Functional Assessment Research Articles

Content comparison of multidimensional functional outcome measures in rehabilitation and the ICF clinical functioning information tool: A scoping literature review

Background: The ICF-based Clinical Functioning Information Tool (ClinFIT) was developed as a standardized tool to facilitate the assessment of functioning in clinical and, research settings. Objective: This review describes the contents of commonly used multidimensional outcome measures that describe functioning in rehabilitation settings and maps these measures to ICF categories covered by the ClinFIT to identify commonalities and discrepancies in the content. Methods: A scoping review included a systematic search of PubMed, Embase, Cochrane Library, and other resources. Twelve outcome measures were selected, and their meaningful concepts were linked to the ClinFIT by 2 authors using established ICF linking rules. Content density, bandwidth, and content diversity indices were calculated for each measure. Results: A total of 369 meaningful concepts from the 292 items from 12 measures were selected. Of these, 293 (79.4%) concepts were linked to the ClinFIT categories, with a majority (80.5%) linked to “activities and participation”; however, 76 (20.6%) meaningful concepts could not be linked to any ClinFIT categories. The extent of content coverage varied significantly between measures, reflecting the differences in the scope of each measure. The “activity and participation” categories had the highest bandwidth for all measures (range: 28.6%–71.4%), while the “body function” category was less represented (range: 0%–33.3%). Conclusions: ClinFIT can be the useful outcome measure for functional assessment in rehabilitation settings, as it covers wider concepts, considered important in rehabilitation settings, compared with other common functional outcome measures. It can establish comparability of a minimal data set on functional outcomes across various medical conditions and settings.

Factors of individual differences between the speeds of the hand and ball during baseball pitching: Assessment of middle finger function based on the hierarchical linear model

ABSTRACT This study aimed to reveal individual differences between the speeds of the hand and ball and clarify the factors affecting those differences. Motion data from 20 highly skilled baseball pitchers, captured using a 16-camera motion analysis system with a sampling frequency of 1,000 hz, were used for correlation and hierarchical linear model analyses. For the hierarchical linear models, the speed of the metacarpophalangeal joint was the independent variable in the 1st level. The independent variables chosen in the 2nd level were the variables regarding the finger length, mean peak angular velocities, and mean peak accelerations of the middle finger joint. Intra-subject correlation analysis showed high positive correlation coefficients between the metacarpophalangeal joint and ball speeds, ranging from 0.803 to 0.992. The difference between the hand and ball speeds ranged from 8.4 m∙s−1 to 12.0 m∙s−1. The hierarchical linear model analyses indicated that the individual differences between the speeds of the hand and ball were partly accounted for by the mean peak accelerations of the proximal and distal interphalangeal joints, suggesting that the force exerted by proximal interphalangeal joint flexion plays an important role in ball speed increment.

Introduction of AI Technology for Objective Physical Function Assessment

Objective physical function assessment is crucial for determining patient eligibility for treatment and adjusting the treatment intensity. Existing assessments, such as performance status, are not well standardized, despite their frequent use in daily clinical practice. This paper explored how artificial intelligence (AI) could predict physical function scores from various patient data sources and reviewed methods to measure objective physical function using this technology. This review included relevant articles published in English that were retrieved from PubMed. These studies utilized AI technology to predict physical function indices from patient data extracted from videos, sensors, or electronic health records, thereby eliminating manual measurements. Studies that used AI technology solely to automate traditional evaluations were excluded. These technologies are recommended for future clinical systems that perform repeated objective physical function assessments in all patients without requiring extra time, personnel, or resources. This enables the detection of minimal changes in a patient’s condition, enabling early intervention and enhanced outcomes.

The prevalence and clinical correlation factors of cognitive impairment in patients with major depressive disorder hospitalized during the acute phase

ObjectiveThis study aimed to investigate the prevalence of cognitive impairment among patients with major depressive disorder (MDD) hospitalized during the acute phase and to analyze the in-depth association between this cognitive impairment and clinical correlation factors.MethodsIn this cross-sectional study, we recruited 126 patients aged between 18 and 65 years who were diagnosed with MDD. All these patients were inpatients from the Department of Psychiatry at the Second People’s Hospital of Hunan Province. We employed a series of assessment tools, including the Pittsburgh Sleep Quality Index (PSQI), the 16-item Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), the Pre-sleep Arousal Scale (PSAS), the Morningness-Eveningness Questionnaire (MEQ), the Hamilton Anxiety Rating Scale (HAMA), and the 17-item Hamilton Depression Rating Scale (HAMD-17). The patients were divided into a cognitive impairment group and a non-cognitive impairment group based on their scores on the Montreal Cognitive Assessment Scale (MoCA). Through Spearman’s correlation analysis, we explored the correlation between the total MoCA score and the score of each factor. Additionally, we utilized binary logistic regression analysis to investigate the relationship between cognitive impairment and clinically relevant factors in MDD patients hospitalized during the acute phase and plotted ROC curves to evaluate their clinical efficacy.ResultsIn this study, we found that the prevalence of cognitive impairment among MDD patients hospitalized during the acute phase was as high as 63.49%. Through statistical analysis, we observed significant differences between the cognitive impairment group and the non-cognitive impairment group in terms of age, place of residence, education level, and HAMD-17 scores. In the Spearman correlation analysis, we noted the following trends: visuospatial and executive abilities were negatively correlated with the HAMD-17 score (P < 0.05); naming ability was positively correlated with the PSAS score but negatively correlated with the MEQ score (P < 0.05); memory was also negatively correlated with the MEQ score (P < 0.05); attention was negatively correlated with the HAMA score; and abstract cognitive ability was negatively correlated with the MEQ score (P < 0.05). Through binary logistic regression analysis, we further revealed the relationship between cognitive impairment and factors such as living in a rural area (OR = 2.7, 95% CI = 1.083-6.731, P < 0.05), increased age (OR = 1.049, 95% CI = 1.013-1.087, P < 0.01), and the HAMD-17 score (OR = 1.10295, 95% CI = 1.031-11.79, P < 0.01). Additionally, ROC curve analysis demonstrated a significant correlation between the HAMD-17 score and the prediction of cognitive function in MDD patients hospitalized during the acute phase (P < 0.001). Specifically, the AUC for the HAMD-17 score was 0.73, with an optimal cut-off value of 19.5, sensitivity of 70.0%, and specificity of 63.0%. Furthermore, the AUC for age was 0.71, with an optimal cut-off value of 33.5, sensitivity of 59.0%, and specificity of 80.0%.ConclusionsThis study indicates that MDD patients hospitalized during the acute phase have a higher prevalence of cognitive impairment. This phenomenon reflects a significant correlation between clinical factors such as age, sleep-related characteristics, and the severity of depression with cognitive impairment. Therefore, regular assessment of cognitive function in MDD patients and early intervention may be crucial for the treatment and prognosis of the disease.

Screening electro-oculography protocol as a part of full-field electroretinography.

To simplify the electro-oculography (EOG) method and integrate it into the full-field electroretinogram (ffERG) protocol for screening purposes. 20 control subjects and 5 patients with Best vitelliform macular dystrophy (BVMD) underwent EOG recording according to both the standard protocol and screening EOG protocol that was integrated as part of ffERG testing. Mean values of light peak-to-dark trough ratio (LP:DT ratio) were compared between both protocols using the Student's t-test, sensitivity and specificity for the detection of RPE dysfunction were evaluated with ROC analysis and a survey on the difficulty of each protocol was completed by each subject. With the standard EOG mean LP:DT ratio was 2.67 ± 0.61 in controls and 1.12 ± 0.16 in BVMD patients (p < 0.001). With the screening protocol mean LP:DT ratio was 1.98 ± 0.33 in controls and 1.02 ± 0.14 in BVMD (p < 0.001). A comparison of LP:DT ratios showed significant difference between the standard and the screening protocol (p < 0.01 in controls; p = 0.02 in BVMD), however both protocols showed 100% sensitivity and 100% specificity for detection of BVMD. Patients stated that participation in the screening protocol was easier and less uncomfortable. Screening EOG performed as part of ffERG gives comparable results to standard EOG, examination is patient-friendly, time saving and can be used as a preliminary test for the assessment of RPE function.

Preliminary report: Reduced hand sensory and motor function in persons living with heart failure.

Despite the growing evidence highlighting reduced functional independence in persons living with heart failure (PwHF), the underlying mechanisms that lead to reduced functional independence in this patient population are unknown. Given the association between functional independence and fine motor skills, which are functionally related to hand sensory and motor functions, we hypothesized that PwHF exhibit reduced sensory and motor function of hands compared to healthy individuals. We recruited a total of 10 PwHF (age: 57.6 ± 12.5 years old, four females) and a total of age- & sex-matched healthy control individuals (age: 58.2 ± 12.2 years old, four females). Participants performed a wide range of tests assessing the level of independence, fitness, cognitive function, and hand sensorimotor function. While the level of independence was comparable between two groups, PwHF exhibited reduced sensory and motor function. Compared to healthy participants, the ability to identify an object via tactile and proprioceptive inputs was reduced in PwHF, though the tactile mechanoreceptor function showed normal integrity. Similarly, PwHF exhibited a decline in manipulating small objects and steady grip force production. Heart failure seems to have repercussions that extend to the sensorimotor control of hand actions in advance to a decline in functional independence. These results underscore the need of further investigation as to the underlying mechanisms of reduced sensorimotor function, potential intervention targets, and determine whether assessments of hand sensorimotor function can serve as a vehicle to quantify restoration of self-care functionality.

Early Palliative Care in Advanced Non-Small Cell Lung Cancer Patients: A Meta-Analysis.

This study aims to assess the efficacy of Early Palliative Care (EPC) in non-small cell lung cancer (NSCLC) through a meta-analysis approach. A computerized search was conducted in databases such as PubMed, Cochrane Library, Scopus, Embase, and Web of Science for prospective randomized controlled trials (RCTs) investigating the application of EPC in advanced NSCLC. Outcome measures including Overall Survival (OS), quality of life, and psychological status were extracted and subjected to pooled analysis. After the computerized search, a total of 7 studies comprising 1185 participants were included, with 597 patients receiving EPC intervention and 588 patients receiving Standard Care (SC) intervention. Three studies reported OS after the intervention, demonstrating a significant improvement in OS for patients receiving EPC (pooled HR = 1.60, 95% CI: 1.22, 1.98). Five studies analyzed the Functional Assessment of Cancer Therapy (FACT) scores after the intervention, revealing a significant improvement in FACT scores for patients receiving EPC (pooled SMD = 1.18, 95% CI: 1.04, 1.31). No significant differences were found in anxiety and depression scores between the 2 interventions in the 5 studies. In advanced NSCLC, EPC provides benefits in terms of increased survival rates and improved quality of life. EPC should be considered as part of multidisciplinary treatment for patients with advanced NSCLC.

Evaluating Meaningful Changes in Patient-Reported Outcome Measurement Information System-Fatigue Scores from Three Phase 3 Clinical Trials of Sarilumab for Patients With Rheumatoid Arthritis.

The aim of this study was to evaluate changes in fatigue measured by Patient-Reported Outcome Measurement Information System (PROMIS)-Fatigue scores in patients with rheumatoid arthritis (RA) who received sarilumab and to assess the proportion of patients achieving clinically meaningful change. Data from three phase 3 randomized controlled trials of patients with RA who received sarilumab-MOBILITY, TARGET, and MONARCH-were evaluated. The 10 RA-relevant items from the 13-item Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue were scored in the PROMIS T score metric. Mean changes in 10-item PROMIS-Fatigue T score (PROMIS-Fatigue 10a) were compared, proportions of patients reporting meaningful within-person change thresholds were assessed, and results were visualized using empirical cumulative distribution function (eCDF) curves. Patients with RA reported high baseline fatigue. Using PROMIS-Fatigue 10a, at week 24, patients receiving 150 or 200 mg sarilumab every other week in MOBILITY and TARGET had rapidly and significantly improved mean levels of fatigue compared to those who received placebo. When compared to patients who received adalimumab in MONARCH, patients who received sarilumab had a trend toward increased improvement. eCDF curves showed separation between active treatment versus placebo with both sarilumab doses and across the score range for improvement. Higher proportions of patients reported three-, five-, and seven-point improvements in PROMIS-Fatigue scores in groups who received active treatment. Substantial proportions of patients with RA who received sarilumab reported meaningful change in fatigue measured by PROMIS-Fatigue 10a over time. This study demonstrates the ability to convert FACIT-Fatigue score onto the PROMIS T score metric, the rapid reduction in fatigue with biologic therapies, and the use of novel eCDF curves to show individual patient-level change.

In Vivo Functional Assessment of Rat Masseter Muscle Following Surgical Creation of a Volumetric Muscle Loss (VML) Injury

In Vivo Functional Assessment of Rat Masseter Muscle Following Surgical Creation of a Volumetric Muscle Loss (VML) Injury

Functional Cognition: Moving the Field Forward.

The concept of functional cognition has been variously defined, but at its core relates to how cognitive and performance abilities are integrated and used in everyday life. Functional cognition is a fundamental element of occupational performance, and functional cognitive assessment and intervention are central to how occupational therapy can improve client outcomes. Attendees at a conference convened by the American Occupational Therapy Foundation identified areas where the construct of functional cognition required further clarification. This paper briefly reviews these issues setting the stage for further conceptual analysis. The paper also examines the practical challenges that must be addressed before functional cognitive assessment and intervention can be fully integrated into occupational therapy practitioners' professional practice. Potential routes to address these challenges are identified.

Quercetin and its potential therapeutic effects on aluminum phosphide-induced cardiotoxicity in rats: Role of NOX4, FOXO1, ERK1/2, and NF-κB.

Acute Aluminum phosphide (AlP) poisoning poses a serious global issue, yet the exact mechanisms behind AlP-induced cardiotoxicity are still not well understood. Moreover, there is no specific antidote available for AlP toxicity. Nevertheless, Quercetin (QE) has emerged as a promising therapeutic candidate in various contexts. Accordingly, our study aimed to evaluate the QE potential therapeutic effects against AlP-induced cardiotoxicity and the mechanisms underlying such effects. Rats were assigned into four groups: Group I (control group), Group II (vehicle (corn oil) group), Group III (AlP group) received a single dose of AlP (10 mg/kg body weight) dissolved in corn oil by oral gavage, and Group IV (AlP + QE group) received a single dose of QE (400 mg/kg body weight) dissolved in saline, one hour after AlP administration. AlP-induced cardiotoxicity was evidenced by the increase in cardiac troponin I (cTnI) as well as the hemodynamic, ECG, and histopathological abnormalities. The AlP group denoted a decrease of the antioxidant enzymes; catalase and SOD and an increase of the lipid peroxidation marker; MDA. This was associated with a notable increase in inflammatory cytokines (TNFα, IL-6, and IL1β), in addition to a significant upregulation of the expression of NOX4, FOXO1, ERK1/2, and NF-κB. Moreover, Caspase3, and BAX showed strong immunopositive expression, while Bcl-2 showed mild immunoexpression. On the other hand, treatment with QE showed an improvement in the cardiotoxic effects of AlP, as indicated by significant enhancements in biomarkers, functional assessments, and histopathological findings. These results suggest that QE may be a promising candidate for treating AlP-induced cardiotoxicity, attributed to its antioxidant, anti-inflammatory, and anti-apoptotic properties, particularly emphasizing the roles of NOX4, FOXO1, ERK1/2, and NF-κB.

Occurrence of protease-like catalytic activity in the polyclonal IgG in schizophrenia and bipolar disorder.

Neuro-immune dysfunction and inflammation are said to be involved in the aetiology of major mental illnesses. This study describes the assessment of the protease-like catalytic function of serum IgG in psychiatric disorders, schizophrenia and bipolar disorder, along with healthy controls of Indian ethnicity. Systemic lupus erythematosus patients experiencing neuropsychiatry conditions were included as comparators for the comprehensive evaluation of IgG catalytic function. The catalytic activity of serum IgG was determined using the generic peptide substrate Pro-Phe-Arg-methylcoumarylamide, and then the apparent kinetic data was computed. Compared to healthy controls (n = 25), the activity of those with schizophrenia (n = 30) was found to be 11-fold higher. The neuropsychiatry lupus patients (n = 25) exhibited 2.7 times less activity than the schizophrenia group. The IgG activity of the bipolar patients' (n = 30) were found to be 2.9 and 12 times higher than lupus and healthy controls. IgG activity showed a modest, no significant, link with PANSS positive and negative disease scores, in a subset of schizophrenia patients. The study's findings express presence of catalytic antibodies in the blood as well as neuro-immune dysfunction in major psychosis disorders. In addition, subsets of schizophrenia patients indicate presence of autoimmune component in them.

"No doctor ever asked me…so I thought it wasn't a valid concern":endometriosis patients' perspectives of barriers and facilitators to sexual health communication in general practice.

Sexual health communication between general practitioners (GPs) and individuals with chronic diseases is well documented as an important component of sexual well-being. However, a notable gap exists in understanding factors that contribute to sexual health communication in the endometriosis context. Endometriosis-related research has focused on the assessment of sexual functioning and its role in influencing health-related quality of life, with a limited understanding of the management of sexual well-being in primary healthcare settings. To explore how individuals with endometriosis perceive their experiences of sexual health communication with GPs to understand the barriers and facilitators of this communication in general practice. This study formed part of a larger online quantitative survey measuring psychological and sexual well-being in individuals with endometriosis. In total 141 participants provided responses via open-ended unlimited free-text questions focused on their experiences of sexual health communication with GPs, including their perspectives on barriers and facilitators. Four overarching themes regarding barriers to sexual health communication were identified through thematic template analysis: (1) systemic factors; (2) practitioner factors; (3) patient factors; and (4) interpersonal factors. Facilitators mirrored strategies to address these barriers. Additionally, participants offered recommendations for developing resources to improve sexual health communication. Despite patients' interest, sexual health concerns in endometriosis are commonly overlooked in general practice due to various barriers, which individuals suggest could be addressed through comprehensive GP education and practical aids including communication tools. Although the sample is large for a qualitative study, the potential selection bias-stemming from participants' high levels of sexual dysfunction and motivation to discuss sexual health with a GP-may limit the diversity of perspectives. GP perspectives were not evaluated, precluding any assessment of the accuracy of individuals' perceptions of practitioner factors. Individuals with endometriosis encounter various systematic, practitioner, personal, and interpersonal factors that hinder or facilitate sexual health communication in general practice. Future research should prioritize strategies to improve sexual health communication for both GPs and patients.

Diagnosis and evaluation of small airway disease and COPD using impulse oscillometry.

Impulse oscillometry (IOS) is a sensitive tool for assessing small airway function in patients with chronic obstructive pulmonary disease (COPD). This study aimed to differentiate between COPD, small airway disease (SAD), and normal groups using IOS, and to evaluate the clinical applicability of IOS. This retrospective cohort study was conducted from January 2020 to February 2022. The eligible population comprised adult patients who simultaneously underwent IOS and pulmonary function tests. The diagnostic value of IOS in differentiating SAD and/or COPD from control was analyzed, and the correlations among IOS parameters, lung function, and radiological assessment results were determined. Among the enrolled 306 patients, 38 (12.4%) had SAD and 134 (43.8%) had COPD. The remainder comprised the control group without COPD and/or SAD. Abnormal airway resistance according to IOS parameters was detected in 17.2% of the patients in the control group, 47.2% of those in the SAD group, and 55.2% of those in the COPD group. Airway resistance estimated by IOS were significantly higher in the SAD and COPD groups than in the control group and correlated with lung function and radiological airway wall thickness. We developed a composite index called the IOS severity index (IOSsi) using IOS parameters that can predict SAD and COPD, and IOSsi showed significantly differentiation of SAD and/or COPD from control. Especially, IOSsi value ≥ 4 was associated with an increased risk of SAD and/or COPD and also with risk for moderate-to-severe exacerbation in patients with COPD. IOS may be a useful tool to differentiate disease status and evaluate disease severity and prognosis in patients with SAD and/or COPD, and a prognostic factor of COPD.

Identifying thresholds for meaningful improvements in NTDT-PRO scores to support conclusions about treatment benefit in clinical studies of patients with non-transfusion-dependent beta-thalassaemia: analysis of pooled data from a phase 2, double-blind, placebo-controlled, randomised trial

ObjectivesTo estimate thresholds for defining meaningful within-patient improvement from baseline to weeks 13–24 and interpreting meaningfulness of between-group difference for the non-transfusion-dependent beta-thalassaemia patient-reported outcome (NTDT-PRO) tiredness/weakness (T/W) and shortness...

HPB SO64 - Outcomes of liver resection for hepatocellular cancer with or without liver functional assessment using Tc 99m Mebrofenate SPECT-CT, portal pressures: A comparative study

Abstract Background Presence of background liver disease increases the post operative morbidity and mortality among patients undergoing liver resection for hepatocellular carcinoma (HCC). These patients need evaluation of background liver function and portal hypertension, in addition to the conventional risk assessment. The current study aims to look at the outcomes of liver resections performed for HCC cases comparing cohorts with conventional risk assessment (CA) and those with functional assessment (FA) of background liver. Method A retrospective study including all liver resections for HCC cases performed in our tertiary care hepatobiliary unit between 2013 and 2022 (10 years) was conducted. A pathway for liver functional assessment using Tc 99m Mebrofenate SPECT-CT, and portal pressures (cut-off values of 2.79/min/m2 and 10mmHg, respectively) was included in the departmental protocol in December 2018. Data on demographics, underlying degree of liver cirrhosis, types of liver resection and post-operative outcomes including post-hepatectomy liver failure (PHLF) were collected and reported using descriptive statistics. Results 200 liver resections, performed for HCC between 2013 and 2022, were divided into a conventional (126 patients) and functional (74 patients) assessment groups. Median age (68 years) was similar. Background liver cirrhosis was present in 27 (21%) vs 19 (26%) cases, and major resections were performed in 47 (37%) and 10 (13%) cases in the CA and FA groups respectively. In the CA group, 90-day mortality was 7% (compared to FA group (1%) (p=0.26). None of the patients in FA group was found to have PHLF whereas 3 patients each had PHLF grade B and C in the conventional group. Conclusion Formal functional assessment of the background liver by evaluating the function of future liver remnant and presence of portal hypertension helps in selection of patients for appropriate surgical treatment options and improve the post-operative outcomes.

OGC SO07 - A retrospective service evaluation of the impact of a dedicated oesophago-gastric cancer (OGC) dietitian in the OG surgical oncology team

Abstract Background Patients with OGC frequently present with malnutrition. Oncological care pathways advocate for dietitian’s to be essential member’s of the multi-disciplinary team (MDT), as it is well-established that malnutrition significantly increases rates of post-operative complications, length-of-stay (LoS) and mortality. However, due to financial constraints, specialist OGC dietetic support is not always resourced. To reduce the potential for nutrition related incidents, a dedicated OGC dietitian’s post was funded to support the pre-operative nutritional optimisation of OGC patients. The aim of this service evaluation was to evaluate the OGC dietitian’s impact on dietetic and surgical outcomes in a tertiary referral centre. Method The OGC dietitian reviewed all potentially curative patients at or within 48 hours of their first OGC surgical clinic; compared to &amp;gt;8 weeks pre-dietitian, with some patients not even reviewed before surgery. Weekly telephone or face-to-face dietetic-led clinics enabled more functional assessments (hand-grip strength (HGS)). Attendance to MDT was mandatory. Dietetic and surgical outcome data was collected for curative patients between July 2022 and April 2023 (pre-dietitian) (n=25) and July 2023 and April 2024 (OGC dietitian in-post) (n=19). Patient reported experience measures (PREMs) were collected. Data was analysed on excel. Ethical approval was not needed for this retrospective service evaluation. Results Pre-dietitian, 28% (n=7) experienced &amp;gt;5% (clinically significant) pre-operative weight loss compared to 11% (n=2) post-dietitian. 58% (n=12) patient’s post-dietitian gained weight from first dietetic contact up until date of surgery, compared to 44% (n=11) pre-dietitian. Mean HGS increased by 1.3kg (SD 2.77) from pre-operative to post-operative dietetic assessments in patients with OGC dietitian. More patient’s pre-dietitian experienced post-operative complications (42%) compared to post-dietitian at 31%. Average post-operative LoS was 19 days pre-dietitian versus 15 days post. 100% positive feedback was received from completed PREMs regarding OGC dietitian, with themes including consistent and timely communication, in-depth knowledge and empathy and compassion. Conclusion Mandatory inclusion of dietitians within the OGC pathway can support the pre-operative optimisation of patients, and impact positively on patient surgical outcomes. This service evaluation demonstrates that with increased dietetic contact, patients experience less clinically important weight loss, whilst feeling empowered and confident in their nutritional care. More research in a larger cohort of patients is required to provide an adequately powered study.

Sexual dysfunction in lymphoma survivors: a scoping review.

Lymphoma and cancer-related treatment can cause many complications, including sexual dysfunction, a common symptom experienced by lymphoma survivors during the disease trajectory and survivorship. A scoping review was performed to determine the current state of knowledge about sexual dysfunction in lymphoma survivors and identify knowledge gaps and implications for future research. PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched to identify all primary peer-reviewed research articles published in the English language that were pertinent to sexual dysfunction in lymphoma survivors. The framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist were used to assess and synthesize the available evidence on sexual dysfunction in lymphoma survivors. This review provided supportive evidence that sexual function in lymphoma survivors is a major ongoing area of concern. Thirty eligible articles published from 1979 to 2023 were appraised in this review. Most of the studies (73.33%) used a cross-sectional design. Using the Methodological Index for Non-Randomized Studies, more than half of the publications (53.33%) achieved a C quality ranking. The reviewed studies revealed that sexual dysfunction was a prevalent symptom experienced by lymphoma survivors, with predictors such as age, gender, sex hormones, stage of disease, and types of cancer treatment. Healthcare providers need to consistently perform routine assessment of sexual function and provide adequate treatment options. The reviewed studies document the problem of sexual dysfunction and offer potential areas of improvement for clinical practice. However, in the majority of the studies, longitudinal data were not obtained which could provide valuable insights on sexual functioning in lymphoma survivors. Despite many years of research on sexual function in lymphoma survivors, substantial gaps in knowledge regarding sexual issues in this population remain. Healthcare providers should routinely assess sexual function of survivors and provide treatment options. Psychosexual interventions should be tailored for the needs of cancer survivors. Sexual function education is essential for all oncologists and should be included in the care pathway from diagnosis until survivorship.

Psychometric evaluation of the Functional Assessment of chronic illness therapy-fatigue (FACIT-Fatigue) in adults with moderately to severely active Crohn's disease.

To provide further evidence on the psychometric properties of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) in moderately to severely active Crohn's disease (CD), and to determine thresholds for meaningful improvement in fatigue. The FACIT-Fatigue is a 13-item patient-reported outcome measure (range, 0-52) assessing fatigue over the previous week. Using pooled data from the Phase 3 VIVID-1 study of moderately to severely active CD, psychometric properties of FACIT-Fatigue were evaluated up to Week 52. The Patient Global Rating of Severity (PGRS) and Patient Global Impression of Change (PGIC) were used as primary anchors to estimate the FACIT-Fatigue score change representing meaningful improvement. Psychometric analyses included 1065 adults. The FACIT-Fatigue demonstrated good internal consistency, and correlations between individual items and the total score were moderate to strong. The FACIT-Fatigue score showed moderate to strong correlations with other patient-reported assessments and weak correlations with endoscopic/laboratory assessments. The FACIT-Fatigue differentiated between distinct groups of participants varying in disease severity, quality of life, and fatigue based on PGRS and other assessments. FACIT-Fatigue improvements during the study differed significantly between most PGRS change and PGIC categories. Anchor-based estimates suggested a 6-9-point increase in the FACIT-Fatigue total score as meaningful improvement. The FACIT-Fatigue demonstrated strong psychometric properties in the VIVID-1 population of adults with moderately to severely active CD and determined a FACIT-Fatigue score change threshold representing meaningful improvement. NCT03926130. Registered 23 April 2019, https://clinicaltrials.gov/study/NCT03926130 .

Factors Affecting Life Satisfaction Among People With Physical Disabilities During COVID-19: Observational Evidence from a Korean Cohort Study.

To determine the factors influencing the life satisfaction of people with physical disabilities during the COVID-19 pandemic, considering demographics, disability-related characteristics, health behaviors, and psychosocial characteristics. We used cross-sectional data from 301 respondents of the 2021/2022 survey of the Korean Health Cohort Study for People with Physical Disabilities. Descriptive statistics were used to analyze the research subjects' characteristics, and chi-square tests and multiple logistic regression were used to identify the determinants of life satisfaction. Among socio demographic variables, occupation had a strong association with life satisfaction. Significant health behavior variables included daily regular meals, weight control effort, and chronic pain. All psychosocial characteristics (perceived stress, depression, suicidal ideation, cognitive function assessment, subjective health status, family satisfaction, income satisfaction) were strongly associated with life satisfaction. Results of the analysis of factors affecting life satisfaction showed that unemployment, lack of regular exercise, elevated stress, suicidal thoughts, and dissatisfaction with family contributed to increased life dissatisfaction. Economic support through job creation that considers the specific characteristics of people with disabilities, and social access through community integration services that encourage participation in social activities, should be prioritized.