linear models analysis confirms these findings, showing that the ODI score decreases significantly between t0 and t2 (p = 0.00023) and increases between t2 and t3, though this increase is not statistically significant (p = 0.079). For VAS scores, there is a significant decrease between t0 and t2 (p = 0.00023) and a significant increase between t2 and t3 (p = 0.04254). Patients with elevated preoperative HADS scores tended to have slower recovery trajectories and reported lower satisfaction levels. These findings reinforce the prognostic value of psychological assessments in spine surgery and suggest that targeted psychological interventions could improve patient outcomes. Conclusions: By identifying psychological predictors of postoperative recovery, this study underscores the importance of integrating preoperative psychological screening into routine clinical practice. The results suggest that a multidisciplinary approach, including both surgical and psychological care, could enhance long-term functional outcomes and quality of life for patients undergoing instrumented lumbar spine surgery.

LIFE AFTER RADICAL PROSTATECTOMY: A LONGITUDINAL STUDY

BackgroundSystemic Lupus Erythematosus (SLE) is a chronic multisystemic autoimmune disease with a very broad clinical picture. Due to its generalized nature, it affects all aspects of the patient’s life, such...