36-item Short Form Health Status Research Articles

Quality of Life Indices in Patients with Coronary Heart Disease with Stable Angina Pectoris Accompanied by Non-alcoholic Steatohepatitis after Complex Treatment Supplemented with Ezetimibe and Ursodeoxycholic Acid

Introduction. Coronary heart disease (CHD) is often complicated by the presence of concomitant diseases, especially non-alcoholic fatty liver disease (NAFLD). According to the data from numerous studies, it is known that the number of cardiovascular complications in patients with NAFLD is increasing. This negatively affects the clinical course of both diseases, worsens the quality of life of patients and increases the percentage of cardiovascular mortality among the population. The aim of the study. To evaluate the quality of life indicators in patients with coronary heart disease with stable angina pectoris in combination with nonalcoholic steatohepatitis after complex therapy including ezetimibe and ursodeoxycholic acid. Materials and methods. The study involved 145 patients with a verified diagnosis of coronary heart disease, stable angina pectoris II functional class combined with nonalcoholic steatohepatitis (NASH) and 100 patients with coronary heart disease without NASH. There were 140 men (57.0 %), and 105 women (43.0 %). The average age of patients is 55.3 ± 6.3 years. Results. A decrease in the number of angina attacks and the need to use nitroglycerin per week was registered in patients with coronary artery disease in combination with NASH under the influence of the treatment, which was more pronounced in the group with the addition of ezetimibe and ursodeoxycholic acid (UDCA). According to the Medical Outcomes Study 36-Item Short-Form Health Status (SF-36) questionnaire after treatment, a tendency to improve most of its indicators was revealed, which was more clearly observed in patients in the group with the addition of ezetimibe and UDCA. Also, according to the EuroQoL-5D (EQ-5D) questionnaire, significant positive dynamics of the quality of life were found for all indicators, which were more reliably increased in the group with the addition of ezetimibe and UDCA. According to the Seattle Angina Questionnaire (SAQ), after treatment, reliable positive changes on 4 scales were observed in patients in the group with the addition of ezetimibe and UDCA. Conclusion. The inclusion of ezetimibe and ursodeoxycholic acid in the basic therapy has a positive effect on the clinical course of coronary heart disease in combination with non-alcoholic steatohepatitis, the quality of life of patients and the patient's attitude to his disease.

Long-Term Outcome of Graves' Disease: A Gender Perspective.

In gender-skewed conditions such as Graves' disease (GD), the outcome naturally becomes dominated by the majority. This may lead to gender-biased misunderstandings regarding treatment outcomes. This especially holds true when complications, such as depression, are unevenly distributed. We have, therefore, studied the long-term outcome of GD from a gender perspective. A cohort of 1186 patients with GD was included in a follow-up 6-10 years after inclusion. Choice of treatment, the feeling of recovery, long-term treatment, comorbidity, and quality of life were investigated with questionnaires. All results were studied sex-divided. We included 973 women and 213 men. There was no difference between men and women in the choice of treatment. At follow-up, women scored significantly worse in the general questionnaire 36-item Short-Form Health Status (SF-36) domain bodily pain and in the thyroid-specific Thyroid-Related Patient-Reported Outcome (ThyPRO) domains depression, impaired sex life, and cosmetic complaints, all p < 0.05. Women were twice as likely (29.5%) to be treated with levothyroxine after successful treatment with antithyroid drugs (ATD) compared with men (14.9%, p < 0.05). After treatment for GD, women were more affected by depression, impaired sex life, cosmetic issues, and bodily pain despite successful cure of hyperthyroidism. The prevalence of hypothyroidism was also doubled in women. Whether these observed gender differences reflect a worse outcome of GD in women or a natural consequence of a higher prevalence of these symptoms and autoimmunity in the female population is difficult to disentangle. Nevertheless, several years after GD, women reveal more persistent symptoms.

Assessment of comorbid profile, quality of life and social functioning in patients with schizophrenia and schizotypal disorders

One of the most common mental illnesses is schizophrenia and schizotypal disorders. According to the literature data, mortality among patients with schizophrenia is 1.5-2 times higher than among the general population. Patients with schizophrenia have a higher prevalence of cardiovascular disease, obesity, diabetes, osteoporosis in comparison with the general population. Such comorbid somatic diseases in the case of schizophrenia have a more acute course, a significant impact on the course of the underlying disease, the development of complications, decrease in quality of life and social functioning. The aim of the study was to study the presence and features of comorbidity, its impact on the quality of life and social functioning of patients with schizophrenia and schizotypal disorders. 100 patients were included in the study. They were divided into two groups: experimental (Group I) with schizophrenia and comparison (Group II), with other schizophrenic diseases, such as schizoaffective and schizotypal disorder. All patients were scaled according to the following methods: The Cumulative Illness Rating Scale (CIRS), Clinical Global Impression – Severity Scale (CGI-S), The Personal Social Performance Scale (PSP), CGI-S, and a short form of the questionnaire Medical Outcomes Study 36-Item Short-Form Health Status (SF-36). Charlson Index was also calculated for all patients included in the study. Due to CIRS, we detected undiagnosed comorbidity that aggravated the course of the underlying disease: 38% in Group I and 26% in Group II. The most common components in the structure of comorbidity in the patients with schizophrenia were diabetes mellitus, musculoskeletal diseases, cardiovascular diseases, non-alcoholic fatty liver disease (NAFLD). Patients with schizotypal disorders were more often diagnosed with peripheral vascular diseases, chronic lung diseases, chronic kidney diseases, and upper gastrointestinal tract disorders. A com­pre­hensive approach to be important in the treatment of such patients. The nature and extent of comorbidity should be definitely taken into account. This will promote the compliance and improve the indicators in the examined category of patients.

NUTRITION, INFLAMMATION, AND PHYSICAL AND MENTAL HEALTH IN AGING ADULTS WITH CHRONIC WOUNDS

Abstract Nutritional status can impact the healing of chronic leg wounds (CLW). This secondary data analysis examined characteristics associated with nutritional status among aging adults (N=62, M= 57.5, SD 12.1 years of age) living with a CLW who were enrolled in a randomized control trial to test a novel ultrasound intervention on wound healing. Nutritional status (Mini-Nutrition Assessment, [MNA]), physical and mental health (36-Item Short-Form Health Status Survey), and inflammation (high-sensitivity C-Reactive Protein [CRP]) were measured at baseline. Majority of the participants were male (54.8%), non-Hispanic Black (67.7%) and either malnourished or at risk of malnutrition (64.5%). Compared to individuals with normal nutrition, individuals with malnutrition or risk for malnutrition had on average poorer physical health (38.7 vs 33.4, p &amp;lt;0.01), mental health (52.4 vs 45.8, p=0.03) and greater inflammation (CRP=13.4 vs 24.0, p=0.05). Tailored interventions targeting nutritional status, inflammation, physical and mental health are needed in aging adults with CLW.

Stereotactic vs open biopsy for non-palpable breast lesions. Their impact on short term quality of life

ABSTRACT Stereotactic biopsy and open biopsy represent useful diagnostic tools of breast lesions. However, both affect the Quality of Life (QoL) in various degrees. We conducted this prospective longitudinal comparative study in order, first to access the impact of these techniques on short-term QoL and second to compare and critically discuss our results with those of literature review. Group A (58 patients) underwent vacuum-assisted stereotactic biopsy and Group B (46 patients) underwent open biopsy. The Health-Related Quality of Life (HRQol) was estimated using the European Quality of Life scale (EuroQol) and the SF-36 (The 36-Item Short-Form Health Status Survey) questionnaires. The stereotactic breast biopsy seems to be more accepted from the patients as it affects quality of life to a lesser extent than open breast biopsy. This difference is mainly attributable to a reduction of physical discomfort and pain.

Outcomes of a Comprehensive Pain Rehabilitation Program for Patients With Fibromyalgia.

ObjectiveTo analyze opioid intake interference with psychological, well-being, and functional outcomes and medication tapering in patients with fibromyalgia admitted to the Mayo Clinic Pain Rehabilitation Program (MCPRP) in Florida.Patients and MethodsA retrospective study on MCPRP outcomes was conducted. We reviewed the health records of 150 patients with fibromyalgia who participated in the program from May 1, 2014, to May 1, 2015. All patients were asked to fill out a survey at admission to and dismissal from the program. Surveys contained questions from the numeric pain score, Multidimensional Pain Inventory (perceived life control and interference of pain subscales), Center for Epidemiological Studies–Depression Scale, Pain Catastrophizing Scale, 36-Item Short-Form Health Status Survey (general health perceptions subscale), and Pain Self-Efficacy Questionnaire. A medical record review identified categories and number of medications at program admission and dismissal. Patients were divided in 2 groups: those whose concomitant medication did not include opioids at admission (no opioids group) and those whose concomitant medication included opioids at admission (opioids group).ResultsBy dismissal from the MCPRP, patients with fibromyalgia in the no opioids group had a significant (P<.05) improvement in all the self-reported scores. Medication, including opioids, were effectively tapered at a substantially higher percentage in the opioids group.ConclusionBenefit of the comprehensive pain rehabilitation program in patients with fibromyalgia was indicated by clinical improvements in pain severity, physical and emotional health, and functional capacity while successfully tapering medication. Opioid intake at admission may modify the program outcomes.

Dynamics of quality of life indicators in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of complex treatment

Introduction. In the case of gastroesophageal reflux disease (GERD) on the background of undifferentiated connective tissue dysplasia (UCTD) causes an even more significant deterioration in the QOL, including sleep disturbances and the onset of excessive daytime sleepiness (EDS). Thus, the study of the peculiarities of GERD on the background of connective tissue dysplasia and determining the impact of comorbid pathology on the QOL of patients with GERD is a topical issue in internal medicine. It has significant socio-economic significance. We believe that monitoring the most important variables that affect the quality of life of patients with GERD can help raise public awareness in this regard. In addition, it can guide the health care system to address these issues.&#x0D; Purpose. The purpose of the work is to increase the awareness of medical workers about the scale of the problem and ways to solve it. to study the features of the dynamics of quality of life in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of the proposed complex therapy.&#x0D; Methodology. 120 patients were included: 65 men and 55 women. In 75 of them (Study Group) GERD was in the background of UCTD, in 45 (?omparison Group ) - developed as an independent disease. The Study Group was divided into three groups. ?omparison Group - 45 patients with GERD without UCTD, received basic standard therapy, which included PPI "Panocid" 40 mg once a day and alginate-antacid formulation (Gaviscon Double Action Liquid) 20 ml, 3 times per day after meals and before bedtime. I Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Magne-B6" for 2 tablets 3 times per day. II Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Calcium-D3 Nicomed" 1 tablet 3 times per day. III Group - 25 patients with GERD +UCTD, who used the drug "Magne-B6" 2 tablets 3 times per day and "Calcium-D3 Nicomed" 1 tablet 3 times per day on the background of standard basic therapy. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36), the Gastrointestinal Symptom Rating Scale (GSRS), and the scale of "Personal and social performance" (PSP) - were used to study patients in detail. A comprehensive examination of patients was performed twice: before and after 30 days of comprehensive treatment.&#x0D; Results and Discussion. Under the influence of the basic therapy in Comparison Group the General Health (GH) improved by 33.03%. While in the groups on the background of complex treatment is increased by 42.52% in patients of the I Group, by 13.10% in patients of the II Group, and 46.28% in patients of the III Group (p1, p2, p3 &lt;0.05).Physical Functiong Scale (PF) improved by 17.9% in patients of the Comparison Group (p &lt;0.05) and by 30.38%; 27.47%, 29.17%, respectively (p1, p2, p3 &lt;0.05). Role Physical Scale (RP) scores improved by 25.14% in Comparison Group (p &lt;0.05) and by 33.6 %, 22.58% and 40.20% respectively (p1, p2, p3 &lt;0.05). Dynamics of data in Body Pain (BP) scale improved by 21.84% in patients of the Comparison Group (p &lt;0.05) and by 37.28%, 25.46%, 35.92% (p1, p2, p3 &lt;0.05).As can be seen from it, under the influence of complex therapy, the values of the Vitality (VT) increased by 17.18% in patients of Group I, by 21.93% – in Group II, by 37.87%– in Group III (p1, p2, p3 &lt;0.05). Among patients of the Comparison Group, the influx of strength and energy felt 9.50% (p &lt;0.05). Data of Social Functioning Scale (SF) improved by 8.8% in patients of the Comparison Group (p &lt;0 , 05) and by 22.7%, 29.6%, 29.31%, respectively(p1, p2, p3 &lt;0.05). Mental Health Scale (MH) improved by 17.23% in patients of Group I, by 22.41% – in Group II, by 21.96% – in Group III (p1, p2, p3 &lt;0.05) and 14.22% - in the Comparison Group (p &lt;0.05). Also in patients were positive dynamics of the Role Emotional functioning scale (RE): by 27.37% in patients of Group I, by 12.36%– in Group II, by 15.7% – in the Group III (p1, p2, p3 &lt;0.05) and 9.05% - in patients of the Comparison Group (p &lt; 0.05).&#x0D; Conclusions. Thus, the inclusion in the standard therapy of gastroesophageal reflux disease in patients with its development on the background of undifferentiated connective tissue dysplasia of magnesium lactate dihydrate in combination with pyridoxine hydrochloride ("Magne -B6 ") and calcium carbonate in combination with cholecalciferol ("Calcium-D3 Nicomed") contributed to a significant improvement in their quality of life

Experience in correcting eating disorders in the clinic of mental illness

Introduction: Eating disorders - a class of psychogenic behavioral syndromes associated with eating disorders. The class of these disorders includes anorexia nervosa, bulimia nervosa, compulsive overeating, as well as several other disorders, which are included in the international classification, to section F 50-F 59.&#x0D; Purpose: The purpose of our study is to trace the dynamics of individual eating disorders in patients with various mental illnesses under the influence of corrective therapy.&#x0D; Methodology: Were examined 77 patients with various mental diseases who have had eating disorders. The first (I) group included 33 patients. They have added Metoclopramide at a dose of 20 mg/day to the main treatment. The second group (II) - 44 patients who received the drug Ondansetron at a dose of 4 mg/day, respectively. The condition of all patients was assessed according to the following scales: Eating Attitudes Test (EAT-26), 36-Item Short-Form Health Status (SF-36). Body mass index (BMI) was calculated to study the dynamics of weight. All examinations of patients were performed at the beginning and after 14 days of treatment.&#x0D; Results: According to the EAT-26 scale the average score in the I group was 29 ± 2.8 points, and in the II - 30.1 ± 2.4, respectively. According to the SF-36 questionnaire, the average total score in the I group was - 69.5 ± 1.8 before treatment, 79.5 ± 1.6 - after treatment improved by 12.5% (p &lt;0,05). In group II - 70.8 ± 1.2 and 89.4 ± 1.5, improving by 20.8%, respectively (p &lt;0.05). Under the influence of the therapy, the patients' manifestations of eating behavior decreased, which contributed to the growth of BMI: in group I - by 2.1 ± 1.3 kg, in group II - by 3.5 ± 2.3 kg, which is 1.6 times more.&#x0D; Conclusions: The drug Ondansetron, intended for the correction of eating disorders, in combination with therapy of the underlying pathology, was likely to be more effective than Metoclopramide hydrochloride, which should be considered in practical psychiatry

The Immediate Effect of Informational Manual Therapy for Improving Quiet Standing and Bodily Pain in University Population

Background: The Informational Manual Therapy (IMT) is a therapeutic touch. This study aims to assess the effect of IMT on quiet standing, pain and health status in university population. Methods: An experiment was conducted on subjects utilizing a comparative paired analysis both before and after the intervention. One IMT session was performed on 57 healthy individuals aged from 18 to 65 years. The primary outcome was quiet standing assessed by the Satel 40 Hz stabilometric force platform. Secondary outcomes were bodily pain assessed by the 36-Item Short Form Survey (SF-36) and health status by EQ-5D-3L. The primary outcome was evaluated before and immediately after treatment. Results: The individuals were divided into 3 age groups, 18–35 (52.6%), 35–50 (29.8%) and 51–65 (17.6%). Statistically significant differences were immediately observed after the session ended when comparing the pre-post quiet stance scores in a number of length parameters: L, Lx, Ly and stabilometry amplitude on Y-axis with eyes open and closed. Significant differences were also found when testing bodily pain (SF-36) and anxiety (5Q-5D-3L). Conclusion: One session of IMT produced positive effects when testing quiet standing with eyes open and eyes closed, as well as a significant reduction in pain and anxiety for those tested. Further research is suggested.

Disorders of social functioning and quality of life in patients with gastroesophageal reflux disease while combined with undifferentiated connective tissue dysplasia

Introduction. It has been scientifically confirmed that the risk of developing gastroesophageal reflux disease (GERD) increases especially with generalized or regional disruption of connective tissue structure, which is widespread among the population. Patients with such comorbid pathology may have a wide range of symptoms that may go beyond the general symptoms of heartburn and regurgitation. The symptoms and complications of GERD affect general health, daily and social functioning, physical and emotional activity. It also affects the quality of life (QoL) associated with health through frequent breaks during sleep, work and social activities.&#x0D; Purpose. study the dynamics of the level of quality of life and social functioning in patients with gastroesophageal reflux disease in combination with the syndrome of undifferentiated connective tissue dysplasia.&#x0D; Methodology. A total of 120 patients were included in the study: 65 men and 55 women: in 75 of them (Group II) GERD occurred on the background of UCTD, in 45 (Group I) as an independent disease. The control group consisted of 12 healthy individuals. The study was comprehensive. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36),the Gastrointestinal Symptom Rating Scale (GSRS) and the scale of "Personal and social performance" (PSP) - were used to study patients in detail.&#x0D; Results and Discussion. Analyzing the results obtained on the basis of the GSRS questionnaire (Table 1), in patients with GERD on the background of UCTD, compared with patients of group I and the control group, there is a significant increase in three and four from the five scales. QoL in patients of Group II on the scale "Abdominal pain" were 14.3 ± 0.4 points, in Group I - 5.6 ± 1.3 points, in the Control Group - 2.4 ± 0.8 points, on the scale "Reflux syndrome": 13.7 ± 0.9, 10.5 ± 1.3 and 3.1 ± 0.9, respectively. "Dyspeptic syndrome" - 15.3 ± 0.4 points in Group II, 12.2 ± 0.6- in Group I and 6.1 ± 0.3- in the control group. "Constipation syndrome" 9.5 ± 0.8, 5.6 ± 1.03 and 5.7 ± 0.4, respectively (p &lt;0,05).&#x0D; Conclusions: In this research we investigated the effect of comorbid pathology on QoL in patients with GERD, which developed against the background of UCTD. The results confirm that patients with such combined pathology have a lower level of quality of life and social functioning, and the tactics of treatment of such patients should take into account these changes

Comparison of quality of life in postoperative patients with cholecystolithiasis and choledocholithiasis. The difference between open and laparoscopic treatment

Gallstone disease is quite common in the adult population and can quickly cause life-threatening conditions that require extensive surgical treatment. In recent years, the assessment of quality of life is becoming increasingly important in world medicine as an indicator of the general condition of the patient and the effectiveness of treatment and rehabilitation measures. The aim of this work – to collect and calculate indicators of quality of life in postoperative patients with gallstones of gall bladder and common bile duct; to compare data from patients with open and laparoscopic treatment; to determine the advantages of the treatment methods. For rating quality of life 36-Item Short-Form Health Status (SF-36) was used. The statistic was collected using retrospective analysis of worked out data in laparoscopic surgery unit in Volynian regional state hospital during 2016–2019 (191 patients). Patients of group I (113 patients) underwent laparoscopic treatment, patients of group II used open surgical treatment (78 people). Statistical processing was performed using the program “Statistica 6.0” (Statsoft Inc., USA). In group I pain level in first two hours was significantly lower than in group II (6.2 vs 8.4 in 10 point scale), in addition, pain relief became faster reaching low pain level of abdomen in 2.48 days. In group II pain level was higher (8.4 points) and pain relief was reached in 5.11 days. Oral nutrition and verticalisation were renewed in 14.7±3.1 hours in group I, and in 22.9±5,5 hours in group II and 6.1±1,9 hours in group I vs 19.7±3,3 hours in group II. Also, according the results SF-36, quality of life indicators indicate faster recovery in the group of laparoscopic treatment compared to the group with the classic version of the operation. The physical functioning and physical performance of the role differed significantly in favor of laparoscopic treatment throughout the follow-up period. Pain indicators in the first group were satisfactory after 1 month of rehabilitation, while in the second group such indicators were achieved only after 6 months – 91/94/94 vs. 74/89/94. Although psychological well-being differed between 1 and 3 months, in favor of minimally invasive treatment, after 6 months the data were comparable in both groups.

Quality of life and psychological outcomes of body-weight supported locomotor training in spinal cord injured persons with long-standing incomplete lesions.

Health-related quality of life (HRQOL) data from two parallel independent single-blinded controlled randomized studies of manual (Study 1) and robotic (Study 2) locomotor training were combined (ClinicalTrials.gov #NCT00854555). To assess effects of body-weight supported locomotor training (BWSLT) programs on HRQOL in persons with long-standing motor incomplete spinal cord injury and poor walking function. Two inpatient rehabilitation facilities and one outpatient clinic in Norway. Data were merged into intervention (locomotor training 60 days) or control group ("usual care"). Participants completed questionnaires before randomization and 2-4 weeks after the study period, including demographic characteristics, HRQOL (36-Item Short-Form Health Status Survey, SF-36), physical activity (The International Physical Activity Questionnaire Short Form, IPAQ-SF), exercise barrier self-efficacy (EBSE), and motivation for training (Behavioral Regulation in Exercise Questionnaire, BREQ). Physical outcomes i.e., Lower extremity motor score (LEMS) was assessed. The main outcome was change in HRQOL. Secondary outcomes included changes in IPAQ-SF, EBSE, BREQ, and physical outcomes. We recruited 37 of 60 predetermined participants. They were autonomously motivated with high baseline physical activity. BWSLT with manual or robot assistance did not improve HRQOL, though LEMS increased in the BWSLT group compared with control group. The study was underpowered due to recruitment problems. The training programs seem to benefit LEMS, but not other physical outcomes, and had minimal effects on HRQOL, EBSE, and motivation. Autonomous motivation and high physical activity prior to the study possibly limited the attainable outcome benefits, in addition to limitations due to poor baseline physical function.

Dynamics of Quality of Life Indices in Case of Metabolic Syndrome in Patients with Paranoid Schizophrenia on the Background of Atypical Neuroleptic Agents Application and Improvement of Comorbidity

The objective of the research was to study the features of quality of life dynamics depending on clinical and psychopathological symptoms in patients with paranoid schizophrenia asso ciated with metabolic syndrome on the background of long-term neuroleptic therapy and to study the eff ectiveness of concomitant corrective therapy. 140 patients with paranoid schizophrenia (F20.0) were examined and divided into three groups. Group I included 40 patients who received haloperidol at an ave rage daily dose of 4.6 ± 1.3 mg/day, Group II consisted of 40 patients who received risperidone (3.7 ± 1.8 mg/day), Group III included 40 patients who received quetiapine (413 ± 116 mg/day). Half of the patients in each of the presented groups continued to receive neuroleptic therapy according to the above mentioned regimen, and the other half of the patients received metformin hydro chloride at a dose of 500 mg/day in addition to the standard therapy. The cont rol group consisted of 20 patients diag nosed with "paranoid schizophrenia, remission", without metabolic syndrome signs, who had not received neuroleptics for the past six months. The Positive and Negative Syndrome Scale (PANSS) and the Medical Outcomes Study 36-Item Short-Form Health Status Questionnaire (SF-36) were used to study the patients’ mental health in detail. In this research, we monitored the impact of comorbidity on quality of life indices in the patients with long-lasting treatment of schizophrenia by neuroleptic agents, and noted that concomitant corrective therapy was appropriate in terms of compliance increase and quality of life indices improvement in the studied category of patients. Keywords: paranoid schizophrenia, metabolic syndrome, atypical neuroleptic agents, quality of life

Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis: A Systematic Review.

Multiple sclerosis (MS) is a common degenerative neurologic condition resulting in walking difficulties. Foot drop is a common walking impairment in MS that can affect health-related quality of life (HRQOL). Functional electrical stimulation (FES) can improve walking in people with MS, but its effect on HRQOL is not well established. This review investigated the effect of FES used for foot drop on HRQOL in adults with MS. A systematic search was performed using CINAHL, MEDLINE, Cochrane Library, PubMed, and PEDro online databases. Inclusion and exclusion criteria were applied to select eligible studies. Data were extracted, and two reviewers independently rated the quality of the studies using the Effective Public Health Practice Project assessment tool. Eight studies were eligible for review; seven were of moderate-to-strong methodological quality and one was weak. Seven studies demonstrated significant positive effects of FES on different aspects of HRQOL as measured by the 29-item Multiple Sclerosis Impact Scale, 36-item Short Form Health Status Survey, Canadian Occupational Performance Measure, and Psychosocial Impact of Assistive Devices Scale. This review provides preliminary evidence that FES has a positive effect on aspects of HRQOL in people with MS; however, the variety of HRQOL outcomes used makes it difficult to determine definitive conclusions. Future larger-scale randomized studies with long-term follow-up are recommended to better understand the effect of FES on HRQOL. This will inform prescribing decisions and support compliance with FES over the longer-term.

Quality of Life Is Worse at 6-10 Years after Radioactive Iodine Treatment of Graves’ Disease as Compared with Antithyroid Drugs or Surgery

Quality of Life Is Worse at 6-10 Years after Radioactive Iodine Treatment of Graves’ Disease as Compared with Antithyroid Drugs or Surgery

Impaired Quality of Life After Radioiodine Therapy Compared to Antithyroid Drugs or Surgical Treatment for Graves' Hyperthyroidism: A Long-Term Follow-Up with the Thyroid-Related Patient-Reported Outcome Questionnaire and 36-Item Short Form Health Status Survey

Hyperthyroidism is known to have a significant impact on quality of life (QoL), at least in the short term. The purpose of the present study was to assess QoL in patients 6-10 years after treatment for Graves' disease (GD) with radioiodine (RAI) compared to those treated with thyroidectomy or antithyroid drugs (ATD) as assessed with both thyroid-specific Thyroid-Related Patient-Reported Outcome (ThyPRO) questionnaire and general (36-item Short Form Health Status) QoL survey. The study evaluated 1186 GD patients in a sub-cohort from an incidence study 2003-2005 who had been treated according to routine clinical practice at seven participating centers. Patients were included if they had returned the ThyPRO (n = 975) and/or the 36-item Short Form Health Status survey questionnaire (n = 964) and informed consent at follow-up. Scores from ThyPRO were compared to scores from a general population sample (n = 712) using multiple linear regression adjusting for age and sex as well as multiple testing. Treatment-related QoL outcome for ATD, RAI, and surgery were compared, including adjustment for the number of treatments received, sex, age, and comorbidity. Regardless of treatment modality, patients with GD had worse thyroid-related QoL 6-10 years after diagnosis compared to the general population. Patients treated with RAI had worse thyroid-related and general QoL than patients treated with ATD or thyroidectomy on the majority of QoL scales. Sensitivity analyses supported the relative negative comparative effects of RAI treatment on QoL in patients with hyperthyroidism. GD is associated with a lower QoL many years after treatment compared to the general population. In a previous small randomized controlled trial, no difference was found in patient satisfaction years after ATD, RAI, or surgery. Now, it is reported that in a large non-randomized cohort, patients who received RAI had adverse scores on ThyPRO and 36-item Short Form Health Status survey. These findings in a Swedish population are limited by comparison to normative data from Denmark, older age, and possibly a more prolonged course in those patients who received RAI, and a lack of information regarding thyroid status at the time of evaluation. The way RAI may adversely affect QoL is unknown, but since the results may be important for future considerations regarding treatment options for GD, they need to be substantiated in further studies.

Improving Quality of Life in Patients at Risk for Post-Intensive Care Syndrome.

ObjectiveTo improve quality of life (QOL) in patients at risk for post–intensive care syndrome (PICS).Patients and MethodsWe conducted a mixed-method, prospective, observational, pre-post interventional study in an adult medical and mixed medical/surgical/transplant intensive care unit (ICU) at a tertiary academic hospital. Preintervention included patients admitted from October 1 through October 31, 2016, and postintervention included patients admitted from January 15 through February 14, 2017. First, a multidisciplinary team of stakeholders identified barriers associated with decreased QOL in patients at risk for PICS. Next, interventions were designed and implemented. The effect of interventions was assessed using a mixed-method analysis. The qualitative analysis used a modified grounded theory approach. The quantitative analysis included assessment of preexisting symptoms and risk factors associated with PICS. The 36-Item Short-Form Health Status Survey (SF-36), which surveys physical and mental composite scores, was used to assess QOL.ResultsBarriers identified were lack of awareness and understanding of PICS. Interventions included educational videos, paper and online education and treatment materials, and online and in-person support groups for education and treatment. After interventions, the qualitative analysis found that patients who participated in the interventions after hospital discharge showed improved QOL, whereas education during hospitalization alone was not effective. The quantitative analysis did not find improvement in QOL, as defined by SF-36 physical or mental composite scores.ConclusionInterventions targeted to patients after hospitalization may offer subjective improvement in QOL for those at risk for PICS.

Effect of multimorbidity on quality of life in adult with cardiovascular disease: a cross-sectional study

BackgroundThe aim of present study was to describe the effect of multimorbidity on Health-Related Quality of Life (HRQoL) in patients with coronary artery disease (CAD).MethodsA cross-sectional study with a simple sampling method of 296 patients undergoing coronary artery bypass surgery in a referral hospital of the northern part of Iran was conducted between April, 2015 and September, 2016. Multimorbidity was defined as the presence of at least two chronic diseases based on self-reporting and medical records. HRQoL was measured using the 36-item short form (SF-36) health status survey. We used analysis of variance (ANOVA) to assess the effect of multimorbidity on mental and physical component of HRQoL.ResultsApproximately, 69% of CAD patients had at least one other disease like diabetes or hypertension. Patients without multimorbidity compared with patients with multimorbidity were significantly older (p = 0.012) and more educated (p = 0.002). Both physical and mental component score of HRQoL was better in patients without any morbidity (48.82 vs. 43.93 with 95%CI of mean difference: 3.37–6.42 and 54.85 vs. 50.44 with 95% CI of mean difference: 1.68–7.15, respectively). Both physical and mental component score was significantly lower in female and lower educated patients (physical mean score 43.07 vs. 46.54 with P = .001 and 42.53 vs. 46.82 with P < .001 and mental mean score 49.98 vs. 52.65 with P = .055 and 49.80 vs. 52.75 with P = .022 for sex and education, respectively). Also, two-way ANOVA showed that regards to morbidity, physical component score was greater in patients with lower education level than higher education level (P < .001).ConclusionThe findings of this study suggest that women, lower education level and overweight patients reported lower quality of life. HRQoL is affected by multimorbidity among CAD patients specially in less educated.

Effects of exercise training on exercise capacity, cardiac function, BMI, and quality of life in patients with atrial fibrillation: a meta-analysis of randomized-controlled trials.

Exercise training has become part of the standard care for patients with cardiovascular disease. We investigated the effects of exercise training on exercise capacity, cardiac function, BMI, and quality of life in patients with atrial fibrillation (AF). We searched for randomized-controlled trials of supervised exercise training versus care without exercise training (the control) in patients with permanent or nonpermanent AF published up to November 2016. Standard mean differences (SMD) or mean differences (MD), and 95% confidence intervals (CIs) were calculated using random-effect models. We identified 259 trials, and after an assessment of relevance, five trials with a combined total of 379 participants were analyzed. In AF patients, exercise training significantly improved exercise capacity and left ventricular ejection fraction compared with the control (SMD: 0.91, 95% CI: 0.70 to 1.12; MD: 4.8%, 95% CIs: 1.56 to 8.03, respectively). Compared with the control, exercise training also significantly reduced BMI (MD: -0.47 kg/m, 95% CIs: -0.89 to -0.06) and significantly improved scores in the 'general health' and 'vitality' sections of the 36-item Short Form Health Status Survey (SMD: 0.71, 95% CIs: 0.30 to 1.12; SMD: 0.81, 95% CIs: 0.40 to 1.23, respectively). Exercise training improved exercise capacity, left ventricular ejection fraction, and some the 36-item Short Form Health Status Survey scores, and reduced BMI in AF patients.

Mindfulness in Motion for People with Multiple Sclerosis: A Feasibility Study.

Mindfulness in Motion is an 8-week mindfulness-based intervention that uses yoga movement, mindfulness meditation, and relaxing music. This study examined the feasibility of using Mindfulness in Motion in people with multiple sclerosis (MS) and the effect of this program on stress, anxiety, depression, fatigue, and quality of life in people with MS. Twenty-two people with MS completed the 8-week mindfulness program as well as assessments 1 week before and after the intervention. Pre/post comparison of four self-reported questionnaires-the Mental Health Inventory, 36-item Short Form Health Status Survey, Modified Fatigue Impact Scale, and Five Facet Mindfulness Questionnaire-showed significant improvement in physical functioning, vitality, and mental health. Specifically, improvements were seen in anxiety, depression, and positive affect; cognitive, psychosocial, and overall functioning regarding fatigue; and mindfulness in the areas of observing, acting with awareness, nonjudgment, and nonreactivity. Due to the uncertainty in disease progression associated with MS, and the multiplicity of mental and physical symptoms associated with it, programming that addresses anxiety, depression, and fatigue is a key area of future research in MS disease management. Mindfulness in Motion proved to be a feasible program yielding positive results, supporting the need for research to determine the extent to which the program can improve quality-of-life outcomes for people with MS.