Aspects Of Quality Of Life Research Articles

Do Causes Influence Functional Aspects and Quality of Life in Patients with Nonfibrocystic Bronchiectasis?

The denomination of noncystic fibrosis bronchiectasis (NCFB) includes several causes, and differences may be expected between the patient subgroups regarding age, comorbidities, and clinical and functional evolution. This study sought to identify the main causes of NCFB in a cohort of stable adult patients and to investigate whether such conditions would be different in their clinical, functional, and quality of life aspects. Between 2017 and 2019, all active patients with NCFB were prospectively evaluated searching for clinical data, past medical history, dyspnea severity grading, quality of life data, microbiological profile, and lung function (spirometry and six-minute walk test). There was a female predominance; mean age was 54.7 years. Causes were identified in 82% of the patients, the most frequent being postinfections (n = 39), ciliary dyskinesia (CD) (n = 32), and chronic obstructive pulmonary disease (COPD) (n = 29). COPD patients were older, more often smokers (or former smokers) and with more comorbidities; they also had worse lung function (spirometry and oxygenation) and showed worse performance in the six-minute walk test (6MWT) (walked distance and exercise-induced hypoxemia). Considering the degree of dyspnea, in the more symptomatic group, patients had higher scores in the three domains and total score in SGRQ, besides having more exacerbations and more patients in home oxygen therapy. Causes most identified were postinfections, CD, and COPD. Patients with COPD are older and have worse pulmonary function and more comorbidities. The most symptomatic patients are clinically and functionally more severe, besides having worse quality of life.

Quality of Life in Children with Cerebral Palsy: The Role of Having Access to Rehabilitation Services

Background: Cerebral palsy (CP) is a neurological motor disability, and children with CP should receive rehabilitation services to achieve their full potential. Objectives: The purpose of this study was to explore the quality of life (QOL) of children with CP across various domains and to assess the role of access to rehabilitation services on their QOL. Methods: We conducted a cross-sectional study involving all 126 children aged 4 - 12 with CP and their parents in Saqqez county, Kurdistan province, Iran. The "Physical Rehabilitation Accessibility Assessment Questionnaire" and the "Parental Proxy CP QOL-Child questionnaire" were used to measure the main variables. The analysis performed separately for two subpopulations: 27 children aged 4 - 6 years and 99 children older than six, using SPSS version 23. After prforming Kolmogorov-Smirnov test, the Spearman correlation coefficient was employed to identify correlations. Results: The average age of the participants was 8 ± 2.36 years, with 51 (40.5%) being girls. Of the 126 children with CP, 45 (35.7%) had independent mobility function (GMFCS levels I and II). The mean CP QOL-Child domain scores ranged from 35.3 ± 25.1 in the 'access to services' domain to 74.5 ± 16.1 in the 'Emotional well-being and self-esteem' domain. The average accessibility score was 53.8 ± 22.1. Among children older than 6 years, access to rehabilitation services showed a significant correlation with all CP QOL-Child domain scores (P < 0.05), except for 'social well-being and acceptance.' In children aged 4 - 6 years, only the Family Health domain score was significantly correlated with access to rehabilitation services (r = 0.44, P = 0.021). Conclusions: Access to rehabilitation services is a significant predictor of QOL in children older than 6 years. Further experimental research is needed to examine changes in various aspects of QOL in children with CP following improved access to rehabilitation services.

Medical care priorities of community-dwelling older adults according to three dimensions of quality of life: Quality of daily living, satisfaction and happiness from birth to death, and human vitality.

Although the maintenance and improvement of quality of life (QoL) through holistic care are important in geriatric medical care, care priorities might differ depending on three essential aspects of QoL: the quality of daily living, satisfaction and happiness from birth to death, and human vitality, which are "Seikatsu," "Jinsei," "Seimei" in Japanese, respectively. We aimed to clarify these priorities in terms of medical care and examined how the definitions of QoL affected these priorities' rankings. This cross-sectional study involved community-dwelling older adults aged ≥65 years living in Kashiwa City, Chiba Prefecture, Japan. The number of participants was 1550 (mean age, 76.1 ± 5.8 years; 699 women [45.1%]). A self-administered questionnaire distributed in advance was used to rank 12 items sought in medical care. Participants were randomly assigned to one of three groups and sent the corresponding questionnaire, which differed only in the definition of QoL. The top priorities for medical care were "effective treatment of illness," "improvement of physical function," and "maintaining a high level of activity." When QoL was defined as "the quality of daily living, satisfaction and happiness from birth to death, and human vitality," participants were significantly more likely to rank QoL improvement as one of the top three items (adjusted odds ratio, 1.46; 95% confidence interval, 1.03-2.05). As a medical care priority, older adults desire improvement of multidimensional elements of life, including human vitality. Health care providers should consider this when making medical care decisions. Geriatr Gerontol Int 2024; 24: 493-498.

Impact of subjective and objective language function and psychological distress on quality of life in glioma patients awaiting surgery

ABSTRACT Background Maintaining quality of life (QoL) and identifying contributing factors is an important aspect of treatment for glioma patients. Little is known about to what extent language function and psychological distress impact QoL before surgery. Aims The aim of the present study was to investigate the impact of subjective and objective language function, as well as psychological distress on domains of QoL before surgery. Methods and procedures Twenty-seven patients (52% female) with a suspected glioma, grade 1‒3 based on symptoms and MRI imaging diagnostics were assessed pre-surgery. Subjective language concerns, psychological distress and QoL were investigated with self-reported questionnaires. A Subjective language index was calculated, based on items addressing word-finding, expression of thoughts, reading and writing. Objective language function was assessed with tasks of naming (The Boston Naming Test), verbal comprehension (Vocabulary and Similarities), verbal fluency (Semantic and Phonemic fluency) and verbal short-term and working memory (Digit span forward and backward). The strength of associations was determined using Spearman’s rho correlations. Linear regression analyses were used to examine predictors for QoL. Outcomes and Results Clinically significant reductions in QoL were found in 48% of the sample. Subjective language concerns were highly common, with 85% reporting some degree of difficulty. Group means on objective language tests were within normative range on the included measures. The Subjective language index correlated significantly with several QoL domains, whereas objective performance mainly correlated with functional well-being. Psychological distress was a strong predictor for QoL. Conclusions The findings demonstrate that reductions in QoL may occur during the diagnostic phase, even before glioma treatment starts. Subjective language concerns and psychological distress contributed to all aspects of QoL and highlight the importance of acknowledging patient-reported information. The results suggest a comprehensive multi-modal assessment of glioma patients pre-surgery, to establish a base-line and facilitate patient-centered treatment planning.

Effect of an exercise-based cardiac rehabilitation program on quality of life of patients with chronic Chagas cardiomyopathy: results from the PEACH randomized clinical trial.

To investigate the effect of an exercise-based cardiac rehabilitation program on the quality of life (QoL) of patients with chronic Chagas cardiomyopathy (CCC). PEACH study was a single-center, superiority randomized clinical trial of exercise training versus no exercise (control). The sample comprised Chagas disease patients with CCC, left ventricular ejection fraction < 45%, without or with HF symptoms (CCC stages B2 or C, respectively). QoL was assessed at baseline, after three months, and at the end of six months of follow-up using the SF-36 questionnaire. Patients randomized for the exercise group (n = 15) performed exercise training (aerobic, strength and stretching exercises) for 60min, three times a week, during six months. Patients in the control group (n = 15) were not provided with a formal exercise prescription. Both groups received identical nutritional and pharmaceutical counseling during the study. Longitudinal analysis of the effects of exercise training on QoL, considering the interaction term (group × time) to estimate the rate of changes between groups in the outcomes (represented as beta coefficient), was performed using linear mixed models. Models were fitted adjusting for each respective baseline QoL value. There were significant improvements in physical functioning (β = + 10.7; p = 0.02), role limitations due to physical problems (β = + 25.0; p = 0.01), and social functioning (β = + 19.2; p < 0.01) scales during the first three months in the exercise compared to the control group. No significant differences were observed between groups after six months. Exercise-based cardiac rehabilitation provided short-term improvements in the physical and mental aspects of QoL of patients with CCC.Trial registration: ClinicalTrials.gov Identifier: NCT02517632; August 7, 2015.

Correlation of xerostomia in methadone therapy program patient with oral health related quality of life using oral health impact profile-14: a cross-sectional study

ABSTRACTIntroduction: Methadone Therapy Program (MTP) patients receive treatment with antidepressants which work as salivary flow inhibitors that promote xerostomia. Decreased salivary secretion affects several essential aspects of life quality, such as speaking, chewing, and food swallowing. It also increases the risk of rampant caries. This study aimed to analyze correlation of xerostomia in MTP with Oral Health Related Quality of Life (OHRQoL) using the Oral Health Impact Profile (OHI-P 14). Methods: Type of research was a cross-sectional design, this study's main independent variable was xerostomia, the dependent variable was OHRQoL, and the confounders were age, gender, education, occupation, caries status, oral hygiene status, history of HIV infection, smoking habits, and alcohol consumption. Data analysis used logistic regression to see the risk factors that influence OHRQoL. Results: Xerostomia is a subjective dry mouth complaint asked through a questionnaire. Of the 26 respondents, 13 (50%) reported dry mouth. Salivary Flow Rate (SFR) measurement showed the result of 13 people was &lt;0.3 (hyposalivation). OHrQOL was measured using OHI-P 14 questionnaire, 12 respondents had good OHRQoL (score &gt; 6.5) and 13 respondents had bad (score ≤6.5). Risk factors associated with OHRQoL were age (p=0.08) and duration of methadone consumption (p=0.06). Conclusion: There is no correlation between xerostomia in MTP with Oral Health Related Quality of Life (OHRQoL) using the Oral Health Impact Profile (OHI-P 14). Future research should involve several hospitals that carry out MTP so that the research results are more valid.KEYWORDSmethadone, oral health related quality of life, OHrQOL, OHIP-14, xerostomia

ADOLESCENTS AND EARLY ADULTS WITH ACNE VULGARIS: A SCOPING REVIEW ON PSYCHOLOGICAL AND PSYCHOSOCIAL IMPACTS AND QUALITY OF LIFE

Introduction: Acne vulgaris (acne) is one of the main reasons adolescents and early adults visit dermatology clinics. Several studies have found serious non-physiological effects of acne on adolescents and early adults. Objective: This scoping review aims to provide a comprehensive overview of the existing literature on the impact of acne on psychological, psychosocial, and quality of life aspects among adolescents and early adults. Methods: The scoping review was enforced based on Arskey and O'Malley's framework. A structured article search was performed on three databases, namely CINAHL Plus with Full-Text, Scopus, and ScienceDirect. Search words were determined based on elements of population, concept, and context. Article selection and reporting were enforced following the PRISMA-ScR pathway and based on inclusion and exclusion criteria. Results: This study analyzed thirteen articles (ten primary research articles and three literature study articles) which revealed that adolescents and early adults with acne could experience psychological and psychosocial problems as well as decreased quality of life. Discussion: The emergence of psychological and psychosocial impacts of acne was related to one another and could be a predictor of a decrease in the quality of life among adolescents and early adults with acne. Health professionals need to understand the needs of adolescents and early adults regarding the physiological and psychological management of acne

ASSOCIATIONS BETWEEN QUALITY OF LIFE WITH PSYCHOLOGICAL STATE, DISORDERS OF THE CARDIOVASCULAR SYSTEM AND PECULIARITIES OF INFECTIOUS PNEUMONIA 3 MONTHS AFTER COVID-19

Highlights The severity of pneumonia and the presence of cardiovascular diseases have a negative impact on the physical aspect of quality of life. Women`s quality of life indicators tend to be worse than men`s. Regular work activity is a factor that improves the physical aspect of the quality of life. AbstractAim. To analyze the relationship between the quality of life (QoL) and the psychological and somatic state of patients 3 months after Coronavirus disease 2019 (COVID-19) pneumonia.Methods. The study is a part of the “Prospective Follow-up Study of Patients after COVID-19 Pneumonia” that involves data on 351 patients (age 53±11) 3 months after hospitalization. Women accounted for 51% of all patients. Cardiologist and clinical psychologist examined cardiovascular and psychological health of patients. We assessed QoL by using the SF-36 survey, and psychometric properties by using the GAD-7, PHQ-9 and PSS-10. We estimated the severity of the COVID-19 using the discharge summaries information.Results. The prevalence of stress symptoms (27,4% vs 5,1%, p = 0,030) and depression (18,00 [13,00–25,00] vs 20,00 [15,00–24,00], p = 0,032) were higher in patients with cardiovascular disorders. Moreover, QoL was lower in this group of patients in all subscales except for “Mental health” and “Mental health aspect”. Women were more 3 times more likely to experience psychological and emotional disorders compared to men (29,1% vs 16,2%, ОR = 2,615 95%; 95% CI 1,695–4,035; p&lt;0,001). At the same time, all QoL indicators in women were significantly lower. For example, the average score on subscales “Mental health aspect” was equal to 47,17 [41,33–51,35] in women and 50,16 [46,65–52,35] in men (p&lt;0,001), and the average score on subscale “Physical health aspect” was equal to 66,32 [60,71–72,62] in women and 63,82 [56,04–70,93] in men (p = 0,003). The QoL scores on physical health subscales were higher in patients with mild and moderate lung lesions. Scores on the “Social functioning” subscale were higher in unmarried patients (87,00 [62,50–100,00] in married patients and 100,00 [75,10–100,00] in unmarried patients; p = 0,017), and scores on the subscale “Physical health aspect” were lower in unemployed patients (48,73 [44,43–52,31] in employed patients and 44,84 [41,32–49,73] in unemployed patients; p&lt;0,001).Conclusion. Тhe presence of cardiovascular disorders and severity of the COVID-19 pneumonia affected the physical aspect of QoL. QoL in women is worse compared with men. Regular work activity improves the physical aspect of QoL. There is a decrease in social activity in married patients after COVID-19 compared to unmarried patients.

A comparative study of psychiatric comorbidities and quality of life in patients with epilepsy and psychogenic non-epileptic seizures

Background: Epilepsy and psychogenic non-epileptic seizures (PNES) are both common disease entities and psychiatric comorbidities are also high among the sufferers. Studies on the comparison of the levels of comorbidities between the two groups are few in number. Aims and Objectives: The aims of this study were to investigate different psychiatric disorders like depression, anxiety, social functioning, and quality of life (QoL) in epilepsy and PNES patients and compare them statistically. Materials and Methods: 38 epilepsy and 22 PNES patients were evaluated with clinical history and different tools like the mini international neuropsychiatric interview - 5, Beck’s Depression Inventory - 2,state and trait anxiety inventory, Social and Occupational functioning scale for epilepsy and QoL in epilepsy - 31 questionnaire. Comparisons were made between the groups regarding sociodemographic data, scores on different aspects of psychiatric disorders, social functioning, and QoL. Results: The majority in the epilepsy group were males, and in the PNES group were females, while younger age group predominates in both groups. There was a high prevalence of depression and anxiety in both groups, while PNES subjects had significantly higher depression and trait anxiety scores. Social and occupational functions were comparable in the two groups, but QoL indexes were significantly worse in the PNES group. Conclusion: Findings in this study indicate that psychiatric comorbidities like depression and anxiety disorders are much more common among patients with epilepsy and PNES. Occurrence of depression is even higher among patients with PNES. Both epilepsy/PNES and these psychiatric comorbidities affect Socio-occupational functions and their QoL. Thus, it is very important to look for these psychiatric comorbidities and QoL in these patients and implement proper management protocols to improve their mental health as well as their QoL.

Quality of life of patients treated with robotic surgery in the oral and maxillofacial region: a scoping review of empirical evidence

BackgroundThere is a blooming trend in the application of robotic surgery in oral and maxillofacial care, and different studies had evaluated the quality of life (QoL) outcomes among patients who underwent robotic surgery in the oral and maxillofacial region. However, empirical evidence on the QoL outcomes from these procedures is yet to be mapped. Thus, this study was conducted to evaluate the available scientific evidence and gaps concerning the QoL outcomes of patients treated with robotic surgery in the oral and maxillofacial region.MethodsThis study adopted a scoping review design, and it was conducted and reported based on the Arksey and O’Malley, PRISMA-ScR, and AMSTAR-2 guidelines. SCOPUS, PubMed, CINAHL Complete, and APA PsycINFO were searched to retrieve relevant literature. Using Rayyan software, the retrieved literature were deduplicated, and screened based on the review’s eligibility criteria. Only the eligible articles were included in the review. From the included articles, relevant data were charted, collated, and summarized.ResultsA total of 123 literature were retrieved from the literature search. After deduplication and screening, only 18 heterogeneous original articles were included in the review. A total of 771 transoral robotic surgeries (TORSs) were reported in these articles, and the TORSs were conducted on patients with oropharyngeal carcinomas (OPC), recurrent tonsillitis, and obstructive sleep apnoea (OSA). In total, 20 different QoL instruments were used in these articles to assess patients’ QoL outcomes, and the most used instrument was the MD Anderson Dysphagia Inventory Questionnaire (MDADI). Physical functions related to swallowing, speech and salivary functions were the most assessed QoL aspects. TORS was reported to result in improved QOL in patients with OPC, OSA, and recurrent tonsillitis, most significantly within the first postoperative year. Notably, the site of the lesion, involvement of neck dissections and the characteristics of the adjuvant therapy seemed to affect the QOL outcome in patients with OPC.ConclusionCompared to the conventional treatment modalities, TORS has demonstrated better QoL, mostly in the domains related to oral functions such as swallowing and speech, among patients treated with such. This improvement was most evident within the initial post-operative year.

Assessing the Impact of Organ Failure and Metastases on Quality of Life in Breast Cancer Patients: A Prospective Study Based on Utilizing EORTC QLQ-C30 and EORTC QLQ-BR45 Questionnaires in Romania.

Breast cancer (BC) significantly impacts the quality of life (QoL) of affected individuals. This study, conducted at Colțea Clinical Hospital, Bucharest, aimed to assess the impact of organ failures and metastases on QoL in breast cancer patients using EORTC QLQ-C30 and EORTC QLQ-BR45 questionnaires and the survival rate to understand the clinical journey and the quality of life status in breast cancer patients. From January 2019 to October 2022, a prospective, observational study surveyed 874 patients, revealing 201 fatalities, 66 refusals, and 607 eligible participants. Results indicated statistically significant differences in various QoL aspects for patients experiencing heart failure, including physical functioning, pain, insomnia, global health status, and overall summary score. Kidney failure exhibited significance in physical functioning for QLQ-C30 and body image, sexual functioning, and endocrine sexual symptoms for QLQ-BR45. Respiratory failure demonstrated significant differences across multiple QoL domains. Patients with bone metastases reported lower physical functioning (p = 0.006) and increased pain (p = 0.002). This study has revealed an overall 5-year life expectancy of 68.8%, with survival rates of 93.8% for Stage I, 86.3% for Stage II, and 77.2% for Stage III breast cancer. Metastatic cancer patients have shown a 35.6% survival rate over 45 months, with a median survival duration of 36 months. A significant limitation of our study was the administration of the questionnaire only once, preventing us from quantifying the impact of specific treatment types on quality of life. This study emphasizes the necessity of using standardized QoL assessments in clinical practice from the initial presentation to ongoing follow-up.

Development and initial validation of the ILD-Anxiety-Questionnaire (IAQ): A new instrument for assessing disease specific fears in interstitial lung disease.

Multiple studies focusing on chronic lung diseases (i.e. COPD), have indicated that the quality of life (QoL) can be impacted by disease-related fears. In the context of Interstitial Lung Diseases (ILD), however, these have never been systematically examined. Therefore, the aim of the present study was to develop and evaluate an appropriate measuring tool, and to investigate the influence of disease-related anxieties on QoL in ILD. N = 166 ILD patients participated in the study and completed an itempool on disease-related fears, based on the COPD-Anxiety-Questionnaire (CAF-R) and expert assessments. Further, demographic and psychological variables were assessed (anxiety: GAD-7, QoL: K-BILD; Beliefs about Health: KKG). Psychometric properties were analyzed (factor structure, reliability, validity). Regression analyses were used to calculate the differential predictive power of disease-related anxieties on QoL. The factor structure was confirmed (Scales: Fear-of-Dependence-and-Progression, Fear-of-Social-Exclusion-and-Isolation, Fear-of-Physical-Activity, Fear-of-Dyspnea, and Sleep-related- Complaints). The Scales showed satisfying reliabilities (α = 0.68 to 0.89) and good validity. Disease-related anxieties proved to be differential predictors for different scales of the K-BILD (ß = -0.15 to ß = -0.58, all ps < .01). The ILD-Anxiety-Questionnaire (IAQ) is an easy-to-use, valid measurement tool for assessing disease-related anxieties. These vary in their impact on different aspects of QoL. Therefore, it might aid in specifying the indication for potential psychological supplementary interventions. Additional long-term studies are required to investigate how specific anxieties affect both overall and condition-specific QoL in diverse situations.

Impact of digital assistive technologies on the quality of life for people with dementia: a scoping review

BackgroundDigital assistive technologies (DATs) have emerged as promising tools to support the daily life of people with dementia (PWD). Current research tends to concentrate either on specific categories of DATs...

Kvalitet života bolesnika nakon transtibijalne amputacije i različiti periodi nošenja proteze

Introduction. Research into patients with lower limb amputation (LLA) puts strong emphasis on quality of life (QoL) and importance of the research in that regard as a measure for the rehabilitation outcomes. The aim of this study was to show which aspects of QoL are related to the duration of wearing a prosthesis in patients with transtibial amputation (TTA). Methods. The study sample comprised 40 patients who used prosthesis for 1 - 3 years (group A), 4 - 7 years (group B) and &gt; 8 years (group C). All patients completed Trinity Amputation and Prosthesis Experience Scale-Revised (TAPES-R). Results. Prosthesis wearing history was significantly different between the groups: group A (2.2 ± 0.7 years), group B (5.5 ± 1.3 years) and group C (22.9 ± 13.6 years), p&lt;0.001. Patients in group B were significantly (p &lt; 0.05) older compared to patients in group C, displayed a significantly (p &lt; 0.05) lower rate of employment and significantly (p &lt; 0.05) longer duration of diabetes mellitus. Patients in group C displayed a significantly (p = 0.005) lower rate of diabetes mellitus. TAPES-R showed that social adjustment was significantly lower (p &lt; 0.05) in patients in group C compared to patients in group A (3.14 ± 0.46 vs. 3.55 ± 0.41). Conclusion. Although patients with TTA showed good QoL, the group with a long history of wearing a prosthesis differed significantly in social adjustment compared to patients with a short period of wearing a prosthesis. The age and etiology of amputation differed significantly between the groups.

From biology to clinical practice: antiproliferative effects of somatostatin analogs in neuroendocrine neoplasms.

Somatostatin analogs (SSA), specifically octreotide and lanreotide, have demonstrated antiproliferative effects in patients with neuroendocrine tumors (NET), a group of rare malignancies of diverse origin and presentation. A prominent feature of NET cells is the expression of G protein-coupled receptors called somatostatin receptors (SSTR). Although these SSTR are not uniformly present in NET, they can be instrumental in the diagnosis and treatment of NET. Apart from their application in nuclear imaging and radionuclide therapy, SSA have proven invaluable in the treatment of hormonal syndromes associated with certain NET (antisecretory effects of SSA), but it took more than two decades to convincingly demonstrate the antiproliferative effects of SSA in metastatic NET with the two pivotal studies PROMID and CLARINET. The current review summarizes three decades of SSA treatment and provides an overview of the clinical trial landscape for SSA monotherapy and combination therapy, including clinical implications and quality of life aspects, as well as ongoing fields of research.

The humanistic and societal impact of obesity in Japan: a targeted literature review.

Obesity is a focus of Japanese public health policy, due to Japanese individuals' high susceptibility to weight-related conditions. In contrast to global definitions, obesity is defined as a body-mass-index (BMI) of ≥25 kg/m2 in Japan. Despite public efforts, rates of obesity have not decreased over the past decade. To better understand its societal impact, we examined the economic, quality of life (QoL), and complications burden of obesity in Japan. Electronic databases were searched for English and Japanese-language publications from 2005 to December 2020 reporting on adults with obesity in Japan; other diseases were excluded, with no restriction on intervention. Outcomes of interest included costs or resource use, QoL, risk of complications, and other clinical outcomes. We identified 137 studies, including 19 reporting on economic evidence, eight reporting on QoL, and 115 reporting on the relationship between obesity and the risk of complications or mortality. The studies consistently showed that Japanese adults with obesity (BMI ≥25 kg/m2) are at increased risk of complications vs. normal weight adults. They also confirmed higher total and medical costs, resource use, and hospitalization costs among adults with obesity vs. normal weight adults. In addition, the studies confirmed a considerable impact of obesity on physical and mental aspects of QoL. Overall, this study found that obesity in Japan is associated with a substantial burden. Japanese people are at risk even with BMI ≥25-<30 kg/m2, which are generally considered as pre-obese in other countries.

Impact of HIV pre-exposure prophylaxis (PREP) on health-related quality of life (QOL) of patients followed up at a reference center in São Paulo, Brazil

BackgroundHIV Pre-Exposure Pophylaxis (PrEP) is provided free of charge by the Brazilian national health system. Though effective in preventing HIV infection, little is known about its impact on the health-related Quality of Life (QoL) of users. ObjectiveThe present study aimed at assessing the impact of PrEP on the QoL of its users. MethodsProspective cohort study with 114 HIV-negative participants aged 18 years or older. Participants' QoL was assessed before starting PrEP and after 7 months of use, using the self-responsive WHOQOL-bref questionnaire. Sociodemographic and behavioral aspects were described and the Wilcoxon signed-rank test with p ≤ 0.05 was considered statistically significant. ResultsImprovement was seen in QoL scores for the environment domain (p = 0.02), which addresses feeling of physical safety, access to information and health services, and participation in leisure activities. Furthermore, participants reported improved satisfaction with their sex life, when questioned about the social relationships domain. There was no statistically significant change in the global QoL score, in the global health score, in the physical and psychological domains, nor in the total score for the social relationships domain. As for their socio-demographic profile, most participants were white and highly educated young cisgender men who have sex with men. 76.3% had unprotected sex in the 3 months before starting PrEP. 60.5% had reported substance use: marijuana (42.1%), club drugs (35.1%), and poppers (20.2%). ConclusionsThis study unveiled that PrEP benefited our cohort beyond its effectiveness in preventing HIV infection, having improved environmental aspects of QoL and self-satisfaction with sex life.

IMPACT OF DIGITAL AND SOCIAL ENGAGEMENT ON QUALITY OF LIFE AMONG RURAL OLDER ADULTS

Abstract Objectives In the current digitalized society, digital and social engagement are important elements in the well-being of older adults. This study examines how different types of digital and social engagement are associated with different aspects of quality of life among rural healthy older adults. Methods Older adults without cognitive impairments, residing in the community in Southeast Idaho (n=154) participated in the ‘Aging in Idaho study’ in 2018. Internet use for communication, instrumental purposes, and health information searches were measured. Informal and formal social participation were measured. Five aspects of quality of life (QOL) were measured using the WHOQOL-BREF. Multiple regression analyses were performed. Results Well-educated (M=16 years) rural older adults used the Internet for various purposes, actively engaged in social activities, and reported higher level of QOL for overall and life environment (e.g., M=4.6, Range=1-5). Internet use for communication was positively associated with QOL general health (β=.20, P &amp;lt;.05). Online health information search was negatively associated with QOL general health (β= -.42, P &amp;lt;.05). Informal social participation was positively associated with QOL overall (β=.17, P &amp;lt;.05), psychological health (β=.13, P &amp;lt;.05), and life environment (β=.20, P &amp;lt;.05). Formal social participation was positively associated with QOL social relationships (β=.16, P &amp;lt;.05). Discussion Digital and social engagement relate in distinct ways with different aspects of QOL. Older adults perceived QOL to be better when they actively adopted digital technology whereas maintaining social engagement well in the community. Promoting digital engagement which enables to facilitate social engagement in later life will be discussed.

Family Functioning in Children With ADHD and Subthreshold ADHD: A 3-Year Longitudinal Study

Objective: To compare family functioning over time for elementary school children with Attention-Deficit/Hyperactivity Disorder (ADHD; N = 179) and subthreshold ADHD (ST-ADHD; N = 86), to children without ADHD (Control; N = 212). Method: ADHD was assessed using the Conners 3 ADHD Index and Diagnostic Interview Schedule for Children IV. At baseline, 18-month follow-up and 36-month follow-up, parents completed measures assessing a range of family functioning domains. Results: At baseline, the ADHD group reported higher psychological distress, less parenting self-efficacy, less parenting consistency, and more stressful life events; and both groups reported poorer family quality of life (QoL) and greater parenting anger. Trajectories were largely similar to controls (i.e., stable over time), but unlike controls, ADHD and ST-ADHD groups showed lessening parent-partner support and parenting warmth, respectively; and both groups showed worsening aspects of family QoL. Conclusion: Families of children with ADHD and ST-ADHD report persistently poor or worsening family functioning; highlighting a need for tailored psycho-social supports.

The Functional Assessment of Cancer Therapy Scale: Development and Validation of the General Measure.

We developed and validated a brief, yet sensitive, 33-item general cancer quality-of-life (QL) measure for evaluating patients receiving cancer treatment, called the Functional Assessment of Cancer Therapy (FACT) scale. The five-phase validation process involved 854 patients with cancer and 15 oncology specialists. The initial pool of 370 overlapping items for breast, lung, and colorectal cancer was generated by open-ended interview with patients experienced with the symptoms of cancer and oncology professionals. Using preselected criteria, items were reduced to a 38-item general version. Factor and scaling analyses of these 38 items on 545 patients with mixed cancer diagnoses resulted in the 28-item FACT-general (FACT-G, version 2). In addition to a total score, this version produces subscale scores for physical, functional, social, and emotional well-being, as well as satisfaction with the treatment relationship. Coefficients of reliability and validity were uniformly high. The scale's ability to discriminate patients on the basis of stage of disease, performance status rating (PSR), and hospitalization status supports its sensitivity. It has also demonstrated sensitivity to change over time. Finally, the validity of measuring separate areas, or dimensions, of QL was supported by the differential responsiveness of subscales when applied to groups known to differ along the dimensions of physical, functional, social, and emotional well-being. The FACT-G meets or exceeds all requirements for use in oncology clinical trials, including ease of administration, brevity, reliability, validity, and responsiveness to clinical change. Selecting it for a clinical trial adds the capability to assess the relative weight of various aspects of QL from the patient's perspective.