EQ-5D Questionnaire Research Articles

Toward the Definition of Patient-Reported Outcome Measurements in Hereditary Spastic Paraplegia.

Hereditary spastic paraplegias (HSPs) are a heterogeneous group of rare neurodegenerative diseases, characterized by a progressive spastic paraparesis. Currently, there is a HSP-specific clinician-reported outcome measure (CROM) called Spastic Paraplegia Rating Scale (SPRS). There are, however, no specific patient-reported outcome measures (PROMs) for HSP. In the present cohort study, we prospectively follow up a well-examined Austrian HSP cohort using validated rating scales and compared PROM with disease-specific and non-disease-specific CROM. Patients were recruited and followed up at the Center for Rare Movement Disorders, Innsbruck, Austria. CROM included the SPRS, Scale for the Assessment and Rating of Ataxia (SARA), Barthel Index (BI), and Mini-Mental State Examination (MMSE). PROM included the EQ-5D questionnaire and the Patient Health Questionnaire 9 (PHQ-9). Standardized response means (SRMs) were calculated for all scales at follow-up (FU) after 1 year. A total of 55 patients (36 males) with HSP were included in the study. FU was performed for 30 patients (21 males). Apart from females reporting more problems in the EQ-5D domain of anxiety and depression (p = 0.008), other clinician-reported outcomes (CROs) or patient-reported outcomes (PROs) did not differ significantly across sex. SPRS showed significant correlations with SARA (p < 0.001), mainly driven by the gait item, as well as the BI. Although SPRS did not correlate with EQ-5D visual analogue scale and PHQ-9 scores, several EQ-5D domains correlated significantly with SPRS. At FU, SPRS showed the highest responsiveness (SRM 1.11), followed by SARA (SRM 0.47). Neither MMSE nor PRO significantly increased at FU. In this study, we present an Austrian cohort of patients with HSP and a prospective study evaluating correlations of CRO and PRO as well as their progression. Demographics from our cohort are comparable with several other European cohort studies. Our data highlight the capabilities of the SPRS to show clinical progression and warrant consideration of ataxia rating scales such as SARA in HSP cohorts. We also show that the generic PROMs are not suitable to detect change in HSP, and thus, we propose to create a disease-specific PROM fully depicting the effect of HSP on the patients' lives.

Medium to long term follow-up of survival and quality of life in patients with primary tumors of the cervical spine: Experience From a large single center.

To evaluate the survival and medium to long term health-related quality of life (HRQoL) of patients with primary cervical spinal tumors in a cross-sectional study and to identify any significant associations with demographic or clinical characteristics. Patients diagnosed with primary cervical spinal tumors were retrospectively enrolled and their clinical, radiologic, and follow-up data (specifically the EQ-5D questionnaire) were collected. Univariate and multivariate Cox time-dependent regression analyses were performed to examine the significance of certain variables on overall survival. Univariate and multivariate logistic regression analyses were conducted to identify variables significant for overall HRQoL and each dimension of the EQ-5D. A total of 341 patients were enrolled in the study with a mean follow-up of 70 months. The diagnosis was benign in 246 cases, malignant in 84, and unconfirmed in 11. The 5-year overall survival rate was 86% and the 10-year overall survival rate was 65%. Multivariate analysis suggested that surgical treatment (P = 0.002, hazard ratio [HR] = 0.431, 95% CI. [0.254, 0.729]), benign and malignant tumors [P < 0.001, HR = 2.788, 95% CI. (1.721, 4.516)], tumor and surrounding normal tissue boundary [P = 0.010, HR = 1.950, 95% CI. (1.171, 3.249)], and spinal instability [P = 0.031, HR = 1.731, 95% CI. (1.051, 2.851)] still had significant effects on survival. In this cross-sectional study, we evaluated the survival period and medium and long-term health-related quality of life of patients with primary tumors of the cervical spine, and analyzed the significant related factors of tumor clinical characteristics. Surgery, myelopathy, malignancy, spinal pain relieved by lying down or supine position, and tumor infiltration on MRI were significant predictors for overall survival. Enneking stage and age were significant predictors for HRQoL.

Health-Related Quality of Life Following Robotic-Assisted or Video-Assisted Lobectomy in Patients With Non-Small Cell Lung Cancer: Results From the RVlob Randomized Clinical Trial

Robot-assisted lobectomy (RAL) is increasingly used as an alternative to video-assisted lobectomy (VAL) for resectable non-small cell lung cancer (NSCLC). However, there is little evidence of any difference in postoperative health-related quality of life (HRQoL) between these two approaches. Is RAL superior to VAL in improving quality of life in patients with resectable NSCLC? We performed a single-center, open-label randomized clinical trial from May 2017 to May 2020 with 320 enrolled patients undergoing RAL or VAL for resectable NSCLC (RVlob trial; NCT03134534). Postoperative pain was evaluated by visual analog score or numeric rating score on postoperative day 1 and at weeks 4, 24, and 48. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30), EORTC Quality of Life Questionnaire in Lung Cancer (QLQ-LC13), and the European Quality of Life 5 Dimensions (EQ-5D) questionnaire were also administered at weeks 4, 24, and 48 after surgery. One hundred and fifty-seven patients underwent RAL and 163 underwent VAL. The mean pain score of patients after RAL was significantly lower at week 4 (2.097 ± 0.111 vs2.431 ± 0.108; P= .032). QLQ-C30 and QLQ-LC13 summary scores (P > .05) were similar for both RAL and VAL during the first 48weeks of follow-up. HRQoL scores assessed with the EQ-5D questionnaire were also comparable between the two groups (P > .05) during the whole study period. Both RAL and VAL showed satisfactory and comparable HRQoL and postoperative pain up to 48weeks after surgery, despite some minor statistical differences at week4. ClinicalTrials.gov; No.: NCT03134534; URL: www. gov.

Assessment of the Quality of Life Among Patients under Palliative Care

Abstract Background Palliative care is a form of medical care that focuses on providing comfort and pain relief to patients with severe, incurable diseases. The World Health Organization defines quality of life as “an individual’s perception of their position in life in the context of culture and value systems in which they live and in relation to their goals, expectations, standards and concerns”. Quality of life and palliative medicine represent two aspects that should be inseparable in the comprehensive care and treatment of a patient at the end of life. Objectives The aim of this study was to assess quality of life among patients under palliative care using the WHOQOL-BREF and EQ-5D questionnaire. Material and methods The study included 100 consecutive patients admitted to palliative care between September 2018 and January 2019 being treated in a hospice and at home. A three-part survey process was used to collect data, including the following: Demographic Data Form; WHOQOL-BREF questionnaire; EQ-5D questionnaire. Results The WHOQOL-BREF questionnaire was analyzed for 4 domains. The study obtained the following results: Domain 1=40.2; Domain 2=39.94; Domain 3=36.1; Domain 4=37.7. According to the guidelines of the EQ-5D questionnaire, it was shown that 43% of patients are unable to walk or have serious problems with walking, 59% of patients are unable or have serious problems with self-care, 61% of patients are unable or have serious problems with ordinary activities, 52% of patients have severe or extreme pain/discomfort, 65% of patients are very anxious or depressed. Conclusions 1. The study showed that patients covered by palliative care present low indicators of quality of life. 2. According to the data obtained, palliative care programs should pay special attention to the improvement of quality of life by taking an interdisciplinary approach to its resources.

Comparison of Quality of Life Between Breast Cancer Patients Treated With and Without Adjunctive Traditional Chinese Medicine in Taiwan.

In Taiwan, breast cancer has the highest incidence among all cancers. Although adjunctive traditional Chinese medicine treatment (TCM) have been used to ameliorate the side effects or discomfort caused by cancer treatments, no study has focused on the assessment of the quality of life of patients undergoing adjunctive TCM treatments. This study compared the quality of life between breast cancer patients treated with and without adjunctive TCM. Questionnaires were collected from 7 hospitals with a Chinese medicine clinic in 2018 to 2019. Breast cancer patients who had cancer stages I, II, or III and also underwent resection surgery were included in the study. They were divided into 2 groups: patients receiving cancer treatments with adjunctive traditional Chinese medicine (TCM group) and those receiving cancer treatments without adjunctive traditional Chinese medicine (non-TCM group). A 1:1 matching was used to obtain the study participants. The EQ-5D questionnaire was used to assess the quality of life. Statistical analysis was performed using the t-test and ANOVA to compare the differences between variables. The conditional multiple regression model was applied to explore the factors associated with quality of life in breast cancer patients. A total of 543 participants were surveyed, and 450 participants were included in the study. The EQ-5D score of the TCM group (81.60 ± 11.67) was significantly higher than that of the non-TCM group (78.80 ± 13.10; P < .05). The results of a conditional multiple regression model showed that the TCM group had a higher (3.45 points) quality of life than non-TCM group (P = .002) after adjusting for other related factors. After stratifying by cancer stage, patients with cancer stages II and III scored 5.58 and 4.35 points higher in the TCM group than did those in the non-TCM group (P < .05). Breast cancer patients undergoing cancer treatment with adjunctive traditional Chinese medicine have a higher quality of life than those treated without adjunctive traditional Chinese medicine.

Occupational performance skills in Parkinson's disease: relationship with health-related quality of life and caregiver burden.

The progression of Parkinson's disease (PD) results in a loss of ability to performance activities of daily living and health-related quality of life. The objectives of this study were to establish the relations between occupational performance skills and health-related quality of life, and the degree of caregiver burden in PD patients. Forty-nine patients at different stages of PD according to the Hoehn and Yahr scale participated in the study. Patients were assessed using the Parkinson's Disease Questionnaire (PDQ-39), the EuroQoL (EQ-5D), the Assessment of Motor and Process Skills (AMPS), and the Zarit Caregiver Burden Interview (ZCBI). Strong correlations were found between the motor skills section of the AMPS scale and the PDQ-39 (r = -0.76; p = 0.001), and the EQ-5D questionnaires (r = 0.72; p = 0.001), while moderate correlations were found with the process skills. AMPS process skills were moderately correlated with mobility and activities of daily living. The ZCBI was only weakly correlated with the AMPS motor skills (r = -0.34; p = 0.02). Declining scores on the AMPS scale are closely related to the loss of health-related quality of life in PD patients, and, to a lesser extent, with the degree of caregiver burden.

Comparison of the clinical efficacy of surgical versus medical method for first trimester pregnancy termination in Iran: A quasi-experimental research.

The surgical and medical options for management of pregnancy termination procedures are acceptable in practice but differ in clinical efficacy, costs, and patient experiences, and deciding what the best method is not clear always. This study aimed to compare clinical efficacy, outcomes, and patient acceptance of dilatation and curettage (D and C) versus medical abortion using misoprostol for first trimester of gestation in Iranian context. A prospective, multicenter, quasi-experimental research conducted from July 2021 to January 2022. The primary outcomes were the rate of composite complications or complete abortion. Data were analyzed with SPSS 18 using descriptive statistics, independent t-test, analysis of variance and non-parametric tests. Secondary outcomes were quality of life using EQ5D questionnaire, estimated blood loss, pelvic infection, pain level, hospital stay, and acceptability of intervention and relative risk as the effect size. Finally, 168 patients were included in this study. The composite complication rate among medical abortion patients is significantly more than that of surgical abortion patients (39.3% vs. 4.76%). The relative risk calculated 8.25 (3.05-22.26 CI). Medical abortion patients have experienced higher levels of ongoing bleeding, pain, and symptoms of pelvic infection. The higher level of acceptance has been reported by surgical group patients in comparison to the medical group patients (85.7% vs. 59.5%). Quality of life scores for surgical and medical group estimated 0.6605 and 0.5419, respectively. Surgical method of abortion using D and C is a very safe and highly successful option in comparison to the medical method using misoprostol alone and is associated with better clinical outcomes, acceptance, and quality of life in first trimester of pregnancy among Iranian women.

Asthenic post-COVID syndrome

To evaluate the efficacy and safety of combination therapy for post-COVID asthenic syndrome with multicomponent bioregulatory drugs Traumeel S, Ubichinon compositum and Coenzyme compositum. The study included 104 patients (averaged age 39.5 [30.8; 48] years) after COVID-19, clinically recovered from an acute infectious process, with asthenic syndrome lasting from 2 weeks to 6 months; the severity of asthenic syndrome on the asthenia VAS scale was at least 30 points. Before the start of the study, in addition to a physical examination, the patient's condition was assessed using the following questionnaires and scales: VAS for asthenia, subjective scale for assessing asthenia (MFI-20), L.D. Malkova, a questionnaire for the quality of life (EQ-5D), a questionnaire for identifying signs of autonomic disorders (Vayne A.M.). The patient's condition was monitored during follow-up visits 2 weeks, 1 month after the start of treatment and 1 month after the end of treatment. Patients of the main group received combination therapy, which included Traumeel S 1 tablet x 3 times a day, Ubichinone compositum and Coenzyme compositum 2.2 ml intramuscularly, alternating every other day, for 1 month (15 injections of each drug per course of treatment). Patients of the comparison group received eleutherococcus extract 100 mg during 30 days, 2 tablets x 2 times a day before mealsand vitamins B. The effectiveness of therapy was assessed by analysis of the asthenia severity (VAS scale), quality of life (EQ-5D questionnaire), patient satisfaction with treatment on a 5-point scale, which was carried out 1 month after the end of the course of treatment. As a result of the treatment was positive. The general asthenia severity, low activity and motivation significantly decreased in patients of both groups without significant differences. At the same time, in patients of the comparison group, there was no correlation between the quality of life and physical and mental asthenia, while in the main group there was an inverse correlation with the asthenia severity, which indicates an increase in the quality of life with a decrease in the severity of asthenia. One of the significant differences was the regression of headache and musculoskeletal pain in patients of the main group. The advantage of combined therapy of post-COVID asthenic syndrome with bioregulation therapy Traumeel S, Ubichinone compositum and Coenzyme compositum was shown in comparison with one of the common treatment regimens, including eleutherococcus extract and combined preparations of B vitamins.

Оценка эффективности и безопасности совместной терапии препаратом хондроитина сульфата и эндопротеза синовиальной жидкости Ревиск у пациентов с остеоартритом коленных суставов

Gonarthrosis is a chronic degenerative-inflammatory disease of the knee joint in which all components of the joint are affected. In current clinical guidelines for the treatment of osteoarthritis of the knee, the first step in therapy is the prescription of symptom-modifying drugs with delayed action. One of the most well-studied and effective of these drugs is chondroitin sulfate. A promising remedy for the treatment of gonarthrosis is intra-articular injections, primarily of high-molecular-weight hyaluronic acid preparations, which have proven effective in clinical practice. Their use at an early stage of the disease can contribute to a more complete implementation of the potential of these drugs. The purpose — to study the effect of the combined use of chondroitin sulfate and the Revisk synovial fluid prosthesis on reducing the severity of pain and improving functionality in patients with knee osteoarthritis. Material and methods. 60 patients with stage I–II gonarthrosis according to Kellgren-Lawrence, with intensity of pain according to VAS ≥ 50 mm, and with algofunctional Lequesne index ≥ 5 points were divided into three comparable groups of 20 people. All patients had no contraindications for intramuscular injection of chondroitin sulfate and intraarticular injection of hyaluronic acids, there were no anamnestic indications of their intolerance. In the comparison groups, patients received monotherapy with chondroitin sulfate intramuscularly (group 1) and hyaluronic acid 2.2% (group 2), in the main group, patients received combined therapy with chondroitin sulfate intramuscularly and Revisk intraarticular hyaluronic acid. The effectiveness of therapy was assessed by the dynamics of pain according to the VAS, the algofunctional index of Lequesne, the WOMAC index, and the EQ-5D questionnaire. Results. With the combined use of chondroitin sulfate and the Revisk synovial fluid prosthesis, a clinically more significant decrease in pain syndrome and an improvement in functional parameters were revealed than with monotherapy with chondroitin sulfate, and than with a single administration of hyaluronic acid preparations. At the end of the course of therapy, the severity of the pain syndrome decreased by 75.57%. Conclusions. The data obtained allow the use of both drugs in the complex therapy of knee osteoarthritis in patients with comorbidity. The combined use of chondroitin sulfate and Revisk synovial fluid prosthesis in patients with osteoarthritis of the knee joints reduces the severity of pain, improves functional activity, improves the quality of life of patients.

Health-Seeking Behavior and Quality of Life of People Living With HIV: Novel Evidence From Ghana.

The health and economic burdens of HIV/AIDS in low-and-middle-income countries are enormous despite global and local efforts to prevent and mitigate its effect. This study seeks to assess cadres' (or people living with HIV [PLHIV]) health-seeking behavior and its effects on their quality of life (QoL). We collected cross-sectional data from 218 HIV community cadres and 255 noncadres in 11 out of the 16 political regions in Ghana based on a modified WHOQOL-HIV-Brief and EQ-5D questionnaires. We used descriptive statistics to describe the sample and calculate the QoL scores. We also used regression analysis (ordered logit and ordinary least squares) to analyze the factors associated with the QoL of our respondents. We found that women (77%) are still disproportionally affected by HIV. Similarly, the youth, less educated and informal sector employees continue to be affected most by HIV. Factors related to QoL of PLHIV include being a community cadre, health-seeking behavior, comorbidities, and employment type. We recommend that alternative health providers be educated on the basic science of HIV/AIDS to help them offer appropriate support to PLHIV who visit them for care. Additionally, PLHIV should be supported to engage in less energy demanding employment options.

Prevalence and interference of neuropathic pain in the quality of life in patients with knee osteoarthritis

ObjectiveWith the aging of the population, more patients have complained of pain due to knee Osteoarthritis (OA), and the number of arthroplasties has also increased. The objective of this study is to evaluate the prevalence of the neuropathic pain component in candidates for Total Knee Replacement and the effects of this component on their quality of life. MethodsIn this cross-sectional study, patients with OA candidates for knee arthroplasty in the present institution were evaluated using the pain detection questionnaire and the Visual Analog Pain (VAS) scale to measure the pain index and the presence of associated neuropathic pain. In addition, evaluation of the quality of life and functionality using the EQ5D and SF12 questionnaires and their relationship with cases of neuropathic pain were performed. ResultsOne hundred twenty-six patients were evaluated, and 71.4 % were female. The age ranged from 46 to 85 years, and about 70 % of the patients had some associated clinical comorbidity. Neuropathic pain was present in 28.6 % of the patients evaluated. Patients with neuropathic pain presented worse results in the VAS evaluation, in the care, pain, and anxiety domains of the EQ5D, and in the physical and mental scores of the SF12. ConclusionNeuropathic pain was present in 28.6 % of the patients with knee OA who are candidates for arthroplasty. Patients with associated neuropathic pain present a higher level of pain and worse quality of life scores. Recognizing this type of pathology is extremely important in fully monitoring gonarthrosis.

Health-related quality of life variation by socioeconomic status: Evidence from an Iranian population-based study.

Health-Related Quality of Life (HRQoL) values based on the accurate and reliable European Quality of Life Five Dimension (EQ-5D) questionnaire gives health-state utilities as a helpful data set for studying socio-demographic and socio-economic inequalities in health status in the general population. We aimed to do a population-based study to see how HRQoL varies by socio-demographics and socioeconomic status (SES). The study was a cross-sectional population-based study in Shiraz, Iran's southwest. Data was gathered utilizing a personal digital assistant (PDA). A trained interviewer administered the EQ-5D questionnaire to a representative sample of 1036 inhabitants. Principal component analysis (PCA) was used to create SES indices. Because of the skewed distribution, quantile regression was utilized to model the quartiles of HRQoL values. STATA 12.0 was used to perform all statistical analyses. P <0.05 was considered statistically significant. In 1036 study respondents, women had a mean HRQoL of 0.67 ± 0.28, whereas men had a mean HRQoL of 0.78 ± 0.25. Gender and age remained significant in all quartiles of HRQoL value. Participants with insurance showed 0.14 and 0.08 higher HRQoL values in the first and second HRQoL quartiles than those without coverage, respectively. Education [95% CI: 0.034, 0.111)], economy [95% CI: 0.013, 0.077], and assets [95% CI: 0.003, 0.069] all had an impact on HRQoL value in the lowest quintile. In all quartiles of HRQoL value, women had lower reported HRQoL than men. Insurance programs aimed at more disadvantaged groups with poorer HRQoL may help to minimize inequity. Education, economics, and assets all had an impact on the lower quartiles of HRQoL value, emphasizing the importance of general policies in determining public health status.

THE ROLE OF BIOCHEMICAL MARKERS AND PATIENT-REPORTED OUTCOMES IN PREDICTING COMPOSITE ONE-YEAR ENDPOINT IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

Aim of our study was to determine the role of the clinical and biochemical markers in predicting the outcomes at one year in patients with STEMI who have undergone primary PCI. Materials and methods: The study included 165 patients admitted with STEMI within 12 hours of the onset of symptoms be¬tween January 2020 and August 2021. All patients underwent primary PCI according to the guidelines, followed by standard examination and treatment at the hospital. Blood samples for biomarker analysis (MMP-9, cTnI) and other routine tests were taken on admission. At six months after the event, all patients underwent clinical follow-up. Patients were contacted either by phone, through family members or their physicians 1 year after the event. Results: The composite endpoint reached 9% of patients at one-year follow-up. ROC analysis of MMP-9 with the one-year com¬posite endpoint showed an AUC=0.711, with 91.7% sensitivity, and 47.4% specificity, 95% CI - 0.604 to 0.802, p=0.0037. ROC analysis of EQ-5D questionnaire with the one-year composite endpoint showed AUC = 0.73, the 95% CI - 0.624 to 0.820, p< 0.0195, with sensitivity 54.5% and specificity 94.7%. A logistic regression model showed a statistical association with the com¬posite endpoint at one year after STEMI in both EQ-5D (OR=0.89, 95% CI: 0.8313- 0.9725, p=0.0079) and MMP-9 (OR=1.0151, 95% CI:1.0001-1.0304, p=0.0481). Conclusions: The level of MMP-9 more than 194 ng/ml and <55 points in EQ-5D predicts major adverse cardiovascular events, in¬cluding cardiovascular mortality and progressive heart failure, as well as other elements of composite endpoints, during a 1-year follow-up in patients with STEMI after primary PCI. Future studies are needed to clarify this result.

KORELASI ANTARA KADAR GULA DARAH DENGAN KUALITAS HIDUP PASIEN DIABETES MELLITUS DI FASILITAS PELAYANAN KESEHATAN PRIMER

Diabetes mellitus is a metabolic symptom caused by an increase in blood glucose due to impaired insulin secretion, insulin resistance, or both. Blood glucose levels above the normal limit have an influence on the quality of life of diabetes mellitus patients. The study was conducted with a cross sectional design. Data collection was carried out prospectively during the period from May to June 2022. The sample in this study was patients with diabetes mellitus in one of the primary health care centers in Banjarmasin City. Quality of life data was collected using the EQ-5D questionnaire, while blood glucose levels data was obtained from medical record patient. A total of 75 samples participated in this study. The results showed that the mean fasting blood sugar level was 162,95 mg/dL. The mean value of the sample's quality of life score based on the EQ-5D index was 0,739. There is a significant correlation between blood glucose levels and the quality of life of patients with diabetes mellitus. The results of the correlation indicated that the lower the blood

Application of non-drug methods in rehabilitation programs to improve the quality of life of patients after lower limb joint endoprosthetics

BACKGROUND: All over the world, osteoarthritis is a common disease and accounts for 10% of all diseases in the population, and therefore, the frequency of large joint arthroplasty continues to increase, which determines the need to develop new methods of complex treatment in the rehabilitation of patients after arthroplasty operations.&#x0D; AIM: Scientific substantiation of the expediency of the complex use of a stabilometric multifunctional platform with biofeedback and light therapy in patients after arthroplasty of the joints of the lower extremities to improve the quality of life in the late recovery period.&#x0D; MATERIAL AND METHODS: 60 patients were examined three months after total joint replacement of the lower limb at the age of 55 to 75 years. All patients were randomly divided into three groups of 20 people comparable in terms of clinical and functional characteristics. Patients of the main group were exposed to monochromatic polarized incoherent light and underwent physical training using a stabilometric complex with biofeedback COBS (mtd-Systems, Germany), in the comparison group, patients received therapeutic exercises on a stabilometric simulator with biofeedback, patients the control group received only a standard rehabilitation complex and drug therapy, which served as a background in the main group and the comparison group.&#x0D; RESULTS: Prior to the start of treatment, when analyzing the indicators of static and dynamic stabilometric studies, an uneven distribution of the load was established during tests with a preponderance towards the healthy leg. After a course of treatment, patients of all groups showed statistically significant positive results, however, a more pronounced improvement in indicators was observed in patients of the main group, less pronounced, but statistically significant results were obtained in the comparison group, and insignificant positive dynamics was noted in patients of the control group. When studying the quality of life and the effectiveness of treatment according to the EQ-5D questionnaire in the examined patients in the initial state, the indicator averaged 6.60.8 points. After the course of treatment, patients of the main group showed a statistically significant decrease in the scores of the EQ-5D questionnaire from 6.70.9 points in the initial state to 4.20.9 (p 0.001), which lasted up to 6 months. In patients of the comparison group, in all periods of observation, a decrease in the indicator was also noted, but less pronounced, in patients of the control group ― only a positive trend. The findings were supported by the results of the Hospital Anxiety and Depression Scale (HADS).&#x0D; CONCLUSION: The use of a comprehensive rehabilitation program with the inclusion of a stabilometric platform with biofeedback and polarized light "Bioptron" contributes to a marked improvement in the state of balance, balance and coordination abilities of patients, normalization of muscle tone, a significant reduction in anxiety and depression and can significantly improve the quality of life of patients with endoprostheses in the late recovery period.

Measuring the quality of life of long-term care service users in Japan: a cross-sectional questionnaire study

BackgroundIn Japan’s super-aging society, the number of long-term care service providers is increasing, and the quality of care is a matter of concern. One aspect of the quality of care is the user’s quality of life. The questionnaires EQ-5D and WHO-5 are representative indicators of quality of life. Herein, we aimed to measure the quality of life in long-term care service users in Japan and to clarify the relationship between quality of life and the level of care required.MethodsA questionnaire study was conducted in 106 facilities of 22 corporations. In addition to the EQ-5D and WHO-5, sex, age, and the level of care required were assessed by descriptive statistics. Bonferroni’s multiple comparison test was used to analyze each quality of life score, and the differences by sex and age were analyzed multiple regression analyses, with each quality of life score as the objective variable.ResultsOf 4647 cases collected, 2830 were analyzed, with no missing data. Both indicators tended to be lower than the general older population. Those scores tended to be higher in females than males (EQ-5D: males, 0.58 ± 0.26; females, 0.60 ± 0.24; P = 0.06 and WHO-5: males, 13.8 ± 5.92; females 14.9 ± 5.70; P < 0.001). In terms of age, those under 65 years old with specific diseases had lower EQ-5D scores than those in other age groups (P < 0.001); however, WHO-5 scores did not differ by age. Multiple regression analysis showed a significant association between the EQ-5D score and level of care required, except for support-required level 1, which tended to worsen as the level of care required increased. Conversely, the WHO-5 score was significantly lower for care need levels 2, 4, and 5.ConclusionsThe quality of life of long-term care service users was worse than that of the general older population, it tended to be low among males and those under 65 years old with specific diseases. Furthermore, it gradually decreased as the level of care required increased. It is important to monitor users’ quality of life as a quality indicator of care, to improve and manage it.

Some features of the effect of different methods of medical rehabilitation on the intensity of pain syndrome in patients after an ischemic stroke in the late recovery period

BACKGROUND: All over the world, scientific research is being actively conducted aimed at the prevention, treatment and rehabilitation of patients with cerebrovascular pathology, but acute cerebrovascular accidents still remain an acute medical and social problem in the world. Post-stroke complications include pain in the upper limb, which affects the performance of simple movements, reduces the level of daily life activity and, as a result, the quality of life of patients.&#x0D; AIM: to evaluate the effectiveness of the influence of various complexes of medical rehabilitation on the intensity of the pain syndrome in dynamics and quality of life in patients with acute cerebrovascular accident in the late recovery period of medical rehabilitation.&#x0D; MATERIALS AND METHODS: The paper presents data on the effectiveness of the influence of various methods of medical rehabilitation in the late recovery period in 120 patients with ischemic stroke in the late recovery period on pain intensity (according to the digital pain rating scale, NRS, and the Verbal Descriptive Pain Assessment Scale), activity of daily life (according to according to the Barthel index) and quality of life (according to the EQ-5D questionnaire). All patients were divided into 3 groups comparable in terms of clinical and functional characteristics: according to the clinical and functional characteristics of the group: group 1 ― 40 patients who received standard drug therapy and medical rehabilitation (exercise therapy, medical massage, mechanotherapy), group 2 (40 patients) who, in addition to the standard treatment complex, were prescribed massage with a pulsed low-frequency electrostatic field from the Khivamat apparatus and broadband modulation currents, group 3 (40 patients), who, against the background of standard therapy and medical rehabilitation, were included in physiotherapy methods from the Alpha apparatus LED Oxy Light-Spa.&#x0D; RESULTS: The data obtained indicate the advantage of including in the standard complex of medical rehabilitation and treatment of patients who have had ischemic stroke with movement disorders in the form of hemiparesis of a pulsed low-frequency electrostatic field and broadband modulation currents. This was confirmed by the improvement in the index of activity of daily life.&#x0D; CONCLUSIONS: In the course of the work, it was proved that the inclusion of a pulsed low-frequency electrostatic field and broadband modulation currents in a standard medical rehabilitation complex contributes to a significant reduction in pain syndrome, and also positively affects the assessment of the quality of life of patients after a course of treatment.

Remote Rehabilitation System for Patients after COVID-19 in Tyumen Region: a Prospective Comparative Randomized Study of 100 Patients

AIM. To evaluate the system of remote rehabilitation for patients after coronavirus infection (COVID-19) in Tyumen region and its first results. MATERIAL AND METHODS. A randomized trial, including 100 cases in patients who had had a moderately severe coronavirus infection. The following were analyzed: dyspnea progression (according to mMRS), the Borg test progression, Stange and Henci functional tests, and quality of life results according to the EQ-5D questionnaire. Telemedicine interaction was carried out using the Telemed72 application. The rehabilitation program included physical exercises and video classes. RESULTS AND DISCUSSION. There were no major problems with remote communication between the patient and the therapist in the course of the telerehabilitation. At the end of the rehabilitation period, two groups showed some positive changes. Group 1 reduced the severity of dyspnea by 2 points, Group 2 – by 1.5 points, the data of functional breathing tests improved, muscle strength increased and self-evaluation of the quality of life also improved. Contact with a medical professional during telerehabilitation sessions and exercising under the remote supervision of a specialist are of great importance for the patient. This preserves the principle of continuity and consistency in rehabilitation care. CONCLUSION. A system of telerehabilitation has been launched in Tyumen region. The patients, participating in remote tele-rehabilitation sessions, demonstrate improvements in functional breathing tests and quality of life scores. Expanding the boundaries of distant rehabilitation beyond large scientific and clinical centres will require training in the use of videoconferencing and operating special equipment.

Patient reported outcomes based on EQ-5D-5L questionnaires in head and neck cancer patients: a real-world study

ObjectiveHealth economic comparisons of various therapies are often based on health-related quality of life (HRQOL) using EQ-5D questionnaires within the framework of clinical trials. This real-world study prospectively evaluates the patient reported outcomes (PROs)-based HRQOL of head-and-neck (H&N) cancer patients undergoing modern radiotherapy (RT) to reflect PRO trajectories.MethodsAll H&N cancer patients treated in our clinic between July 2019 and December 2020 who completed the self-reported validated EQ-5D-5L questionnaire (health state index (HI) and Visual Analog Scale (VAS)) at baseline, end of radiotherapy, and at each respective follow up (FU) were included. Descriptive analysis of clinical and sociodemographic data, the frequency and level of each dimension was conducted. To assess the significance of therapy-induced HRQOL changes within and between the group, a distribution-based approach was used.ResultsAltogether, 366 participants completed a total of 565 questionnaires. For the whole cohort, HI at baseline was 0.804 (±0.208), 0.830 (±0.162) at RT completion, 0.812 (±0.205) at the first follow-up, and 0.769 (±0.224) at the second follow-up. The respective VAS values were 62.06 (±23,94), 66.73 (±82.20), 63.30 (±22.74), and 65.48 (±23.39). Females showed significantly lower HI values compared to males, but only at baseline (p = 0.034). Significantly lower HI values were also seen in patients with definitive RT as compared to adjuvant RT at baseline (p = 0.023), the second follow-up (p = 0.047), and the third follow-up (p = 0.010). As compared to outpatients, inpatients had significantly lower HI values at RT completion (p = 0.017), the second follow-up (p = 0.007), and the third follow-up (p = 0.031). Subgroup analyses by age (< 65 vs. ≥65) and smoking status (smokers vs. non-smokers) showed no difference at any time point.ConclusionPROs demonstrated detectability of time- and intra−/inter-group therapy-induced HRQOL changes. A further detailed exploration of EQ-5D-5L responsiveness for H&N cancer patients is required.

Improved health-related quality of life after cardioneuroablation in patients with vasovagal syncope.

As the most common cause of syncope, vasovagal syncope (VVS) is mediated by parasympathetic overactivity and/or sympathetic withdrawal. Although catheter ablation of ganglionated plexi or cardioneuroablation has been used to treat VVS, its role in quality of life (QoL) has not been formally evaluated. The aim of this study was to demonstrate if this novel treatment results in improvement QoL of patients with VVS. Twenty-seven consecutive patients (age: 34 ± 14years, 51.8% male) with dominant cardioinhibitory type VVS were prospectively enrolled in the study. After confirmation of > 3s asystole on head-up tilt testing (HUT), all patients underwent cardioneuroablation. ECGs were obtained prior to procedure and at 12-month follow-up visit. HUTs were repeated 1month after cardioneuroablation procedures. QoL was assessed with the use of SF-36, EQ-5D, and EQ VAS questionnaires. ECG, HUT, and QoL data were available in all patients. At 12-month follow-up, heart rate on rest ECG significantly increased (from 74 ± 15 to 84 ± 14bpm, p = 0.003). Repeated HUTs were negative in 23 (85.1%) patients. All of 27 patients remained free of syncope. QoL assessed by SF-36 score significantly improved in postprocedural follow-up (92 ± 9 and 96 ± 11, p = 0.016). Similarly, significant improvements in mobility, self-care, and usual activity domains of EQ-5D were observed (mean scores of 3.0 ± 1.5 and 2.1 ± 1.3, p < 0.001; 1.3 ± 0.9 and 1.2 ± 0.6, p = 0.041; 1.7 ± 1.0 and 1.4 ± 0.8 respectively). EQ-VAS score also improved significantly (39 ± 24 to 77 ± 18, p < 0.001). Our findings suggest that cardioneuroablation may be associated with intermediate term improvement in QoL in patients with VVS.