Component Summary Research Articles

Assessment of Health-Related Quality of Life in Tuberculosis Treatment Centers in a Local Government Area in Southern Nigeria

Background: Studies from Rivers State have demonstrated high burden of drug resistance among pulmonary tuberculosis (PTB) patients and declining cure rate despite adequate treatment retention and highly effective directly observed treatment short-course. Aim: to explore the perception of clients on how PTB disease or its treatment affect their health (health-related quality of life), which could impact on TB treatment success rate among clients with PTB. Methods: A total of 225 adult clients with PTB were recruited by systematic random sampling method from each of the 8 randomly selected centers out of 40 active treatment centers in Obio/Akpor LGA of Rivers State. The SF 36 was used to collect responses which were grouped into 8 domains yielding 2 summary measures. Scores ≤49 were classified as poor, 50-74 relatively favourable and good for scores ≥75. Categorical data were presented as frequencies and proportions using tables and pie charts while quantitative data were presented as means and standard deviations. Results: Specific domains mean scores ranged from 34.9±33.7 (role physical) to 61.8±11.9 (general health) while physical component summary (PCS) and mental component summary (MCS) recorded 53.35±16.79 and 51.11±12.26 respectively. The overall HRQoL mean score for the study was 55.2 (± 3.6) with an undesirable score of 20.7%. Conclusion: Pulmonary tuberculosis patients in treatment centers in Obio / Akpor LGA had poor to relatively favourable HRQoL mean scores. Strengthening counselling practice may help improve support for the clients in coping with the disease and the effect of its treatment.

Functional disability and health-related quality of life among systemic sclerosis patients in Bangladesh

ObjectiveTo assess the relationship between functional disability and health-related quality of life (HRQoL) among systemic sclerosis (SSc) patients.MethodologyThis cross-sectional study was carried out on 78 adults who met the classification criteria for SSc defined by the American College of Rheumatology/European League of Rheumatology (ACR/EULAR)-2013. The Bangla version of Short Form 36 (SF-36) and Health Assessment Questionnaire-Disability Index (HAQ-DI) were used to measure HRQoL and functional disability in SSc patients.ResultsThe patients' median [IQR] HAQ-DI was 1.4 [0.6–2.1], with 37.2% having a mild functional disability, 33.3 percent having a moderate functional disability, and 29.5 percent having a severe functional disability. The hygiene and activity domains of the HAQ-DI obtained the highest scores, 2.0 [0.0–3.0] and 2.0 [1.0–3.0], respectively. The Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36 had median [IQR] values of 26.2 [15.0–58.1] and 42.0 [19.6–60.6]. The highest score was 50.0 [25.0–75.0] in social functioning. The PCS of the SF-36 was moderately correlated with the HAQ-DI (rs = − 0.629, P < 0.001) and the MCS of the SF-36 was weakly correlated with the HAQ-DI ((rs = − 0.344, P < 0.001). Age, female sex, and incomplete fist closure substantially influenced functional status. Calcinosis, Raynaud's Phenomenon, and flexion contracture significantly diminished the quality of life.ConclusionsFunctional disability negatively affects health-related quality of life. Age, Musculoskeletal, and skin involvement are significantly associated with poor quality of life and functional disability. Therefore, treatment strategies should be aimed at reducing functional disability, which will enhance the HRQoL of SSc patients.

Prospective associations between diet quality and health-related quality of life in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.

Changes between diet quality and health-related quality of life (HR-QoL) over 12 years were examined in men and women, in 2844 adults (46 % males; mean age 47·3 (sd 9·7) years) from the Australian Diabetes, Obesity and Lifestyle study with data at baseline, 5 and 12 years. Dietary intake was assessed with a seventy-four-item FFQ. Diet quality was estimated with the Dietary Guideline Index, Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurological Delay Index (MIND) and Dietary Inflammatory Index. HR-QoL in terms of global, physical component summary (PCS) and mental component summary (MCS) was assessed with the Short-Form Health Survey-36. Fixed effects regression models adjusted for confounders were performed. Mean MCS increased from baseline (49·0, sd 9·3) to year 12 (50·7, sd 9·1), whereas mean PCS decreased from baseline (51·7, sd 7·4) to year 12 (49·5, sd 8·6). For the total sample, an improvement in MIND was associated with an improvement in global QoL (β = 0·28, 95 % CI (0·007, 0·55)). In men, an improvement in MIND was associated with an improvement in global QoL (β = 0·28, 95 % CI (0·0004, 0·55)). In women, improvement in MIND was associated with improvements in global QoL (β = 0·62 95 % CI (0·38, 0·85)), MCS (β = 0·75, 95 % CI (0·29, 1·22)) and PCS (β = 0·75, 95 % CI (0·29, 1·22)). Positive changes in diet quality were associated with broad improvements in HR-QoL, and most benefits were observed in women when compared to men. These findings support the need for strategies to assist the population in consuming healthy dietary patterns to lead to improvements in HR-QoL.

The Co-Relation between Disease Activity and Quality of Life among Patients with Peripheral Spondyloarthropathy

Background: More disability and incapacity to work and a poorer quality of life in spondyloarthritis (SpA) in the presence of enthesitis is associated with higher disease activity. Objective: To find out the co-relation between disease activity and quality of life among patients with peripheral spondyloarthropathy. Methodology: From March 2021 to February 2022, the Department of Physical Medicine and Rehabilitation at BSMMU, Dhaka, performed a cross-sectional research. A total of 105 individuals diagnosed with pSpA who were included in the trial were chosen on purpose. Excluded from the research were patients with concomitant systemic inflammatory rheumatic diseases such as RA, SSc, lupus, and Dermatomyositis. The validated Bengali version of The Ankylosing Spondylitis Disease Activity Score (ASDAS), including C-reactive protein (ASDAS-CRP), was used to measure disease activity, while the validated Bengali version of the Short Form Health Survey (SF) 12v2 was used to evaluate health-related quality of life. Results: The participants' mean age was 38.8(±9.8) years, and 68(64.8%) were male. The mean duration of sickness was 4.3(±3.3) years, with 55.4% of cases lasting less than 3 years. The mean ASDAS-CRP was 3.9(±0.08), with 69(65.7%) individuals having a very high Disease Activity Score. 100% of the individuals in the research experienced arthritis and inflammatory back pain. The majority of research subjects had the HLA B27 gene (N=101, or 96.2%), and 99(94.3%) had enthesitis. Physical Component Summary (PCS) and Mental Component Summary (MCS) mean scores were 34(±7.8) and 41(±7.7), respectively. A slight negative association existed between age and PCS scores on the SF-12 (r=-0.233, p=0.017). There was a negative connection between illness duration and PCS (r=-0.339, p=0.001) and MCS (r=-0.290, p=0.003) SF-12 scores. Again, there was a moderate negative connection between ASDAS-CRP and the PCS and MCS scores of the SF-12 (r=-0.406, p=0.001) and the MCS scores of the SF-12 (r=-0.461, p0.001). Conclusion: The Disease Activity Score of the majority of individuals with peripheral spondyloarthritis was very high. The psychological health of these patients was superior to their physical health. Both physical and mental health components were negatively linked with illness duration. There was a moderate inverse connection between ASDAS-CRP and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the SF-12.

Assessment of Quality of Life among Patients with Periphera Spondyloarthropathy

Background: Peripheral spondyloarthropathy refers to spondyloarthropathy with predominant peripheral (arthritis, enthesitis or dactylitis) involvement which leads to significant disability. Objective: To assess the quality of life in patient with peripheral spondyloarthropathy (pSpA). Methodology: The study was a cross sectional study conducted in the Department of Physical Medicine and Rehabilitation, BSMMU, Dhaka, from March 2021-February 2022. A total of 105 patients diagnosed with pSpA attending the study place were purposively selected for the study. Patients with concurrent systemic inflammatory rheumatic disease such as RA, SSc, lupus, Dermatomyositis were excluded from the study. Disease activity was measured by the validated Bengali version of The Ankylosing Spondylitis Disease Activity Score (ASDAS), including C-reactive protein (ASDAS-CRP) while health related quality of life was assessed by the validated Bengali version of Short Form Health Survey (SF) 12v2 instrument. Results: The mean age of the study participants was 38.8(±9.8) years where 68 (64.8%) were male. The mean duration of disease was 4.3(±3.3) years where 55 (52.4%) had up to 3 years’ duration of disease. The mean ASDAS-CRP was 3.9 ±0.8 where 69(65.7%) had very high Disease Activity Score. All (100.0%) study participants had arthritis and inflammatory back pain. HLA B27 was present in most of the study participants (N=101, 96.2%) and 99 (94.3%) had enthesitis. The mean Physical Component Summary (PCS) and Mental Component Summary (MCS) was 34.0(±7.8) and 41.3 (±7.7) respectively. There was weak negative correlation between age and PCS of SF-12 scores (r=-0.233, p=0.017). There was negative correlation between duration of the disease and PCS of SF-12 scores (r=-0.339, p&lt;0.001) and MCS (r=-0.290, p=0.003). Again, there was moderate inverse correlation ASDAS-CRP and PCS of SF-12 scores (r=-0.406, p&lt;0.001) and MCS of SF-12 scores (r=- 0.461, p&lt;0.001). Conclusion: Majority of the patients .....

Quality of life in the community-dwelling elderly and associated factors: A Cross-Sectional study

Introduction: Recent medical and health advances have reduced mortality, consequently a relative increase in life expectancy and aging of population. One of the indices that properly indicate the status of elderly is the quality of life. Identifying the factors affecting the quality of life of the elderly in Zahedan, Iran.&#x0D; Methods: This cross-sectional study was performed on 600 elderly people referring to the Zahedan health centers. Sampling method was two-stage clustering, the data were collected in the check list by using quality of life (QOL) questionnaire SF12 through interview and then were analyzed using independent t-test, one-way ANOVA, Pearson correlation coefficient and multiple linear regression.&#x0D; Results: Of the 600 elderly men and women over 60 years, 472 subjects participated in the study, of whom 291 (61%) were male and 182 (39%) were female. The mean age of the study subjects was 66.2(4.04), and the mean overall quality of life scores in males and females were 28.4(3.7) and 29.07(3.7), respectively. The mean and standard deviation of physical component summary (PCS) and mental component summary (MCS) scores in males and females were 12.3(2.2) and 16.6(2.5), respectively. Age had inverse correlation with QOL and MS and had a direct and significant relationship with PCS. In multiple linear regression, significant relation was observed between chronic illness, hypertension, skeletal disease, diabetes, gastrointestinal disease, marital status, hookah using and smoking with PCS and also between marital status, hypertension and mental illness with MCS.&#x0D; Conclusion: What is obtained from this study and the other relevant studies indicate that QOL is a multifactorial phenomenon that is influenced by demographic, clinical and behavioral factors, but the role of chronic diseases is more obvious. Therefore, it seems necessary to adopt health policies to correct the lifestyle of society.

Examining physical literacy in young adults: psychometric properties of the PLAYself.

The PLAYself is a commonly utilized tool to assess physical literacy in child and adolescent populations. Currently, there are no measurement tools designed to examine physical literacy among adults. The purpose of this cross-sectional study was to examine the psychometric properties of PLAYself subsections in a sample of young adults. Two hundred forty-five young adults (ages 18-25) from the United States completed the PLAYself questionnaire. Multiple principal component analyses using promax rotation were utilized to assess the current factor structure of the PLAYself subsections. Each subsection was analyzed independently to explore individual summary components. PLAYself subsections were assessed for reliability using Cronbach'sα, inter-item correlations, and item-total correlations. A multi-factor structure was identified for each PLAYself subsection. A 2-factor structure was identified for the Environment subsection accounting for 55.2% of the variance. A 2-factor structure was identified for the Physical Literacy Self-Description subsection accounting for 57.1% of the variance. A 3-factor structure was identified for the Relative Ranking of Literacies subsection accounting for 70.3% of the variance. The Environment, Physical Literacy Self-Description, and Relative Ranking of Literacies subsections demonstrated poor (α = 0.577), good (α = 0.89), and acceptable (α = 0.79) internal consistencies, respectively. The Physical Literacy Self-Description subsection demonstrated the best psychometric properties in our sample, and thus may be an appropriate tool to assess physical literacy in a young adult population until additional measurement tools are developed.

Development and Validation of Models to Predict Poor Health-Related Quality of Life Among Adult Survivors of Childhood Cancer

Risk prediction models are important to identify survivors of childhood cancer who are at risk of experiencing poor health-related quality of life (HRQOL) as they age. To develop and validate prediction models for a decline in HRQOL among adult survivors of childhood cancer. This prognostic study included 4755 adults from the Childhood Cancer Survivor Study (CCSS) diagnosed between January 5, 1970, and December 31, 1986, who completed baseline (time 0 [November 3, 1992, to August 28, 2003]) and 2 follow-up (time 1 [February 12, 2002, to May 21, 2005] and time 2 [January 6, 2014, to November 30, 2016]) surveys. Data were analyzed from June 19, 2019, to February 2, 2022. Sociodemographic, lifestyle, and emotional factors, and chronic health conditions (CHCs) were assessed at time 0 and time 1, and neurocognitive factors were assessed at time 1 to predict HRQOL at time 2 and a decline in HRQOL between time 1 and time 2. Impaired health states were defined as CHC grades 2 to 4 using the modified Common Terminology Criteria for Adverse Events, version 4.03, and mental and neurocognitive status as 1 SD or more below reference levels. Health-related quality of life was operationalized using the Medical Outcomes Study 36-Item Short Form Health Survey Physical (PCS) and Mental (MCS) Component Summary and classified by optimal (≥40) or suboptimal (<40) at each point (main outcome). A decline in HRQOL was defined as a change from optimal to suboptimal between time 1 and time 2. Multivariable logistic regression identified factors associated with HRQOL decline. The cohort was randomly split into training (80%) and test (20%) data sets for model development and validation; the area under the receiver operating characteristic curve was used to evaluate prediction performance. A total of 4755 adults (mean [SD] age at time 0, 24.3 [7.6] years; 2623 [55.2%] women) were included in the analysis. Between time 1 and time 2, 285 of 3294 survivors (8.7%) had declining PCS and 278 of 3294 (8.4%) had declining MCS. Risk factors associated with PCS decline included female sex (odds ratio [OR], 1.67 [95% CI, 1.25-2.24]), family income less than $20 000 vs $80 000 or more (OR, 2.00 [95% CI, 1.21-3.30]), presence of CHCs (OR for neurological, 2.16 [95% CI, 1.51-3.10]; OR for endocrine, 2.25 [95% CI, 1.44-3.52]; OR for gastrointestinal tract, 1.89 [95% CI, 1.32-2.69]; OR for respiratory, 1.66 [95% CI, 1.06-2.59]; OR for cardiovascular, 1.53 [95% CI, 1.14-2.06]), and depression (OR, 1.79 [95% CI, 1.20-2.67]). Risk factors associated with MCS decline included unemployment vs full-time employment (OR, 1.68; [95% CI, 1.19-2.38]), current vs never cigarette smoking (OR, 2.03 [95% CI, 1.37-3.00]), depression (OR, 4.29 [95% CI, 2.44-7.55]), somatization (OR, 1.63 [95% CI, 1.05-2.53]), impaired task efficiency (OR, 1.90 [95% CI, 1.34-2.68]), and impaired organization (OR, 1.67 [95% CI, 1.12-2.48]). The areas under the receiver operating characteristic curve for the test models were 0.74 (95% CI, 0.67-0.81) for declining PCS and 0.68 (95% CI, 0.60-0.75) for declining MCS. In this prognostic study of adult survivors of childhood cancer who experienced declining HRQOL, CHCs were associated with a decline in physical HRQOL, whereas current smoking and emotional and neurocognitive impairment were associated with a decline in mental HRQOL. These findings suggest that interventions targeting modifiable risk factors are needed to prevent poor HRQOL in this population.

Impact of Hospitalization on the Quality of Life of Patients with Chronic Kidney Disease in Saudi Arabia.

Chronic kidney disease (CKD) is a global health problem. CKD causes patients to be hospitalized for a longer time to treat the disease. The impact of the hospitalization brings major changes and affects the quality of life (QoL) of the patients. In this study, we aimed to evaluate the impact of hospitalization on the QoL of patients with CKD. A cross-sectional study was conducted at the inpatient departments (IPDs) and outpatient departments (OPDs) of selected hospitals, in the eastern region of Saudi Arabia. The kidney disease quality of life (KDQOL) scale was used for the data collection and the findings were analyzed. The hospitalized patients had a poorer QoL than the OPD patients. The physical component summary (PCS) and mental component summary (MCS) mean scores were 52.82 ± 2.32 and 52.57 ± 2.93 in IPD patients, respectively, and 63.46 ± 3.65 and 66.39 ± 0.91 in OPD patients, respectively, which was significant (p < 0.0001). The QoL of patients decreased in the end stages of CKD. A significant association was observed between gender, occupation, smoking, and the stages of CKD with the QoL of the hospitalized patients. Measures must be taken to improve the QoL of these patients at all levels.

Psychosocial measures in relation to smartwatch alerts for atrial fibrillation detection

Psychosocial measures in relation to smartwatch alerts for atrial fibrillation detection

Health-related quality of life of patients with multiple sclerosis: Analysis of ten years of national data

BackgroundMultiple sclerosis (MS) is a progressive autoimmune disease of the central nervous system. Both the physical and mental burden of MS affect patients’ health-related quality of life (HRQoL). However, there is limited research at the national level evaluating the humanistic burden among MS patients. ObjectivesThis study evaluated the HRQoL and functional limitations among MS patients using ten years of national survey data. MethodsGuided by the conceptual framework of the Wilson and Cleary model, this study compared HRQoL between adults diagnosed with MS (Clinical Classification Code= “080″) and non-MS adults using the 2006–2015 Medical Expenditure Panel Survey (MEPS) data. The humanistic burden included HRQoL and functional limitations. The HRQoL was evaluated using physical component summary (PCS) and mental component summary (MCS) based on the Short Form Health Survey (SF-12). The study applied the multivariable Generalized Linear Models (GLM) to estimate the marginal differences in PCS and MCS based on the SF-12. In addition, seeking help for activities of daily living (ADL) and instrumental activities of daily living (IADL) were modeled with multivariable logistic regression. ResultsAccording to the MEPS, the estimated annual prevalence of MS was 0.52 million (95% Confidence Interval [CI]: 0.42–0.60). MS patients were mainly female (71.90%), middle aged (50–64 years, 40.21%), non-Hispanic whites (78.29%), and enrolled in private insurance plans (68.93%). The average PCS scores in MS and non-MS groups were 35.70 and 49.48, respectively. The average MCS scores were 45.58 and 51.25 for MS and non-MS groups, respectively. In addition, 18.26% of MS patients sought help for ADL, and 27.08% sought help for IADL. After adjusting for individual, biological, and environmental characteristics, the multivariable GLM with Poisson distribution indicated that the marginal difference of PCS score was 11.10 (95% CI: 9.50–12.61) units lower, and the MCS score was 4.89 (95% CI: 3.44–6.30) units lower among MS patients. In addition, MS patients were 17.32 (95% CI: 11.61–25.84) and 14.43 (95% CI: 10.09–20.65) times more likely to request assistance for ADL and IADL, respectively. ConclusionsMS was associated with lower physical and mental HRQoL than their non-MS counterparts and MS patients were more likely to request help for ADL and IADL. More work is needed to evaluate the effect of treatment strategies on improving the HRQoL and functional limitations in MS.

Impact of apremilast on quality of life in Behçet’s syndrome: analysis of the phase 3 RELIEF study

ObjectiveTo assess apremilast’s impact on patient quality of life (QoL) in active Behçet’s syndrome and correlations between improvement in patients’ QoL and efficacy measures in the phase 3 RELIEF study.MethodsQoL...

Poster 207: Effects of the COVID-19 Pandemic Lockdown on Access to Physical Therapy and Postoperative Sport Testing, Patient Reported Outcomes and Mental Health Scores Following Anterior Cruciate Ligament Reconstruction

Objectives:When the COVID-19 pandemic caused mandatory closures of physical therapy offices and gyms in the winter and spring of 2020, many patients who had undergone ACL reconstruction (ACLR) over the previous months experienced unexpected interruptions in their rehabilitation process. The purpose of this study was to compare the sport testing, patient reported outcomes, and mental health scores between ACLR patients whose postoperative physical therapy may have been disrupted by the COVID-19 pandemic versus a control cohort of ACLR patients who completed their physical therapy the year prior to the pandemic. With the barriers created by COVID-19, we aimed to understand the relationship between access to physical therapy and objective/subjective patient outcomes as well as mental health scores.Methods:A retrospective study of prospectively collected data as well as prospective collection of patient questionnaires was performed. The control group was patients who underwent ACLR from November 2018 to March 2019 while the experimental “COVID” group consisted of patients who underwent ACLR from November 2019 through March 2020. Patients with concomitant meniscal injury were included, but any revision surgery or multiligamentous knee injury was excluded. Patients must have completed sport testing at 6-7 months postoperatively to be enrolled. Retrospective chart data including surgery specific data, patient specific demographic data, sport testing outcomes including thigh girth, quadriceps and hamstring index, Y-balance, Keiser leg press were reviewed. Patient reported outcome measures were collected through our institutional registry including IKDC, Lysholm, Tegner, SF-12 physical (PCS) and mental (MCS) component summaries, WOMAC and patient satisfaction. Finally, prospectively collected data included the ACL-RSI questionnaire as well as a study-specific questionnaire administered to the experimental population to assess the effect of the pandemic closures on their access to postoperative rehabilitation. Primary analysis compared sport testing outcomes at 6-7 months postoperative between the control group and the COVID group. Secondary analyses compared patient reported outcomes and patient satisfaction between groups. Subgroup analyses included comparisons within the COVID group based on ACL-RSI scores as well as access to PT and self-directed therapy during the pandemic.Results:A total of 50 patients with median age 34.5 years (52% female) were enrolled in the study, 25 in the control group and 25 in the COVID experimental group. Baseline demographics, surgery specific details and preoperative outcomes scores were similar between the groups, with the exception of a higher number of meniscal repairs performed in the COVID group (48% vs. 24%, p = 0.032). Median follow-up for sport testing was 7 months, and no statistically significant differences were seen between the two groups when comparing quadriceps index, hamstring index, Keiser power, Keiser reaction, y-balance, or girth testing (Table 1). Notably, more patients reached full flexion (≥140 degrees) in the control group than the COVID group (96% vs. 76%, p=0.05). Additionally, no differences were seen with regards to patient reported outcomes between the two groups.Subgroup analyses were then performed on the COVID group only. 48% of patients missed in-person physical therapy appointments due to the pandemic, while 68% of patients were able to perform self-directed physical therapy with the largest proportion reporting a frequency of 3-5x a week or higher. Interestingly, missing in-person physical therapy appointments was not statistically significantly associated with worsened postoperative sport testing, patient reported outcome or ACL-RSI scores. Meanwhile, those who participated in frequent (>3x per week) self-directed physical therapy reported improved ACL-RSI scores overall when compared to those patients only participating <2x per week, however only the risk appraisal subscore of the ACL-RSI was statistically significant (median 83 vs 38, p=0.03).Conclusions:Patients who underwent ACLR in the 4 months prior to the 2020 COVID-19 pandemic demonstrated a high rate of decreased access to physical therapy, but did not have significantly worsened sport testing, subjective outcome measures or mental health scores compared to a matched population undergoing ACLR in the same 4 months of 2019. Even when controlling for patients who specifically reported missing physical therapy appointments during the pandemic, no differences were seen. Participation in higher frequency of self-directed therapy led to improved ACL-RSI scores at 1- year postoperatively. These results may suggest that the bourgeoning availability of online and virtual therapy resources necessitated by the pandemic may have long-lasting value in supplementing postoperative rehabilitation, especially for those patients with limited access to in-person therapy due to time, distance, financial or insurance constraints. Additionally, these results have implications for any ongoing ACLR study that may have concerns about data validity in those patients whose perioperative period coincided with the COVID-19 pandemic.Table 1.Comparison of Experimental versus Control groups with respect to physical rehabilitation return to sport assessments.

Quality of Life Assessment and Related Factors of HIV-Infected Patients in Hangzhou Using a Path Analysis Model: An Observational Study.

ObjectiveThis study aimed to examine which path among direct and indirect effects was more influential to the quality of life (QOL) for patients with human immunodeficiency virus (HIV).MethodsAn observational study among 951 individuals diagnosed with HIV was conducted in designated acquired immunodeficiency syndrome (AIDS) medical institutions in Hangzhou using simple random sampling technique. We collected the demographic data of patients and then evaluated their QOL by 12-Item Short-Form (SF-12) questionnaire survey. The two-stage least squares analysis was firstly performed to filter the independent influencing factors of Physical Component Summary (PCS) and Mental Component Summary (MCS). We then enrolled the PCS, MCS, and their influencing factors into the path analysis of QOL, and further revealed the direct and indirect effects of variables and examined the important path that was more influential on the patient’s QOL.ResultsThe patient’s PCS, MCS, and quality of life showed a significant difference between groups in terms of education level and working condition (all P<0.05). Regression analysis showed that depression, age, education level, and treatment independently affected the PCS (all P<0.05), and depression and anxiety exerted an independent effect on the MCS (all P<0.05). Further path analysis integrating related variables showed that the main indexes of the goodness of fit implied the final model fit the data well. The path analysis showed that PCS and MCS exerted direct effects on the QOL (all P<0.001), especially the MCS (β=0.785), but other variables exerted no direct effects (all β=0, all P>0.05). It should be noted that anxiety presented an obvious indirect effect on the QOL (β=0.460), and its indirect effect was similar to the direct effect of PCS (β=0.471).ConclusionThe MCS might exert a more important effect on the QOL of HIV patients. In addition, the indirect effect of anxiety on the QOL should not be ignored.

Intraportal Islet Autotransplantation Independently Improves Quality of Life After Total Pancreatectomy in Patients With Chronic Refractory Pancreatitis.

To determine if islet autotransplantation (IAT) independently improves the quality of life (QoL) in patients after total pancreatectomy and islet autotransplantation (TP-IAT). TP-IAT is increasingly being used for intractable chronic pancreatitis. However, the impact of IAT on long-term islet function and QoL is unclear. TP-IAT patients at our center >1 year after TP-IAT with ≥1 Short Form-36 QoL measure were included. Patients were classified as insulin-independent or insulin-dependent, and as having islet graft function or failure by C-peptide. The associations of insulin use and islet graft function with QoL measures were analyzed by using a linear mixed model, accounting for time since transplant and within-person correlation. Among 817 islet autograft recipients, 564 patients [median (interquartile range) age: 34 (20, 45) years, 71% female] and 2161 total QoL surveys were included. QoL data were available for >5 years after TP-IAT for 42.7% and for >10 years for 17.3%. Insulin-independent patients exhibited higher QoL in 7 of 8 subscale domains and for Physical Component Summary and Mental Component Summary scores ( P <0.05 for all). Physical Component Summary was 2.91 (SE=0.57) higher in insulin-independent patients ( P <0.001). No differences in QoL were observed between those with and without graft function, but islet graft failure was rare (15% of patients). However, glycosylated hemoglobin was much higher with islet graft failure. QoL is significantly improved when insulin independence is present, and glycosylated hemoglobin is lower with a functioning islet graft. These data support offering IAT, rather than just performing total pancreatectomy and treating with exogenous insulin.

Quality of Life in University Students with Diabetes Distress: Type 1 and Type 2 of Diabetes Differences.

Background This study constitutes a preliminary trial to clarify the relationship between quality of life (QoL) and diabetes distress (DD in patients with diabetes mellitus (DM) by comparing patients with type 1 and type 2 diabetes. Methods A cross-sectional study of university students with diabetes (type 1 and type 2) diabetes. One hundred sixty-six students were assigned to participate in this study. A self-report questionnaire on demographic and clinical parameters was taken. Rating worries and anxieties related to diabetes were evaluated using the diabetes distress scale-17, and quality of life was tested using SF-36 v2. Results No significant differences were observed in the level of DD according to sociodemographics in type 1 DM (T1DM) and type 2 DM (T2DM) (p > 0.05). The mean scores for Physical Component Summary (PCS) and Mental Component Summary (MCS) and six subscales of the SF-36 v2 demonstrated no significant differences between T1DM and T2DM (p > 0.05). High scores of diabetes distress were independently associated with lower glycemic control for students with both types of diabetes. Likewise, high scores of distress were associated with lower PCS (p < 0.05). Additionally, the results showed that high scores of diabetes distress were associated with lower MCS (p < 0.05). Conclusions University students with diabetes showed a high level of DD with no significant differences between both types of diabetes; this consequently affects all components of QoL. Psychological support is the better choice for those students for better health and future career.

Associations of health-related quality of life with depression and stigma in MERS-CoV survivors during the recovery period.

We explored factors related to health-related quality of life (HRQOL), including psychiatric symptoms and stigma related to Middle East respiratory syndrome coronavirus (MERS-CoV) infection, among MERS-CoV survivors during the recovery period.Sixty-three MERS-COV survivors were recruited from five hospitals for a cohort study, one year after their infection in 2015. The subjects’ demographic information and medical conditions associated with MERS-CoV were recorded. HRQOL was evaluated using the Short Form-8 Health Survey (SF-8). Depression, post-traumatic stress symptoms, chronic fatigue, and perceived stigma were assessed using several questionnairesThe mean physical component summary (PCS) and mean mental component summary (MCS) of the SF-8 score were below 50 T (43.47 ± 9.60, 45.74 ± 10.18). Depression, chronic fatigue, posttraumatic stress symptoms and stigma were negatively correlated with the SF-8 PCS and MCS. Multivariate logistic regression analysis showed that the PCS was associated with stigma (OR 8.66, 95% CI 1.96–38.23), whereas MCS was associated with depression (OR 26.62, 95% CI 3.56–198.85).The estimated HRQOL of MERS-CoV survivors during recovery was poor and appeared to be associated with depression and MERS-related stigma.

Comparisons between US norm-based two-component and Japanese norm-based three-component SF-36 summary scores in systemic lupus erythematosus patients.

We compared the US norm-based two-component vs. Japanese norm-based three-component summary scores of the Medical Outcomes Study Short Form-36 (SF-36) in patients with systemic lupus erythematosus (SLE). One hundred fourteen Japanese SLE patients were studied. SF-36 physical component summary (PCS) and mental component summary (MCS) scores were computed by the US norm-based two-component (US2) and Japanese norm-based three-component (JP3) models, respectively, and compared. Their association with demographics and disease characteristics was also analysed. The US2-PCS scores were significantly higher than the JP3-PCS scores (p < .001); however, the US2-MCS and JP3-MCS scores were not significantly different (p = .16). Bland-Altman analyses demonstrated that the US2-PCS scores were generally higher than the JP3-PCS scores, and their difference was larger in the subjects with lower PCS scores. However, the multiple linear regression analyses for the PCS and MCS scores computed by the different models demonstrated mostly equivalent standardized regression coefficients with the variables. Although the agreement between the US norm-based two-component and Japanese norm-based three-component models of the SF-36 was insufficient, their scores demonstrated similar associations with other variables. The application of the US original version could be acceptable in certain studies depending on the research question.

Comprehensive analysis of non-motor symptoms and their association with quality of life in Writer's cramp

ObjectiveLimited studies have focused on non-motor symptoms (NMS) in patients with Writer's cramp (WC). The current study aimed to examine the frequency of NMS and their association with health-related quality of life (HR-QoL) in patients with WC. MethodsA total of 80 patients with WC and 69 healthy controls (HCs) were enrolled. Motor symptoms was assessed by Burke-Fahn-Marsden dystonia rating scale and NMS was evaluated through several specific scales, including Hamilton depression rating scale-24 items (HDRS-24), Hamilton anxiety rating scale, Epworth sleepiness scale, Pittsburgh sleep quality index, fatigue severity scale (FSS), numerical rating scale for pain, and Montreal cognitive assessment. The HR-QoL was assessed using 36-item short form health survey (SF-36), which can be divided into physical component summary (PCS) and mental component summary (MCS). Multiple linear regression was used to analysis the association between each NMS and HR-QoL. ResultsThe patients presented more symptoms of depression, anxiety, poor quality of sleep, excessive daytime sleepiness, and fatigue than the HCs. The most frequent NMS in patients with WC was anxiety (51.25%) and depression (46.25%) symptoms. We found that motor symptoms had no association with HR-QoL. Higher scores of HDRS-24 were associated with lower scores of SF-36 in PCS and MCS. Meantime, higher scores of FSS were significantly associated with lower scores of SF-36 in MCS. ConclusionThe NMS was prevalent in patients with WC, with frequent anxiety and depression symptoms. Depression symptoms and fatigue had a strongly negative impact on HR-QoL and deserve attention in clinic practice.

Health-related quality of life among women aging with and without HIV in Peru.

Studies have shown that women aging with HIV have significantly lower health-related quality of life (HRQoL) compared to women without HIV. However, no studies have examined this issue in Latin America and the Caribbean. We aimed to explore HRQoL measured by the 36-Item Short Form Health Survey (SF-36) among women aging with and without HIV in Peru. We conducted a cross-sectional study at a large HIV-clinic in Peru. Outcomes of the SF-36 were evaluated, exploring the relationship between physical activity (International Physical Activity Questionnaire), sociodemographic factors (ethnicity, alcohol/tobacco use, age, BMI) and clinical data (AIDS progression, treatment duration, CD4+ cell count and viral load, years since HIV diagnosis) with HRQoL using regression analysis. Statistical significance was set with a two-tailed p-value <0.05. We enrolled 427 women (175 HIV-infected) with mean age of 54±8 years. From the SF-36 individual domains: physical functioning, role limitations due to physical and emotional health, and emotional wellbeing were significantly lower for HIV-infected women. Summary component scores were lower for the HIV-subset for both physical (45.8 vs 47.3) and mental (45.1 vs 45.8) components, although they did not achieve statistical significance. Regression analysis of the HIV-infected women revealed that the physical component score was significantly associated with physical activity, ethnicity, and chronic comorbidities while the mental component was significantly associated with physical activity, employment, and CD4+ cell count. In our study, HIV-infected women scored lower in both physical and mental component scores. Important determinants for each component included CD4+ cell count as an assessment of HIV severity for the mental component, and ethnicity, reflecting socio-cultural factors, for the physical component. These results reveal the importance of a holistic approach to addressing HRQoL in this population. Better understanding of these factors will help shape future policies and interventions to improve HRQoL of women aging with HIV.