Aspects Of Quality Of Life Research Articles

A cross-sectional survey study of the impact of COVID-19 pandemic on the training and quality of life of Italian medical residents in the Lombardy region

Introduction The reorganization of the healthcare system prompted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has posed unique challenges for Residency Training Programs worldwide. To mitigate its potential negative effects, it is crucial to assess how the pandemic influenced the activity and quality of life of residents. The purpose of this study was to assess the impact of the pandemic on residents’ competencies, satisfaction, working load, training patterns and occupational exposure in the clinical, surgical, research and didactic fields and to quantify its effects on quality of life and risk perception. Methods An online cross-sectional survey was distributed between 1 June 2020 and 31 July 2020 to 1645 residents enrolled in all Residency Programs of four Universities in northern Italy. The survey included questions about clinical, surgical, and research competencies, educational activity, and quality of life pre- and post-pandemic, and on policies and workplace interventions to reduce exposure to SARS-CoV-2. The main outcome measure was the variation in self-perceived clinical, surgical and research competencies and in specialistic training. Data were analysed using the statistical package R Core Team 4.0.0, estimating mean and standard deviation or median and interquartile range for continuous variables. Variables were compared using chi-square test, Fisher exact tests or McNemar test, as appropriate. A multivariate binary logistic regression analysis was performed to test the effect of different factors on the impact of coronavirus disease-2019 (COVID-19) on self-perceived clinical and research competencies and on didactic training. Results A total of 498 residents completed the survey (response rate 30.3%). The mean age of respondents was 28.9 years, 62.9% were women, and 52.4% were enrolled in the first two years of Training Programs. On the first pandemic wave, over 60% of residents reported a negative impact of the pandemic on their specialistic training. In contrast, 40% of residents involved in clinical duties perceived an improvement in their clinical competences, especially those involved in COVID-19 care, and 34.5% perceived an improvement in their research competences, particularly junior residents, while only 3.5% reported an improvement in surgical skills. Most surgical residents (88.5%) reported a decrease in surgical activities, mainly due to reduced hospital bed capacity and reduction of elective surgery. Almost 90% of all residents experienced a reduction in their didactic activities, but 80% stated their Residency Program adopted virtual training methods. A statistically significant reduction in all examined quality of life items post-pandemic vs. pre-pandemic was found. Even though most survey participants reported the availability of personal protective equipment for residents, 44% considered themselves to be at higher risk of exposure compared to senior staff. Conclusion COVID-19 pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care. The pandemic had a detrimental effect on all quality of life aspects, and most residents considered themselves at higher risk of SARS-CoV-2 infection compared to other healthcare professionals. Key Messages Coronavirus disease-2019 (COVID-19) pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care. Most residents experienced a reduction of didactic activities. Although the majority of training programs implemented virtual training methods to counteract the restrictions imposed by the pandemic, only half of the residents were satisfied of them. A vast proportion of residents had a high occupational exposure to SARS-CoV-2 and considered themselves at higher risk of COVID-19 infection compared to senior staff. The survey highlighted a statistically significant reduction in five key quality of life measures (i.e. sleep, mood, familiar relationships and social relationships quality and employment satisfaction) during the first wave, with mood and social relationships being the most affected. Notably, employment satisfaction was significantly higher in medical compared to surgical residents.

Quality of life in terminally ill cancer patients: what is the role of using complementary and alternative medicines?

Background and purposeCancer is the world’s second greatest cause of mortality and a leading cause of death in both developed and developing countries. Patients employ a number of complementary and alternative medicine (CAM) methods to deal with the problems and difficulties of cancer, which can have an impact on their quality of life (QOL). The aim of the present study was to assess the correlation between QOL and the use of different CAM methods in terminally ill cancer patients.MethodsThis was a cross-sectional study. In southern Iran, 238 individuals with advanced cancer were studied in oncology centers and doctors’ offices. During the months of January to August 2021, patients were selected using convenience sampling. A demographic information questionnaire, the EORTC core quality of life questionnaire, and the CAM questionnaire were used to collect data.ResultsThe results showed that terminally ill cancer patients had a good quality of life. Last year, 85.7% of participants used at least one kind of CAM. Furthermore, 45.4% of participants used only one form of CAM, 30.3% used two types of CAM, 6.7% used three types of CAM, and 3.4% used four to five types of CAM. When all CAM users were compared to non-CAM users, CAM users had significantly higher social QOL and overall quality of life. Two subscales of QOL symptoms and function were correlated with cancer history, income, and use of CAMs, and the scores of QOL symptoms and function were greater in CAM users compared to non-CAM users. Among all the study variables, only the usage of CAM was correlated to overall QOL among terminally ill cancer patients.ConclusionThe current study found that using CAM could affect different aspects of QOL in terminally ill cancer patients. As a result, it is feasible that using CAM could help these people enhance their health and QOL.

Quality of Life Parameters - An Urban Design Perspective

Quality of life (QoL) is an important goal that needs to be achieved by an urban society in general and a neighborhood in particular. The physical space and the QoL of a community are related to a very significant extent. Physical space provides a setting for community living among the residents. There is a sense of place attachment through the way people interact and engage with the physical space. This sense of space becomes even more important in the present context, because of the rapid process of urbanization, which has negatively impacted the QoL in Urban areas. This paper attempts to identify the connection between urban design parameters and Quality of life (QoL) through a literature survey. The attempt is to review various definitions and dimensions of QoL as discussed in the contemporary urban design theories and approaches, both objective and subjective. Furthermore, this paper discusses methods put forward by various researchers to quantify the qualitative aspects of QoL. Finally, a matrix is proposed to establish a set of parameters that includes physical, social, environmental, and psychological concerns of Quality of life in urban neighborhoods. These parameters may act as a guide for the analysis of the urban neighborhoods from the perspective of Quality of Life (QoL)

Quality-of-life results in adults with epilepsy using diazepam nasal spray for seizure clusters from a long-term, open-label safety study

BackgroundThe impact of seizure clusters and the use of intermittent rescue therapy for clusters on the quality of life (QoL) of patients with epilepsy has not been widely studied. The present analysis assessed QoL as a secondary endpoint among adult patients with seizure clusters enrolled in a long-term, phase 3, open-label safety study (NCT02721069) of diazepam nasal spray (Valtoco®). The QoL aspect of patients in this study has not been previously published. MethodsThe 12-month safety study of diazepam nasal spray enrolled patients aged 6–65 years with seizure clusters. Adults aged ≥18 years completed the Quality of Life in Epilepsy (QOLIE)-31-P at baseline (day 0) and days 30, 150, 270, and 365. This instrument includes questions about patient health and daily activities with numeric values (1–100) assigned to responses; higher scores indicate better QoL. The QOLIE-31-P includes 7 subscales: Seizure Worry, Overall QoL, Emotional Well-Being, Energy/Fatigue, Cognitive Functioning, Medication Effects, and Social Functioning; an Overall Score is calculated as a weighted composite of the 7 subscales. Comparisons were made between subgroups of patients who had frequent (≥2) and infrequent (<2) monthly dosing of diazepam nasal spray and those whose doses were administered by the patient or a care partner. This safety study was not powered to assess efficacy endpoints; descriptive statistics were calculated across time points. In addition, safety measures, including treatment-emergent adverse events, are reported. ResultsSeventy-two adults who responded to the QOLIE-31-P were included in the analyses. Mean QOLIE-31-P scores were stable or increased across time points. The mean total scores increased from day 0 to day 365 by 5.2 among patients providing data for ≥1 time point (follow-up group) and 2.2 among patients providing data at all time points (QOLIE all-assessments subgroup). Subscale means for Seizure Worry and Social Functioning showed the greatest numeric increase from baseline. Mean QOLIE-31-P scores were similar in all subgroups. The safety profile in the follow-up group was similar to that seen in all study adults. ConclusionsAdults with refractory epilepsy who were treated with diazepam nasal spray for seizure clusters maintained or improved QOLIE subscale scores across the 12-month study period. Seizure Worry and Social Functioning subscale scores increased over time, suggesting improvement in these domains for this population with intractable epilepsy. Changes among subscale results suggest differences in sensitivity to the use of an intermittent treatment. The potential to improve patient function with treatment for seizure clusters warrants further study.

Relationship Between Exercise Training and Quality of Life in Heart Failure Patients

Background: Heart failure (HF) is a growing disease that affects up to 6.5 million Americans and greatly contributes to the rising expense of health care. HF affects almost 23 million individuals worldwide. Exercise training increased patients' quality of life (QoL) and may be connected with lower morbidity and mortality. Aim: To assess the association between exercise training and QoL in HF patients. Methods: We examined databases from 2008 to 2019 for research that looked at the association between exercise training and QoL in HF patients. For the analysis, eight controlled studies that met the inclusion criteria were chosen. The study's characteristics, as well as data on QoL in HF patients, exercise training, and aerobic capacity, were extracted and examined. Results: The investigation showed a more positive effect of the training exercise on patients' QoL after heart failure. Conclusion: Regular 30-minute exercise training three times a week for eight weeks is an effective strategy to improve all QoL aspects in individuals with chronic heart failure caused by various etiologies. These exercises had to be modified based on the patients' age and functional capacity.

Shyness, Emotion Processing, and Objective Quality of Life among Adults with Schizophrenia: An ERP Study

Although individual differences in temperament have been shown to influence Quality of Life (QoL) among individuals with schizophrenia, there exists large heterogeneity in such outcomes suggesting moderating factors. Here we used event-related potential (ERP) methodology to examine whether the processing of facial emotions moderated the association between shyness and objective QoL among adults with schizophrenia. Forty stable outpatients with schizophrenia completed measures of shyness and QoL. Early visual ERP components (P1, N170) were recorded while participants viewed emotional faces. We observed a significant interaction between shyness and P1 and N170 amplitudes in response to fearful faces in predicting Intrapsychic Foundations QoL. Patients with reduced P1 and N170 amplitudes to fearful compared to neutral faces displayed the lowest QoL, but only if they were also high in shyness. We also found a significant interaction between shyness and ERP latency at the P1 and N170 in response to happy faces. Patients who displayed longer P1 and N170 latencies to happy faces compared to neutral faces and with higher shyness levels scored lower on Intrapsychic Foundations and Interpersonal Relations QoL, respectively. These findings suggest that the neural processing of emotional faces and shyness interact to predict aspects of QoL among outpatients with schizophrenia.

Valuing the "Burden" and Impact of Rare Diseases: A Scoping Review.

Introduction: Rare diseases (RDs) are a severe, chronic, degenerative and often life-threatening group of conditions affecting more than 30 million people in Europe. Their impact is often underreported and ranges from psychological and physical symptoms seriously compromising quality of life. There is then a need to consolidate knowledge on the economic, social, and quality of life impacts of rare diseases. Methods: This scoping review is the result of 9 qualitative interviews with experts and a literature search on Cost-of-Illness (COI) studies and quality of life (QoL) studies following the PRISMA methodology. Grey literature was also included to complement findings. Results. 63 COI studies were retrieved, covering 42 diseases and a vast majority of them using a prevalence-based approach (94%). All studies included medical costs, while 60% included non-medical costs, 68% productivity losses and 43% informal care costs. 56 studies on QoL were retrieved, mostly from Europe, with 30 different measurement tools. Grey literature included surveys from the pharmaceutical industry and patient organisations. Discussion: The majority of studies evaluating the impact of RDs on the individual and society use the COI approach, mostly from a societal perspective. Studies often vary in scope, making them difficult to consolidate or compare results. While medical costs and productivity losses are consistently included, QoL aspects are rarely considered in COI and are usually measured through generic tools. Conclusion: A comprehensive study on impact of rare disease across countries in Europe is lacking. Existing studies are heterogeneous in their scope and methodology and often lack a holistic picture of the impact of rare. Consensus on standards and methodology across countries and diseases is then needed. Studies that consider a holistic approach are often conducted by pharmaceutical companies and patient organisations exploring a specific disease area but are not necessarily visible in the literature and could benefit from the sharing of standards and best practices.

The Effect of Social Isolation Types on Quality of Life during the Coronavirus Disease 2019 Pandemic in Saudi Arabia: A Cross-Sectional Study.

COVID-19 has caused a global pandemic that has spread rapidly to six continents, with over 2.5 million deaths from December 2019 to March 2021. The number of confirmed COVID-19 cases is still growing worldwide, and quarantines have been recommended to prevent the disease’s spread. However, quarantines affect people’s quality of life (QOL). The aim of this study is to assess the effect of social isolation—quarantine—on QOL during the first wave of the COVID-19 pandemic in Saudi Arabia. A cross-sectional, descriptive design was used in the present study. We obtained data from an online survey conducted in Saudi Arabia. We included a convenience sample of 775 participants in the study. Most of the participants were female (67%), with a mean age of 46 years ranging from 18 to 75 years. Many participants were government employees (n = 308, 39.7%) and had a bachelor’s degree or greater (n = 513, 66.2%). Most of the participants (n = 629, 81%) were free from any chronic disease. Nearly 88% of participants were partially isolated socially owing to COVID-19. Concerning QOL, the means of both the Physical Health Composite Scale and the Mental Health Composite Scale SF-12 scores were 44.7 and 34.6, respectively. Furthermore, the results demonstrate that partially socially isolated participants appeared to have significantly better physical health statuses (M = 44.96, SD = 5.90) than completely socially isolated participants (M = 42.87 ± 7.26). There was no significant social isolation effect on mental health status (t (773) = 2.5, p = 0.115). Social isolation during the COVID-19 pandemic considerably influenced various aspects of QOL including physical and mental health. Community-based interventions such as online counseling services and wellness programs are required to reduce the pandemic’s negative impact and enhance overall health status and QOL.

The impact of lower limb chronic venous disease on quality of life: patient and physician perspectives.

Aim: This research compared patient and physician perceptions of quality of life (QoL) in C0-4 chronic venous disease (CVD). Methods: Qualitative standardized phone interviews were conducted with 100 patients and 60 specialists from Brazil, China, the Czech Republic, Italy and Russia. Results: In addition to the impact of physical symptoms on QoL, patient interviews revealed a high aesthetic and emotional burden of C0-4 CVD that contributes to social isolation and affects relationships. Physicians were aware of the physical impact but underestimated the other implications of CVD on their patients' QoL. Conclusion: Healthcare professional awareness of the overall impact of CVD on QoL needs improvement. All aspects of QoL should be assessed in order to manage CVD effectively.

Obsessive-compulsive symptoms moderates the effects of cognitive functioning on quality of life in clozapine-treated schizophrenia

Obsessive-compulsive symptoms (OCS) are frequently reported in clozapine-treated schizophrenia. Studies on the effects of OCS on cognitive abilities and quality of life (QoL) yielded contrasting results, ranging from benefits to adverse effects. We investigated the interactive effects of OCS and cognitive functioning on different aspects of QoL in clozapine-treated patients. 54 patients with schizophrenia underwent a neurocognitive, functional and psychopathological battery. Using moderation models, we examined the interplay between OCS and cognitive abilities on different QoL domains. We found several main effects and interactions between I.Q. and OCS on global QoL, as well as specific effects on psychological and environmental domains. Mild OCS have beneficial effects on QoL, but, as OCS become more severe in patients with more preserved cognitive abilities, the QoL drops steeply. Findings highlight the complex interplay between OCS and cognitive functioning, whose effects on QoL appear to depend on patients’ OCS severity and cognitive profile, as well as on the functional domain addressed. Our data may help to reconcile the seemingly contrasting results from previous studies, and shed a new light on the importance of evaluating OCS in schizophrenia, thus establishing specific interventions that can lead to consequent effects on social well-being and QoL. • Some OCS (e.g., checking) are more frequent in patients treated with clozapine. • Mild OCS act as a “protective” organizing factor on quality of life. • Severe OCS and cognitive abilities interplay negatively affects quality of life. • Effects on quality of life depends on the functional domain addressed.

A Combination of Magnesium, B Vitamins, Rhodiola, and Green Tea (L-theanine) Alleviates Chronic Stress in Healthy Volunteers: A Randomized, Placebo-Controlled Study

ObjectivesThe effect of a combination of magnesium, vitamin B6, B9, B12, and Teadiola® (rhodiola and green tea/L-theanine extracts) on stress was evaluated in chronically stressed but otherwise healthy subjects. The effects on stress-related quality-of-life (QoL) parameters, like sleep and perception of pain were also explored.MethodsThis single-blinded study (NCT04391452) included adults with stress for ≥1 month and with ≥14 points on Depression Anxiety Stress Scale (DASS)-42 stress questionnaire. Subjects were randomized (1:1) to receive either the dietary supplement combination (n = 49) or placebo (n = 51), once daily, for 28 days, with a follow-up assessment at day 56. Primary endpoint was the change in DASS-42 stress score from baseline (BL) to day 28 in dietary supplement vs placebo groups. Secondary endpoints included changes from BL in DASS-42 scores at days 14 and 56; sleep quality (Pittsburgh Sleep Quality Index [PSQI]) at days 14, 28, and 56; pain perception (temperature threshold) in response to cold/warm thermal stimulations at day 28.ResultsAt BL, DASS-42 score (mean [SD]) was 26.3 (6.7) with dietary supplement and 26.8 (8.0) with placebo. At day 28, the scores decreased to 17.6 (7.3) and 20.1 (9.4), respectively, with a significant between-group difference of 3 points (effect size [ES], −0.29; 95% CI [−0.57, −0.01]; p = 0.04). Similar reductions were observed earlier, at day 14 (ES, −0.40; 95% CI [−0.68, −0.11]; p = 0.006), that remained stable up to day 56 (ES, −0.34; 95% CI [−0.62, −0.06]; p = 0.02). At day 28, a significant reduction in sensitivity to cold pain was reported with dietary supplement vs placebo (p = 0.01) and a trend for lesser sensitivity to hot pain was observed (p = 0.06). No significant effect was observed on overall sleep quality, but a trend towards improvement in daytime dysfunction due to sleepiness (PSQI-7 component score) was noticed with dietary supplement vs placebo at day 28 (p = 0.06) which became significant at day 56 (p < 0.001).ConclusionsThe combination is effective for management of stress in healthy individuals. Its beneficial effects on stress-related QoL aspects, notably pain perception, deserve further investigation.Funding SourcesThis study was sponsored by the University Hospital of Clermont-Ferrand, France and received partial financial support from Sanofi Consumer Healthcare, the manufacturer of Stress Resist®.

Comparative Effectiveness of 4 Exercise Interventions Followed by 2 Years of Exercise Maintenance in Multiple Sclerosis: A Randomized Controlled Trial

ObjectiveTo determine the effects of exergaming (EXE) on quality of life (QOL), motor, and clinical symptoms in multiple sclerosis (MS). We compared the effects of EXE, balance (BAL), cycling (CYC), proprioceptive neuromuscular facilitation (PNF), and a standard care wait-listed control group on clinical and motor symptoms and quality of life (QOL) in people with MS (PwMS) and determined the effects of subsequent maintenance programs for 2 years in a hospital setting. DesignA randomized controlled trial, using before-after test design. SettingUniversity hospital setting. ParticipantsOf 82 outpatients with MS, 70 were randomized (N=70), and 68 completed the study. InterventionsThe initial high-intensity and high-frequency interventions consisted of 25 one-hour sessions over 5 weeks. After the 5-week-long initial intervention, the 2-year-long maintenance programs followed, consisting of 3 sessions per week, each for 1 hour. Main Outcome MeasuresThe primary outcome: Multiple Sclerosis Impact Scale (MSIS-29). Secondary outcomes: Measures 5 aspects of health-related QOL (EuroQol 5-Dimension questionnaire), Beck Depression Inventory, 6-minute walk test (6MWT), Berg Balance Scale (BBS), Tinetti Assessment Tool (TAT), and static BAL (center of pressure). ResultsMSIS-29 improved most in EXE (11 points), BAL (6), and CYC (6) (all P<.05). QOL improved most in EXE (3 points), CYC, and BAL (2) (all P<.05). TAT and BBS improved significantly (P<.05) but similarly (P>.05) in EXE, BAL, and CYC. 6MWT improved most in EXE (57m), BAL (32m), and CYC (19m) (all P<.001). Standing sway did not change. Maintenance programs further increased the initial exercise-induced gains, robustly in EXE. ConclusionsA total of 25 sessions of EXE, BAL, CYC, and PNF, in this order, improved clinical and motor symptoms and QOL, and subsequent 2-year-long thrice weekly maintenance programs further slowed symptom worsening and improved QOL. EXE was the most and PNF was the least effective to improve clinical symptoms, motor function, and QOL in PwMS.

Personally Generated Quality of Life Outcomes in Adults With Juvenile Idiopathic Arthritis

To explore quality of life (QOL) using the individualized Patient Generated Index (PGI) in young adults who were diagnosed with juvenile idiopathic arthritis (JIA) in childhood, and to examine associations between PGI ratings and standardized health-related outcome measures. Patients (N = 79, mean age 25.1 [SD 4.2] yrs, 72% female) completed the PGI and the standardized measures: Health Assessment Questionnaire-Disability Index, 12-item Short Form Health Survey (SF-12; physical and mental health-related QOL [HRQOL]), Brief Pain Inventory (pain severity and interference), 5-item Hopkins Symptom Checklist, and visual analog scale for fatigue. Information on morning stiffness, medications, and demographics was also collected. Patients were compared to 79 matched controls. The most frequently nominated areas of importance for patients' personally generated QOL (assessed by PGI) were physical activity (n = 38, 48%), work/school (n = 31, 39%), fatigue (n = 29, 37%) and self-image (n = 26, 33%). Nomination of physical activity was associated with older age, morning stiffness, and more pain interference. Nomination of fatigue was associated with current use of disease-modifying antirheumatic drugs, whereas nomination of self-image was associated with polyarticular course JIA and pain interference. Nomination of work/school was not associated with other factors. Higher PGI scores (indicating better QOL) correlated positively with all SF-12 subscales except role emotional, and negatively with disability, pain severity, pain interference, and morning stiffness. Compared to controls, patients had more pain, poorer physical HRQOL, and less participation in full-time work or school. Physical activity, work/school, fatigue, and self-image were frequently nominated areas affecting QOL in young adults with JIA. The PGI included aspects of QOL not covered in standardized measures.

The impact of COVID-19 infection on the quality of life of healthcare workers

AbstractObjectivesCOVID-19 pandemic has negatively affected the entire world and one of its impacts was the increased level of stress and anxiety, especially among healthcare workers. Therefore, this study aims at evaluating the quality of life (QoL) and sleep quality of healthcare workers in Iraq.MethodsThis study assessed the QoL and sleep quality by using World Health Organization Quality of Life Instruments (WHOQOL-BREF) and the Insomnia Severity Index (ISI), respectively. The questionnaires were administered through an online cross-sectional survey targeted at workers in medical fields in Iraq from 1st to 20th of August 2021.Key findingsThree hundred healthcare workers participated, and females constituted 75.3%. The two questionnaires had very good internal consistency. The highest scoring domain was social relationships, followed by physical health. A significant difference was found in the mean scores of psychological health domain between males and females, with higher scores observed in males. The mean of the total ISI score was 11.58 ± 6.88 with a range between 0 and 27. Severe insomnia was observed in only 9.7% of the participants. A significant negative correlation (r = −0.118) was found between age and ISI scores of the participants. Significant differences were found between males and females with higher ISI mean scores observed among males.ConclusionsThe QoL and sleep pattern can be affected by COVID-19 infection with the psychological aspect of QoL being the most affected and some degrees of insomnia being observed in many participants.

Evaluation of the Effectiveness of Distance Self-Care Training on Self-efficacy and Quality of Life of Patients With Intestinal Ostomy

Background &amp; Aims: Living with a temporary or permanent ostomy affects the quality of life (QoL) of people with an ostomy and requires increasing patients' self-efficacy to take care of themselves. Education is one way to improve individuals' QoL and self-care. Therefore, this study aimed to determine the effectiveness of distance self-care education on self-efficacy and QoL of patients with an intestinal ostomy in patients referred to Kermanshah hospitals in 2020-2021. Materials &amp; Methods: In a quasi-experimental study before and after the process, 61 patients with intestinal ostomy referred to Imam Reza (AS), and Taleghani hospitals in Kermanshah province were selected from April to July 2021, using a simple sampling method. The samples first answered the self-efficacy questionnaires of ostomy patients and the quality of life of Weir and Sherborn. Then, the self-care program developed in the form of 8 45-minute group sessions was taught to patients by the researcher through discussion and conversation through a virtual network (WhatsApp), according to which they can use self-care at home, and two months after the end of the intervention. The mentioned questionnaires were distributed and completed among the patients again. Data were reported using SPSS software v. 20, and paired t-test and Wilcoxon tests were used for statistical analysis. Results: The Mean±SD of patients' QoL before the intervention was 34.05±16.53, reaching 49.63±21.59 after the intervention. Based on paired t-test, this difference was significant (P&lt;0.001). There was a statistically significant difference between the mean of all aspects of patients' QoL except general health before and after the intervention (P&lt;0.043). The Mean±SD of patients' self-efficacy before the intervention was 50.40±4.57 (51.18±5.03 after the intervention) and based on the paired t-test, this difference was significant (P=0.036). Conclusion: The findings of the present study, while confirming and supporting the research hypothesis, showed that distance self-care education in patients with an intestinal ostomy effectively affects their self-efficacy and QoL. Using this treatment plan as one of the simple, cheap, feasible, and effective non-pharmacological interventions can help promote self-efficacy and, consequently, the QoL of the patients with an intestinal ostomy.

Changing the paradigm in postherpetic neuralgia treatment: lidocaine 700 mg medicated plaster.

Chronic pain is currently considered a disease state with biopsychosocial consequences and a negative impact on patients' quality of life (QoL). Pain from postherpetic neuralgia (PHN) can persist for months or years and is a prototypical example of chronic pain. We analyzed PHN as a model of chronic pain, including its effects on QoL and clinical aspects. We explored treatment options, focusing on the topical treatment with lidocaine 700 mg medicated plaster (LMP) and how this impacts PHN management. This article is a narrative review of published studies. Preclinical and clinical studies were retrieved from literature through a search performed in PubMed/MEDLINE. To choose the appropriate treatment for chronic pains, such as PHN, not only efficacy but also tolerability, manageability, practicality, and compliance are important factors, especially in the long term. It is also important to set treatment expectations with the patients as total suppression of pain may be unrealistic, and a balance needs to be found between pain control and the minimization of adverse events. In this respect, LMP may be the best currently available treatment: it is easy to use, has low systemic absorption and thus a low risk for pharmacological interactions. Therefore, treatments can be personalized, and concomitant medications can be added, if needed. Recent data from a real-world study support this view by showing that LMP has superior effectiveness in reducing pain and improving the QoL compared to other commonly used systemic treatments and confirming its good tolerability profile that is mainly characterized by localized skin reactions. LMP is one of the best currently available treatment options for PHN patients balancing good efficacy with an excellent tolerability profile and can therefore be considered for use as a first-line treatment for PHN.

The Quality of Sex Life Among Patients Before and After Lung Transplantation: A Single-Center Study

BackgroundLung transplantation (LTx) is the only effective method of treatment for patients with end-stage lung diseases; LTx prolongs and increases the quality of life (QoL). An important aspect of QoL that changes in the course of severe diseases is the quality of sex life. This aspect is yet to be discussed in relationship to LTx. We aim to compare patients’ quality of sex life at the qualification process with patients’ who underwent LTx. MethodsThe studied group consisted of 100 patients (24 women before and 16 after LTx, 39 men before and 21 after LTX) who were admitted to the lung transplantology department for qualification or to control the function after LTx. To assess the patients' quality of sex life, we used The Changes in Sexual Functioning Questionnaire (CSFQ) and World Health Organization (WHO) QoL-BREF. To assess lung function, patients underwent a 6-Minute-Walk-Test (6MWT). ResultsPatients after LTx obtained higher results—compared to patients qualified for LTx—in the WHO QoL-BREF in every domain (somatic, psychological, social, and environment). Men after LTx got more points in every domain and better total score (53 ± 5.62 vs 44.23 ± 10.28 point; P < .05) in CSFQ. Women before and after LTx obtained comparable results in CSFQ. Results of 6-Minute-Walk-Test were better among patients after LTx than in qualified patients (523.62 ± 95.71 vs 333.14 ± 145.38 and 524.12 ± 56.17 vs 317.20 ± 141.6, respectively for men and women). ConclusionsPatients after LTx show better pulmonary function and quality of sex life than qualified. Preliminary results encourage us to conduct research on a larger group.

Symptoms, problems and quality of life in patients newly diagnosed with oesophageal and gastric cancer \u2013 a comparative study of treatment strategy

BackgroundPatients with oesophageal and gastric cancer have a low likelihood of being cured and suffer from a broad spectrum of symptoms and problems that negatively affect their quality-of-life (QOL). Although the majority (67–75%) of patients at the time of diagnosis suffer from an incurable disease, research has primarily focused on the pre- and postoperative phase among patients treated with curative intent, with little attention to symptoms and problems in the diagnostic phase, especially in those who cannot be offered a cure.MethodsIn this cross-sectional study 158 patients newly diagnosed with oesophageal and gastric cancer visiting the surgical outpatient department for a preplanned care visit were included consecutively during 2018–2020. The validated instruments QLQ-C30 and QLQ-OG25, developed by the European Organization for Research and Treatment of Cancer (EORTC), and selected items from the Integrated Patient Outcome Scale (IPOS) were used to assess QOL, symptoms and problems. Differences between patients with a curative and a palliative treatment strategy were analysed using t-test and Mann–Whitney U test. The QLQ-C30 and QLQ-OG25 scores were compared to published reference data on the general Swedish population.ResultsAmong all, the QOL was markedly lower, compared with general Swedish population (mean ± SD, 55.9 ± 24.7 vs 76.4 ± 22.8, p < 0.001). Compared to general population, the patients had significant impairment in all QOL aspects, particularly for role and emotional functioning and for symptoms such as eating-related problems, fatigue, insomnia and dyspnea. Majority of patients also reported severe anxiety among family and friends. Among patients with oesophageal cancer those with a palliative treatment strategy, compared with curative strategy, reported significantly lower QOL (mean ± SD, 50.8 ± 28.6 vs 62.0 ± 22.9 p = 0.030), physical (65.5 ± 22.6 vs 83.9 ± 16.5, p < 0.001) and role functioning (55.7 ± 36.6 vs 73.9 ± 33.3, p = 0.012), and a higher burden of several symptoms and problems. No significant differences between treatment groups were shown among patients with gastric cancer.ConclusionsPatients newly diagnosed with oesophageal and gastric cancer, and especially those with incurable oesophageal cancer, have a severely affected QOL and several burdensome symptoms and problems. To better address patients’ needs, it seems important to integrate a palliative approach into oesophageal and gastric cancer care.

Economic and Humanistic Burden of CerebralVasospasm and Its Related Complications after Aneurysmal Subarachnoid Hemorrhage: A Systematic Literature Review.

IntroductionCerebral vasospasm (VSP) is the leading risk factor of neurological deterioration (i.e., delayed cerebral ischemia [DCI] and cerebral infarction) after aneurysmal subarachnoid hemorrhage (aSAH) and a cause of morbidity and mortality. The objective of this systematic literature review is to summarize the economic and humanistic burden of VSP and its related complications after aSAH.MethodsA predefined protocol was designed, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Systematic searches were conducted in MEDLINE, Embase, and Cochrane (in January 2021) to identify studies reporting economic and/or humanistic (i.e., health-related quality of life [HRQoL]) outcomes for patients with asymptomatic and symptomatic VSP after aSAH. Related conferences and additional sources were searched manually. Dual screening, data extraction, and qualitative analysis were conducted.ResultsOf 3818 abstracts identified for review, 43 full-text articles representing 42 single studies met the inclusion criteria and were included. Most studies (33) were observational; nine were randomized clinical trials (RCTs). Economic outcomes were reported in 31 studies, and alongside HRQoL outcomes in 4 studies; 7 studies reported HRQoL outcomes only. Forty studies were conducted in single countries, while only 2 RCTs were conducted in multiple countries. Patients diagnosed with VSP or DCI spent between 2.1 and 7.4 days longer in intensive care and between 4.7 and 17 days longer in hospital (total) compared with patients without VSP or DCI. A significantly higher cost burden of US$33,945 (2021 £26,712) was identified for patients with VSP and £9370 (2021 £13,733) for patients with DCI compared with patients without. Patients with DCI were also disadvantaged by being employed for 62 fewer days (during 24-month follow-up), with an estimated mean cost of £3821 (2021 £5600) for days off work. Poor HRQoL was associated with ≥ 1 days with VSP symptoms (odds ratio [OR]: 2.8, 95% confidence interval [CI]: 1.4–5.3), symptomatic VSP (OR: 1.9, 95% CI: 1.0–3.6), and DCI (OR: 2.3, 95% CI: 1.3–4.2), although this was not consistent across all studies. Symptomatic VSP and DCI were identified as significant risk factors for depressed mood (OR: 2.2, 95% CI: 1.0–4.9) and global cognitive impairment (OR: 2.3) at 12 months, respectively. The severity of VSP was a critical predictor of post-aSAH economic and humanistic burden. Similar trends in economic and humanistic burden were identified in the general aSAH patient population. Study design and patient heterogeneity precluded direct metaanalysis of the results.ConclusionA substantial direct and indirect economic burden is linked to VSP and its related complications after aSAH. Although limited evidence was identified for humanistic burden, these patients seem to suffer from poor HRQoL with long-lasting burden. Overall, there is an urgent need to understand better the concept of “burden of illness” of VSP and its related complications after aSAH.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40120-022-00348-6.

Longitudinal analysis of quality of life of patients on home parenteral nutrition at a regional centre

Home parenteral nutrition (HPN) is the primary treatment for patients with intestinal failure (IF). Quality of life (QOL) of patients receiving home parenteral nutrition is well documented by Baxter et al.1 A QOL assessment tool (HPN-QOL©) has been developed and validated specifically for this patient population. We assessed the QOL in our HPN cohort in 2016 and throughout 2019-2020. This study assesses the impact of HPN on QOL over time in this cohort. We aimed to determine if there was a significant change in relation to different aspects of QOL.