European Quality Of Life Questionnaire Research Articles

A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL COMPARING THE DIRECT SUPERIOR APPROACH WITH THE POSTERIOR APPROACH FOR TOTAL HIP ARTHROPLASTY

The direct superior approach (DSA) is a modification of the posterior approach (PA) that preserves the iliotibial band and short external rotators except for the piriformis or conjoined tendon during total hip arthroplasty (THA). The objective of this study was to compare postoperative pain, early functional rehabilitation, functional outcomes, implant positioning, implant migration, and complications in patients undergoing the DSA versus PA for THA.This study included 80 patients with symptomatic hip arthritis undergoing primary THA. Patients were prospectively randomised to receive either the DSA or PA for THA, surgery was undertaken using identical implant designs in both groups, and all patients received a standardized postoperative rehabilitation programme. Predefined study outcomes were recorded by blinded observers at regular intervals for two-years after THA. Radiosteriometric analysis (RSA) was used to assess implant migration.There were no statistical differences between the DSA and PA in postoperative pain scores (p=0.312), opiate analgesia consumption (p=0.067), and time to hospital discharge (p=0.416). At two years follow-up, both groups had comparable Oxford hip scores (p=0.476); Harris hip scores (p=0.293); Hip disability and osteoarthritis outcome scores (p=0.543); University of California at Los Angeles scores (p=0.609); Western Ontario and McMaster Universities Arthritis Index (p=0.833); and European Quality of Life questionnaire with 5 dimensions scores (p=0.418). Radiographic analysis revealed no difference between the two treatment groups for overall accuracy of acetabular cup positioning (p=0.687) and femoral stem alignment (p=0.564). RSA revealed no difference in femoral component migration (p=0.145) between the groups at two years follow-up.There were no differences between patients undergoing the DSA versus PA for THA with respect to postoperative pain scores, functional rehabilitation, patient-reported outcome measurements, accuracy of implant positioning, and implant migration at two years follow-up. Both treatment groups had excellent outcomes that remained comparable at all follow-up intervals.

The development and validation of a needs assessment tool for use with YOUng adult survivors of a CentrAl Nervous system tumor (YOU-CAN).

Adolescent and young adult (AYA) survivors of a central nervous system (CNS) tumor represent a vulnerable group who can experience: social isolation, low rates of employment, and achieving independence can be compromised, leading to poorer quality of life compared with survivors of other cancer types. The aim of this study is to develop and evaluate the validity of a needs assessment tool (NAT) for AYA survivors of a CNS tumor. Items generated using data from 29 qualitative studies and cognitive interviews (n = 8) produced NAT V1.1 (49 items). 128 of 316 eligible participants attending neuro-oncology clinics at 4 NHS sites between June 2022 and March 2023 completed the NAT V1.1 to allow for item reduction and refinement and to evaluate reliability and validity. A pilot study (n = 6) using YOU-CAN in routine follow-up concluded the study. Hierarchical analysis and Rasch analysis identified 18- and 15-items for removal, respectively. YOU-CAN, comprised of the remaining 16 items, demonstrates excellent test-retest reliability (intra-class correlation coefficient, 0.901, n = 40) and sufficient correlation with the European Quality of Life questionnaire and Supportive Care Needs Survey (Pearson r = 0.433 and 0.590, respectively). Pilot testing showed YOU-CAN triggered discussions of unmet needs in consultations and highlighted the importance of multidisciplinary support. YOU-CAN is a valid and reliable instrument containing items related to concerns about physical and emotional health; family and relationships; self-acceptance; and independence. Future efforts should examine YOU-CAN's feasibility, and develop guidance for managing unmet needs. Routine use of YOU-CAN may improve the identification of otherwise undiscussed unmet needs and opportunities to deliver personalized support.

Sex differences in cardiovascular risk factors and quality of life among individuals with hypertension in Korea from 2013 to 2018: A cross-sectional cohort study.

As its prevalence increases and its association with cardiovascular disease and mortality is established, there is a need to improve prevention and management strategies for hypertension. Therefore, we aimed to compare differences in cardiovascular health status between men and women with hypertension defined by systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg, and/or treatment with antihypertensive drugs. The association between cardiovascular health status and health-related quality of life was also evaluated. Additionally, a secondary analysis was performed on the cross-sectional data from 7306 adults with hypertension, ≥40 years of age between 2013 and 2018. Of this sample, 51.2% of patients were women from the Korean National Health and Nutrition Examination Survey. The seven Cardiovascular Health Metrics were used to quantify cardiovascular health status and the 5-dimensional European Quality of Life Questionnaire (EQ-5D) was used to evaluate health-related quality of life. A higher proportion of men than that of women was observed in the poor cardiovascular health score group [total score 0-7], with a higher proportion of women in the intermediate group [total score 8-10] and ideal group [total 11-14] (p<0.0001). The proportion of women in the EQ-5D index was higher than that of men in the poor and intermediate groups (p<0.0001), with no difference in the proportion of men and women in the ideal group (p = 0.1452). Furthermore, specific cardiovascular risk factors were different between men and women: women had lower physical activity level and higher prevalence of high cholesterol (≥200 mg/dl), and men had higher body mass indices and worse diet management. These findings indicate that prevention and management strategies for hypertension and cardiovascular health might need to differ for men and women to improve outcomes.

Early- to Mid-Term Review of a Prospective, Multi-Center, International, Outcomes Study of an Anatomically Designed Implant with Posterior-Stabilized Bearing in Total Knee Arthroplasty.

Background and Objectives: National joint registries report higher total knee arthroplasty (TKA) revision rates in posterior-stabilized (PS) systems compared to non-posterior-stabilized designs. The purpose of this study was to investigate the implant survivorship and clinical outcomes of an anatomic implant with a PS bearing. Materials and Methods: An early- to mid-term follow-up of a prospective, multi-center, non-controlled outcomes study of patients who received primary TKA between November 2014 and June 2017 was performed. A total of 800 cases using PS bearings that were implanted in 664 patients were monitored post-operatively for their implant survivorship and adverse events for up to five years. The Knee Society Knee and Function scores, patient satisfaction, the five-dimensional European Quality of Life questionnaire, and range of motion (ROM) were evaluated pre-operatively and post-operatively at six weeks, six months, one year, two years, three years, and five years. Results: The mean follow-up period was 3.7 ± 1.3 years, and the three-year implant survival rate was 99.3% (95% CI: 98.4%, 99.7%) with five revisions during the five-year follow-up. Patient satisfaction was 96.1% at six weeks and increased to 99.3% at one year. All patient-reported outcome measures significantly (p < 0.0001) increased up to the one-year follow-up and then remained stable up to the five-year follow-up. Conclusions: This study supports the excellent survivorship and patient-reported outcomes of the Persona® Knee system using cemented, fixed bearing, posterior-stabilized components with minimal complications at early- to mid-term follow-up in an international Asian population. Ongoing observations are being performed to investigate the mid- to long-term survivorship and clinical outcomes associated with this knee system.

Health literacy, quality of life and burden of informal caregivers in Portugal

Abstract Background The process of informal caregiving may have significant impacts on physical, psychological, social and economic conditions of informal caregivers. Worldwide lower levels of health literacy are associated with worse informal care, reduced quality of life and higher burden of informal caregivers. The aim of this study is to assess the correlation between health literacy score (HL), quality of life (QoL) and informal caregiver burden in Portugal. Methods A cross-sectional study was conducted through an online survey directed to informal caregivers. Three validated scales were applied in Portuguese versions: a) European Health Literacy Survey (HLS-EU-PT-Q16); b) European Quality of Life Questionnaire (EQ-5D-5L), c) Modified Caregiver Strain Index (M-CSI). Overall statistical analysis and the Pearsońs correlation test at 5% significance level were performed in SPSS®. Results In total, 760 informal caregivers were surveyed, mean age 57 years (±9.9), 92.5% female, 62.6% married or living with a partner, 41,5% at least university level, 44.4% works full or part-time. Regarding the process of care, 78.9% takes care of one person, 85.2% have been caring for more than 1 year, 54.3% feel that are not supported at all, and 20.3% do not feel competent to care. The mean HL score of informal caregiver (n = 673) was 31.9 (+7.8), QoL (n = 733) was 0.8 (+0.2), and burden (n = 760) was 14.8 (+5.3). HL Score is directly correlated with QoL (r = 0.215; p &amp;lt; 0.001) and inversely correlated with informal caregiver burden (r=-0.150; p &amp;lt; 0.001). Conclusions A higher health literacy score is associated with better quality of life and lower informal caregiver burden. Improving health literacy may be strategic to promote health conditions and quality of life and care for both the informal caregiver and the person being cared for. Key messages • A higher health literacy score is associated with better quality of life and lower informal caregiver burden. • It is crucial to invest on the definition of an integrated strategy, between Health and Social Security, to provide better health conditions to informal caregivers.

Resort treatment for gonarthrosis with «Tonus» gel by Balneomed (Russia)

The aim of the research is to study the effectiveness of using «Tonus» gel by Balneomed (Russia) in the resort treatment of patients with gonarthrosis. Material and methods. Under the conditions of «Metallurg» Sanatorium (Essentuki), 65 patients with gonarthrosis at the age of 40 to 65 years old underwent resort treatment. By simple randomization, 2 groups were formed: in the comparison group, the patients had treatment in accordance with the federal clinical guidelines; in the main group, «Tonus» gel by Balneomed (Russia) was additionally included in the form of ultraphonophoresis and applications. The efficiency control was performed using tables of clinical symptoms by S. P. Mironov, pain scores were assessed according to the Lequesne index, and quality of life — according to the European Quality of Life Questionnaire (EQ-5D). Results. After the resort treatment, there was a more significant positive dynamics in the main group (p &lt; 0.05): the Lequesne index decreased by 2.1 times (p &lt; 0.01), compared to 1.8 times (p &lt; 0.01) in the comparison group; according to the EQ-5D questionnaire, in 10‑12 months after the treatment, the quality of life improved on average in 62.4 % of patients in the main group and in 53.2 % in the comparison group. Conclusion. The analysis of the obtained data indicates an increase in the effectiveness of treatment of patients with gonarthrosis using ultraphonophoresis with «Tonus» gel by Balneomed.

Poor sleep quality is an overlooked risk for geriatric syndromes in older adults with type 2 diabetes mellitus

ABSTRACT Background Aging and type 2 diabetes mellitus (DM) are two different conditions that impair sleep quality. The primary objective of this study was to investigate the impact of sleep quality on geriatric syndromes in older diabetic adults. Methods Comprehensive geriatric assessment was performed on 236 patients. The assessment included the Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life Questionnaire (EQ-5D), Mini Mental Statement Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), Mini Nutritional Assessment, and measurement of handgrip strength (HGS). Results Of the participants, 55% had DM, and 61.4% had poor sleep quality. Poor sleep prevalence was higher in diabetic patients (68.5%) than in non-diabetics (52.8%). Diabetic patients with poor sleep quality had higher frequencies of chronic pain, recurrent urinary tract infections, confirmed sarcopenia, and frailty (p = 0.015, p < 0.001, p = 0.027, and p < 0.001, respectively), a higher number of comorbidities and higher GDS and BAI scores (p = 0.046, p < 0.001 and p < 0.001, respectively), and lower scores of activities of daily living, HGS, and EQ-5D index (p = 0.023, p = 0.004, and p < 0.001, respectively) compared to diabetic patients with good sleep quality. According to the correlation analysis results, PSQI score had a positive correlation with GDS score (r = 0.461, p < 0.001) and a negative correlation with Mini Nutritional Assessment score (r = –0.317, p < 0.001), skeletal muscle mass index (r = –0.283, p = 0.002) and HGS (r = –0.307, p < 0.001) scores in diabetic older adults. Conclusion Poor sleep quality in older diabetic patients has a negative impact on several geriatric syndromes. Our findings suggest that poor sleep quality is an independent risk factor for depression, malnutrition, and lower muscle mass in older diabetic adults. Improving sleep quality may play a crucial role in preventing and managing geriatric syndromes in this population.

Enhanced supportive care: prospective cohort study of oncology patients and caregivers

ObjectivesA prospective cohort study to evaluate clinical effectiveness of the enhanced supportive care (ESC) service at a comprehensive cancer centre and to explore the impact of the service on patient...

The Surgical Timing and Prognoses of Elderly Patients with Hip Fractures: A Retrospective Analysis.

Guidelines exist for the surgical treatment of hip fractures, but the association between the surgical timing and the incidence of postoperative complications and other important outcomes in elderly patients with hip fracture remains controversial. This study aims to explore the association between the surgical timing and the prognoses in elderly patients with hip fracture. A total of 701 elderly patients (age ≥ 65 years) with hip fractures who were treated in our hospital from June 2020 to June 2021 were selected. Patients who underwent surgery within 2 d of admission were assigned to the early surgery group, and those who underwent surgery after 2 d of admission were assigned to the delayed surgery group. The prognosis indices of the patients in the two groups were recorded and compared. The length of postoperative hospitalisation in the early surgery group was significantly lower than that in the delayed surgery group (P < 0.001). The European quality of life questionnaire (EQ-5D) utility in the delayed surgery group was significantly lower than that in the early surgery group at 30 days and 6 months after operation (P<0.05). Compared with the delayed surgery group, the incidence of pulmonary infection, urinary tract infection (UTI) and deep vein thrombosis (DVT) in the early surgery group were significantly lower. There were no significant differences between the two groups in terms of mortality and excellent rates of the HHS at six months after the operation. In addition, the early surgery group had a lower readmission rate than the delayed surgery group [34 (9.5%) vs 56 (16.3%), P = 0.008]. Earlier surgery can reduce the incidence of pulmonary infections, UTI, DVT and readmission rate among elderly patients with hip fractures, shorten postoperative hospitalisation.

Feasibility of the 30 s Sit-to-Stand Test in the Telehealth Setting and Its Relationship to Persistent Symptoms in Non-Hospitalized Patients with Long COVID.

Fatigue, dyspnea and pain are the main limitations of patients with long COVID. The aim of this study was to determine the feasibility of the 30 s sit-to-stand (30s-STS) test in the telehealth setting and its relationship to persistent symptoms in a sample of non-hospitalized patients with long COVID. A cross-sectional study was conducted in community patients with long COVID. Data collection and assessments were performed by videoconference and consisted of the fatigue assessment scale (FAS), London activity of daily living scale (LCADL), post-COVID-19 functional status (PCFS) and European quality of life questionnaire (EQ-5D-5L), including the pain/discomfort dimension. The 30s-STS test was performed using a standardized protocol adapted for remote use, and the modified Borg scale (0−10) was used to assess dyspnea and lower limb fatigue immediately after the test. The feasibility of the 30s-STS test was assessed by the proportion of eligible participants who were able to complete the test. Safety was assessed by the number of adverse events that occurred during the test. Seventy-nine participants were included (median age: 44 years, 86.1% women). Performance in the 30s-STS test was 11.5 ± 3.2 repetitions with 60.8% of the sample below reference values. All eligible participants were able to complete the test. No adverse events were reported during the evaluation. Participants with lower 30s-STS performance had more fatigue and dyspnea, worse quality of life, more severe pain/discomfort, and worse functional status (p < 0.05). A significant correlation was obtained between LCADL and dyspnea, reported on the Borg scale (0−10) post 30s-STS (r = 0.71; p < 0.001). In conclusion, the 30s-STS test proved to be a feasible test to implement in the telehealth setting and is related to fatigue, dyspnea, quality of life and pain in non-hospitalized patients with long COVID. Clinicians may use this test when assessment of the physical sequelae of COVID-19 in the face-to-face setting is not possible.

Family Caregivers of People with Dementia Associate with Poor Health-Related Quality of Life: A Nationwide Population-Based Study

Despite the growing awareness of poor health-related quality of life (HRQoL) in family caregivers of people with dementia (PWD), their relationship has rarely been explored with population-based samples. The current cross-sectional study aimed to determine the detrimental impact of informal dementia caregiving on HRQoL by using nationally representative population-based samples from the Korean Community Health Survey. Demographics, socioeconomic, and physical and mental health-related characteristics as well as HRQoL measured by the Korean version of the European Quality of Life Questionnaire Five Dimension (EQ-5D) were compared between 9563 family caregivers of PWD and 186,165 noncaregivers. Caregivers had lower index scores and higher frequency of some/extreme problems in all five dimensions of the EQ-5D compared with noncaregivers. Logistic regression adjusting for potential confounding factors found that caregivers had a higher frequency of poor HRQoL (lowest quartile of EQ-5D index) than noncaregivers (adjusted odds ratio [95% confidence interval] = 1.46 [1.39-1.53]). Compared to noncaregivers, caregivers had a higher frequency of some/extreme problems in each dimension of the EQ-5D: mobility (1.30 [1.21-1.40]), self-care (1.62 [1.46-1.80]), usual activity (1.39 [1.29-1.51]), pain/discomfort (1.37 [1.31-1.45]), and anxiety/depression (1.51 [1.42-1.61]). A one-to-one propensity score matching analysis confirmed that poor HRQoL was more frequently found in caregivers compared to noncaregivers (1.38 [1.29-1.48]). Our results indicated that family caregivers of PWD are significantly associated with overall poor HRQoL, underscoring the detrimental impact of informal dementia caregiving on HRQoL. Given the high frequency of poor HRQoL in dementia caregivers and the important recognition of its serious consequences on physical and mental health, clinicians should take into consideration efficient interventions to improve health and HRQoL for family caregivers of PWD.

A multi-center, randomized, double-blinded, parallel, placebo-controlled study to assess the efficacy and safety of Shenqisuxin granule in complex coronary artery disease after PCI: Study protocol.

IntroductionThe Shenqisuxin granule (SQSX), a novel Chinese herbal formula, has the effect of preventing in-stent restenosis and improving angiogenesis. We intend to evaluate the efficacy and safety of SQSX to provide a possible therapeutic strategy for complex coronary artery disease (CCAD) after percutaneous coronary intervention (PCI).Methods/designThe study is a multi-center, randomized, double-blinded, parallel, placebo-controlled trial. A total of 120 participants will be randomized 1:1 into the intervention group and the control group. Based on standardized treatment, the intervention group and control group will receive SQSX and placebo for 2 months, respectively. The primary outcomes, metabolic equivalents (METS) and peak oxygen uptake (Peak VO2), and the secondary outcomes, including other indicators of cardiorespiratory fitness (CRF), the European Quality of Life Questionnaire (EQ-5D-5L), the Seattle Angina Scale (SAQ), etc., will be assessed at baseline and 2 months ± 3 days. In addition, the survey scales will also be tested at 1 month ± 3 days. Trimethylamine N-oxide (TMAO), high-sensitivity C-reactive protein (hs-CRP), and gut microbiota features will be assessed at baseline and 2 months ± 3 days to probe possible mechanism. The major adverse cardiac and cerebrovascular events (MACCE) and bleeding events will be monitored until the 12-month follow-up.DiscussionThis study is launched to assess the efficacy and safety of SQSX in CCAD after PCI and probe the possible mechanism.Clinical trial registrationChina Clinical Trial Registry, ChiCTR2200060979, Registered on June 14, 2022.

Changes in treatment outcomes in patients undergoing an integrated psychosomatic inpatient treatment: Results from a cohort study.

ObjectiveIn Germany, multimodal psychosomatic inpatient treatment can be initiated for patients with substantial mental disorders (e.g., depression, anxiety, somatoform disorders) and comorbid physical disease. However, studies investigating changes in psychological and functional treatment outcomes, and predictors of long-term treatment effects in patients undergoing psychosomatic inpatient treatment are needed.MethodsThis cohort study analyzed 160 patients aged ≥18 who were treated on an integrated psychosomatic inpatient unit at the University of Göttingen Medical Center. Its aim was to analyze changes in psychological and functional outcomes, and to identify predictors of long-term improvements in health-related quality of life (HRQoL) in patients with comorbid mental and physical illness who were undergoing integrated inpatient psychosomatic treatment. Assessments were completed at admission, discharge, and 12- or 24-month follow-up. Outcomes included physical complaints [Giessen Subjective Complaints List (GBB-24)], psychological symptoms [Brief Symptom Inventory (BSI)], and HRQoL [European Quality of Life Questionnaire (EQ-5D)].ResultsOne-hundred sixty inpatients were included (mean age = 53.1 ± 12.6; 53.8% female). There were significant, medium- to large-sized improvements in psychological symptoms (BSI-Global Severity Index; d = −0.83, p < 0.001), physical symptom burden (d = −0.94, p < 0.001), and HRQoL (d = 0.65, p < 0.001) from admission to discharge, and significant, small- to medium-sized greater improvements in all psychological outcomes from admission to follow-up (BSI-GSI: d = −0.54, p < 0.001; GBB-24 total symptom burden: d = −0.39, p < 0.001; EQ-5D: d = 0.52, p < 0.001). Furthermore, better improvement in HRQoL during hospitalization (partial η2 = 0.386; p < 0.001) was associated with higher HRQoL at follow-up. Finally, intake of antidepressant at discharge was associated with impaired HRQoL at follow-up (η2 = 0.053; p = 0.03).ConclusionThere were significant short- and long-term improvements in psychological symptoms, physical complaints, and HRQoL after treatment on an integrated psychosomatic inpatient unit in patients with mental disorders and a comorbid physical disease.

Assessment of health-related quality of life in patients with adult onset Still disease: Results from a multicentre cross-sectional study.

We aimed to investigate the health-related quality of life (HRQoL) in Adult onset Still disease (AOSD) patients, a rare systemic auto-inflammatory disorder of unknown etiology usually affecting young adults. In this multicentre cross-sectional study, AOSD patients and age and gender matched healthy controls (HCs) were included. All patients had a low or absent clinical expressiveness, they were categorized as having a monocyclic pattern or a chronic disease course. The Health Assessment Questionnaire (HAQ), European Quality of Life Questionnaire (EUROQoL), 36-Items Short-Form Healthy Survey (SF-36), Functional Assessment of Chronic Illness Therapy Fatigue subscale (FACIT-F), 100 mm-visual analogue scale (VAS) of pain, fatigue, and global health assessment, were used to evaluate HRQoL. The results were compared between patients and HCs, analyzed according to clinical course, and correlated with clinical features at the time of diagnosis. HRQoL resulted to be altered in 53 AOSD patients compared to 53 age and gender matched HCs. Many SF-36 domains differed between the 2 groups, mainly those of physical functioning which were reduced in AOSD respect to HCs. Furthermore, HAQ, FACIT-F, EuroQoL, VAS state of health, VAS pain, and VAS fatigue significantly differed between AOSD and HCs. No substantial differences were found comparing monocyclic pattern with chronic disease course. AOSD patients showed an impairment of many SF-36 domains, HAQ, FACIT-F, EuroQoL, VAS state of health, VAS pain, and VAS fatigue when compared to matched HCs, despite a low or absent clinical expressiveness; these findings were similarly retrieved in both monocyclic pattern and chronic disease course.

Cardiovascular risk factors and quality of life among stroke survivors in Korea from 2013 to 2018: a cross-sectional cohort study

BackgroundAlthough the cardiovascular health and quality of life (QoL) of stroke survivors have been previously studied, no study has investigated the correlation between cardiovascular health and QoL. This study aimed to investigate whether there would be a difference in the quality of life (QoL) in this population depending on the degree of cardiovascular health.MethodsOverall, 577 people aged > 40 years who participated in the Korea National Health and Nutrition Examination Survey from 2013 to 2018 were included and were divided into three groups according to the survey period (2013–2014, n = 145; 2015–2016, n = 198; and 2017–2018, n = 234). Participants were further divided into the following groups based on their cardiovascular health score, as defined by the American Heart Association: poor, intermediate, and ideal groups. We examined how the health-related QoL score was expressed through the five-dimensional European Quality of Life Questionnaire (EQ-5D-3L).ResultsThe ideal (cardiovascular health scores 11–14) and intermediate (cardiovascular health scores 8–10) groups had the lowest (7.72–8.14%) and highest (46.39–57.70%) number of participants, respectively. The total EQ-5D index score was highest in the ideal group, followed by the intermediate and poor groups across all three periods (2013–2014, p = 0.0015; 2015–2016, p = 0.0040; 2017–2018, p < 0.0001). The dimension-specific analysis revealed that, Findings showed that stroke survivors' mobility significantly varied by cardiovascular health scores (p = 0.0371 in 2015–2016, p =0.0486 in 2017–2018), whereas usual activities (p = 0.0322) and pain/discomfort (p = 0.0420) were significantly different among the three groups in 2015–2016.ConclusionQoL in post-stroke survivors, when related to cardiovascular health degree, could be correlated with stroke sequelae.

Phenotypes of body composition, physical performance and quality of life in women with rheumatoid arthritis

To evaluate the frequency of different body composition phenotypes, physical performance (PP) and their relationship with quality of life in women with rheumatoid arthritis (RA). The study included 157 women (average age 58.68.8 years) with RA. Clinical and laboratory examination, dual-energy X-ray absorptiometry, quality of life assessment according to the questionnaires EQ-5D (European Quality of Life Questionnaire), HADS (Hospital Anxiety and Depression Scale) and RAID (Rheumatoid Arthritis Impact of Disease), determination of muscle strength and the PP of skeletal muscles were carried out. Osteoporotic, sarcopenic and osteosarcopenic phenotypes of body composition were identified in 27 (17%), 16 (10%) and 16 (10%) patients, respectively; 139 (88.5%) people had low muscle strength, and 96 (61.1%) had reduced PP. Quality of life according to the EQ-5D index and RAID, the severity of depression according to HADS in women with different phenotypes of body composition did not differ. Women with osteosarcopenic phenotype had worse indicators for EQ-5D-VAS (VAS visual analog scale), and patients with sarcopenic phenotype had more severe anxiety according to the HADS questionnaire compared to those with normal phenotype (p=0.014 and p=0.027, respectively). The quality of life according to all questionnaires was significantly worse in patients with reduced PP. Pathological phenotypes of body composition were found in 37% of RA patients. A decrease in muscle strength was revealed in 88.5%, and a low PP in 61.1% of patients. The relationship between quality of life and body composition has not been established, at the same time quality of life associated with the PP of skeletal muscles.

Quality of life following two different techniques of an open ventral hernia repair for large hernias: a prospective randomized study

BackgroundWe compare the health-related quality of life (QoL) of patients with incision hernias before and after surgery with two different techniques.MethodsIn this prospective randomized study, the study population consisted of all patients who underwent the first surgical incisional hernias repair during the 1-year study period. Patients who met the criteria for inclusion in the study were randomized into two groups: the first group consisted of patients operated by an open Rives sublay technique, and the second group included patients operated by a segregation component technique. The change in the quality of life before and 6 months after surgery was assessed using two general (Short form of SF-36 questionnaires and European Quality of Life Questionnaire—EQ-5D-3L), and three specific hernia questionnaires (Hernia Related Quality of Life Survey-HerQles, Eura HS Quality of Life Scale—EuraHS QoL, and Carolinas Comfort Scale—CCS).ResultsA total of 93 patients were included in the study. Patients operated on by the Rives technique had a better role physical score before surgery, according to the SF-36 tool, although this was not found after surgery. The postoperative QoL measured with each scale of all questionnaires was significantly better after surgery. Comparing two groups of patients after surgery, only the pain domain of the EuraHS Qol questionnaire was worse in patients operated by a segregation component technique.ConclusionBoth techniques improve the quality of life after surgery. Generic QoL questionnaires showed no difference in the quality of life compared to repair technique but specific hernia-related questionnaires showed differences.

Patient-oriented medical rehabilitation after stroke in long-term recovery period

To evaluate the effectiveness of patient-oriented medical rehabilitation on microcirculation, motions in affected limbs and quality of life in patients with previous stroke in long-term recovery period. The study included 120 patients with previous stroke, hemiparesis and spastic disorders in late recovery period. All patients received standard drug therapy and medical rehabilitation (exercise therapy and medical massage). All patients were divided into 3 groups depending on additional measures: group 1 (n=40) - massage in a pulsed low-frequency electrostatic field in addition to standard complex of rehabilitation; group 2 (n=40) - course of multimodal physiotherapeutic effects (Alpha LED Oxy Light-Spa) in addition to standard complex; group 3 (n=40) - standard drug therapy and medical rehabilitation only (exercise therapy and medical massage). Patients were examined immediately after treatment, 3 and 6 months later. We analyzed effectiveness of rehabilitation using laser Doppler flowmetry (LAKK-01, Russia) and goniometry. Subjective indicators of quality of life were assessed according to the EQ-5D questionnaire (European Quality of Life Questionnaire). At baseline, all patients showed a decrease in microcirculation, motions in affected limbs and subjective decrease in the quality of life. In the 1st group, rehabilitation program improved microcirculatory processes that was confirmed by increment of capillary blood flow by 24% and total vasomotor activity of capillaries by 26.8%. There was a significant decrease in EQ-5D score by 37% in the 1st and 2nd groups after treatment that indicated increase in the quality of life. In the 3rd group, we observed mild increase of microcirculation parameters, range of motions and quality of life. Ersonalized methods of complex rehabilitation contribute to improvement of microcirculation, range of motions in affected limbs and quality of life in patients with spasticity in long-term recovery period after stroke.

Chronic Kidney Disease on Health-Related Quality of Life in Patients with Diabetes Mellitus: A National Representative Study.

Importance: With an increasing prevalence of diabetes mellitus (DM) and comorbid chronic kidney disease (CKD), health-related quality of life (HRQoL) in patients with DM and CKD needs to be better understood. Objective: To investigate the association between the severity of CKD on HRQoL in DM patients. Design: A cross-sectional study of a nationally representative population-based survey, the Korea National Health and Nutrition Examination Survey (KNHANES). Setting: Data collected between 2007 and 2018 from the KNHANES. Participants: Adult participants with DM who completed the self-administered European Quality of Life Questionnaire Five Dimension (EQ-5D) questionnaire (n = 7243). Exposures: CKD stages defined by the Kidney Disease Improving Global System (KDIGO) staging system. Main Outcomes and Measures: We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of the presence of having problems in the 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) of EQ-5D by CKD stage after adjusting for socio-demographic parameters and comorbid conditions. In addition, the EQ-5D index, reflecting the overall health status, was compared across CKD stages. Results: Among 7243 participants (mean (standard error) age 58.2 (0.2) 56.9% male), 24.0% (n = 1768) had CKD and 8.6% (n = 775) had stage 3–5 CKD. Pain/discomfort was the most common problem (30.5%) among patients with DM. Participants with more advanced CKD were more likely to experience problems in all dimensions of EQ-5D except the anxiety/depression dimension. In particular, compared to those without CKD, the adjusted ORs (95% CI) for any problem in the usual activities dimension was 1.65 (1.30, 2.10) in CKD stage 3 and 4.23 (2.07, 8.67) in CKD stage 4–5. Moreover, participants with stage 3 (−0.016 (−0.029, −0.003)) and stage 4–5 CKD (−0.088 (−0.129, −0.048)) had significantly lower EQ-5D index than those without CKD. However, compared with no CKD, CKD stage 1–2 was not significantly associated with having any problem in any dimensions. Conclusions and Relevance: In this nationally representative study, patients with DM had a high prevalence of self-reported poor HRQoL and the prevalence increased with more advanced stages of CKD. Therefore, assessment of HRQoL and interventions are necessary at early stages of CKD in DM patients.

A Home-Based eHealth Intervention for an Older Adult Population With Food Insecurity: Feasibility and Acceptability Study.

BackgroundFood insecurity is a global public health challenge, affecting predominately the most vulnerable people in society, including older adults. For this population, eHealth interventions represent an opportunity for promoting healthy lifestyle habits, thus mitigating the consequences of food insecurity. However, before their widespread dissemination, it is essential to evaluate the feasibility and acceptability of these interventions among end users.ObjectiveThis study aims to explore the feasibility and acceptability of a home-based eHealth intervention focused on improving dietary and physical activity through an interactive television (TV) app among older adults with food insecurity.MethodsA pilot noncontrolled quasi-experimental study was designed with baseline and 3-month follow-up assessments. Older adult participants with food insecurity were recruited from 17 primary health care centers in Portugal. A home-based intervention program using an interactive TV app aimed at promoting healthy lifestyle behaviors was implemented over 12 weeks. Primary outcomes were feasibility (self-reported use and interest in eHealth) and acceptability (affective attitude, burden, ethicality, perceived effectiveness, and self-efficacy), which were evaluated using a structured questionnaire with a 7-point Likert scale. Secondary outcomes were changes in food insecurity (Household Food Insecurity Scale), quality of life (European Quality of Life Questionnaire with five dimensions and three levels and Functional Assessment of Chronic Illness Therapy-Fatigue), physical function (Health Assessment Questionnaire, Elderly Mobility Scale, grip strength, and regularity of exercise), and nutritional status (adherence to the Mediterranean diet).ResultsA sample of 31 older adult individuals with food insecurity was enrolled in the 12-week intervention program with no dropouts. A total of 10 participants self-reported low use of the TV app. After the intervention, participants were significantly more interested in using eHealth to improve food insecurity (baseline median 1.0, IQR 3.0; 3-month median 5.0, IQR 5.0; P=.01) and for other purposes (baseline median 1.0, IQR 2.0; 3-month median 6.0, IQR 2.0; P=.03). High levels of acceptability were found both before and after (median range 7.0-7.0, IQR 2.0-0.0 and 5.0-7.0, IQR 2.0-2.0, respectively) the intervention, with no significant changes for most constructs. Clinically, there was a reduction of 40% in food insecurity (P=.001), decreased fatigue (mean −3.82, SD 8.27; P=.02), and improved physical function (Health Assessment Questionnaire: mean −0.22, SD 0.38; P=.01; Elderly Mobility Scale: mean −1.50, SD 1.08; P=.01; regularity of exercise: baseline 10/31, 32%; 3 months 18/31, 58%; P=.02). No differences were found for the European Quality of Life Questionnaire with five dimensions and three levels, grip strength, or adherence to the Mediterranean diet.ConclusionsThe home-based eHealth intervention was feasible and highly acceptable by participants, thus supporting a future full-scale trial. The intervention program not only reduced the proportion of older adults with food insecurity but also improved participants’ fatigue and physical function.International Registered Report Identifier (IRRID)RR2-10.2196/resprot.6626