Bodily Pain Dimension Research Articles

Health-related quality of life after surviving intensive care for COVID-19: a prospective multicenter cohort study

In survivors of severe coronavirus disease 2019 (COVID-19) incomplete mental and physical recovery may considerably impact daily activities and health-related quality of life (HRQoL). HRQoL can be evaluated with the RAND-36 questionnaire, a multidimensional instrument that assesses physical and mental aspects of health in eight dimensions. The objective was to investigate HRQoL in intensive care patients previously treated for COVID-19 at three Nordic university hospitals, in a prospective multi-center cohort study. HRQoL was measured using RAND-36, 3–9 months after discharge from intensive care units (ICU). One hospital performed a second follow-up 12 months after discharge. A score under the lower limit of the 95% confidence interval in the reference cohorts was considered as significantly reduced HRQoL. We screened 542 and included 252 patients. There was more than twice as many male (174) as female (78) patients and the median age was 61 (interquartile range, IQR 52–69) years. Hypertension was the most common comorbidity observed in 132 (52%) patients and 121 (48%) patients were mechanically ventilated for a median of 8 (IQR 4–14) days. In RAND-36 physical functioning, physical role functioning, general health (p < 0.001 for all) and social functioning (p < 0.05) were below reference, whereas bodily pain, emotional role functioning and mental health were not. In a time-to-event analysis female sex was associated with a decreased chance of reaching the reference HRQoL in the physical function, bodily pain and mental health dimensions. Higher body mass index was found in the physical functioning dimension and hypertension in the physical functioning, vitality and social functioning dimensions. Similar results were seen for diabetes mellitus in general health, vitality and mental health dimensions, as well as pulmonary illness in the physical role functioning dimension and psychiatric diagnosis in the social functioning dimension. Mechanical ventilation was associated with a decreased likelihood of achieving reference HRQoL in the bodily pain and physical functioning dimensions. Patients treated in an ICU because of COVID-19 had lower HRQoL 3–9 months after ICU discharge than 95% of the general population. Physical dimensions were more severely affected than mental dimensions. Female sex and several comorbidities were associated with a slower rate of recovery.Study registration: clinicaltrials.gov: NCT04316884 registered on the 13th of March 2020, NCT04474249 registered on the 29th of June 2020 and NCT04864938 registered on the 4th of April 2021.

Addition of preoperative transversus abdominis plane block to multimodal analgesia in open gynecological surgery: a randomized controlled trial

BackgroundTransversus abdominis plane (TAP) block can provide effective analgesia for abdominal surgery. However, it was questionable whether TAP had additional effect in the context of multimodal analgesia (MMA). Therefore, this study aimed to assess the additional analgesic effect of preoperative TAP block when added to MMA protocol in open gynecological surgery.MethodsIn this prospective, randomized-controlled trial, 64 patients scheduled for open gynecological surgery were randomized to receive preoperative TAP block (Study group, n = 32) or placebo (Control group, n = 32) in addition to MMA protocol comprising dexamethasone, acetaminophen, flurbiprofen and celecoxib, and rescued morphine analgesia. The primary outcome was rescued morphine within 24 h after surgery. Secondary outcomes included pain scores, adverse effects, quality of recovery measured by 40-item quality of recovery questionnaire score (QoR-40) at 24 h, and quality of life measured with short-form health survey (SF − 36) on postoperative day (POD) 30.ResultsThe Study group had less rescued morphine than the control group within 24 h [5 (2–9) vs. 8.5 (5–12.8) mg, P = 0.013]. The Study group had lower pain scores at 1 h [3 (2–4) vs. 4 (3–5), P = 0.007], 2 h [3 (2–4) vs. 3.5 (3–5), P = 0.010] and 6 h [3 (2–3) vs. 3 (2.3–4), P = 0.028], lower incidence of nausea at 48 h (25.8% vs. 50%, P = 0.039), and higher satisfaction score [10 (10–10) vs. 10 (8–10), P = 0.041]. The SF-36 bodily pain score on POD 30 was higher in the Study group (59 ± 13 vs. 49 ± 16, P = 0.023).ConclusionsPreoperative TAP block had additional analgesic effect for open gynecological surgery when used as part of multimodal analgesia. Rescued morphine within 24 h was significantly reduced and the SF-36 bodily pain dimension at 30 days after surgery was significantly improved.Trial registrationwww.chictr.org.cn (ChiCTR2000040343, on Nov 28 2020).

Loneliness Exacerbates the Association Between Bodily Pain and Depressive Symptoms Among Middle-Aged and Older Latinx Adults.

Objectives: To investigate the associations between three bodily pain dimensions (intensity, frequency, severity) and depressive symptoms among middle-aged and older Latinxs ages 40-94 and to determine whether loneliness conditioned the pain-depressive symptoms associations. Methods: Data are from a community-based study of community-dwelling residents in Florida (N = 527). Multivariable linear regression models assessed the impact of each pain dimension on depressive symptoms, controlling for sociodemographic factors. Interactions determined whether loneliness moderated the pain-depressive symptoms relationships. Results: Each pain dimension was positively associated with depressive symptoms (p < .01). Loneliness modified the impact of pain frequency and pain severity on depressive symptoms. Those with moderate and high loneliness levels experienced an amplified pain-depressive symptoms association. Discussion: Findings underscore the synergistic effects of pain and loneliness in exacerbating depressive symptomatology among middle-aged and older Latinx adults. Loneliness is an important point of intervention to improve mental health among aging Latinxs.

Clinical Efficacy and Safety of Long-Term Compression in Patients with Mixed Arterial and Venous Etiology Ulcers in the Leg

AbstractElastic compressions are standard treatment for leg ulcers of venous etiology. The effect of compressions on ulcers of mixed (arterial or venous) etiology, however, has rarely been studied. The objective of this study was to evaluate the variation in transcutaneous oxygen pressure (TcPO2) in patients with ulcers of mixed arterial or venous etiology treated with 1 month of compression. This prospective cohort study was conducted at a university hospital in France. Patient eligibility was for those attending a consultation of a work-up of a leg ulcer of mixed arterial-venous etiology lasting at least 4 to 6 weeks. Compressions were prescribed according to the hemodynamic status and were evaluated by the ankle-brachial index and toe-brachial index using a decision-making algorithm based on French national guidelines. Quality of life was assessed using the Short-Form 36-Item (SF-36) questionnaire. In total, 32 patients were included between September 30, 2018 and May 31, 2019. A difference was observed between TcPO2 before compression (49.3 ± 13.01 mm Hg) and after 1 month (51.2 ± 15.05 mm Hg), average change 1.9 ± 2.04 mm Hg (p = 0.025). The average ulcer size prior to compression was 49 ± 102 cm2 versus 37 ± 94 cm2 after 1 month of effective compression, corresponding to a reduction of 12 ± 8 cm2 (p &lt; 0.001). There was a reduction in the bodily pain dimension of the SF-36. Compressions adapted to the hemodynamic status led to an increase in TcPO2, a reduction in wound size, and an improvement to bodily pain in patients with leg ulcers of mixed arterial-venous etiology.

Effectiveness of e-Health cardiac rehabilitation program on quality of life associated with symptoms of anxiety and depression in moderate-risk patients

Exploring new models of medical care requires evaluating the impact of new care strategies not only on physiological parameters but also on the quality of life of the patient. On the other hand the presence of anxiety together with depression requires further consideration when planning appropriate management strategies. The aim of this study was to examine the effectiveness of a home-based cardiac rehabilitation program incorporating an e-Health technology on health-related quality of life associated with symptoms of anxiety and depression in moderate-risk patients. A multicenter, randomized controlled clinical trial was designed to compare a traditional hospital based cardiac rehabilitation program (n = 38, 35 male) with a mixed home surveillance program where patients exercised at home with a remote electrocardiographic monitoring device (n = 33, 31 male). The Short Form-36 (SF-36) Health Survey and the Goldberg questionnaire were used to evaluate quality of life and the presence of symptoms of anxiety and depression respectively. The results of this study show that the type of cardiac rehabilitation program did not influence the improvement in quality of life (p = 0.854), but the presence of symptoms of anxiety and depression did (p = 0.001). Although both programs achieved a decrease in anxiety and depression symptoms and improved functional capacity (p ≤ 0.001), a significant interaction effect was found between the group with or without anxiety and depression symptoms and the type of program in the bodily pain dimension (p = 0.021). Trial registration: Retrospectively registered NCT02796404 (10/06/2016) in clinialtrials.gov.

Association of physical fitness components and health-related quality of life in women with systemic lupus erythematosus with mild disease activity.

ObjectivesTo study the association of different components of physical fitness [flexibility, muscle strength and cardiorespiratory fitness (CRF)] and a clustered fitness score with health-related quality of life (HRQoL) in women with systemic lupus erythematosus (SLE) and to analyze whether participants with high fitness level have better HRQoL.MethodsThis cross-sectional study included 70 women with SLE (aged 42.5; SD 13.9 years). The back-scratch test assessed flexibility, the 30-sec chair stand and handgrip strength tests assessed muscle strength, and the 6-min walk test (n = 49) assessed CRF. HRQoL was assessed through the 36-item Short-Form Health Survey (SF-36).ResultsFlexibility was positively associated with the physical function dimension and the physical component summary (PCS) (rpartial between 0.26 and 0.31; p<0.05), and negatively related with social functioning dimension (rpartial = -0.26; p<0.05). Muscle strength was positively associated with the physical function, physical role, bodily pain dimensions and the PCS (rpartial between 0.27 and 0.49; all p<0.05). CRF was positively associated with the physical function and bodily pain dimensions, and PCS (rpartial between 0.39 and 0.65; all p<0.05). The clustered fitness score was associated with the physical function (B = 17.16) and bodily pain (B = 14.35) dimensions, and the PCS (B = 6.02), all p<0.005. Patients with high fitness level had greater scores in the physical function, physical role, and bodily pain dimensions and the PCS, all p≤0.05.ConclusionsOur study suggests that muscle strength and CRF are positively associated with HRQoL, while flexibility showed contradictory results. These findings highlight the importance of maintaining adequate fitness levels in women with SLE.

Effects of Pulsatile Cupping on Body Pain and Quality of Life in People with Suboptimal Health:A Randomized Controlled Exploratory Trial.

Objective: The curative effect of pneumatic pulsatile cupping on pain has been shown. This study was conducted to investigate effects of the pulsating frequency of pneumatic pulsatile cupping, compared with traditional cupping (TC), on body pain and quality of life (QoL) in people with suboptimal health status (SHS). Materials and Methods: Ninety-six participants with SHS were randomized to low-frequency (LF; n = 24) or high-frequency (HF; n = 24) pulsating cupping, traditional cupping (TC; n = 24), or wait-list (WL; n = 24) groups. The LF, HF, and TC groups received 4 sessions of cupping over 2 weeks. Visual analogue scale (VAS; 0-100 mm) pain level and Short-Form-36 (SF-36) QoL measurements were taken before and after the intervention. Results: Both LF and HF reduced pain significantly (VAS: -28.26; 95% confidence interval [CI] -36.18 to -20.34; and -31.88, 95% CI -39.81 to -23.96; both P = 0.000) and improved QoL more than WL (SF-36, Bodily Pain dimension: 1.46, 95% CI: 0.85 to 2.07; and 1.75, 95% CI: 1.14 to 2.36, both P = 0.000). Compared to TC, LF and HF significantly reduced pain (VAS: -7.92, 95% CI: -15.75 to -0.08, P LT = 0.048; and -11.54, 95% CI: -19.38 to -3.70, P HT = 0.004) and improved QoL (SF-36, Bodily Pain dimension: 0.61, 95% CI: 0.01 to 1.21, P LT = 0.046; and 0.90, 95% CI: 0.30 to 1.50, P HT = 0.004). There was no significant difference between LF and HF. Conclusions: This study showed that, in patients with SHS, pulsatile cupping therapy could have a more-favorable effect to relieve body pain, compared to TC. LF and HF pulsation produced equivalent pain relief. Further studies investigating the underlying mechanism are needed. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR-INR-16009345).

Evaluation of the quality of care of elderly patients with chronic and breakthrough pain treated with opioids: SAND study

Objective: The objective of this study was to evaluate the quality of care of elderly patients with treatment for chronic pain (CP) and breakthrough pain (BTP).Methods: A cross-sectional observational study was conducted in 20 pain units, selecting patients aged 70 years or older with baseline controlled CP in treatment with opioids and a diagnosis of BTP. Patients were classified as first episode of BTP or patient in follow-up. The patients completed the SF-12 quality of life questionnaire, Brief Pain Inventory, Lattinen Index, and Edmonton Symptoms Assessment Scale. The patient’s satisfaction with the treatment was evaluated through a visual analogue scale (VAS).Results: A total of 199 patients were included with 67.7% women (132). There were 28.5% (55) attending the first visit for BTP and 71.5% (138) were on follow-up visits. On the physical component of the SF-12, 95% had a score below the mean for the Spanish general population and 44% had a score below the mean on the mental component. Worse scores were observed for women in the bodily pain dimension (p = .032) and in the overall physical component (p = .045). There were 62.9% (112) patients satisfied with the treatment for BTP. In the multivariate analysis, SF-12 physical component scores (p = .017) and patient’s satisfaction with BTP treatment was better in follow-up visits (p = .031).Conclusions: All clinical parameters compared between first visit for the treatment of BTP and follow-up visits were improved, so the quality of care was also considered improved. Elderly women and non-oncologic patients were observed to be the population with worse symptom control.

Health-related quality of life of people with multimorbidity at a community-based, interprofessional student-assisted clinic: Implications for assessment and intervention.

Objective This study examined the relationship between the number of comorbidities and health-related quality of life (HRQoL) and between select physical conditions and HRQoL. Differences in HRQoL in comparison to a normative sample were also examined. Method A cross-sectional study among people with multimorbidity ( n = 401) attending a community-based, interdisciplinary health clinic was conducted. HRQoL was measured using the eight dimensions of the SF-36. Multiple linear regression and t-tests were used to analyse the data. Results A downward trend in HRQoL continued from 2 to 14 concurrent comorbidities. Patients with a higher number of comorbidities reported greater deficits in HRQoL, when age, gender, education and perceived social support were controlled for (beta = -0.11 to -0.31). The impact of the number of comorbidities was greatest for the bodily pain dimension of the SF-36 (beta = -0.31). Deficits were greatest for people with gastrointestinal conditions and back pain or sciatica. Moderate to large deficits in HRQoL compared to a normative population were found (Cohen's d = 0.54-1.16). Discussion Understanding associations between the number and type of physical comorbidities and HRQoL may assist clinical services to design broad but targeted interventions to optimize HRQoL in this group of people.

Religious coping methods predict depression and quality of life among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study

BackgroundPoor quality of life (QOL) and a high prevalence of depression have been identified among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We aimed to evaluate the associations between religious/spiritual (R/S) coping methods and both QOL and depression among ESRD patients undergoing hemodialysis (HD).MethodsThe sample included 161 ESRD patients over 18 years of age who had been undergoing HD for more than 3 months. R/S coping methods were assessed using the Religious Coping Questionnaire (RCOPE). The RCOPE generates scores (from 1 to 5) for positive and negative R/S coping methods. The higher the score, the more frequent the use of that coping method. Depression was evaluated using the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Scores on the CES-D range from 0 to 60. A cutoff of 18 was used to define depression. QOL was evaluated using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36); this survey was used to generate scores for the eight dimensions of QOL, which can vary from 0 (worst) to 100 (best).ResultsWe identified a depression prevalence of 27.3%. Positive R/S coping scores were higher among non-depressed than depressed patients (2.98 vs. 2.77; p = 0.037). Positive R/S coping scores were negatively correlated with depression scores (r = −0.200; p = 0.012) and were an independent protective factor for depression (OR = 0.13; CI 95% = 0.02-0.91; p = 0.039). Regarding QOL, a positive correlation was identified between positive R/S coping scores and scores related to general health (r = 0.171; p = 0.030) and vitality (r = 0.183; p = 0.019), and an inverse correlation was identified between negative R/S coping scores and scores in the social functioning (r = −0.191; p = 0.015) and mental health (r = −0.214; p = 0.006) dimensions. In addition, positive R/S coping scores were an independent predictor of higher scores in the bodily pain (β = 14.401; p = 0.048) and vitality (β = 12.580; p = 0.022) dimensions. In contrast, negative R/S coping scores independently predicted lower social functioning scores (β = −21.158; p = 0.017).ConclusionsOur results provide further evidence suggesting that R/S coping methods may be associated with QOL and depression among HD patients. In our opinion, the use of religious resources should be encouraged among HD patients, and psycho-spiritual interventions should be attempted to target religious struggles (negative R/S coping) in patients undergoing HD.

Health Related Quality of Life And its Associated Factors Among Diabetic Patients Attending Diabetes Clinic in Jimma University Teaching Hospital, Ethiopia,2014

Background: Diabetes mellitus is likely to become one of the most prevalent and economically important diseases of the 21st century. Diabetes mellitus, like any chronic medical condition, impacts on quality of life. Objective: The aim of this study was to assess quality of life and associated factors among diabetic patients having follow-up in diabetes clinic in Jimma University Specialized Hospital, Jimma ,south west Ethiopia. Methods: Institution based cross sectional study was conducted from February-May, 2014. Consecutive sampling technique was used to select 356 participants. Data collection technique was interview; review of medical records and the mean fasting blood sugar was used as index of glycemic control. Results: A total of 341 respondents participated in the study and the response rate was 96.2%. The sample consisted of 183 males (56%) and 158 females (44%) with mean age 46.37 ± 15.9 years. Mean duration of DM was 5.7 ± 5 years, 229(66.9%) were type II diabetes, mean BMI and FBS were 23.4 ± 4.3 and 172 mg/dl ± 67 respectively. Highest percentages (57%) of poor health related quality of life was found in general health followed by role physical (36%) and highest good quality of life found in bodily pain dimensions in which 88% of the respondents had good quality of life. Additionally, in this study depression symptom, type II diabetes, increased number of drugs, longer duration of illness and number of co morbidity were important predictors of impaired health related quality of life. Conclusion: Depression symptoms, type II diabetes, higher number of drugs, longer duration of illness and number of co morbidity were important predictors of impaired health related quality of life. Additionally, general health and role physical dimensions of respondents’ quality of life were severely impaired. As a result programs addressing the physical and mental needs of the population are required.

Quality of Life during Third Trimester of Pregnant Women with Normal Pre-pregnant Weight and Obese Pre-pregnant Women by Asia-specific BMI Criteria

Objective : To compare quality of life between pre-pregnant normal weight and obese women during third trimester of pregnancy in Phramongkutklao Hospital. Method : This is a cross-sectional study. Pregnant women during third trimester who seek for antenatal care (ANC) at Phramongkutklao Hospital from August 2014 to March 2015 were enrolled to this research by convenience selection. The participants were classified into 2 groups, normal pre-pregnant weight (105 persons) and obese pregnant women (105 persons). All participants was reviewed demographic data, obstetrical and gynecologic history from and ANC record form and a self-administered SF-12 questionnaire was done. Higher score means better quality of life and each group were compared in both physiological and mental component, including 8 dimensions. Results : Median pre-pregnant BMI of normal pregnant women is 20.4 kg/m 2 while obese pregnant women is 26 kg/m 2 Weight gaining between normal weight and obese pregnant women group were 13.8 and 10.7 kg, respectively. Only underlying hypertension and diabetes mellitus showed significant difference (p=0.008). Meanwhile, familial hypertension and diabetic mellitus history were found significant higher in obese pregnant than normal weight group. In physiological and mental components of both groups were not different significantly (p=0.181) but bodily pain dimension was higher in the obese women than the normal weight group significantly (p=0.044) Conclusion : In conclusion, the quality of life during third trimester of the obese pregnant women were not different from the normal weight pregnant women in both physical and mental component. But the obese pregnant women had statistically significant less quality of life only in bodily pain dimension than the normal weight women.

Validity, Reliability, and Responsiveness of the Brief Pain Inventory in Inflammatory Bowel Disease.

Background and Aims. No patient-reported outcome measures targeting pain have yet been validated for use in IBD patients. Consequently, the aim of this study was to test the psychometrical properties of the brief pain inventory (BPI) in an outpatient population with IBD. Methods. Participants were recruited from nine hospitals in the southeastern and western parts of Norway. Clinical and sociodemographic data were collected, and participants completed the BPI, as well as the Short-Form 36 (SF-36). Results. In total, 410 patients were included. The BPI displayed high correlations with the bodily pain dimension of the SF-36, as well as moderate correlations with disease activity indices. The BPI also displayed excellent internal consistency (Cronbach's alpha value of 0.91, regardless of diagnosis) and good to excellent test-retest values (intraclass correlation coefficient (ICC) 0.84–0.90 and Kappa values > .70). In UC, calculation of responsiveness revealed that only BPI interference in patients reporting improvement reached the threshold of 0.2. In CD, Cohen's d ranged from 0.26 to 0.68. Conclusions. The BPI may serve as an important supplement in patient-reported outcome measurement in IBD. There is need to confirm responsiveness in future studies. Moreover, responsiveness should ideally be investigated using changes in objective markers of inflammation.

Qualidade de vida de mulheres com dor pélvica crônica

Os objetivos deste estudo transversal foram comparar a qualidade de vida e as características socioeconômicas de mulheres com e sem dor pélvica e investigar achados clínicos e cirúrgicos de mulheres com dor pélvica crônica. Os dados foram coletados em um hospital público, de Goiânia/GO, Brasil. A intensidade da dor foi aferida pela escala analógica visual e qualidade de vida avaliada pelo SF-36. A maioria das mulheres classificou a dor como intensa (52%) e conviviam com a dor há 8,8 (±7,7) anos. Mulheres do grupo com dor pélvica crônica apresentaram escores inferiores em todas as dimensões avaliadas pelo SF-36 (p&lt; 0,05), exceto na dimensão saúde mental, quando comparado com o grupo sem dor. A correlação foi negativa (p=0,017) entre a intensidade da dor e a dimensão dor do SF-36. A dor pélvica apresentou impacto negativo significativo na qualidade de vida, com prejuízos para a saúde física e mental das mulheres.

Association between Cardiorespiratory Fitness and Health-Related Quality of Life among Patients at Risk for Cardiovascular Disease in Uruguay.

To date, few studies have examined the relationship between cardiorespiratory fitness (CRF) and health-related quality of life (HRQoL) in populations at high risk for developing cardiovascular disease (CVD).PurposeTo examine the association between objectively measured CRF and physical and mental components of HRQoL in a Uruguayan cohort at risk for developing CVD.MethodsPatient data records from 2002–2012 at the Calidad de Vida Center were examined. To assess CRF, participants performed a submaximal exercise test. During the evaluation, participants also completed the SF-36, a HRQoL measure comprised of eight dimensions that are summarized by physical and mental component scores (PCS and MCS, respectively). ANCOVA was used to examine the relationship between HRQoL dimensions and CRF. Logistic regression was then used to compare the odds of having a HRQoL component score above the norm across CRF. All analyses were performed separately for males and females with additional stratified analyses across age and BMI conducted among significant trends.ResultsA total of 2,302 subjects were included in the analysis. Among females, a significant relationship was observed between CRF and vitality, physical functioning, physical role, bodily pain, and general health dimensions. However, for males the only dimension found to be significantly associated with CRF was physical health. After adjusting for potential confounders, a significant linear trend (p<0.001) for PCS scores above the norm across CRF levels was observed for females only.ConclusionAmong females with one or more risk factors for developing CVD, higher levels of CRF were positively associated with the vitality and physical dimensions of HRQoL, as well as the overall PCS. However, among males the only dimension associated with CRF was physical functioning. Future studies should examine this relationship among populations at risk for developing CVD in more detail and over time.

The impact of depression and malnutrition on health-related quality of life among the elderly Iranians.

Introduction:The present study aimed to assess the association between nutritional status and depressive symptoms among elderly Iranians and to explore their impact on their Health-Related Quality of Life (HRQoL).Methods:In this cross-sectional study, 447 elders aging from 55 to 85 years were randomly selected and completed the Iranian version of Geriatric Depression Scale-15 (GDS), Mini Nutritional Assessment (MNA), and the Iranian version of Short Form Health Survey (SF-36).Results:Out of the 447 elderly, 72.1% were female with the mean age of 65.99 ± 7.89 years. The prevalence of depression was 38.1%. In addition, the SF-36 sub-scores tended to be lower among the elders with depressive symptoms according to GDS. The Physical Functioning (PF), Bodily Pain (BP), Role Physical (RP), Role Emotional (RE), and Mental Health (MH) dimensions of the SF-36 were also statistically poorer in the elders with depression. The mean MNA score was 24.6 ± 2.7; 35.4% of the participants were malnourished or at risk of malnutrition and 64.6% were adequately nourished. The sub scores of SF-36 were significantly lower in the elders with impaired nutritional status.Conclusions:Considering the importance of the association among psychological and nutritional problems and HRQoL in caring for and promoting the welfare of the elders, this study provided fundamental information and a basis for further evaluation of this issue in developing and undeveloped countries.

Measuring Outcomes: Pain and Quality of Life 48 Months After Acute Postoperative Total Knee Prosthetic Joint Infection.

Measuring HRQOL is simple, inexpensive, permits the health status to be measured over time, and is useful to compare or initiate treatments and evaluate results, facilitating homogenization in patient inclusion. To evaluate disease-specific and generic HRQOL and influence of associated factors in patients undergoing open debridement for acute postsurgical knee prosthetic joint infection after TKR at 12 and 48 months after completing antibiotic treatment and considered cured of infection. Health-related quality-of-life measures were administered at baseline (WOMAC) and 12 and 48 months (WOMAC and SF-36) in patients with prosthesis retention, no symptoms of infection, and CRP (≤ 1 mg/dL). Thirty patients were included, and 24 were evaluated at 48 months. WOMAC scores improved significantly (P < 0.01) at 12 and 48 months. The effect size was 0.72 for stiffness, 2.01 for pain, and 2.15 for function. At 48 months, improvements were greater (P < 0.02) except for stiffness. The most frequently isolated microorganisms were Staphylococcus aureus (14 patients) and coagulase-negative staphylococci (9 patients). SF-36 physical role, bodily pain, emotional role, and mental health dimension scores at 12 and 48 months were significantly worse in patients with isolates of Staphylococcus aureus (P < 0.05). Health-related quality-of-life measures detected significant differences in outcomes in patients infected by S. aureus compared with patients infected by other microorganisms. HRQOL measures may provide useful complementary information on outcomes after acute postoperative infection.

Epilepsy, Headache, and Quality of Life after Resection of Cerebral Arteriovenous Malformations

In ruptured and unruptured arteriovenous malformations (AVMs), bleeding and re-bleeding rate and efficacy of microsurgical, endovascular, and radiosurgical treatment to prevent hemorrhage are well known. Uncertainty exists concerning the benefit of therapy with regard to headache, epilepsy, and quality of life (QoL) in unruptured AVMs. The objective of the present study was to gain long-term follow-up information after microsurgical AVM resection, in particular with regard to epilepsy, headache, and QoL. A series of 110 patients with cerebral AVM, surgically treated between 1994 and 2009, were analyzed. Epidemiological, sociodemographic, and disease-related characteristics were extracted from the patient records. A detailed follow-up interview was possible with 51 patients after a median of 7 ± 5 years after surgery. A structured telephone interview using the Short Form (SF)-36 for QoL assessment was performed. In addition, specific questions regarding epilepsy and seizure outcome as well as independence and professional activity were asked. Hemorrhage led to hospital admission in 58.2% patients; 35.5% were admitted with epileptic seizures and 24.5% of patients reported chronic headaches. On the Spetzler-Martin scale, 26.0% were grade 1, 38% grade 2, 25% grade 3, and 11% grade 4. Preoperative embolization was performed in 43.6%. Treatment-associated new neurological deficits at the time of discharge from the hospital occurred in 25.5%. At the time of follow-up, 94.2% of the patients were completely independent (Barthel index of 100). 64.7% of the patients with preoperative epilepsy were free of disabling seizures or rarely have disabling seizures (Engel class 1 and 2), 16.7% reported no significant change, and 17.6% reported worsening. A total of 17.6% patients in whom epilepsy was not known at the time of AVM treatment reported new seizures after therapy, all but one had hemorrhage. 38.5% of patients with preoperative chronic headache reported improvement, 53.8% no change, and 7.7% deterioration. Regarding SF-36 QoL scores, a statistically significant difference from the age-matched German norm values was found in the dimensions Bodily Pain (p = 0.03) and Emotional Role Function (p = 0.04). There was a trend for lower physical and mental sum scores in patients undergoing emergency surgery. SF-36-based QoL scores after treatment of AVM differ little from the age-matched German averages. The long-term results regarding chronic epilepsy and chronic headache need further analysis.

The impact of type d personality on health-related quality of life in patients with symptomatic haemorrhoids

IntroductionHaemorrhoids are one of the most common reasons that patients seek consultation from a colon and rectal surgeon. Health-related quality of life (HrQoL) is a significant factor in describing the burden of illness and the impact of treatment in patients with gastrointestinal disease. Type D (distressed) personality is defined as the co-occurrence of negative affect and social inhibition.AimTo assess the prevalence of type D personality in patients with haemorrhoids and to investigate whether the presence of a type D personality would affect HrQoL in patients with haemorrhoids.Material and methodsOne hundred and six outpatients with symptomatic haemorrhoids with no psychiatric comorbidity were consecutively enrolled, along with 96 healthy controls. The Type D Scale (DS14) and the General Health Survey Short Form-36 (SF-36) were used in the collection of data.ResultsOf 106 patients evaluated, 29.2% met criteria for type D personality. Patients with haemorrhoids scored lower on bodily pain and vitality dimensions of SF-36 than did healthy subjects (p < 0.001). Patients with a type D personality were found to score lower on bodily pain domain of HrQoL than patients without a type D personality. Linear regression analysis revealed a significant independent association of type D personality with bodily pain dimension of the SF-36 in patients with symptomatic haemorrhoids (r = –0.315, p < 0.01).ConclusionsType D personality was associated with increased perceived bodily pain in patients with haemorrhoids. Consideration of type D personality construct personality traits could improve risk stratification in research and clinical practice in this patient group.

Clinical survey on neuropathic pain in neurological outpatient department

To survey the features and its impact of neuropathic pain in neurological outpatients. A total of 106 patients with neuropathic pain were selected from Neurology Clinic of the Second Affiliated Hospital of Zhejiang University. General status instrument, SF-36 Quality of Life Scale and Hamilton Anxiety Scale (HAMA) were used in the survey. Trigeminal neuralgia (23.6%), nerve root pain (21.7%), and post-herpetic neuralgia (13.2%) were the most common causes of neuropathic pain. The sequence of impairments in life quality of the patients was role-physical (21.2), bodily pain (39.9), role-emotional (41.2), general health (50.0), physical functioning (55.1), vitality (60.0), mental health (68.5), and social functioning (70.9). Pearson correlation coefficients were statistically significant between bodily pain and other dimensions of life quality (P<0.05). Western medication (45.3%) was the most common treatment adopted by physicians. The prevalence of neuropathic pain is common in elderly patients. The three major types of neuropathic pain seriously affect the quality of life in patients. Although western medicine is the first choice of treatment, clinical drug selection should be standardized with efforts of both doctors and patients.