Aspects Of Quality Of Life Research Articles

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.

The Association of Dry Eye Disease with Functional Visual Acuity and Quality of Life

Background: Dry eye disease (DED) is a common chronic condition with increasing prevalence. Standard discriminative visual acuity is not reflective of real-world visual function, as patients can achieve normal acuities by blinking. Methods: Participants recruited from a tertiary referral eye centre were divided into two groups—Severe DED (with significant, central staining) and Mild DED (absence of such staining). Functional Visual Acuity (FVA) in both groups was assessed using the DryeyeKT mobile application and Impact of Vision Impairment (IVI) questionnaire to assess quality of life (QOL). Results: Among the 78 participants (74.4% women), 30 (38.5%) had Severe DED and 48 (61.5%) Mild DED. In women, Severe DED produced a significantly worse FVA of 0.53 ± 0.20 vs. 0.73 ± 0.30 in the Mild DED group (p = 0.006). FVA decreased with increasing age, showing a significant inverse correlation (r = −0.55). A poorer FVA ≤ 0.6 was seen in older patients (68.2 years ± 7.68) vs. an FVA &gt; 0.6 in younger patients (58.9 years ± 10.7), p &lt; 0.001. When adjusting for age, FVA was still 0.107 lower in the Severe DED group, p = 0.003. There was significant difficulty in performing specific daily activities in the Severe DED group, after adjusting for age, gender and FVA. Conclusions: FVA is reduced in severe DED and older people. Severe DED significantly impacts certain aspects of QOL. However, no significant relationship was found between FVA and QOL. FVA is not the only reason for the compromise of health-related QOL in severe dry eye.

Measuring population health and quality of life: Developing and testing of the significant quality of life measure (SigQOLM)

Quality of life (QOL) should ideally be determined by a broader spectrum of measurable parameters. This study aims to develop and validate a study instrument that is designed to determine a holistic measure of health and non-health aspects of QOL, and it is called the ‘Significant Quality of Life Measure’ (SigQOLM). This study involves five phases which aim to (i) explore and understand the subject matter content, (ii) develop a questionnaire, (iii) assess its content validity and face validity, (iv) conduct a pilot study, and lastly (v) perform a field-test by using the questionnaire. For the field-testing phase, a cross-sectional study was conducted which elicited responses from healthcare workers via a self-administered survey for all the SigQOLM items. Based on the results, the overall framework of the SigQOLM consists of four elements, 18 domains with 69 items. The element of “Health” is measured by nine domains, while “Relationships”, “Functional activities, and “Survival” are measured by three domains respectively. The SigQOLM has been developed successfully and then validated with a high level of reliability, validity, and overall model fit. Therefore, the SigQOLM will provide researchers and policymakers another viable option to elicit a more comprehensive outcome measure of QOL which shall then enable them to implement specific interventions for improving the QOL of all the people, both healthy or otherwise.

Over 50% of self-reported burnout among Latin American orthopaedic surgeons: A cross-sectional survey on prevalence and risk factors

ObjectiveAssess the prevalence of self-reported burnout and identify risk and protective factors based on demographic and life quality aspects, among Latin American orthopaedic surgeons. MethodsThis study employed a cross-sectional analytical design. An original design survey was developed using multiple-choice and Likert-scale questions to gather self-reported burnout, demographic, work-related, social, personal, and mood-related data. The survey was electronically distributed to the Chilean Orthopaedic Surgery Society and the Latin American Society of Arthroscopy, Knee Surgery, and Sports Medicine members. Statistical analysis included Chi-square and Fisher's exact tests to determine associations between self-reported burnout and other variables. Subsequently, a multivariate logistic regression was carried out to identify key risk and protective factors (p ​< ​0.05). ResultsThe survey's response rate was 20 ​% (n ​= ​358) out of the 1779 invitations that were sent. The most representative age range was 41–60 years (50 ​%) and 94 ​% were men. Of those surveyed, 50 ​% reported a burnout episode more than once per year, 60 ​% depersonalization when treating patients at least yearly, 13 ​% anhedonia, 11 ​% a depressive mood more than half of the month or almost every day, and 61 ​% weariness at the end of a working day. Burnout was statistically associated with age under 40 years old (p ​= ​0.012), fewer years as a specialist (p ​= ​0.037), fear of lawsuits (p ​< ​0.001), a non-healthy diet (p ​= ​0.003), non-doing recreational activities (p ​= ​0.004), depersonalization when treating their patients (p ​< ​0.001), weariness (p ​< ​0.001), anhedonia (p ​< ​0.001), depressive mood (p ​< ​0.001), and career dissatisfaction (p ​< ​0.001). The logistic regression demonstrated that fear of lawsuits (p ​< ​0.001), weariness at the end of a workday (p ​= ​0.016), and anhedonia (p ​= ​0.019) were those variables with stronger direct associations with self-reported burnout. A healthy diet was the strongest protective variable (p ​< ​0.001). ConclusionOver 50 ​% of the Latin American orthopaedic surgeons who participated in the survey reported experiencing burnout episodes more than once a year, along with depersonalization when treating their patients at least once a year. Additionally, nearly 10 ​% of respondents experienced weekly depressive symptoms. Among the noteworthy risk factors for self-reported burnout were fear of lawsuits, weariness at the end of the workday, and anhedonia. Conversely, maintaining a healthy diet emerged as the most potent protective factor. Level of evidenceLevel III.

Physical capacity determines physical and mental health in patients with chronic heart failure - a case control study

Abstract Background Chronic heart failure (CHF) is associated with reduced quality of life (QoL), but underlying mechanisms are incompletely understood. In this study we aimed to assess determinants of both physical and mental functioning in patients with and without chronic heart failure and investigated the impact of physical capacity (PC). Methods This is a cross-sectional analysis conducted in two cohorts using a case-control design. Both, the case cohort (RoC-HF, n=205) and the control cohort (BioPersMed, n=1022) were prospective, single center cohort studies. The case cohort included patients with diagnosed CHF with a current left ventricular ejection fraction (LVEF) &amp;lt;50%, while the control cohort included apparently healthy individuals with at least one cardiovascular risk factor. Laboratory parameters, transthoracic echocardiography, PC (Biopersmed: 6-minute walking distance [6MWD]; RoC-HF: 4-meter gait speed [4MGS]), and SF-36 health survey parameters as the main read-out of this study, were available in all participants. Results Cases and controls were matched by age, sex and body mass index yielding a study sample of 188 vs. 188 individuals. Medians with interquartile range of NT-proBNP and LVEF were 985 (325 – 2183) pg/dl and 37 (30 – 44) % in cases, and 72 (33 - 118) pg/dl and 64 (60 – 68) % in controls. Cases had lower levels than controls regarding all eight QoL aspects of the SF-36 HS (Figure 1). Both within the case and the control cohort, measures of heart failure severity (LVEF, NT-proBNP, TAPSE) were not or only marginally associated with SF-36 HS scales. PC parameters correlated significantly with physical component summary score (PCS) both within cases and controls, and with mental component summary score (MCS) only in cases (Figure 2). Multivariate linear regression analyses with adjustment for age, sex, eGFR, LVEF, NT-proBNP and TAPSE were conducted in each cohort, respectively. Within cases, 4MGS, but not LVEF, NT-proBNP and TAPSE, was significantly associated with MCS (adjusted beta 0.228, P=0.011) and PCS (beta = 0.318, P&amp;lt;0.001). Within controls, 6MWD was significantly associated with PCS (beta = 0.332, P&amp;lt;0.001), but not with MCS (beta = -0.62, P=0.472). Conclusion In patients with CHF, impairment of both physical and mental functioning is determined by physical capacity, but not by measures of cardiac function and congestion. By contrast, only physical functioning, but not mental functioning, can be explained by PC in healthy controls. Given the increasing relevance of QoL as a patient-oriented outcome in CHF, assessment and improvement of PC should be considered essential aspects in CHF care, besides biomarker-guided improvements in cardiac function and congestion. Whether targeting PC, for instance by medical and device therapies, translates into better physical and mental well-being in CHF should be specifically addressed in randomized controlled trials.

Physical Activity Behavioral Intervention for type 2 DM Patients: A Literature Review

Various chronic and acute conditions as comorbid diseases are highly influential to the everyday life of type 2 diabetes mellitus patients, including in physical, psychological, economic, family burden, and quality of life aspects. The protocol and evaluation of this literature review used the PRISMA checklist. Using four databases; Pubmed, Science-direct, Scopus/Web of Science, and ProQuest. Five main physical activity behavioral intervention models for diabetes mellitus patients were discovered: 1. empowerment (individual and familial); 2. diabetes self-management education; 3. web-based digital health intervention; 4. motivational interviewing; and 5. SMS-based education. The five models focused on strengthening the importance of physical activity in diabetes mellitus patients’ self-management.

Quality of life measures in children with Down syndrome with disorders of gut-brain interaction.

Down syndrome (DS) is associated with multiple medical comorbidities. Perhaps related to such, caregivers of individuals with DS report lower quality of life (QoL) compared to individuals without DS. It has been shown that disorders of gut-brain interaction (DGBI) such as functional constipation (FC) and irritable bowel syndrome (IBS) are common in individuals with DS. We measured caregiver-reported QoL in individuals with DS with a DGBI and compared them to individuals with DS without a DGBI via a cross-sectional national survey. All measures of QoL were lower in those with DS who meet criteria for a DGBI compared to those with DS without a DGBI. Males and females with DS and at least one DGBI had similar QoL scores. While FC was the most common DGBI seen in individuals with DS, there was no difference in any aspect of QoL in subjects with FC when compared to individuals with other DGBIs. However, all measures of QoL were lower in those with IBS compared to individuals with other DGBIs. These findings suggest that management of gastrointestinal symptoms from DGBIs, particularly IBS, may serve as a target for increasing QoL in a notable subset of individuals with DS.

A Digital Mental Health Support Program for Depression and Anxiety in Populations With Attention-Deficit/Hyperactivity Disorder: Feasibility and Usability Study.

A total of 1 in 2 adults with attention-deficit/hyperactivity disorder (ADHD) struggles with major depressive or anxiety disorders. The co-occurrence of these disorders adds to the complexity of finding utility in as well as adherence to a treatment option. Digital therapeutic solutions may present a promising alternative treatment option that could mitigate these challenges and alleviate symptoms. This study aims to investigate (1) the feasibility and acceptance of a digital mental health intervention, (2) participants' engagement and retention levels, and (3) the potential efficacy with respect to anxiety and depression symptoms in a population with ADHD. Our main hypothesis was that a digital, data-driven, and personalized intervention for adults with coexisting ADHD and depressive or anxiety symptoms would show high engagement and adherence, which would be accompanied by a decrease in depressive and anxiety symptoms along with an increase in quality of life and life satisfaction levels. This real-world data, single-arm study included 30 adult participants with ADHD symptomatology and coexisting depressive or anxiety symptoms who joined a 16-week digital, data-driven mental health support program. This intervention is based on a combination of evidence-based approaches such as cognitive behavioral therapy, mindfulness, and positive psychology techniques. The targeted symptomatology was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Barkley Adult ADHD Rating Scale-IV. Quality of life aspects were evaluated using the Satisfaction With Life Scale and the Life Satisfaction Questionnaire, and user feedback surveys were used to assess user experience and acceptability. The study retention rate was 97% (29/30), and high engagement levels were observed, as depicted by the 69 minutes spent on the app per week, 5 emotion logs per week, and 11.5 mental health actions per week. An average decrease of 46.2% (P<.001; r=0.89) in depressive symptoms and 46.4% (P<.001; r=0.86) in anxiety symptoms was observed, with clinically significant improvement for more than half (17/30, 57% and 18/30, 60%, respectively) of the participants. This was followed by an average increase of 23% (P<.001; r=0.78) and 20% (P=.003; r=0.8) in Satisfaction With Life Scale and Life Satisfaction Questionnaire scores, respectively. The overall participant satisfaction level was 4.3 out of 5. The findings support the feasibility, acceptability, and value of the examined digital program for adults with ADHD symptomatology to address the coexisting depressive or anxiety symptoms. However, controlled trials with larger sample sizes and more diverse participant profiles are required to provide further evidence of clinical efficacy.

Threshold effect of unmet walking needs on quality of life for seniors

Walking is positively related to seniors’ Quality of Life (QoL). However, existing studies neglected the role of unmet walking needs. To address this gap, this study evaluates if and to what extent unmet walking needs affect different aspects of QoL. Ordered logistic models were applied to analyze survey data of 533 seniors from China, results suggest that unmet walking needs have overall negative correlations with all four dimensions of QoL including overall QoL, Physical Health (PhyH), Psychological Health (PsyH), and Social Health (SH). Results also support the assumption that tolerance thresholds exist when detecting correlations between unmet walking frequencies and different aspects of QoL. PsyH has the smallest tolerance threshold, followed by overall QoL and PhyH, and SH has the largest tolerance threshold. These findings provide evidence for policymakers to establish effective strategies on how to reduce unmet walking frequencies and minimize its negative effects on QoL of seniors.

Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study.

Anal fistulas often cause significant impairment to patients' health-related quality of life (HRQOL). This cross-sectional study aimed to compare the HRQOL between patients with anal fistulas with inflammatory bowel disease (IBD) and those without, hypothesizing significant differences in HRQOL scores between these groups. The secondary objectives were to identify specific aspects of life quality most affected and explore potential variables influencing HRQOL. The study was conducted at the Clinical Emergency Hospital "Pius Brinzeu" in Timisoara, Romania, using a convenience sample of 175 adult patients diagnosed with anal fistulas, stratified into IBD and non-IBD groups. Quality of life was evaluated at initial hospital admission and three months post-treatment using four questionnaires: SF-36, GIQLI, HADS, and the WHOQOL-BREF. Initial SF-36 scores were marginally lower in the IBD group, with mean physical and mental scores of 52.0 and 54.5, respectively. Both groups showed an improvement after intervention, but the mean difference was higher in the IBD group, with an increase of 1.1 in physical score. Initial GIQLI scores were significantly lower in the IBD group (110) compared to the non-IBD group (116). Post-intervention, the mean scores increased to 116 and 121, respectively. HADS scores suggested higher anxiety levels in the non-IBD group (7.5 vs. 6.1), although depression scores were similar. Post-intervention, anxiety scores decreased more substantially in the non-IBD group (-0.9 vs. -0.3). The WHOQOL-BREF scores were lower across all domains for the IBD group at the initial test (physical health: 12.4, psychological health: 14.9, social relationships: 14.4, environment: 13.0). Post-intervention, scores increased marginally in the IBD group (physical health: 12.7, psychological health: 15.9, social relationships: 14.1, environment: 13.8) but varied in the non-IBD group. HRQOL, as measured by multiple questionnaires, is impacted differently in anal fistula patients with and without IBD. These findings highlight the importance of a tailored approach to managing this patient population to improve their quality of life post-treatment.

The quality of life in primary school children according to the teaching format and motor activity

Objective. To study the impact of the duration of distance learning on the quality of life (QOL) in primary school children. Subjects and methods. An open cohort prospective study of primary school children and their parents was conducted using the Pediatric Quality of Life Inventory PedsQL 4.0ТМ. A study group included 182 children (and their parents) who had learned in the distance format for 6 months (Lugansk). A comparison group consisted of 234 primary school children (and their parents) who had had distance learning for 2 months (Rostov-on-Don). Results. The analysis of the results indicated that the first ranking place showing in discomfort and the greatest decrease in the QoL indicators in the study group was displayed by the physical functioning scale (6-month distance learning). The second ranking place belonged to school functioning, the level of which in the study group decreased by 1.27 scores compared to the baseline level. The third ranking place is shown by social functioning of primary school children, the indicators of which in the study group were 18.49 scores lower than the initial levels. Conclusion. Prolonged education of primary school children in a distance format affects all aspects of QOL. The greatest decrease in QOL indicators in younger schoolchildren during the formation of basic learning skills is observed in the field of physical, school and social functioning. The assessment of QOL by primary school children and their parents differs.

Comprehensive Geriatric Assessment and Quality of Life Aspects in Patients with Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (HNSCC).

To define frailty in older cancer patients, the aim of this study was to assess the geriatric status and quality of life (QoL) aspects in patients suffering from recurrent/metastatic head and neck squamous cell carcinoma (r/m HNSCC) under palliative treatment. A comprehensive geriatric assessment (CGA) was performed on 21 r/m HNSCC patients at two defined assessments, and the QoL aspects and the impact of descriptive data were evaluated. The Kolmogorov-Smirnov test, Spearman's rho correlation, and two-way mixed ANOVA were used for statistical analysis. All patients were found to be "frail". Pain, fatigue, and the burden of illness were the highest-rated symptoms. Oral function and orofacial appearance were highly impaired. A significant impact of descriptive data on the CGA and QoL results was found (all p ≤ 0.05). Thus, the CGA results revealed high frailty, severe comorbidities, and high impairments in QoL aspects. The CGA and QoL results were negatively affected by the primary HNSCC treatment approach, the need for prosthetic treatment, and worse oral functional capacity. Therefore, frailty in r/m HNSCC patients seems to be multidimensional. The evaluation of the CGA and QoL aspects in r/m HNSCC patients can be recommended to detect special needs, organize aftercare, and improve the support for frail and vulnerable cancer patients to create a multidisciplinary treatment approach.

Individual and Family Determinants for Quality of Life in Parents of Children With Inborn Errors of Metabolism Requiring a Restricted Diet: A Multilevel Analysis Approach

ABSTRACT Inborn errors of metabolism (IEMs) requiring a restricted diet can have a significant impact on both children and their caregivers. Previous research has shown conflicting findings in the quality of life (QoL) of caregivers specifically, as many factors can influence daily interactions: home care demands, the potential for acute health crises and hospitalization, dietary constraints, medications, and others. Influencing factors have previously been reported to include emotional, adaptive, and socioeconomic factors, and previous research has varied greatly in sample characteristics, methods of collecting data and measuring QoL, and methods of analysis. This study was performed to clarify previous findings and provide a clearer picture of QoL in parents of children with IEMs requiring a restricted diet compared with the general population based on parent self-report. The final analysis included 785 parents of 578 children with IEMs requiring a restricted diet. Quality of life was assessed using the World Health Organization Quality of Life–BREF and was compared with age- and sex-matched control subjects from the general population. Parents of children with IEMs requiring a restricted diet in this study population experienced a significantly lower QoL in the areas of physical health (mean, −6.09 [SD, 15.01]) and social relationships (mean, −6.82 [SD, 17.71]), as well as a significantly higher QoL in psychological health (mean, +3.10 [SD, 14.25]). Multivariate models were examined to determine factors responsible for these differences in QoL; parental anxiety was negatively associated with all QoL domains. Other factors negatively associated with at least 1 domain included being a father (physical health and social relationships), older parent (physical and psychological health), having an education higher than high school (psychological health), and using more social support–seeking coping strategies (physical health and environment). Factors positively associated with at least 1 domain included having an education level higher than high school (environment), being a working parent (physical and psychological health, environment), and using more positive thinking coping strategies (psychological health). Child-related factors negatively associated with parental QoL included having at least 1 disease complication (social relationships and environment) and a higher number of hospital medical providers (physical health). A child being older positively impacted parental QoL in the environment domain. It is not uncommon for parents of children with chronic diseases or impairments to experience a lower QoL. In this study, some aspects of QoL were enhanced by the demands of caregiving, and some were negatively impacted. Discrepancies in previous literature may be partially attributed to varying tests, variable characteristics within a sample (eg, longer time since diagnosis), or differences in analysis methods. The results in this study indicate a potential need for resources to support parents of children with IEMs requiring a restricted diet. Previous literature has shown efficacy in providing in-home health care professionals for occasional relief of caregiving duties for parents, as well as support groups of parents in similar situations. Parental anxiety in particular was shown to impact QoL negatively in all domains, and thus targeting interventions toward reducing parental anxiety might be one way to improve QoL. The adaptation of parents to their child's condition and to the demands of caregiving could explain some aspects of the QoL difference from the general population, but these differences should still be addressed to improve QoL.

Vaginal health and quality of sexual life of postmenopausal women on hyaluronic acid and Biosaccharide Gum-1 vaginal gel.

To evaluate the efficacy of daily vaginal gel containing hyaluronic acid (HA) and Biosaccharide Gum-1 (BG-1) on vulvovaginal atrophy (VVA) and on sexual function and quality of life (QoL). One hundred-four postmenopausal women with VVA were enrolled in the nonrandomized comparison cohort study. Of them, 50 women on HA/BG-1 participated in the study group and 54 women on lubricants/moisturizers on-demand as a control group. The primary endpoint was the efficacy of the vaginal gel on VVA evaluated by the Vaginal Health Index (VHI) score. Secondary endpoints included sexual behavior by the self-administered female sexual function index (FSFI) questionnaire, and quality of life (QoL), by the Short Form-36 questionnaire (SF-36). All symptoms of AVV improved after 12 weeks of treatment in women on HA/BG-1. The VMI, although improved at the 12-week follow-up compared to baseline, it connoted a low estrogenic stimulation value. Sexual function improved significantly in women on HA/BG-1. Moreover, women reported a significant improvement in the somatic aspects of QoL. No benefits were obtained by the women in the control group. Treatment with HA/BG-1 could have used in postmenopausal women who complain of vaginal dryness. The amelioration of VVA-related signs could improve sexual function and QoL.

The Effect of Dysphagia on Quality of Life in Stroke Patients

Purpose: Dysphagia is a prevalent condition following a stroke. Dysphagia and its implications negatively affect quality of life (QOL) aspects. The purpose of this study was to measure the effect of dysphagia on QOL aspects, and to explore its association with sociodemographic factors.Methods: This cross-sectional study included 31 stroke patients with dysphagia. The effect of dysphagia on QOL aspects was measured using the Dysphagia Handicap Index (DHI). Demographic variables included gender, age, educational level, annual family income and the time of onset of dysphagia.Results: The majority of the participants (61.3%) were male, and 67.7% were between 60-70 years old. The onset of dysphagia was less than three months for most of the patients (61.3%). The mean±SD of the DHI total score was 53.5±9.6. Furthermore, the study’s findings revealed significant mean differences in the physical subscale (&lt;i&gt;p&lt;/i&gt;=0.003), emotional subscale (&lt;i&gt;p&lt;/i&gt;=0.020), and the DHI total score (&lt;i&gt;p&lt;/i&gt;=0.005) between groups with different onsets of dysphagia. This means that the effect of dysphagia on physical and emotional aspects, as well as overall quality of life, diminishes over time following a stroke.Conclusions: This study’s results underscore the adverse effect of dysphagia on QOL aspects in stroke patients, with a gradual reduction in this impact over the post-stroke period.