EUROHIS-QOL 8-item Index Research Articles

Long-term quality of life and work ability among severe COVID-19 survivors: A multicenter study.

Coronavirus disease 2019 (COVID-19), is known for its variable severity and high infectivity. Though fewer than 15% of infected cases develop severe disease, a major proportion had prolonged stay in the intensive care unit (ICU). Prolonged ICU stay is known to have a long-term impact on behavior and quality of life.8 Therefore, it is likely that patients discharged after severe COVID-19 have issues that persist for long term. The current study aimed to assess the long-term impact of severe COVID-19 on the Quality of life (QOL), sleep pattern, behavior, and workability. The current multicenter study adopted a cross-sectional design to analyze data from two tertiary care COVID-19 dedicated hospitals. All experimental procedures were approved by the ethics committee of the M.L.B Medical College. Participants were 20-60 age group who had been admitted to the ICU because of severe COVID-19 and had elapsed at least one and a half year since their discharge. After informed written consent the participants were assessed for: EUROHIS-QOL 8-item index; Workability Score; Quality of sleep; The major depression inventory (MDI) questionnaire; Generalized anxiety disorder 7 item scale (GAD-7); Current global health status score: an innovative subjective scale (1 -10) to determine the current global health status when 5 is the status before COVID-19. 491 participants were assessed, the median follow-up time after discharge from the hospital was 561·0days (range, 548-580days). The mean duration of ICU stay was 8.72±2.85days. There was significant reduction in the prevalence of obesity, diabetes, and hypertension as compared with discharge time. The mean of EUROHIS-QOL score, workability score, current global health status score was 3.28±0.98, 6.87±0.85, 4.53±1.36 respectively. The mean MDI and anxiety scores were 4.12±1.45 and 18.63±3.28, respectively. Severe COVID-19 survivors have new-onset psychological disorders and sleep disturbances. Long term quality of life and work ability remains poor after prolong ICU admission secondary to severe COVID-19.

Staging Parkinson's disease according to the MNCD classification correlates with caregiver burden.

Recently, we demonstrated that staging Parkinson's disease (PD) with a novel simple classification called MNCD, based on four axes (motor, non-motor, cognition, and dependency) and five stages, correlated with disease severity and patients' quality of life. Here, we analyzed the correlation of MNCD staging with PD caregiver's status. Data from the baseline visit of PD patients and their principal caregiver recruited from 35 centers in Spain from the COPPADIS cohort from January 2016 to November 2017 were used to apply the MNCD total score (from 0 to 12) and MNCD stages (from 1 to 5) in this cross-sectional analysis. Caregivers completed the Zarit Caregiver Burden Inventory (ZCBI), Caregiver Strain Index (CSI), Beck Depression Inventory-II (BDI-II), PQ-10, and EUROHIS-QOL 8-item index (EUROHIS-QOL8). Two hundred and twenty-four PD patients (63±9.6 years old; 61.2% males) and their caregivers (58.5±12.1 years old; 67.9% females) were included. The frequency of MNCD stages was 1, 7.6%; 2, 58.9%; 3, 31.3%; and 4-5, 2.2%. A more advanced MNCD stage was associated with a higher score on the ZCBI (p<.0001) and CSI (p<.0001), and a lower score on the PQ-10 (p=.001), but no significant differences were observed in the BDI-II (p=.310) and EUROHIS-QOL8 (p=.133). Moderate correlations were observed between the MNCD total score and the ZCBI (r=.496; p<.0001), CSI (r=.433; p<.0001), and BDI-II (r=.306; p<.0001) in caregivers. Staging PD according to the MNCD classification is correlated with caregivers' strain and burden.

Quality of life among people with different chronic diseases – A Finnish population-based study

Abstract Background In Finland, the associations between different chronic diseases and quality of life have not been comprehensively studied since the early 2000s. Updated information is needed. The aim of this study was to assess how much different common chronic diseases impair quality of life in the adult population. Methods This cross-sectional study was based on the FinHealth 2017 Study (sample n = 10 000) representing the Finnish adult population. The study population comprised 5208 individuals (PR 52%; aged 25+) whose quality of life (QOL) was measured using the EUROHIS-QOL 8-item index (EUROHIS-8). The overall EUROHIS-8 score was calculated by summing the scores on the eight items, with higher scores indicating better QOL. The mean value (ranging 1 to 5) of EUROHIS-8 was used. A total of 14 common chronic diseases including both psychiatric and somatic diseases were determined from the national health registers. Weighted mean values based on predictive margins were analyzed using linear regression models adjusted for age, sex, education, marital status, and other chronic diseases, taking into account the sampling design and non-response. Results Most of the chronic diseases studied impaired the quality of life. The lowest EUROHIS-8 mean scores were observed in individuals with depression (3.35; 95% CI 3.24, 3.46) compared to those without (4.01; 95% CI 3.99, 4.03) followed by Parkinson's disease (3.64; 3.45, 3.82 vs. 3.98; 3.96, 4.00), severe psychological disorders (3.75; 3.60, 3.89 vs. 3.98; 3.96, 4.00), rheumatoid arthritis (3.79; 3.69, 3.89 vs. 3.98; 3.96, 4.00), stroke (3.82; 3.66, 3.97 vs. 3.98; 3.96, 4.00), heart failure (3.84; 3.74, 3.94 vs. 3.98; 3.96, 4.00) and diabetes (3.84; 3.78, 3.91 vs. 3.99; 3.97, 4.01). Conclusions In the Finnish adult population, quality of life is impaired especially in those with mental disorders and in those having chronic diseases which limit physical functioning. Promoting the prevention of common chronic diseases is essential. Key messages • In social and health care, it is important to identify those people who are at the greatest risk to impaired quality of life and support their mental and physical functioning. • Health promotion actions to improve the prevention of chronic diseases are essential to promote quality of life and reduce human suffering at the population level.

Lifestyle and quality of life in children and adolescents during the covid-19 social distancing period

ObjectiveTo evaluate the lifestyle and quality of life in Brazilian children and adolescents during the COVID-19 social distancing period in 2020. MethodsThis cross-sectional study evaluated children and adolescents (2-18 years of age) and their parents, who voluntarily participated in an online survey. Snowball sampling was used to recruit participants during the first 6 months of the pandemic. A questionnaire was used to characterize the study population. The PedsQL 4.0 and the EUROHIS-QOL 8-item index were used to assess the quality of life (QoL) in children/adolescents and parents, respectively. Data were analyzed using SPSS 18.0 statistical program through the ANOVA with post hoc Bonferroni analysis, student's t test, and the generalized estimating equation. ResultsMean screen time increased from 2h pre-pandemic to 5h during the pandemic (p < 0.001), which was associated with a decline in PedSQL4.0 scores (from 75.7 ± 2.6 to 71.3 ± 13.7, p < 0.001). Unhealthy eating habits increased from 11% to 34% and were associated with worse QoL scores compared with improved or unchanged eating habits during the pandemic (69.7 ± 13.3 vs 72.80 ± 13.4 vs 76.4 ± 12.6; p < 0.001). Poor sleep quality increased from 9% to 31.7% and was associated with worse QoL scores compared to improved or unchanged sleep quality during the pandemic (67.3 ± 13.1 vs 74.5 ± 13.1 vs 76.8 ± 12.2; p < 0.05). Physical exercise was associated with better PedSQL4.0 scores (77.5 ± 12.3 vs 72.5 ± 14.4; p < 0.001). Children aged 2-4y old had the best QoLscores. ConclusionsPandemic-related social distancing promoted significant lifestyle changes in children and adolescents, increasing screen time, reducing physical activity, and worsening food and sleep quality, which resulted in worse QoL scores.

Depressive Symptoms and Their Impact on Quality of Life in Parkinson's Disease: An Exploratory Network Analysis Approach.

The clinical presentation of Parkinson's disease (PD) is often dominated by depressive symptoms, which can significantly impact the patients' quality of life (QoL). However, it is not clear how these depressive symptoms are interconnected, or if some symptoms are more influential in affecting QoL. In the Cohort of Patients with Parkinson's Disease in Spain (COPPADIS) study, 686 patients with PD were analyzed using network analyses. The patients completed the Beck Depression Inventory II (BDI-II) and provided their overall QoL (EUROHIS-QOL) at the beginning of the study. The study used centrality measures such as Expected Influence and Bridge Expected Influence to identify depressive symptoms that had the greatest impact on overall QoL. The results of exploratory network analyses indicate that the BDI-II items related to loss of energy, past failure, and tiredness or fatigue have the greatest impact on overall QoL as measured by the EUROHIS-QOL 8-item index. The loss of energy and tiredness or fatigue BDI-II items are also strongly associated with a number of different EUROHIS-QOL items, according to Bridge Expected Influences. For individuals suffering from PD, network analysis can aid in identifying significant non-motor symptoms that impact their QoL, thus paving the way for potential improvements.

Staging Parkinson's Disease According to the MNCD (Motor/Non-motor/Cognition/Dependency) Classification Correlates with Disease Severity and Quality of Life.

Recently, a novel simple classification called MNCD, based on 4 axes (Motor; Non-motor; Cognition; Dependency) and 5 stages, has been proposed to classify Parkinson's disease (PD). Our aim was to apply the MNCD classification in a cohort of PD patients for the first time and also to analyze the correlation with quality of life (QoL) and disease severity. Data from the baseline visit of PD patients recruited from 35 centers in Spain from the COPPADIS cohort fromJanuary 2016 to November 2017 were used to apply the MNCD classification. Three instruments were used to assess QoL:1) the 39-item Parkinson's disease Questionnaire [PDQ-39]); PQ-10; the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Four hundred and thirty-nine PD patients (62.05±7.84 years old; 59% males) were included. MNCD stage was:stage 1, 8.4% (N = 37); stage 2, 62% (N = 272); stage 3, 28.2% (N = 124); stage 4-5, 1.4% (N = 6). A more advancedMNCD stage was associated with a higher score on the PDQ39SI (p < 0.0001) and a lower score on the PQ-10 (p< 0.0001) and EUROHIS-QOL8 (p< 0.0001). In many other aspects of the disease, such as disease duration, levodopa equivalent daily dose, motor symptoms, non-motor symptoms, and autonomy for activities of daily living, an association between the stage and severity was observed, with data indicating a progressive worsening related to disease progression throughout the proposed stages. Staging PD according to the MNCD classification correlated with QoL and disease severity. The MNCD could be a proper tool to monitor the progression of PD.

Predictors of the change in burden, strain, mood, and quality of life among caregivers of Parkinson's disease patients.

Caregiver burden in Parkinson's disease (PD) has been studied in many cross-sectional studies but poorly in longitudinal ones. The aim of the present study was to analyze the change in burden, strain, mood, and quality of life (QoL) after a 2-year follow-up in a cohort of caregivers of patients with PD and also to identify predictors of these changes. PD patients and their caregivers who were recruited from January/2016 to November/2017 from 35 centers of Spain from the COPPADIS cohort were included in the study. They were evaluated again at 2-year follow-up. Caregivers completed the Zarit Caregiver Burden Inventory (ZCBI), Caregiver Strain Index (CSI), Beck Depression Inventory-II (BDI-II), and EUROHIS-QOL 8-item index (EUROHIS-QOL8) at baseline (V0) and at 2-year follow-up (V2). General linear model repeated measure and lineal regression models were applied. Significant changes, indicating an impairment, were detected on the total score of the ZCBI (p<0.0001), CSI (p<0.0001), BDI-II (p=0.024), and EUROHIS-QOL8 (p=0.002) in 192 PD caregivers (58.82±11.71years old; 69.3% were females). Mood impairment (BDI-II; β=0.652; p<0.0001) in patients from V0 to V2 was the strongest factor associated with caregiver's mood impairment after the 2-year follow-up. Caregiver's mood impairment was the strongest factor associated with an increase from V0 to V2 on the total score of the ZCBI (β=0.416; p<0.0001), CSI (β=0.277; p=0.001), and EUROHIS-QOL (β=0.397; p=0.002). Burden, strain, mood, and QoL were impaired in caregivers of PD patients after a 2-year follow-up. Mood changes in both the patient and the caregiver are key aspects related to caregiver burden increase.

Predictors of clinically significant quality of life impairment in Parkinson\u2019s disease

Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.

Headache and quality of life in Finnish female municipal employees.

Migraine and other specific types of chronic headache impair health-related quality of life (HRQoL). However, undefined headache is common in general population and little is known about its impact on QoL. This study addresses the impact of undefined headache symptoms on quality of life in a population of working-age females. This cross-sectional study consisted of 633 female municipal employees. Self-reported headache recurrence was defined by asking whether headache was occasional or recurrent. We assessed quality of life with two different instruments, the generic EUROHIS-QOL 8-item index (EUROHIS-8) and the preference-based instrument EuroQoL (EQ-5D) representing health-related QoL. Anxiety, depressive symptoms and work stress were measured using validated questionnaires. Adjusted hypothesis of linearity was evaluated using bootstrap type analysis of covariance with age, education and number of comorbidities as covariates. In the study population, 76% (n=481) had experienced headache during the past year, and of those 38% (n=184) had recurrent headache. The EQ-5D index decreased linearly with increasing headache symptoms and four out of five EQ-5D dimensions were lowest in recurrent headache group. Females with headache had lower QoL on every EUROHIS-8 item except for conditions of living place, compared to females without headache. These results remained statistically significant after adjustment with age, education and number of comorbidities. There were no differences in prevalence of musculoskeletal disorders between study groups. This cross-sectional, observational study showed that self-reported recurrent headache is common among Finnish women belonging to active work force. Both health-related and general QoL is best in females without headache and lowest in the recurrent headache group. We conclude that recurrent headache, even when the subjects have low anxiety and depressive symptoms scores, is associated with low HRQoL in working-age females. These results underline the importance of headache, a common and neglected symptom deteriorating female employees' wellbeing.

ANALYSIS OF THE EFFECTIVENESS OF THE FUNCTIONAL ORGANIZATIONAL MODEL FOR KNOWN PROPHYLAXIS OF CHRONIC NONINFECTIOUS DISEASES BASED ON THE ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS AT THE MEDICAL INSTITUTION

The aim: Study of the indicators of quality of life of patients served by a multidisciplinary health care institution with the functionally-organizational model of coded prevention of chronic noninfectious diseases is implemented. Materials and methods: To evaluate the effectiveness of the model's use we used the assessment of the dynamics of QL indices, which was assessed according to the EUROHISQOL 8-item index methodology among 376 patients aged over 18 years. Results: Most of the respondents (61.4%) were dissatisfied to varying degrees with their state of health and, on average, evaluated their QL (56.1%). ЗThe overall assessment of the quality of life of the surveyed population was on a 20-point scale of 13.5 (3.19) points in 2017 before the introduction of the program of managed prevention of СNCDs and 14.6 (3.48) points after its three-year operation, with an increase integrated indicator on average by 1.1 (95% CI 0.59 - 1.60) points (p <0.001). Among the areas of QOL assessment, the assessments in the physical sphere and the environment increased at most (p<0.05). It is determined that the overall level of QOL of patients with NCDs is 40% due to medical and social factors that can be positively influenced by medical care using a model of managed prevention. Conclusions: The analysis of changes in the quality of life of patients of multidisciplinary institutions who have risk factors for СNCDs or suffer from chronic non-communicable diseases, showed that the introduction of a functional-organizational model of managed prevention at the health care institution level can improve integrated assessment of QOL and positively affect the overall complex of medical and social factors, including managed risk factors. This indicates the effectiveness of this model of managed prevention at the level of a multidisciplinary health care institution.

Sense of Community and Quality of Life for Older Adults In Puerto Rico 2 Years After Hurricane Maria

Psychological sense of community plays an important role in the wellbeing of older adults, especially in cultures that revolve around community involvement and support. In 2017, Hurricane Maria devastated Puerto Rico, deeply altering community structure and social life. This study draws on the Ecological Theory of Aging to test the proposition that older adults’ sense of community is associated with self-assessed quality of life two years later. We conducted face-to-face interviews with a non-probability sample of 154 community-dwelling adults aged 60+ in Puerto Rico. We measured sense of community with the Brief Sense of Community Scale (BSCS) (range 0-32, mean= 24.75, SD= 6.04) and quality of life (QOL) with the EUROHIS-QOL 8-item index (range 0-32, mean= 21.61, SD=5.92). We used multiple linear regression to test the association of sense of community and quality of life while controlling for relevant covariates. Higher levels of sense of community were associated with better quality of life (β=0.270, p<0.001), while increased mental health symptoms (β=-0.557, p<0.001) and poor self-rated health (β=2.964, SE=7.17, p<0.001) were associated with lower quality of life. Findings indicate that sense of community is an important contributor to older adult’s quality of life in Puerto Rico, perhaps in part due to cultural and age-related factors. Moreover, sense of community may serve as a protective factor against adverse outcomes after large scale natural disasters. Researchers should continue to examine this association while advocating for and developing policies and programs that promote older adults' sense of community in post-disaster contexts.

Quality of life and non-motor symptoms in Parkinson's disease patients with subthreshold depression

BackgroundThe role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear. The present study aimed to compare the quality of life (QoL) in PD patients with subD vs patients with no depressive disorder (nonD). Factors related to subD were identified. Material and methodsPD patients and controls recruited from the COPPADIS cohort were included. SubD was defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL. ResultsThe frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD, 17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 ± 12.8 vs 11.6 ± 10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 ± 0.5 vs 4 ± 0.5; p < 0.0001) were significantly worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD patients (45.9 ± 32 vs 29.1 ± 25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011–1.028; p < 0.0001), neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045–1.139; p < 0.0001), impulse control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007–1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983–0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086–1.293; p < 0.0001; VAFS-mental; OR = 1.164; 95%CI 1.058–1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent levodopa dose, motor status (UPDRS-III), and living alone. ConclusionsSubD is a frequent problem in patients with PD and is more prevalent in these patients than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD patients.

Quality of life, psychological distress and violence among women in close relationships: a population-based study in Finland

BackgroundThe aim of this study was to examine associations between exposure to violence, quality of life, and psychological distress. Women aged 19–54 years who had been exposed to violence by someone in a close relationship were compared with women unexposed to violence in Finland. We also aimed to investigate associations between different forms of violence (physical, sexual, emotional, or any combination of these) with quality of life and psychological distress.MethodsWe selected a sample of 22,398 women who had returned self-completed questionnaires from a Finnish population-based health survey between 2013 and 2016. Exposure to violence during the past year was assessed through specific questions from the survey. The EUROHIS-QOL 8-item index was used to measure quality of life, and ordinary least square regressions were fitted. The mental health inventory (MHI-5) was used to measure psychological distress. We investigated associations with multivariate logistic regression analysis.ResultsAmong women in Finland, the prevalence of exposure to violence in any type of close relationship during the past year was 7.6%. Women who had been exposed to violence had significantly worse scores of the EUROHIS-QOL 8-item index, and psychological distress was significantly worse (p < 0.001), compared with unexposed women. Strong associations were found between combinations of violence and both quality of life (coefficient − 0.51, p < 0.001) and mental health (odds ratio 4.16, 95% confidence interval 3.44–5.03). Compared with women who had been exposed to violence by a stranger, women who had been exposed to violence by someone in a close relationship had significantly lower quality-of-life scores (p < 0.001).ConclusionsThis study found that experience of close relationship violence had a negative influence on both quality of life and psychological distress among women in the general Finnish population. Comparison with victims of violence by strangers shows that some of the lower quality-of-life scores among victims are driven by the perpetrator and victim being in a close relationship. Preventive policies in primary care settings aimed at screening and educating young people should be considered as an early form of intervention to reduce the negative mental health consequences of violence.

5-2-1 Criteria: A Simple Screening Tool for Identifying Advanced PD Patients Who Need an Optimization of Parkinson's Treatment.

Objective 5- (5 times oral levodopa tablet taken/day) 2- (2 hours of OFF time/day) 1- (1 hour/day of troublesome dyskinesia) criteria have been proposed by a Delphi expert consensus panel for diagnosing advanced Parkinson's disease (PD). The aim of the present study is to compare quality of life (QoL) in PD patients with “5-2-1 positive criteria” vs QoL in PD patients without “5-2-1 positive criteria” (defined as meeting ≥1 of the criteria). Methods This is a cross-sectional, observational, monocenter study. Three different instruments were used to assess QoL: the 39-Item Parkinson's Disease Quality of Life Questionnaire Summary Index Score (PDQ-39SI); a subjective rating of perceived QoL (PQ-10); and the EUROHIS-QOL 8-Item Index (EUROHIS-QOL8). Results From a cohort of 102 PD patients (65.4 ± 8.2 years old, 53.9% males; disease duration 4.7 ± 4.5 years), 20 (19.6%) presented positive 5-2-1 criteria: 6.9% for 5, 17.6% for 2, and 4.9% for 1. 37.5% (12/32) and 25% (5/20) of patients with motor complications and dyskinesia, respectively, presented 5-2-1 negative criteria. Both health-related (PDQ-39SI, 25.6 ± 14 vs 12.1 ± 9.2; p < 0.0001) and global QoL (PQ-10, 6.1 ± 2 vs 7.1 ± 1.3; p=0.007; EUROHIS-QOL8, 3.5 ± 0.5 vs 3.7 ± 0.4; p=0.034) were worse in patients with 5-2-1 positive criteria. Moreover, nonmotor symptoms burden (Non-Motor Symptoms Scale total score, 64.8 ± 44.8 vs 39.4 ± 35.1; p < 0.0001) and autonomy for activities of daily living (ADLS scale, 73.5 ± 13.1 vs 89.2 ± 9.3; p < 0.0001) were worse in patients with 5-2-1 positive criteria. Patient's principal caregiver's strain (Caregiver Stain Index, 4.3 ± 3 vs 1.5 ± 1.6; p < 0.0001), burden (Zarit Caregiver Burden Inventory, 28.4 ± 12.5 vs 10.9 ± 9.8; p < 0.0001), and mood (Beck Depression Inventory II, 12.2 ± 7.2 vs 6.2 ± 6.1; p < 0.0001) were worse in patients with 5-2-1 positive criteria as well. Conclusions QoL is worse in patients meeting ≥1 of the 5-2-1 criteria. This group of patients and their caregivers are more affected as a whole. These criteria could be useful for identifying patients in which it is necessary to optimize Parkinson's treatment.

Cognitive and Structural Social Capital as Predictors of Quality of Life for Sub-Saharan African Migrants in Germany

This paper assesses the structural links between Cognitive Social Capital (CSC), Structural Social Capital (SSC), and Quality of Life (QoL) among Sub-Saharan African (SSA) migrants in Germany. Data from 518 SSA migrants in Germany were analysed. QoL as measured by EUROHIS-QOL 8-item Index, CSC, and SSC were included in a Structural Equation Model performed with Analysis of Moment Structures and Maximum Likelihood as methods of estimation. The overall model fit was evaluated based on the Chi-Square Statistic (χ2), the Comparative Fit Index (CFI), the Root Mean Square Error of Approximation (RMSEA) and the Standardised Root Mean Squared Residual (SRMR). The structural model testing the direct effects of CSC and SSC on QoL had a good fit with χ2(47) = 157.60, p < .01, χ2/df = 3.35, CFI = .95; RMSEA = .07 (p = .007; 90% CI = .06/.08); and SRMR = .04 and explained 15% of the variance in QoL. Significant direct effects of CSC and SSC were found on QoL, with β = .27, p < .01 and β = .23, p < .01, respectively. Furthermore, multi-group analyses yielded no significant differences in the structural weights across genders (Δχ2(2) = 5.46, p = .07) or German language skill levels (Δχ2(2) = 2.27, p = .32). SSC and CSC are significant for facilitating quality of life among SSA migrants living in Germany. While these findings support results from previous research, they provide a unique insight into the life of SSA migrants in Germany and provoke more questions concerning the wellbeing of this migrant group.

Quality of life after stroke rehabilitation discharge: a 12-month longitudinal study

Purpose To analyse trends in quality of life (QoL) development among older stroke patients within the first year after rehabilitation discharge, and to investigate the impact of including proxy interviews in research and practice. Methods A prospective cohort study with follow-up at 3, 6, and 12 months with 411 patients and proxy respondents was conducted. The EUROHIS-QOL 8-item index was used to assess QoL. By performing descriptive analyses, QoL development over time was compared among subgroups. Linear mixed models were calculated to estimate mean changes from baseline to 12-month follow-up. The effects of patient characteristics and time on QoL were investigated using comprehensive mixed models. Results One year after rehabilitation discharge, the majority of patients had neither maintained nor regained their initial QoL. Proxy respondents reported significantly lower QoL (22.6–29.5 points, p < 0.001). Characteristics associated with lower QoL were stroke severity, depression, and pain. Having a small social network was negatively associated with QoL (–1.66 points, 95%CI: –2.84/–0.48, p = 0.006). Conclusions Quality of life scores reported at the time of rehabilitation discharge are often not lasting. Including severely impaired patients via proxies reduces the risk of overestimating QoL outcomes. Outpatient’s characteristics should be taken into account when planning therapy strategies to maintain previously achieved health goals. Regular re-assessments are required. Implications for rehabilitation There should be an awareness that improvements in quality of life (QoL) achieved during rehabilitation are not sustainable. Regularly re-assessing pain status, psychological burden, and social network size could help clinicians to determine treatment strategies for maintaining and improving rehabilitation achievements. Conducting proxy interviews is required to assess disease burden of patients with severe stroke (e.g., non-linguistic patients).

Non-motor symptoms burden, mood, and gait problems are the most significant factors contributing to a poor quality of life in non-demented Parkinson's disease patients: Results from the COPPADIS Study Cohort

ObjectiveTo identify factors related to a poor health-related and global quality of life (QoL) in a cohort of non-demented Parkinson's disease (PD) patients and compare to a control group. MethodsThe data correspond to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures. ResultsQoL was worse in PD patients (n = 692; 62.6 ± 8.9 years old, 60.3% males) than controls (n = 206; 61 ± 8.3 years old, 49.5% males): PDQ-39, 17.1 ± 13.5 vs 4.4 ± 6.3 (p < 0.0001); PQ-10, 7.3 ± 1.6 vs 8.1 ± 1.2 (p < 0.0001); EUROHIS-QOL8, 3.8 ± 0.6 vs 4.2 ± 0.5 (p < 0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (r = 0.72; p < 0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (r = 0.65; p < 0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire [FOGQ]) provided the highest contribution to the model (β = 0.32, 0.28, and 0.27, respectively; p < 0.0001); whereas mood and gait problems contributed the most to global QoL (PQ-10, β = -0.46 and −0.21, respectively; EUROHIS-QOL8, β = -0.44 and −0.23, respectively). ConclusionsQoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.

Ideal cardiovascular health and quality of life among Finnish municipal employees.

Ideal cardiovascular health has been defined by the American Heart Association as the absence of clinically manifest cardiovascular disease together with the presence of favorable levels of cardiovascular health metrics. The ideal metrics are hard to achieve and the aim of this study was to assess the association between favorable cardiovascular health and perceived overall quality of life (QoL).A cross-sectional study was conducted in Finland among 836 employees in 2014 (732 women, 104 men, mean age 48 (SD 10) years) from ten municipal work units. The ideal metrics were evaluated with a physical examination, laboratory tests, medical history and self-administered questionnaires. The cardiovascular health was categorized into three groups by achievement of the ideal metrics. QoL was assessed with the EUROHIS-QOL 8-item index.The prevalence of having 5–7 of the ideal metrics was 25.1% (210), of having 3–4 it was 53.6% (448) and for 0–2 it was 21.3% (178). The EUROHIS-QOL mean score among all participants was 3.92 (SD 0.54). The EUROHIS-QOL mean score had a positive association with the sum of ideal metrics, and was 3.72, 3.91 and 4.10 among subjects with 0–2, 3–4 and 5–7 ideal metrics, respectively. Furthermore, poor sleep quality and disease burden had a significant negative association with QoL.A favorable cardiovascular health status together with good sleep quality seems to have a clear association with overall quality of life among employees in municipal work units.

What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study

ObjectiveThis study determined the prevalence and factors associated with sexual dysfunction in breastfeeding women.DesignCross-sectional analytical study.SettingPopulation-based study of individuals living in the northeast region of São Paulo state, Brazil.ParticipantsFrom May...

Exploring the association of learning participation with the quality of life of older Chinese adults: A mixed methods approach

ABSTRACTThe study aims to investigate the association of learning participation with the quality of life (QoL) in older Chinese adults, verifying how the differing types of learning activity participation may influence their QoL. We conducted two studies to gain a better understanding of learning participation and QoL among adults over 55 years of age. In the first study, we conducted five focus groups among 43 older adults about their understanding of learning benefits and their general well-being. In a second study, we assessed the QoL using the EUROHIS-QOL 8-item index, while learning participation was measured through a questionnaire addressing the frequency of involvement in educational activities among 579 Chinese older adults. The results indicate that being engaged in learning activities in old age has the potential to increase the QoL of older adults. Moreover, in contrast to nonformal learning, the results of the hierarchical linear regression model demonstrate that both informal and formal learning have a significant positive influence on QoL. The paper concludes by discussing the implications for research and practice pertaining to the encouragement of learning participation in later life.