Quality Of Life Assessment Research Articles

Pilot Study of Speech and Ventilation Quality of Life After Cleft Palate Repair in Chinese Patients.

This pilot study aimed to assess the quality of life (QoL) in Chinese patients with velopharyngeal competence (VPC) after primary cleft palate surgery or after secondary posterior pharyngeal flap (PPF) surgery. A two-center cross-sectional study was conducted in two stomatological hospitals in China between December 2021 and December 2022. A total of 68 patients and healthy volunteers were enrolled in this study, categorized into the control group, the group of patients with VPC after primary cleft palate repair, and the group of patients with VPC after secondary PPF. The Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) instrument and the Quebec Sleep Questionnaire (QSQ) were used for the assessment of speech-related QoL and ventilation-impairment-related QoL. Healthy subjects had better VELO total scores (speech-related QoL) than patients with VPC. Patients who reached VPC by secondary PPF surgery had better VELO scores in the domain of perception by others, compared with patients who reached VPC after the primary cleft palate surgery. Ventilation-impairment-related QoL assessment showed that patients who underwent secondary PPF surgery had worse QSQ total scores and domain scores than those who only had primary surgery. Surgical age only had a negative correlation with VELO scores of swallowing problems in patients who underwent PPF surgery. Despite achieving VPC after both primary and secondary surgery, patients could still exhibit worse speech-related QoL than healthy individuals. Among patients with VPC, patients who underwent secondary PPF could have worse ventilation-impairment-related QoL than those who only had primary cleft palate surgery. 3 Laryngoscope, 2025.

Relationship between incident cardiovascular disease and quality of life after a breast cancer diagnosis.

Breast cancer survivors are at risk for both poor quality of life (QoL) and cardiovascular disease (CVD). This study examines whether incident CVD after breast cancer independently predicts QoL. Using data from the Women's Health Initiative, we included women who were diagnosed with invasive breast cancer during follow-up and free of prevalent CVD prior to breast cancer. CVD was defined as adjudicated coronary heart disease, heart failure, or stroke. Physical and mental QoL, measured by the SF-36 Physical and Mental Component Scores (PCS and MCS, respectively), were recorded after breast cancer. Poor PCS and MCS were defined as scores < 40. We used adjusted time-dependent Cox proportional hazards models, accounting for time to CVD. Among 2912 BC survivors (mean age at BC diagnosis = 67), 1094 (37.6%) and 313 (10.7%) women had a post-breast cancer PCS and MCS score < 40, respectively, at a median of 2.5years. A higher proportion of women had poor PCS scores post-BC (37.5% vs. 19.2%, P < 0.001) but not MCS (10.4% vs. 8.2%, P = 0.10). After adjustment for key covariates, incident CVD was associated with a 1.95-fold (95% CI 1.42, 2.67) greater risk of poor PCS scores (P < 0.001), but was not associated with poor MCS (HR 1.23, 95% CI 0.57, 2.65, P = 0.59)). Incident CVD after breast cancer was associated with poor physical QoL but not mental QoL. This study highlights the importance of regular assessments of QoL and need for strategies to improve physical QoL in breast cancer survivors with CVD.

Quality of Life Outcomes With a Risk-Based Precision Testing Strategy Versus Usual Testing in Stable Patients With Suspected Coronary Disease: Results From the PRECISE Randomized Trial.

The PRECISE (Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization) trial compared an investigational precision diagnostic testing strategy (n=1057) with usual testing (n=1046) in patients with stable chest pain and suspected coronary artery disease. Quality of life (QOL) outcomes were a prespecified secondary end point. We assessed QOL by structured interviews in all trial participants at baseline and 45 days, 6 months, and 12 months postrandomization. QOL assessments included angina-related QOL (19-item Seattle Angina Questionnaire [SAQ-19]), generic health status (EQ-5D), and a 4-item care satisfaction survey (at 45 days only). The prespecified primary comparison was the 6-month SAQ Summary score outcomes (scale, 0 to 100; higher scores indicate greater health status). QOL data collection rates were high, with 99% complete baseline SAQ scores and 86.5% complete at the 6-month primary comparison follow-up. All comparisons were made as randomized. At baseline, mean SAQ Summary scores were 70.9 in the Precision Strategy group (n=1050) and 70.4 in the Usual Testing group (n=1042). By 6 months, mean SAQ Summary scores had improved to 89.9 in the Precision Strategy group and 89.2 in the Usual Testing group, with a mean adjusted difference of 0.8 (95% CI, -0.3 to 2.0). The SAQ component scores showed similar improvement from baseline in both groups and no statistically significant or clinically meaningful differences between the 2 groups at any follow-up time point. By 6 months, 66% of patients in both groups were chest pain-free. EQ-5D visual analog scores also improved from baseline and showed no difference between groups during follow-up. Care satisfaction scores were high and similar at 45 days. In stable patients with symptoms suggesting coronary artery disease, angina-related and overall QOL improved substantially over the initial 6 months independent of the testing strategy assigned. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03702244.

Effect of baseline geriatric and quality of life assessments on treatment outcomes in ECOG-ACRIN EA2186 (GIANT): A randomized phase II study of gemcitabine and nab-paclitaxel compared with 5-fluorouracil, leucovorin, and liposomal irinotecan in older patients with treatment-naïve metastatic pancreatic cancer.

676 Background: Data is lacking to guide the care of vulnerable older adults (OA) with newly diagnosed metastatic pancreatic adenocarcinoma (mPDAC). EA2186 trial demonstrated poor outcomes among vulnerable OA with mPDAC treated with dose-reduced chemotherapy. To understand the factors driving treatment outcomes in this patient population, we analyzed the correlation between baseline geriatric and quality of life (QOL) assessments and treatment outcomes. Methods: Vulnerable OA ≥70 yo with mPDAC, ECOG PS 0-2 were enrolled. Vulnerability was defined by screening geriatric assessment (GA) demonstrating mild abnormalities in function, comorbidities, cognition, or age≥80y. Pts were randomized to Arm A: Gemcitabine (1000mg/m2) + Nab-Paclitaxel (125mg/m2) q14 days or Arm B: 5-Fluorouracil (2400mg/m2 46hr) + Leucovorin (400mg/m2) + Liposomal Irinotecan (50mg/m2) q14 days. GA and QOL evaluations were completed at baseline and 3 time points. Secondary endpoints of the study included evaluating the correlation between baseline GA, QOL and treatment outcomes. Regression models were used to evaluate the associations between baseline GA and QOL factors, survival and grade 3 or higher toxicity, with 80% power to detect doubling in grade 3 toxicity for GA/QOL measures. Results: 176 pts (88 per arm) enrolled with median age 77 (range 70-90), 24% ECOG-0, 64% ECOG-1 and 12% ECOG-2. Pts were deemed vulnerable by cognition (46%), age (36%) or comorbidities (31.4%), with 35% meeting vulnerability criteria in ≥2 domains. No significant difference was seen in median OS (4.7 vs. 4.4 months; p=0.72) or ≥grade 3 toxicity rate (45.6% vs. 58.7%; p=0.10) between arms A and B, respectively. Strong correlation was found between OS and baseline instrumental activities of daily living score (HR 0.84; p=0.02), nutritional scores (HR 0.82; p&lt;0.0001), depression scores (HR 1.07; p=0.02), and scores of all QOL measures (HR 0.98; p&lt;0.0001). No correlation was found between OS and comorbidity, cognition, and Activities of Daily Living scores. After adjustment for age and PS, only baseline WBC level (OR=0.35; p=0.0054), and depression scores (OR=1.20 per score unit; p=0.021) and to a lesser extent FACT-G score (OR=0.98 per score unit; p=0.061) were found to correlate with rates of ≥grade 3 toxicity. Conclusions: Baseline GA and QOL factors among vulnerable older adults with mPDAC correlate strongly with survival and treatment tolerance. Supportive care to address these factors may favorably affect outcomes in this patient population. Clinical trial information: NCT04233866 .

Evaluating single-level vs. multi-level lateral lumbar interbody fusion: Clinical outcomes and complications.

Lateral Lumbar Interbody Fusion (LLIF) treats lumbar degenerative diseases (LDD) with spinal alignment and decompression advantages but can cause sensory and motor disturbances, especially in multilevel procedures. This study compares single-level and multi-level LLIF focusing on sensory and motor disturbances, surgical duration, and quality of life (QOL). A retrospective review of 139 patients (84 males, 55 females; average age 70years) with LDD who underwent LLIF and posterior fixation between May 2018 and January 2023 was conducted. Patients were divided into two groups: 89 patients who underwent single-level LLIF and 50 patients who underwent multi-level LLIF (two or more levels). Data on demographics, surgical details, perioperative complications, and clinical outcomes, including pain scores (Numeric Rating Scales: NRS) and QOL assessments (Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: JOABPEQ), were collected preoperatively and one year postoperatively. Statistical analysis was performed to compare the outcomes between the two groups. Patients who underwent multi-level LLIF had significantly longer operative times (145.1min vs. 98.9min, p<0.001) and higher estimated blood loss (126.5mL vs. 62.9mL, p<0.001) compared with the single-level group. Both groups significantly improved pain intensity and QOL, including NRS and JOABPEQ score, with no significant differences in perioperative complication rates (cage subsidence, motor paralysis, thigh pain/numbness) or revision rates (4% vs. 8%, p=0.396). Short-term clinical outcomes suggested that both single-level and multi-level LLIF effectively improved pain and QOL outcomes in patients with LDD.

A cross-sectional observational study of quality of life in adult short bowel syndrome patients: What role does autologous gut reconstruction play?

Intestinal failure (IF) describes a condition of insufficient absorption capacity and general function of the gastrointestinal tract and may necessitate long-term intravenous fluid and nutrient supplementation. Quality of life (QoL) may be reduced in these patients. The aim of the study was to analyze QoL by two tools (SBS-QoL and SF-12) to elucidate which parameters impact QoL in patients with IF. QoL was assessed in a cohort of 105 patients with IF at a tertiary referral center for intestinal rehabilitation. Complete data for SBS-QoL and SF-12 were available in 44 of 81 surviving patients at a single time point for a cross-sectional analysis. Medical data, outcome parameters, and comorbidities (Charlson comorbidity index [CCI]) were extracted and entered in a prospective database for analysis and correlation with QoL assessment. Subscales of SBS-QoL and SF-12 highly correlated with each other (P = -0.64 for physical subscales; P = -0.75 for mental subscales). Significant differences in QoL were detected in patients with Messing Type I (end-jejunostomy) and Type III anatomy (ileocolonic anastomosis) (one-way ANOVA: P < 0.05). Performance of autologous gut reconstruction (AGR) was associated with significantly better physical QoL. CCI correlated significantly with QoL scores. Longer duration of illness resulted in higher QoL in SBS-QoL (reduction of 0.15 per month; P = 0.045). Both SBS-QoL and SF-12 are useful to determine QoL in patients with IF. AGR was associated with improved QoL by changing SBS-related anatomy and function. Thus, AGR surgery should be included in the treatment plan whenever possible. Comorbidities should be addressed interdisciplinarily to improve QoL.

Development of the symptomatic dermographism quality of life questionnaire.

Symptomatic Dermographism (SD), also known as "urticaria factitia", is the most common subtype of chronic inducible urticaria. Affected patients develop itch and strip-shaped wheals that usually last for 30min after minor stroking, rubbing, or scratching of the skin. The quality of life (QoL) of patients with SD is often strongly affected. However, a QoL instrument to properly assess this impairment is not yet available. The aim of this study was to develop the first disease-specific patient reported outcome measure|patient reported outcome measures (PROM) to evaluate QoL impairment in SD patients, the Symptomatic Dermographism Quality of Life Questionnaire (SD-QoL). SD-QoL was developed following current guidelines for PROM development. We first generated a hypothetical conceptional framework of the SD-QoL, followed by an item generation and an item selection/reduction phase. During the item generation phase, 69 potential items of the SD-QoL were generated by applying a combined approach consisting of literature review, expert input as well as semi-structured interviews with affected patients. During the item selection phase, we reduced this long list of items to a final 13-item set by means of impact analysis, inter-item correlation, and additional criteria for item reduction, including an expert review for content (face) validity. Finally, a US-American-English version of the SD-QoL was developed using a structured translation process. The SD-QoL is the first disease-specific-QoL instrument for SD with a recall period of 7days that allows the assessment of QoL in SD patients. A subsequent validation study will determine its validity and reliability.

Quality-of-Life Measurement in Epidermolysis Bullosa. Position Statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient-Oriented Outcomes and External Experts.

In this paper, the European Academy of Dermatology and Venereology (EADV) Task Force on Quality of Life (QoL) and Patient-Oriented Outcomes presents its position statements on health-related (HR) QoL assessment in epidermolysis bullosa (EB). The EADV TF on QoL and Patient-Oriented Outcomes recommends the use of the EB-specific instrument QOLEB in patients over the age of 10 years and, in addition to the QOLEB, the use of iscorEB-p in moderate-to-severe EB; the IntoDermQoL proxy instrument with its EB-specific module should be used in children aged under 5 years. The EB-specific instrument iscorEB-p, and the dermatology-specific instrument CDLQI may measure HRQoL in children with EB aged from 5 to 10 years. Dermatology-specific and/or generic HRQoL instruments should be used to compare the impact on QoL of EB with other diseases; family QoL of patients with EB should be studied using the EB-specific EB-BoD, dermatology-specific family measures, and/or generic family QoL instruments.

Impact of signs and symptoms of dry eye disease on health-related quality of life: a cross-sectional population study among older adults.

To assess the relationship between quality of life (QoL) and ocular surface health within a Finnish population-based cohort. A cross-sectional study involved 601 individuals born between the years 1933-1956. Ocular surface health and dry eye disease (DED) were clinically evaluated using several diagnostic tests. Participants completed the Ocular Surface Disease Index (OSDI), QoL assessment with the 15D and Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and the Beck's Depression Inventory (BDI-II) questionnaires. Various statistical methods were employed to explore the associations between QoL, ocular surface health, and sex disparities. DED had negative impact on QoL in all participants, and especially in women. Adjusted for comorbidities, DED doubled the odds of worse health-related QoL (15D: OR = 2.31 [95% CI: 1.24-4.31, p < 0.01]) and mental health (SF-36 MCS and BDI-II: OR = 2.08 [95% CI: 1.04-4.16, p < 0.05]). Noninvasive tear break-up time (NIBUT) correlated with all QoL scores. In women, the most significant clinical signs correlating with low QoL were NIBUT (15D: r = 0.20, p = 0.002; SF-36 MCS: r = 0.18, p = 0.026), and conjunctival staining (15D: r=-0.19, p = 0.004; BDI-II: r = 0.27, p < 0.001), whereas in men, blepharitis correlated with depression score (BDI-II: r = 0.20, p = 0.036). High OSDI was associated with worse QoL in women, but not in men. This first population-based study assessing general QoL data with objective clinical measures of DED indicated that among elderly population, both symptoms and signs of DED independently impacted different aspects of QoL. In addition, significant sex-differences in these associations were observed and should be considered both in research settings and when assessing and treating people with DED.

Sociodemographic and Clinical Determinants of the Quality of Life of Moroccan People With Multiple Sclerosis.

The quality of life (QOL) of people with multiple sclerosis (MS) is considerably poorer than the QOL of people with other chronic diseases. QOL management should not be restricted to only clinical aspects but also factors modifying QOL. The aim of this study was to identify the sociodemographic and clinical determinants of QOL in people with MS. A cross-sectional study conducted from 2022 to 2023 included 200 participants aged 18 and over recruited from the Hassan II University Medical Hospital in Fez, Morocco. QOL assessment was performed using the Arabic version of the Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire. Univariate analysis using Student t test, analysis of variance, and Pearson correlation was performed, followed by multiple linear regression analysis to determine the main factors associated with QOL. QOL was impaired in the physical health (PH) (48.51±22.08) and mental health (MH) (48.69±17.18) components of the MSQOL-54. Male sex, unemployment, and high scores on the Expanded Disability Status Scale (EDSS) were factors significantly associated with lower scores on both the PH and MH components. In contrast, later age at MS diagnosis and older age were significantly associated with worse PH and MH, respectively. EDSS score was a strong predictor of QOL (PH: β = -34.983; 95% CI, -39.64 to -30.31; MH: β = -23.383; 95% CI, -27.62 to -19.14). The results highlight the importance of sociodemographic and clinical determinants of QOL. Clinicians need to integrate a biopsychosocial approach into therapeutic education programs, considering the risk factors and specific needs of people with MS to optimize their QOL.

P0267 Proactive Remote Monitoring of Inflammatory Bowel Disease for Improved Outcomes and Flare Prediction

Abstract Background This study evaluated a remote monitoring program for IBD patients, using a mobile app to track disease activity and improve patient-provider communication. The app included disease activity questionnaires, quality of life assessments, and home-based calprotectin tests. we aimed to develop a data-driven, patient-reported care management system for early detection of clinical flares in IBD patients, enabling timely treatment adjustments. Methods A 12-month prospective cohort study included 100 adult IBD patients. Participants completed monthly online questionnaires via the “DATOS” platform, assessing disease activity (PRO2/SCCAI), quality of life (PROMIS-10, SIBDQ), emotional state (DASS-21), and perceived disease control (IBD CONTROL). Home calprotectin tests were performed at baseline, 6 months, and 12 months. Data from 533 monthly observations were used to develop a machine learning model to predict flares. Results Among 100 patients (74% Crohn’s, 26% ulcerative colitis; median age 31 years), 94% were on biological therapy. Adherence to the remote platform declined over time (86% at 0 months, 53% at 6 months, 30% at 12 months). Over the study period, 40 flares, 14 hospitalizations, 6 surgeries, and 31 changes in biological therapy occurred. Patients experiencing a flare had significantly higher fecal calprotectin levels (mean: 901.8 vs. 330.6 mg/kg, p=0.044), as well as increased anxiety, depression, and stress (DASS-21, p&amp;lt;0.05), poorer quality of life (PROMIS-10, p=0.005; SIBDQ, p&amp;lt;0.001), and reduced perceived disease control (IBD-Control, p&amp;lt;0.001). A machine learning model incorporating calprotectin and patient-reported outcomes demonstrated a 0.85 accuracy in predicting flares. Conclusion This study demonstrates the feasibility of a remote monitoring program for IBD patients. Although the program facilitated streamlined patient follow-up, long-term adherence was challenging, highlighting the need for improvements in system usability and patient engagement. The machine-learning model, which combined fecal calprotectin and patient-reported outcomes, showed good accuracy in identifying patients at risk of flares. These findings suggest that remote monitoring, supported by machine learning, could enhance IBD management.

3D Technology for Autologous Breast Reconstruction: Increased Aesthetic Outcomes and Quality of Life Using Patient-Specific Templates.

In autologous breast reconstruction accomplishing aesthetically pleasing outcomes represents an integral challenge. 3-dimensional technology may aid in accurate flap shaping and subsequent breast appearance. The aim of this study was to evaluate the applicability of 3-dimensional technology for surgical planning and its influence on outcomes for breast reconstruction. Outcomes of 50 female patients who underwent deep epigastric artery perforator flap breast reconstruction were analyzed. The patient population was divided into 2 study groups (with 3-dimensional technology vs without) including 25 patients each. Based on individual 3-dimensional scans and simulations, patient-specific templates were used intraoperatively within the 3-dimensional group. Quality of life assessment and aesthetic evaluations of breast appearance were statistically evaluated and compared. Various scales of the BREAST-Q showed statistically significantly better values within the 3-dimensional group (p < 0.05). Concerning breast appearance, patients with 3-dimensional technology rated their breast shape and projection statistically significantly higher compared to the control group (p < 0.05). In addition, blinded ratings of external plastic surgeons were statistically significantly higher in shape, symmetry and projection of breasts using 3-dimensional technology (p < 0.05). All patients treated with 3-dimensional assisted breast reconstruction strongly recommended this approach. Using patient-specific templates represents a practical method facilitating personalized flap planning and shaping. Our results demonstrate that 3-dimensional technology significantly enhances outcomes in breast reconstruction concerning aesthetics and postoperative quality of life.

Baseline Vitamin D Levels on Quality of Life and Pain Perception Among Patients with Chronic Pain with Long-Term Prescription Opioid Use: A Prospective Study.

Objectives: To investigate the correlation between baseline serum concentrations of 25-hydroxyvitamin D (25-OHD) and quality of life (QoL), as well as pain perception in patients with chronic pain with long-term prescription opioid usage before opioid detoxification. Methods: We prospectively studied 45 patients with chronic pain with long-term prescription opioid usage who were selected for elective detoxification. Baseline serum 25-OHD levels were measured prior to detoxification, classifying patients as either vitamin D deficient (<75 nmol/L) or sufficient (≥75 nmol/L). QoL was assessed using the SF-36v2TM questionnaire, while pain levels were assessed using Visual Analogue Scale (VAS) scores before treatment. Results: Mean pain scores before detoxification of the patients with sufficient baseline 25-OHD levels vs. those with deficient levels were, respectively, 6.06 ± 2.32 vs. 6.86 ± 2.10 (normalized scores 1.22 ± 0.571 vs. 0.950 ± 0.632; p = 0.164). The analysis of SF-36v2™ questionnaire scores revealed minimal variation between groups (35.00 ± 14.198 vs. 34.97 ± 13.52), indicating no significant association between Vitamin D levels and QoL (p = 0.913). Conclusions: The analysis of baseline 25-OHD levels in relation to QoL assessments and pain scores did not reveal a statistically significant association, indicating that variations in baseline vitamin D levels may not substantially impact QoL or pain perception. Further studies may help determine how to assess and optimize vitamin D levels in patients with chronic pain on long-term prescription opioids.

Association between abnormal systemic coagulation inflammation index and recurrence of deep venous thrombosis as well as quality of life: A retrospective study.

Deep vein thrombosis (DVT) of the lower limb is a significant clinical challenge with the potential for recurrence, which can lead to increased morbidity and reduced quality of life. A retrospective case-control study was conducted involving 367 patients diagnosed with lower limb DVT from June 2020 to June 2023. Patients were categorized into a recurrence group (n = 121) and a non-recurrence group (n = 246) based on DVT occurrence. Data were systematically collected from medical records, including demographic information, thrombus characteristics, patient compliance, coagulation parameters, inflammatory markers, and quality of life assessments using the CIVIQ-20 and SF-36 scales. The recurrence group had significantly higher mean age, history of orthopedic diseases, and pregnancy, reduced compliance with compression therapy and anticoagulation, and elevated inflammatory markers including IL-6, IL-8, and TNF-α. Prolonged coagulation times (PT, APTT, TT) were associated with a lower risk of recurrence. The SCI index was significantly lower in the recurrence group. Multivariate logistic regression identified age, IL-6, IL-8, PT, APTT, TT, and SCI index as significant predictors of recurrence. Quality of life scores were lower in the recurrence group, indicating a higher impact on mental and overall health. ROC analyses demonstrated strong predictive capacity (AUC = 0.905) of SCI index. The study underscores the multifactorial nature of DVT recurrence, highlighting the role of age, systemic inflammation, coagulation times, and compliance with therapeutic interventions. The SCI index emerges as a compelling prognostic marker for assessing the risk of DVT recurrence. These findings emphasize the need for comprehensive management strategies incorporating these parameters to prevent recurrence and improve patients' quality of life.

Quality of life assessment after minimally invasive operative treatment in children with pectus excavatum: A single-center study and literature review.

Most patients with chest wall deformities have a negative body image, which affects their self-esteem and quality of life (QoL). The aim of this study was to evaluate changes in patients' QoL after minimally invasive repair of pectus excavatum (MIRPE). A prospective, single-center study was conducted between 2019 and 2023. We included 20 pediatric patients at a median age of 15 years and 9 months who underwent MIRPE. Two QoL questionnaires were used: the KIDSCREEN-52 and the EQ-5D-Y. The data were statistically analyzed with the Wilcoxon and Mann-Whitney tests. All patients and their parents were asked to complete questionnaires preoperatively and 12 months after surgical treatment. All patients were followed up during the 12-month study period. The study group was comprised of 65% male patients. The median Haller index was 5.0 standard deviation (SD) = 1.58). The assessment of general health condition was higher among the boys (with postoperative improvement), though this finding was not statistically significant. Routine daily activities were easier for all patients after MIRPE (p = 0.048). The patients showed improved physical activity (p = 0.038) and psychological wellbeing (p = 0.013) after elevation of the anterior chest wall. There was no impact on relations with parents, free time or school environment, but we found better patient contact with peers in the postoperative period. A high correlation was confirmed between the parents' and the patients' responses in each questionnaire. Chest wall deformities can have a strong impact on the patient's wellbeing, which is a very important part of psychological development in adolescents. Our study showed that improved QoL should be always considered as an indication for surgical treatment of chest wall deformities in children.

PACOPED QL: Development and evaluation of the quality-of-life scale for children with life-threatening illnesses.

This study aims to validate the Palliative and Complex Chronic Pediatric Patients QoL Inventory (PACOPED QL), a new quality-of-life (QoL) assessment tool for pediatric palliative patients with complex chronic conditions. The goal is to create a comprehensive and inclusive instrument tailored to this unique population, addressing the gap in existing tools that do not meet these specific needs. The validation process included a literature review and consultations with experts. A pilot study refined the items, followed by a cross-sectional study involving pediatric palliative patients and their caregivers. Statistical analyses, such as Cronbach's alpha for internal consistency and exploratory factor analysis for structural validity, were utilized. The PACOPED QL, comprising 50 items across 8 domains and 6 subdomains, demonstrated strong reliability with Cronbach's alpha and Guttman split-half reliability both exceeding .9. Validity assessments confirmed its suitability for children with complex illnesses. The tool was refined through expert consultations and pilot testing, reducing items from an initial 85 to a final 50, ensuring relevance and clarity. The PACOPED QL shows strong reliability and validity in assessing QoL in pediatric palliative patients. Its comprehensive structure makes it a promising tool for clinical practice and research, addressing a critical need for a tailored assessment in this population. The instrument's robust psychometric properties indicate its potential utility in improving the QoL assessment and care for children with life-threatening illnesses. Further studies are encouraged to confirm its effectiveness across various settings.

A Cross-sectional Study to Evaluate the Quality of Life among Children Diagnosed with Thalassemia Major in Gujarat

Abstract Background Thalassemia, a chronic condition that lacks an effective treatment, significantly impairs a child's quality of life (QoL), affecting academic performance and various dimensions such as physical, emotional, and social functioning. The objectives of this study are to evaluate the QoL of children with thalassemia major and to investigate the relationship with selected demographic variables of children. This study addresses the crucial need to assess the QoL among children living with thalassemia major. By evaluating QoL, health care professionals can tailor treatment approaches to improve the lives of children affected by thalassemia major. Study Design and Methods This cross-sectional analytical study was conducted at the district division of the Indian Red Cross in Ahmedabad, Gujarat. The consecutive sampling technique was used. The study included 117 children with β-thalassemia major. The QoL of children aged 8 to 18 years was evaluated in September 2021 using the Short Form-36 (SF-36) questionnaire. Statistical analysis involved mean, standard deviation, and chi-square test. Results The mean age of the participants was 14.9 ± 3.1 years. The majority of the included children (56%) received blood transfusions for 15 days. The mean total score of SF-36 was 68.62 ± 12.96. Out of the total number of children, 55 had a score of more than 70, 50 had a score between 50 and 70, and 12 had a poor QoL with a score less than 50. The chi-square analysis reveals a statistically significant association between gender perception and QoL (p = 0.033). Similarly, a notable association is noted between monthly family income and QoL (p = 0.037). Conclusion This study revealed that the QoL in children diagnosed with thalassemia major is compromised. QoL assessment should be initiated for all children with thalassemia to identify and implement essential interventions that focus on the affected domains.

Stress shielding in reverse shoulder arthroplasty using a proximally coated stem for proximal humeral fractures: Does it have clinical relevance?

To evaluate the clinical significance of stress shielding in patients who have undergone an uncemented reverse shoulder arthroplasty (RSA) with a proximally coated stem for complex proximal humeral fractures (PHF) comprising 3 or 4 parts, assessed at 2 years postoperatively. Additionally, this study aims to examine the correlation between tuberosity healing and clinical outcomes. Setting: Single Centre.Patient Selection Criteria: 43 patients underwent surgery involving a cementless RSA with an anatomical stem (Mini Stem of Zimmer Biomet ® Comprehensive System) following an acute 3- or 4-part or 4-part with luxation PHF within 4 weeks of injury. Patients who were excluded from the study included those who passed away, did not have a minimum 2-year follow-up, or had undergone cemented RSAs or alternative humeral components, as well as those who required RSA due to fracture sequelae.Outcome Measures and Comparisons: Stress shielding, tuberosity healing and its positioning were evaluated. Clinical-functional assessments were made using the Constant and ASES scores. Furthermore, quality of life assessments, including QuickDASH score, SF-12, satisfaction test (SANE) and Visual Analogue Scale (VAS) were performed. Of the total shoulders, 6 (13.9%) were excluded, leaving 37 PHFs that met the inclusion criteria. The mean age at the time of surgery was 72 years (range, 61-85). Stress shielding was observed in 31 shoulders (83.8%). There was no observed correlation between stress shielding and clinical-functional or quality of life assessments. The greater tuberosity in patients without stress shielding was found to be above the tray (66.7%) (P < 0.05). Tuberosity healing was observed in 94.6% (35/37) of the shoulders. No significant clinical difference was observed between patients with and without stress shielding in terms of short-term functional outcomes. Successful consolidation of the tuberosities can be attained even in cases with notable stress shielding. Level IV; Case Series; Treatment study.

Chronic enteropathy in dogs affects the quality of life in both dogs and their owners-are veterinarians proficient in handling the caregiver burden?

Chronic disease is generally known to affect dogs' quality of life (QoL) as well as being associated with increased strain on their owners. Gastrointestinal (GI) disease is a common problem in companion animal practice, yet little is known about the QoL of dogs with chronic enteropathy (CE) and how their owners and veterinarians assess it. The aim of this study was to explore: (i) how dog owners and veterinarians observed and evaluated QoL for dogs with chronic GI disease, (ii) how having a dog with CE affected the owner's QoL, and (iii) characteristics of the communication and relationship between the dog owner and veterinarian. Twenty owners of dogs with CE and 20 companion animal veterinarians were included in this qualitative, interview-based, exploratory study. Owners evaluated QoL based on their dog's apparent emotional state, the presence of clinical signs, or restrictions in their daily life. In their assessments, veterinarians looked at the presence or absence of normal behavior, but also at disease severity and the emotional state of the dog. The majority of owners experienced many concerns and burdens that impacted their own QoL, including daily logistical challenges, implementing therapeutic regimens such as diet restriction, administering multiple daily medications, and the strain of nursing responsibilities on the owner-dog relationship. Dog owners generally felt that communication with their veterinarians was good, while veterinarians found the communication laborious and time-consuming. In general, owners and veterinarians were aligned in their QoL assessments, and the majority of veterinarians relied heavily on the owners' input and observations. However, assessments were not done in a standardized fashion among either group. Logistical challenges of having a dog with a chronic GI disease often lead to lifestyle changes for the owners, including altering working hours and cancelling holidays or other social arrangements. Having a dog with CE therefore affected the owners' QoL even when the dogs were clinically stable. Providing owners with written material about the condition in addition to medical and feeding regimen instructions may help the owner, improve compliance, and decrease the non-billable hours the veterinarian must spend communicating with the owner about their dog's CE.

Implantable Port Catheters versus Peripherally Inserted Central Catheters for Cancer Patients Requiring Chemotherapy: An RCT-Based Meta-Analysis.

Background: Implantable port catheters (IPCs) and peripherally inserted central catheters (PICCs) are commonly used venous access methods for chemotherapy in cancer patients. However, the question of which is superior remains controversial. This meta-analysis, based on randomized controlled trials (RCTs), systematically compares the safety, cost, and impact on quality of life between these two methods. Methods: Eligible RCTs comparing IPC and PICC were identified through searches in seven databases. Complications were the primary endpoint, while secondary endpoints included cost, impact on chemotherapy, and quality of life assessments. Results: Six studies based on five RCTs, including a total of 1,127 patients, were analyzed. Patient data indicated that the PICC group experienced a higher incidence of total complications, thrombosis, deep vein thrombosis, implantation failure, unplanned catheter removal, and local reactions. Conversely, the IPC group had a higher incidence of pocket infection/exit-site infection without septicemia and pain. When considering catheter days, the PICC group again showed a higher incidence of total complications, thrombosis, deep vein thrombosis, implantation failure, unplanned catheter removal, edema, and local reactions. Complication-free survival was better in the IPC group. Although the impact on chemotherapy tended to favor the IPC group, this difference was not statistically significant. The total cost was higher in the IPC group, while the cost per catheter day was similar between the two groups. Quality of life assessments (using EORTC QLQ-C30) revealed similar global health status between the two groups during the post-implantation, mid-treatment, and end-treatment periods. However, the IPC group experienced a smaller decline in global health status post-implantation compared to the PICC group. Conclusions: Compared to PICC, IPC appears to be a safer and more comfortable intravenous catheterization option for cancer patients undergoing chemotherapy.