Disease Quality Of Life Questionnaire Research Articles

Measuring quality of life in trials including patients on haemodialysis: methodological issues surrounding the use of the Kidney Disease Quality of Life Questionnaire.

Haemodialysis (HD) treatment causes a significant decrease in quality of life (QoL). When enrolled in a clinical trial, some patients are lost prior to follow-up because they die or they receive a kidney transplant. It is unclear how these patients are dealt with in the analysis of QoL data. There are questions surrounding the consistency of how QoL measures are used, reported and analysed. A systematic search of electronic databases for trials measuring QoL in HD patients using any variation of the Kidney Disease Quality of Life (KDQoL) Questionnaire was conducted. The review was conducted in Covidence version 2. Quantitative analysis was conducted in Stata version 16. We included 61 trials in the review, of which 82% reported dropouts. The methods to account for missing data due to dropouts include imputation (7%) and complete case analysis (72%). Few trials (7%) conducted a sensitivity analysis to assess the impact of missing data on the study results. Single imputation techniques were used, but are only valid under strong assumptions regarding the type and pattern of missingness. There was inconsistency in the reporting of the KDQoL, with many articles (70%) amending the validated questionnaires or reporting only statistically significant results. Missing data are not dealt with according to the missing data mechanism, which may lead to biased results. Inconsistency in the use of patient-reported outcome measures raises questions about the validity of these trials. Methodological issues in nephrology trials could be a contributing factor to why there are limited effective interventions to improve QoL in this patient group. CRD42020223869.

Suicide and Related Factors in Parkinson’s Disease

Introduction Parkinson’s disease(PD) is a progressive, neurodegenerative nervous system disease.Psychiatric symptoms are common in PD,it is important to consider the suicide risk of these patients.ObjectivesThe aim of this study is to investigate the risk of suicide in PD with a case control study and to determine the factors that may be associated.Methods126 Parkinson’s patients and 117 age,gender matched healthy controls were included.Montreal Cognitive Assessment Scale(MoCA),Suicide Probability Scale(SPS),Beck Hopelessness Scale(BHS),Apathy Rating Scale(AES) and Multidimensional Scale of Perceived Social Support(MSPSS) were completed by participants.The PD group completed Parkinson’s Disease Quality of Life Questionnaire(PDQ-39) and data on disease duration,Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),levodopa-equivalent daily doses(LEDD) were obtained.Hamilton Anxiety Rating Scale(HAM-A) and Hamilton Depression Rating Scale(HAM-D) were administered to all participants.Results SPS total scores were significantly lower and total scores of HAM-A,HAM-D and MSPSS were found to be significantly higher in the PD group.There was no significant difference between the two groups in terms of BHS total scores.In PD group a linear relationship was found between SPS total scores and BHS,PDQ39, HAM-A and HAM-D and an inverse relationship with AES.In the regression analysis,it was concluded that a one-unit increase in BHS total scores increased the probability of suicide by 17.1%.ConclusionsIt is seen that SPS scores in patients are lower than controls and observed that SPS is correlated with hopelessness,depression,anxiety and quality of life.Although the possibility of suicide is found to be low in PD,this risk increases in patients with untreated depression and anxiety.Therefore,psychiatric evaluation may be recommended in these patients.DisclosureNo significant relationships.

Assessing quality of life in patients with autoimmune bullous diseases using the Persian version of Treatment of Autoimmune Bullous Disease Quality of Life questionnaire finds similar effects in women as men.

Background:In autoimmune bullous diseases (AIBDs), autoantibodies loosen molecular adhesions in the skin and/or mucosa and lead to blisters and erosions. Immunosuppressive drugs reduce mortality of the AIBD; therefore, patients will have to live longer with comorbidities.Objective:This study aims to determine the quality of life of AIBD patients undergoing systemic treatment while investigating the survey’s relationship with various factors.Methods:In this 2-step cross-sectional study, we initially included 53 consecutive pemphigus patients to investigate reliability and validity of the Persian version of Treatment of Autoimmune Bullous Disease Quality of Life (TABQOL) questionnaire. Then, we conducted the study on 119 AIBD patients, currently under treatment at an AIBD clinic in Iran.Results:The mean TABQOL score for our patients was 13.87 ± 7.51. The highest TABQOL was for epidermolysis bullosa acquisita (24 ± 8.485) followed by pemphigus foliaceus (20.5 ± 14.181) and the lowest for pemphigus vulgaris (13.24 ± 6.54). There was no significant difference between patients’ TABQOL scores and their gender, history of rituximab injection, and disease severity scores. We only found a positive correlation between TABQOL and prednisolone dose.Conclusion:Treatments of AIBD considerably impact the quality of life of patients and an impairment in quality of life is correlated to higher doses of prednisolone.

Neuropsychiatric Symptoms in Parkinson's Disease Patients Are Associated with Reduced Health-Related Quality of Life and Increased Caregiver Burden.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder resulting in reduced health-related quality of life (HR-QoL) of people with PD (PwP) and their caregivers. Furthermore, there is an accumulating burden on caregivers of patients in advanced stages of the disease. In previous studies, motor- and non-motor-symptoms of PwP have been identified to contribute to reduced HR-QoL and an increased caregiver burden. This cross-sectional observational study aimed to study the influence of neuropsychiatric symptoms measured with the Scale for Evaluation of Neuropsychiatric Disorders in Parkinson’s Disease (SEND-PD) questionnaire on the HR-QoL of PwP, as well as the caregiver burden. Analyses revealed a significant association between SEND-PD subscale mood/apathy and reduced HR-QoL in PwP, measured by the Parkinson’s disease quality of life questionnaire (PDQ-8) (p < 0.001). Furthermore, mood/apathy was significantly correlated with caregiver burden (p = 0.001) in the multiple linear regression analysis. Hence, neuropsychiatric symptoms were found to have a profound impact on the HR-QoL of PwP, as well as on caregiver burden. Since neuropsychiatric symptoms were one of the main predictors for caregiver burden, physicians of PwP should treat these symptoms to stabilize caregiver burden, as well as HR-QoL in PwP and their caregivers.

Prevalence of Advanced Parkinson's Disease in Patients Treated in the Hospitals of the Spanish National Healthcare System: The PARADISE Study.

Background: Advanced Parkinson’s disease (APD) has been recently defined as a stage in which certain symptoms and complications are present, with a detrimental influence on the overall patient’s health conditions and with a poor response to conventional treatments. However, historically, the term APD has been controversial, thus consequently, APD prevalence has not been previously studied. Objectives: The main objective was to determine the prevalence of APD in patients diagnosed with idiopathic PD in hospitals of the Spanish National Healthcare System. Secondary objectives were the prevalence and incidence of PD and the clinical and sociodemographic characteristics and quality of life of patients with APD or non-APD. Methods: This was a non-interventional, cross-sectional, multicenter, national study in the hospital setting. Results: The study population included 929 patients with PD (mean age 71.8 ± 10.1 years; 53.8% male) and a mean time since diagnosis of 6.6 ± 5.4 years. At the time of diagnosis, 613 patients (66.06%) reported having had premotor symptoms. The Hoehn and Yahr stage was 1 in 15.7% of the patients, 2 in 42.8%, 3 in 30.1%, 4 in 9.9%, and 5 in 1.4%; 46.9% of the patients had comorbidities (mean age-adjusted Charlson comorbidity index 3.5 ± 1.7; median 10-year survival 77%) and the mean 8-item Parkinson’s Disease Quality of Life Questionnaire was 27.8 ± 20.5. We found an APD prevalence of 38.21% (95%CI: 35.08–41.42%), a PD prevalence of 118.4 (95%CI: 117.3–119.6), and a PD incidence of 9.4 (95%CI: 5.42–13.4) all per 100,000 population. Among the APD population, a 15.2% were receiving some form of therapy for advanced stages of the disease (deep brain stimulation, levodopa/carbidopa intestinal gel, or apomorphine subcutaneous infusion). Conclusions: The percentage of patients with APD in the hospitals of the Spanish National Healthcare System was 38.2%.

Clinical assessment of endovenous thermal ablation combined with concomitant phlebectomy for the treatment of lower limb varicose veins with or without poor glycemic control

BackgroundThis study aimed to investigate the clinical results of endovenous thermal ablation combined with stab phlebectomy for unilateral varicose veins based on diabetic management. MethodsThe study reviewed 501 patients who underwent endovenous thermal ablation combined with stab phlebectomy for unilateral varicose veins, including 337 nondiabetics (control group) and 164 diabetics. Diabetics with hemoglobin A1c ≥7% were classified as the poor glycemic control group, and hemoglobin A1c <7% as the good glycemic control group. Surgical outcomes were assessed by Venous Clinical Severity Score. The Chronic Venous disease quality of life Questionnaire was used to assess the quality of life. ResultsLower limb varicose veins can be treated successfully with endovenous thermal ablation combined with stab phlebectomy in patients with or without poor glycemic control, accompanied by a significant improvement in health status. For patients with initial varicose veins (preoperative Venous Clinical Severity Score <10), the results revealed satisfactory improvements in Venous Clinical Severity Score and quality of life among the control, poor glycemic control, and good glycemic control groups. Patients with advanced varicose veins (preoperative Venous Clinical Severity Score ≥10) also showed an obvious amelioration concerning venous symptoms and quality of life. However, the extent of improvement varied among the 3 groups. Patients subjected to advanced varicose veins with the condition of poor glycemic control exhibited a less desirable improvement in postoperative health conditions compared with the control and good glycemic control groups, especially in edema relief and ulcer healing. ConclusionEndovenous thermal ablation combined with stab phlebectomy is safe and effective in the treatment of varicose veins with or without poor glycemic control. Clinical attempts at hemoglobin A1c management may contribute to improved clinical outcomes in patients with advanced varicose veins.

Mental health in people with Parkinson\u2019s disease during the COVID-19 pandemic: potential for targeted interventions?

The COVID-19 pandemic has introduced a myriad of challenges to the social life and care of people with Parkinson’s disease (PD), which could potentially worsen mental health problems. We used baseline data of the PRIME-NL study (N = 844) to examine whether the association between COVID-19 stressors and mental health is disproportionately large in specific subgroups of people with PD and to explore effects of hypothetical reductions in COVID-19 stressors on mental health and quality of life. The mean (SD) age of the study population was 70.3 (7.8) years and 321 (38.0%) were women. The linear regression effect estimate of the association of COVID-19 stressors with mental health was most pronounced in women, highly educated people, people with advanced PD and people prone to distancing or seeking social support. Smaller effect estimates were found in people scoring high on confrontive coping or planful problem solving. The parametric G-formula method was used to calculate the effects of hypothetical interventions on COVID-19 stressors. An intervention reducing stressors with 50% in people with above median MDS-UPDRS-II decreased the Beck Depression Inventory in this group from 14.7 to 10.6, the State-Trait Anxiety Inventory from 81.6 to 73.1 and the Parkinson’s Disease Quality of Life Questionnaire from 35.0 to 24.3. Insights from this cross-sectional study help to inform tailored care interventions to subgroups of people with PD most vulnerable to the impact of COVID-19 on mental health and quality of life.

Efficacy of C-Mill gait training for improving walking adaptability in early and middle stages of Parkinson’s disease

BackgroundWalking adaptability is an obvious manifestation of Parkinson’s disease (PD). Augmented reality technologies such as interactive walkways may improve walking adaptability in patients with Parkinson’s Disease (PWP). Research questionHow effective is C-Mill gait adaptability training in the early and middle stages of PD for improving walking adaptability in motor subtypes of the disease? MethodsFifty-two patients with early- or middle-stage PD were divided into two groups according to motor subtype (postural instability/gait disorder [PIGD] and non-PIGD) and received 7 days of training (0.5 h every day, 2 h after medication) on an augmented reality treadmill with built-in visual targets and obstacles. Functional assessments were performed before and after intervention, including posture control and walking, C-gait assessment, and participant experience. The Parkinson Disease Quality of Life questionnaire was administered at 3-month follow-up. ResultsBoth the PIGD (n = 29) and non-PIGD (n = 23) groups showed improved tandem walking, obstacle avoidance, and overall score in C-gait assessment and Timed Up and Go test after C-Mill training. However, there were no differences between the two groups. The PIGD group showed improvement in visually guided stepping and Speed adaptations, whereas the non-PIGD group did not improve. The non-PIGD group reported they could complete the training with less exertion after the intervention and at the 3-month follow-up, these patients reported improvement in quality of life. SignificanceC-Mill gait adaptation training in the early and middle stages of PD improves walking adaptability in both motor subtypes. Cue strategies are the probable mechanism and may decrease fall risk after training. There was no difference between the groups in the improvements of perceived exertion and quality of life at follow-up. Although PIGD patients showed statistic improvements in visually guided stepping compared with non-PIGD patients, but the difference was not likely to be clinically meaningful. Specific effects of C-mill training for different types of PD were not observed in our study.

Health related quality of life (HRQOL) of patients with End Stage Kidney Disease (ESKD) on hemodialysis in Addis Ababa, Ethiopia: a cross-sectional study

BackgroundEnd-Stage Kidney Disease, the most severe form of chronic kidney disease, is fatal if not treated by renal replacement therapy. Thus, patients with End-Stage Kidney Disease depend on hemodialysis as a lifesaving treatment for the remainder of their lives. However, the health-related quality of life (HRQOL) of patients on hemodialysis is much more underappreciated in resource limited countries.MethodsA hospital based cross-sectional study was conducted in Addis Ababa, Ethiopia, from August 01 to October 31, 2019. All patients who were on hemodialysis in five randomly selected public and private hospitals (n = 125) were included in the study. Data were administered by trained nurses by using a standardized Kidney Disease Quality of Life questionnaire. Clinical data were extracted from the patients’ medical charts. HRQOL was categorized as low, if the overall mean score was ≤ 50, or as high, if the overall mean score was > 50. Factors associated with lower HRQOL were identified by multi-variable binary logistic regression analysis and expressed by adjusted odds ratio (aOR) and its respective 95 % confidence interval.ResultsThe mean age of the study participants (n = 125) was 50.33 years (± 15.07) and more than two-thirds (68.8 %) of the participants were males. The mean score of HRQOL was 49.08 ± 11.09, with 48.0 % (95 % CI: 42.2 − 54.5 %) of them had lower HRQOL. Unemployed patients (aOR = 2.40, 95 % CI: 1.10–5.90) and patients who had hemodialysis 2 times per week (aOR = 1.71, 95 % CI: 1.07–3.83) had lower HRQOL. Elderly patients had higher odds of having lower mean score on the burden of kidney disease (aOR = 2.07; 95 % CI 1.18–4.13) as compared to the younger patients.ConclusionsNearly half of the patients with ESKD on hemodialysis had lower overall HRQOL which is associated with their unemployment status and frequency of hemodialysis per week. Elderly patients had lower mean score of burden of kidney disease. Therefore, quality of life of patients with chronic dialysis should be given special attention during the patients’ care. Measures should be taken by the government to ensure accessibility and affordability of the hemodialysis services in the country.

Assessment of Quality of Life and Treatment Adherence in Patients under Maintenance Hemodialysis: A Cross- Sectional Study

Introduction: Chronic Kidney Disease causes sudden changes in the daily lives of patients and creates a great impact on their quality of life. Failure of adherence in Hemodialysis can lead to increased morbidity, mortality, cost, and burden on health care system.&#x0D; Objectives: This study was conducted to assess the quality of life and adherence to treatment of patients undergoing Hemodialysis.&#x0D; Methodology: A descriptive correlational study was carried out at Nobel Medical College Teaching Hospital, Biratnagar, among 96 patients who were under HD using convenience sampling technique. The data was collected through face to face interview for the period of 5 months. Quality of life and adherence to treatment were assessed using Kidney Disease Quality of Life Questionnaire (KDQOL) and End Stage Renal Disease Adherence Questionnaire (ESRD – AQ) respectively. The data was analyzed using t test, Spearman correlation statistics.&#x0D; Results In this study, the overall mean score of quality of life (QOL) of patients under HD was 48.9±13.7. More than half (54.1%) of the patients had moderate adherence to treatment while 31.2% had good adherence. Domains with the highest and lowest scores on quality of life and adherence to treatment were social domain and illness impact and adherence to HD treatment and diet restriction, respectively. There was statistically significant association between total score of quality of life and duration of HD (p≤0.05). Likewise, there was statistically significant association between adherence to treatment and marital status (p≤0.05), educational status (p≤0.05), ethnicity (p≤0.05), duration of illness (p≤0.05). Poor correlation (r= 0.273) was observed between quality of life and adherence to treatment.&#x0D; Conclusion: On average, the kidney disease component dimension of quality of life of patients under HD is higher and the overall level of adherence to treatment was moderate. Thus proper periodic counseling on illness and its long term impact, regular follow up as well as information on adherance to dietary measures are important to improve the quality of life and treatment adherance of patients under hemodialysis.

Utility of the 50% stenosis criterion for patients undergoing stenting for chronic iliofemoral venous obstruction

ObjectiveThe criterion for venous stenting in symptomatic chronic iliofemoral venous obstruction has been the arbitrary use of stenosis of ≥50%. In the present study, we evaluated the intravascular ultrasound (IVUS)-determined degree of stenosis in patients who had undergone stenting for quality of life (QOL)-impairing symptoms and assessed the utility of the 50% stenosis cutoff. MethodsA retrospective review of contemporaneously entered electronic medical record data from 480 continuous patients (480 limbs) with initial iliofemoral stents placed (2014 to 2017) for symptomatic chronic iliofemoral venous obstruction impairing their QOL was performed. The IVUS-determined normal minimal luminal areas for the common femoral vein (125 mm), external iliac vein (150 mm), and common iliac vein (200 mm) were used to group limbs as having <50% (low-grade stenosis [LGS]) or ≥50% (high-grade stenosis [HGS]) stenosis. The variables compared included the visual analog scale (VAS) for pain score, venous clinical severity score (VCSS; range, 0-27), ulcer healing, supine foot venous pressures, QOL (20-item chronic venous disease QOL questionnaire), and stent patency. A composite chronic venous insufficiency score (CCVIS) incorporating the VAS score, VCSS, and CIVIQ-20 score for predicting improvement after stenting was evaluated. ResultsOf the 480 limbs, 283 and 197 were in the LGS and HGS groups, respectively. A preponderance of women, left laterality, and post-thrombotic syndrome were noted in both groups. At baseline, although no difference was found in the VAS for pain score between groups, the LGS group had a higher VCSS than did the HGS group (P = .05). The baseline median supine foot venous pressure was 15 and 14 mm Hg in the LGS and HGS groups, respectively (P = .17). At 24 months after stenting, the mean VCSS had improved from 6.3 to 4.4 (P < .0001) and from 5.7 to 3.7 (P < .0001) in the LGS and HGS groups, respectively, without significant differences between the two groups (P = .07). A greater prevalence of ulcers was found in the LGS group (18% vs 11%; P = .04), with no differences in healing (P = .41) or recurrence rates (P = .36). The QOL scores had improved in both groups (LGS, from 58 to 37 [P < .0001]; HGS, from 61 to 35 [P < .0001]), without differences between the two groups (P > .3). No significant differences in stent patency or reinterventions rates were found. A baseline CCVIS of ≥84.5, ≥86.9, or ≥105.3 was needed for a 30-, 40-, and 50-point improvement in most limbs after stenting. ConclusionsThe degree of IVUS-determined iliofemoral venous stenosis did not appear to affect the initial clinical presentation, CEAP (clinical, etiologic, anatomic, pathophysiologic) clinical class, supine foot venous pressure, clinical improvement, QOL improvement, stent patency, or reintervention rates after stenting. Patients presenting with QOL-impairing symptoms in whom conservative treatment has failed merit consideration of correction of their obstruction even if the degree of stenosis is <50%. The use of a CCVIS might be helpful but requires further study.

Quality of Life and Health Status Among Patients Receiving Renal Replacement Therapy in Trinidad and Tobago, West Indies.

PurposeThe determinants of quality of life for patients on renal replacement therapy vary across the world. The aim of this study is to determine the quality of life of patients on renal replacement therapy in Trinidad and Tobago and predictors thereof.Patients and MethodsThis cross-sectional study took place over a 1-year period. Data were obtained from 530 out of 1383 patients meeting inclusion criteria (100 transplants, 80 peritoneal dialyses, 350 hemodialyses) using the survey instruments. Stratified random sampling with proportional allocation was used to select patients at hemodialysis centres. The Kidney Disease Quality of Life questionnaire (KDQOL-36), EuroQol and demographic questionnaires were administered via face-to-face interviews. SPSS24, STATA14 and MINITAB18 were used for descriptive and inferential data analysis.ResultsOf the 530 patients, 52.5% were male, 37.5% were in the 56–65 years age group and 51.3% were of Indo-Trinbagonian descent. Hypertension (25.5%) and type 2 diabetes mellitus (62.0%) were reported as the main causes of kidney disease in the dialysis group. In the transplant category, chronic glomerulonephritis (45%) was the main aetiology of kidney disease. The KDQOL-36 domain scores and significantly associated variables included modality of renal replacement, Charlson’s Comorbidity Index, ethnicity, income and employment status. Transplant patients had higher mean subcomponent Kidney Disease Quality of Life scores and performed better in the EuroQol than patients on dialysis. Patients on peritoneal dialysis had a better quality of life than hemodialysis patients. Among patients on hemodialysis, an arteriovenous fistula significantly impacted their quality of life.ConclusionRenal transplant recipients enjoy the best quality of life and health state among patients on renal replacement therapy in Trinidad and Tobago. Increasing patients’ access to renal transplantation or peritoneal dialysis will markedly improve health status for the number of years of renal replacement therapy.

The Parkinson’s Real-World Impact Assessment (PRISM) Study: A European Survey of the Burden of Parkinson’s Disease in Patients and their Carers

Background:A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice.Objective:The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers.Methods:PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI).Results:Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8%. Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6).Conclusions:The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.

POS-601 QUALITY OF LIFE AND CLINICAL OUTCOMES OF HEMODIALYSIS PATIENTS IN A TERTIARY HOSPITAL IN METRO MANILA

The incidence of ESRD requiring dialysis has been increasing worldwide across age group and exerts a negative impact on patient’s quality of life. This study aimed to assess the quality of life and clinical outcomes in different age groups of hemodialysis patients in a tertiary hospital. One hundred ten hemodialysis patients were included in this cross-sectional study. Subjects were classified based on the following age group: young adult (20 to 40 years old), middle adult (41 to 64 years old), young old (65 to 74 years old), middle old (75 to 84 years old) and old-old (85 years old and above). Overall and quality of life scores per age group was assessed using the Kidney Disease Quality of Life questionnaire (KDQOL-SFTM1.3). Mean and median scores for individual domain, overall health, summary component scores namely - physical(PCS), mental(MCS), kidney disease(KDCS) - were analyzed and compared to demographics and clinical data. The overall quality of life scores of hemodialysis patients were above average for overall health, mental component (MCS) and kidney disease component scores (KDCS) and borderline for physical component score (PCS). However, only overall health and MCS scores were statistically significant when compared per age group. Older adults (young old to old-old) had better quality of life compared to the young adults. Age, mode of treatment, type of vascular access, hemoglobin and phosphorus levels were found to have effects on at least one of the QOL scores. Hospitalization rate was not significantly different across age groups and did not affect the quality of life scores. Young adults on hemodialysis had the poorest quality of life based on KDQOL scores compared to their older counterparts. Component scores were noted to be improving almost directly proportional to age which could be attributed to age-related differences on disease perception and coping process.

Improvement in quality of life with treatment of chronic venous disease: A longitudinal observational study in Kandy, Sri Lanka.

This study assessed the improvement in Quality of Life (QoL) of Chronic Venous Disease (CVD) patients in Sri Lanka following treatment. This was a prospective observational study of 58 newly or previously diagnosed CVD patients. QoL was assessed by the 14-item ChronIc Venous dIsease quality of life Questionnaire (CIVIQ-14) at 4 and 8 weeks after treatment. At 8 weeks, the improvement in Global score from baseline was greatest in the surgical group with adjusted least squares mean of 23.5 (p < 0.001) followed by the non-surgical group at 13.3 (p < 0.001). There was no significant improvement in the no-treatment group at 0.333 (p = 0.950). Similar results were obtained for Pain and Physical domain scores at 8 weeks. Likewise, at 4 weeks, Global score and Pain and Physical domain scores showed significant improvement in the surgical and non-surgical groups (all p < 0.001) only. Both surgical and non-surgical treatments improved QoL of CVD patients.

The Persian Translation and validation of the celiac disease quality of life questionnaire (CDQOL)

BackgroundConsidering the importance of having a celiac disease-specific measure of the quality of life (QOL) in Persian, the present study aimed to translate the celiac disease quality of life questionnaire (CDQOL) into Persian and evaluate its psychometric properties.MethodsIn this cross-sectional study, the Forward–Backward translation method was used. The content validation ratio (CVR) and the content validity index (CVI) were used for content validity assessment. The construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on 220 celiac patients who were selected randomly from the celiac disease (CD) registry database. The correlations between the result of the Persian version of CDQOL (PCDQOL), self-rated QOL, and short form-36 (SF36) were analyzed using the Pearson correlation test. The internal consistency and test–retest reliability were measured through Cronbach’s alpha and intraclass correlation coefficient (ICC).ResultsIn the present study, 220 celiac patients with a mean age of 35.54 ± 10.29 years participated. The mean CVI, CVR, and impact score of PCDQOL were 0.98, 0.96, and 4.82 respectively. Using EFA, four factors have extracted that had a good fit in CFA (Chi-square/DF = 1.74, RMSEA: 0.08, and CFI: 0.90, and NFI: 0.90). The results showed that there was a moderate to high correlation between PCDQOL, SF36 (r: 0.587, p = 0.02), and self-rated QOL (r: 0.64, p < 0.001). The questionnaire had high internal consistency (Cronbach alpha: 0.93) and test–retest reliability (ICC: 0.96 [0.86–0.99]).ConclusionThe PCDQOL questionnaire could be used by physicians and nutritionists to assess HRQOL in celiac patients in Iran.

Structural validation and dyadic child-parent measurement invariance of the celiac disease quality of life questionnaire.

The celiac disease quality of life questionnaire (CDDUX) is used widely in numerous languages worldwide. However, it's structural and construct validity and child-parent invariance had not been thoroughly examined. The objective of this study was to examine the psychometric properties of the 12-item CDDUX and the extent to which it meets the acceptable requirements of reliability and structural and convergent validity, as well as its child-parent invariance. In this cross-sectional study, 126 dyads of children aged 8-18 years and their parents completed the Hebrew version self-report and parent-proxy report CDDUX. Recently developed methods to examine psychometric properties and to measure invariance of dyadic samples were used while properly accounting for nonindependence in measurement patterns. A three-factor structure, each with sufficient internal consistency, is confirmed for both children and parents. Removing a single indicator of the diet subscale resulted in full configural (χ2(181) = 202.277, P > 0.05, RMSEA = 0.026) and metric (χ2(189) = 209.543, P > 0.05, RMSEA = 0.043) invariance of the measure between children and parents. However, this occurred only in partial-scalar (χ2(198) = 229.813, P > 0.05, RMSEA = 0.031) and uniqueness invariance, which is nevertheless sufficient for meaningful comparison between the groups. Overall, with minor modifications, the Hebrew version of the CDDUX was found to be a valid measure of children's celiac-related quality of life when measured across children's self-reports and parent-proxy reports. The CDDUX provides meaningful measurement and allows child-parent comparison.

Mapping MacNew Heart Disease Quality of Life Questionnaire onto country-specific EQ-5D-5L utility scores: a comparison of traditional regression models with a machine learning technique.

This study aims to derive country-specific EQ-5D-5L health status utility (HSU) from the MacNew Heart Disease Health-related Quality of Life questionnaire (MacNew) using both traditional regression analyses, as well as a machine learning technique. Data were drawn from the Multi-Instrument Comparison (MIC) survey. The EQ-5D-5L was scored using 4 country-specific tariffs (United States, United Kingdom, Germany, and Canada). The traditional regression techniques, as well as a machine learning technique, deep neural network (DNN), were adopted to directly predict country-specific EQ-5D-5L HSUs (i.e. a direct mapping approach). An indirect response mapping was undertaken additionally. The optimal algorithm was identified based on three goodness-of-fit tests, namely, the mean absolute error (MAE), mean error (ME) and root mean square error (RMSE), with the first being the primary criteria. Internal validation was undertaken. Indirect response mapping and direct mapping (via betamix with MacNew items as the key predictors) were found to produce the optimal mapping algorithms with the lowest MAE when EQ-5D-5L were scored using three country-specific tariffs (United Kingdom, Canada, and Germany for the former and United Kingdom, United States, Canada and Germany for the latter approach). DNN approach generated the lowest MAE and RMSE when using the Germany-specific tariff. Among different approaches been explored, there is not a conclusive conclusion regarding the optimal method for developing mapping algorithms. A machine learning approach represents an alternative mapping approach that should be explored further. The reported algorithms from response mapping have the potential to be more widely used; however, the performance needs to be externally validated.

Impact of cognitive intervention on cognitive symptoms and quality of life in idiopathic Parkinson's disease: a randomized and controlled study.

ABSTRACT.Pharmacological treatments for mild cognitive impairment (MCI), are lacking, and alternative approaches have been implemented, including cognitive training (CT).Objective:To determine the impact of CT on cognitive and quality of life measures in patients with Parkinson’s disease (PD) who were seen a hospital neurorehabilitation program.Methods:Thirty-nine individuals with MCI-PD, according to the Movement Disorder Society, were randomly distributed into two groups: experimental and control group, matched for demographic and clinical characteristics. Both groups were assessed for cognition and quality of life at the beginning of the study and at the end of the intervention protocol. The following instruments were used to assess cognition and quality of life: Addenbrooke’s Cognitive Examination III, Digit Span, Trail Making Test (TMT, A and B) and Parkinson disease quality of life questionnaire. The experimental group (EG) engaged in CT, whereas the control group (CG) underwent activities of the general rehabilitation program.Results:No baseline evaluation differences were found. Intergroup analysis showed differences in measures, such as total score (1.977, p=0.0480) and visuospatial domain (-2.636, p=0.0084) of the ACE-III, with the EG performing better, in addition to better performance in TMT-B mistakes (-1.928, p=0.0439). Intragroup analysis revealed that the EG showed significant improvement in almost all the cognitive variables, well as in self-reported quality of life (total score and mobility, activities of daily living, body discomfort dimensions).Conclusions:Engagement in cognitive activities was associated with better cognitive abilities in PD-MCI. Future studies should consider the long-term effect of this type of intervention and impact on functional activities.

Assessment of Health Related Quality of Life among Chronic Kidney Disease Patients: Challenges for Nephrologists in Pakistan

Introduction: During the past few decades, health related quality of life has been considered as an important predictor for positive health outcomes. Health-related quality of life assessment helps in determining the impact of disease on the everyday life of patients. Chronic kidney disease severely affects health related quality of life of patient.&#x0D; Objective: The objective of this study was to assess health related quality of life among patients with chronic kidney diseases in Pakistan.&#x0D; Methodology: A descriptive cross-sectional study design was used. Study respondents included CKD pre-dialysis and dialysis patients with or without comorbidities visiting tertiary care facilities located in twin cities of Pakistan. Sample size was calculated to be 386 pharmacists to achieve 95% confidence level with 5% margin of error. Convenient sampling technique was used to select respondents. A pre- validated questionnaire Kidney Disease Quality of Life questionnaire (KDQoL-36) was used. Data was coded and analyzed using SPSS 21 after collection. Mann-Whitney and Kruskal-Wallis (p ≥ 0.05) tests were according to different demographic variables.&#x0D; Results: The results of the current study showed lowest scores for HRQoL in domain of physical health composite (30.77±11.16) followed by domain of symptoms and problems associated with CKD whereas daily life had the highest scores. The results highlighted that females had better HRQoL in all domains mental health (46.30, ± 8.73), burden of kidney disease (69.47, ± 32.35), symptoms (29.79, ± 31.22) and effect of disease on daily activities (40.96, ± 32.11) while lowest score for physical health (30.90, ± 10.34). Married respondents had better HRQoL among all domains than unmarried patients except for physical health (32.26, ± 10.7). A significant difference (p ≥ 0.05) was observed among different domains of HRQoL of CKD patients with respect to different genders, marital status, age groups and qualification levels. Males had relatively better physical health scores but their daily activities were also affected more by their disease. Married respondents had relatively better HRQoL among all domains than unmarried patients except for physical health. No significant difference (p ≥ 0.05) was observed for different stages of disease.&#x0D; Conclusion: The present study concluded that patients with CKD had poor HRQoL regardless of novel treatments availability. A negative impact was observed across all domains of health related quality of life among chronic kidney disease patients. Necessary programs focusing on health education for patients with low literacy levels should be initiated to increase health awareness and improve mental health among CKD patients.