Generic Quality Of Life Questionnaire Research Articles

Features, measurements, determinants, treatments, and outcomes of musculoskeletal symptoms in postmenopausal women: A scoping review

BackgroundThe literature lacks a consistent review of musculoskeletal symptoms in postmenopausal women. AimTo identify features, measurements, determinants, treatments, and outcomes of musculoskeletal symptoms in postmenopausal women. MethodA scoping review was completed using six databases: Embase, Medline, Cochrane, CINAHL, Web of Science, and Scopus up to December 2022. Sixty-three articles were identified. ResultsMusculoskeletal symptoms in postmenopausal women include somatic symptoms of non-specific origin, upper and lower limb symptoms, spinal pain, and decline in physical performance. Measurements were categorized into four groups: musculoskeletal symptoms for menopause, general musculoskeletal symptoms, menopause-specific quality of life, and general quality of life questionnaires. The determinants were grouped into four themes: demographics, physical determinants, psychosocial determinants, and lifestyle. Pharmacological interventions, supplementation options, and exercise regimens exist for postmenopausal women with musculoskeletal symptoms. ConclusionA comprehensive policy is needed to address musculoskeletal symptoms in postmenopausal women, promoting diverse treatments for improved quality of life.

Patient experiences with value-based healthcare interventions at the HIV outpatient clinic of the Erasmus Medical Centre.

One of the aims of value-based healthcare (VBHC) is to deliver more patient-centred care. However, little is known about the effect of VBHC interventions on patient experiences. We aim to explore how patients experience VBHC as implemented in an HIV outpatient clinic in an academic hospital in the Netherlands. The HIV outpatient clinic of the Erasmus MC, Rotterdam, the Netherlands, an academic tertiary hospital, implemented a VBHC intervention consisting of 1) implementation of a generic quality of life questionnaire, administered before each visit, 2) a change in consultation schedule; from twice a year face-to-face to one face-to-face double consultation and one remote consultation per year, and 3) a change in consultation structure; from a single face-to-face consultation with the infectious diseases (ID) specialist to a double consultation in which the patient visits both the nurse and the ID specialist. Semi-structured interviews were held with Dutch or English-speaking adult patients, that had been a patient within Erasmus MC for more than 5 years, on their experiences with the implemented changes. Thirty patients were interviewed. Patients had no objections towards completing the questionnaires especially if it could provide the professionals with additional information. Patients were primarily positive about the change in consultation schedule. For the yearly remote consultation they preferred a telephone-consultation above a video-consultation. The change in consultation structure ensured that more topics, including psychosocial and medical aspects could be discussed. Some patients did not see the added value of talking to two professionals on the same day or completing the quality of life questionnaire before their consultation. Patients are generally positive towards the VBHC interventions implemented at the HIV outpatient clinic. Our findings may inform further optimization of VBHC interventions and improve patient-centred care in outpatient HIV clinics.

Comparison of quality of life in patients with mitral valve replacement and mitral valve repair in Imam Ali Hospital during 2014 to 2020: a cross-sectional study

ObjectiveMitral valve failure is one of the most common valvular heart diseases worldwide. Valve replacement and repair have an impact on the quality of life of patients. Therefore, the present study was conducted to compare the quality of life in patients with mitral valve replacement and those who underwent mitral valve repair.MethodsIn this cross-sectional study, we considered all cardiac patients with ischemic mitral insufficiency who underwent mitral valve repair and patients with a history of valve replacement in Imam Ali Hospital of Kermanshah between 2014 and 2020. Two Minnesota and general quality of life questionnaires along with a checklist for demographic variables were used for data collection. Data analysis was performed using SPSS version 21 software.ResultsThe mean quality of life score based on the general quality of life scale in the valve repair group was 32.33 (SD = 2.29) and in the valve replacement group 32.89(SD = 2.60), (p = 0.917). Also, mean quality of life, as measured by the Minnesota MLHFQ was 60.89(SD = 17.67) in the valve repair group and 63.42 (SD = 12.13) in the valve replacement group (p = 0.308). The results showed that the average general quality of life was different in study groups regarding education. Tukey’s post hoc test showed that the average general quality of life in illiterate people is significantly lower than in people with academic degrees (P-value = 0.001).ConclusionThe quality of life of the patients in both the valve repair and replacement groups was at an average level. There was no significant difference between the general quality of life and the Minnesota scales, suggesting that both tools can be effectively used to measure patients’ quality of life. The study’s findings can be valuable for monitoring patients, screening for conditions, and enhancing communication between doctors and patients.

Health-Related Quality of Life Correlates with Bladder and Bowel Dysfunction: the Need for a New Patient-Centered Questionnaire

Background and Hypothesis: Children with voiding dysfunction (VD), such as incontinence or urinary frequency, may report lower quality of life (QOL) compared to their peers. QOL questionnaires which could be used in this population have several limitations. PinQ is a bladder-specific, health-related QOL questionnaire, but it was developed without stakeholder input and fails to separate symptoms from QOL. Kidscreen-10 is a generic QOL questionnaire. We aimed to understand how QOL captured using existing instruments correlates with VD severity in a cross-sectional study. We hypothesized that large differences in symptoms would correspond with large differences in bladder-specific QOL but small differences in generic QOL.
 Methods: We recruited children 8-18 years old with VD at a pediatric urology clinic (June-July 2023). VD included daytime incontinence, enuresis, frequency, urgency, and dysuria. We excluded children with severe developmental delay, anatomical urological abnormalities, or history ofurologic surgery. We captured demographics, symptoms (Vancouver Dysfunction Voiding Symptom Score, DVSS), and QOL (PinQ and Kidscreen-10). Questionnaire scores were compared to weighted means from previous studies. We calculated Spearman correlations and QOL differences corresponding with the reported 20-point range of DVSS scores.
 Results: Twenty children (11 girls) at a median age of 10 years old participated (Table 1). Mean DVSS score was 14, similar to previous studies (weighted mean: 15). PinQ scores had a moderate positive correlation with DVSS scores (r = 0.37) with a 20-point DVSS difference corresponding to a 24% difference in PinQ scores (Figure 1). Kidscreen-10 scores had a moderate negative correlation with DVSS scores (r = -0.33) with a 20-point DVSS difference corresponding to a 12% difference in Kidscreen-10 scores (Figure 2).
 Conclusions: Previously published QOL questionnaires have significant limitations, limiting their clinical use in the care of patients with VD. A new, patient-centered, highly specific, and sensitive healthrelated QOL questionnaire is needed.

FRI599 Quality Of Life In Girls With Turner Syndrome Using The Quality Of Life In Short Stature Youth Questionnaire (QoLISSY) - A Cross-sectional Study

Abstract Disclosure: N. Vijayakanthi: None. D.J. Marcus: None. S.P. Fritz: None. Y. Xiang: None. D.O. Fadoju: None. Background: Short Stature is a common finding in girls with Turner syndrome (TS). Its impact on Quality of life (QoL) in adolescents/adults with TS have been studied using generic QoL questionnaires. Short stature specific QoL questionnaires have not been used to study the impact of short stature and GH therapy in TS in previous studies. Methods: In this cross-sectional study, we aimed to evaluate QoL and the association between GH therapy and height on QoL of adolescents using the short stature specific questionnaire -Quality of Life in Short Stature Youth (QoLISSY). QoLISSY was designed specifically to assess QoL in short stature children with scales for both parents and children which assesses 3 core QOL dimensions: physical, social, emotional and 3 predictors of quality of life: Coping, Beliefs and Treatment (GH therapy). It has not been previously used in TS. Results: Of the 41 eligible patients, 37 patients were enrolled in the study. The mean age of our cohort was 16.3 ±1.3 years and the average final adult height was 145.03 ± 7.3 cm. About 70% of the patients received GH therapy and 80% received estrogen therapy. Compared to the reference short stature mean values, our TS cohort had comparable scores in all QoL subscales and total scores in both parent and patient reports apart from the parental report treatment subscale which was significantly lower than their respective reference short stature means [Mean ± SD: 47.43±27.13 vs 58.82±16.75; p=0.03]. Girls with height >-3SD had significantly lower score in the coping subscale, compared to the <-2SD height group [Mean ± SD: 42.14 ± 19.04 vs 62.25 ± 16.60; p= 0.024; multivariate analysis: p=0.012. In the parent report, the social subscale was significantly lower in the > -3SD height group compared to the <-2SD height group [Mean ± SD: 57.59 ± 22.25 vs 80.94 ± 11.26; p=0.022; multivariate analysis: p=0.024]. There was no statistically significant difference in the QOL between the GH vs no GH groups. Conclusion: We conclude that the QoL in girls with TS was comparable to the reference short stature population. GH therapy did not improve the QoL in girls with TS in our cohort. Height does not appear correlate with the overall QoL in girls with TS though they have some coping and social difficulties. We recommend psychological counseling and support for girls with TS especially to address their coping and social difficulties. Presentation: Friday, June 16, 2023

Musculoskeletal pain, kinesiophobia, and quality of life in obese patients

Objectives: This study aims to examine musculoskeletal pain, kinesiophobia, and quality of life in individuals with normal body mass index and in individuals with obesity, and to determine the relationship between the variables. Methods: In the study; individuals aged between 20-65 years, with a body mass index of 30 kg/m2 and above (Group obesity) with obesity, and individuals with a range of 18.5-24.9 kg/m2 (Group normal) were included. General Practice Physical Activity Questionnaire, Orebro Musculoskeletal Screening Questionnaire, Short Form-12 Health Survey, and Kinesiophopia Causes Scale were applied to the participants for primary care. Results: When the descriptive characteristics of the individuals in the sample which were divided into two groups as the Group normal (n = 82; 22.6 ± 1.7 kg/m2) and Group obesity (n = 92; 33.0 ± 2.8 kg/m2 were analyzed; while a difference was determined in terms of sex, education level and presence of chronic disease (p ˂ 0.05), no difference was found in terms of age, marital status and regular drug use for the treatment of chronic disease (p ˃ 0.05). Although the activity level rates of Group obesity were lower according to the physical activity questionnaire classification for primary care, no statistically significant difference was found between the groups (p = 0.090). More musculoskeletal pain was found in the individuals of the obesity group (p = 0.003), the physical sub-dimension score of the general quality of life questionnaire was negatively affected (p = 0.014), and a difference in favor of phobia was determined in all domains of the kinesiophobia causes scale (p < 0.001). There was a weak positive correlation between body mass index and musculoskeletal pain, while a moderate positive correlation with kinesiophobia. Conclusions: Although physical activity level is similar to individuals with normal body mass index, musculoskeletal pain and kinesiophobia are higher in individuals with obesity, and their quality of life is negatively affected.

Deep Brain Stimulation of Subthalamic Nucleus Improves Quality of Life in General and Mental Health Domains in Parkinson’s Disease to the Level of the General Population

ObjectivesParkinson’s disease (PD) leads to significant impairment in quality of life (QoL) across various domains. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is known to improve motor and nonmotor symptoms in PD. The aim was to study whether STN-DBS could improve the QoL of patients with PD to the level of the general population, and to determine factors predicting better motor outcomes. Materials and MethodsThe retrospective analysis included 43 patients who underwent either primary or revision STN-DBS. Patients filled out a general QoL questionnaire (RAND 36-item health survey) before and 12 months after surgery, and scores were compared with age- and sex-adjusted national population values. In addition, motor scores were calculated using Unified Parkinson Disease Rating Scale part 3 (UPDRS 3) with the best PD medication. Levodopa equivalent daily dose (LEDD) was also collected. Changes in the QoL were compared with operation age, disease duration, and preoperative QoL. ResultsPreoperatively, patients had significantly impaired QoL in all subsections compared with that of the general population. The mean postoperative UPDRS 3 improvement was 50.0%, and reduction in LEDD was 69.0%. Statistically significant QoL improvements were found in Physical Function, Mental Health, Social Function, Vitality, and Role Physical 12 months postoperatively compared with baseline. The mean differences compared with a healthy population were not statistically significant in General Health, Mental Health, Vitality, and Role Emotional. Furthermore, disease duration was found to be negatively correlated with improvements in UPDRS 3 score, and worse preoperative QoL positively correlated with changes in Physical Function. ConclusionsPatients experienced significant QoL improvements after STN-DBS. The General Health and Mental Health of patients were postoperatively most comparable with age- and sex-adjusted population values. Moreover, earlier stimulation predicted better motor improvements, which emphasizes the importance of earlier timing of STN-DBS surgery and minimizing loss of function at a critical disease stage.

Health-related quality of life in asthma measured by the World Health Organization brief questionnaire (WHO-BREF) and the effect of concomitant allergic rhinitis-A population-based study.

The impact of allergic rhinitis (AR), a common comorbidity in asthma, on global quality of life (QoL) using generic QoL questionnaires has not been extensively evaluated. This was a cross-sectional population-based study among adults ≥18 years old. Generic QoL was measured using the World Health Organization (WHO) questionnaire (WHOQOL-BREF), and asthma control was assessed using the Asthma Control Test. Participants were categorized into four groups: Group 1 (No asthma, no AR), Group 2 (Asthma only), Group 3 (AR only) and Group 4 (Concomitant asthma and AR). The student t-test or the ANOVA was used for comparison between groups and based on the level of asthma control. Linear regression was used to assess the association between the level of asthma control and QoL scores, adjusted for age and sex. A p-value of less than 0.05 was considered significant for all associations. There were 9115 participants; 906 (9.9%) had asthma, and 1998 (21.9%) had AR. The lowest QoL scores were in the environment domain. Mean QoL scores were significantly lower in asthma compared to 'no asthma' and in AR compared to 'no AR'. Either asthma or rhinitis (Group 2 or 3) had significantly lower scores compared to no disease (Group 1) only in the environment domain, but the concomitant disease (Group 4) had lower scores across all categories and domains. Scores were significantly lower for uncontrolled asthma compared to controlled asthma and for 'concomitant asthma and AR' compared to 'asthma only'. Increasing age and uncontrolled asthma predicted worse health-related quality of life (HRQoL) consistently. Although asthma and AR negatively impact HRQoL independently, concomitant asthma and AR are worse. Uncontrolled asthma underpins poor QoL in asthma because QoL is not impaired in controlled disease. This underscores the need for recognition and treatment of AR in asthma and reinforces the benefits of achieving asthma control as a priority in asthma treatment.

TRANSCULTURAL ADAPTATION AND VALIDATION OF THE UKRAINIAN VERSION OF THE SPECIALIZED PHLEBOLOGICAL QUESTIONNAIRE FOR QUALITY OF LIFE ASSESSMENT

Today, quality of life assessment is an informative, reliable and economical method of studying health, both at the individual and group levels, and is an important integral indicator of the severity and dynamics of the pathological process in different nosologies. The most convenient way to measure the quality of life is to use questionnaires, which are divided into general, used for all diseases, and specialized, used for a particular nosological unit. Proper construction of quality of life questionnaires is extremely important for obtaining objective information, and in the case of using foreign language versions, it is necessary not only to make a correct translation, but also to follow the procedure of transcultural adaptation and validation. A number of general quality of life questionnaires (SF-36, Euro-Quality of Life 5D-5L) have Ukrainian versions and have been adapted and validated in accordance with international requirements. As for specialized phlebological questionnaires for quality of life assessment, after analyzing the available information resources, we did not find any description of the process of transcultural adaptation and validation of questionnaires for patients with varicose veins of the lower extremities in Ukrainian language, which became the basis of our work, during which, in accordance with the recommendations of the WHO and the Professional Society for Health Economics and Outcomes Research, the process of transcultural adaptation of the specialized phlebological questionnaire for quality of life assessment, Aberdeen Varicose Vein Questionnaire, was conducted. The validity of the adapted Ukrainian version of the questionnaire was determined using various methods: by analyzing the internal stability (Cronbach's coefficient), which according to the study is 0.76, which is comparable to the original version of the questionnaire and shows the internal consistency of the questionnaire. The next tool used to determine the validity of questionnaire questions is the "test-retest" method: conducting two tests with an interval of 14 days. According to the results of this method, a strong direct relationship with the overall Spearman coefficient = 0.965 (p <0.01) prevailed, which indicates a reliable repeatability of the test. The result of the Lawshe validation assessment aimed at the involvement of specialized experts and confirmed the importance of all 13 questions of the questionnaire for assessing the quality of life in patients with varicose veins of the lower extremities. Based on the study, the following conclusions were made: the Ukrainian language version of the AVVQ phlebological questionnaire, performed in accordance with international standards of language and cultural adaptation is an effective tool for assessing quality of life in patients with varicose veins of the lower extremities. The total quality of life assessment significantly complements the characteristics of the pathological process in patients with varicose veins of the lower extremities, its dynamics under the influence of various treatment measures, provides valuable information about the patient's response to the disease and treatment. The Ukrainian-language version of AVVQ can be used as a guide to record changes in the quality of life of people with varicose veins of the lower extremities and used in the future as an independent, no less important indicator than the usual clinical and sonographic criteria.

Establishment of MOS-SF36 percentile ranks in the general youth French population

BackgroundThe SF-36 is a generic quality of life questionnaire, massively translated and widely used to obtain physical and mental health status. However, validation work in the French language was carried out over a generation ago. The objective of this study was to obtain the norms of the SF-36 in the French young population.MethodThe sample consisted of 958 non-pre-screened French people aged between 18 and 24 years.ResultsThe internal consistencies of the scales were high and the metrics associated with the factor structure were satisfactory. In general, women presented significantly higher scores than men.ConclusionOur results suggest that the SF-36 remains a reliable tool for studying quality of life in the young French population.

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.

Hidradenitis Suppurativa Quality of Life 24 (HSQoL-24) now available for Polish patients: creation and validation of the Polish language version.

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disorder with a well-documented impact on quality of life (QoL). Due to the very distinctive features of HS the clinical picture, and lack of specific questions, generic dermatology QoL questionnaires cannot adequately reflect patients' suffering. To translate and validate the Polish version of the Hidradenitis Suppurativa Quality of Life 24 (HSQoL-24) questionnaire. The standardized translation process included forward and backward translation from the English version of the instrument. The final version was subsequently validated on a group of 30 HS patients, who completed the questionnaire twice. Internal consistency, test-retest reliability, and reproducibility of the results were also analysed. The Polish version of HSQoL-24 showed excellent internal consistency, with a Cronbach α coefficient of 0.908. Moreover, excellent reproducibility of the results was observed, with an intraclass correlation coefficient of 0.908. The HSQoL global score correlated positively with Dermatology Life Quality Index (DLQI) and Hidradenitis Suppurativa Quality of Life (HiSQoL) questionnaire. The Polish version of HSQoL-24 has excellent internal consistency, good reproducibility, and adequate validity. It may be of help in assessing QoL impairment in HS patients in daily practice and research.

Assessing quality of life and associated factors in post-stroke patients using the world health organization abbreviated generic quality of life questionnaire (WHOQOL-BREF)

IntroductionThis study piloted the World Health Organization Quality of Life short version form (WHOQOL-BREF) to compare the quality of life (QoL) in post-stroke patients who followed the medical stroke rehabilitation program and those whom did not. This study determined which quality of life domains were mostly affected by stroke, and whether there are influencing factors other than rehabilitation. MethodsA cross-sectional study was conducted at Public Hospital in Surabaya. Patients with stroke less than two years since the first attack were included in this study (n = 52). Cronbach's alpha test was performed to assess the internal consistency of WHOQOL-BREF questionnaire. The independent t-test and ANOVA were used to compare the differences between patient's characteristics and the six domains of QoL (i.e., perception of QoL, perception of health, physical of health, psychological health, social relationship, and environmental health). Multiple linear regression was performed to assess the influential factors of QoL. Resultspost-stroke patients aged more than 50 years old (76.9%), male (55.8%). But, only 48.1% of those patients participating in medical rehabilitation programs. Age group was significantly associated with QoL in the psychological health domain (p = 0.021); participating in medical stroke rehabilitation programs was significantly associated with social relationship domain (p = 0.026) and the education level was significantly associated to physical health (p = 0.005), psychological heath (p = 0.035) and perception of health (p = 0.003). ConclusionLower education level was significantly associated with a low perception of health, one of QoL domains; and it was the most influential factor of QoL among post-stroke patients.

Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease.

IntroductionNeuromuscular stimulation (NMES) has been shown to improve peripheral blood flow in healthy people. We investigated the effect of bilateral leg NMES on the symptoms of chronic venous disease.MethodsForty subjects were recruited from four groups: healthy, superficial insufficiency, deep insufficiency, and deep obstruction. Haemodynamic venous measurements were taken from the right femoral vein with ultrasound, laser Doppler fluximetry from the left hand and foot. Devices were then worn for 4–6 hours per day, for 6 weeks. Haemodynamic measurements were repeated at week 6. Quality of life questionnaires were taken at week 0, 6 and 8.ResultsThe mean age was 48.7, BMI 28.6kg/m2, and maximum calf circumference 39.0 cm. Twenty-four subjects were men. NMES increased femoral vein peak velocity, TAMV and volume flow by 55%, 20%, 36% at 20 minutes (all p<0.05), which was enhanced at week 6 (PV and TAMV p<0.05). Mean increases in arm and leg fluximetry were 71% and 194% (both p<0.01). Leg swelling was reduced by mean 252.7 mL (13%, p<0.05) overall; 338.9 mL (16%, p<0.05) in venous disease. For those with venous pathology, scores for disease specific and generic quality of life questionnaires improved. Those with C4-6 disease benefitted the most, with improvements in VDS score of 1, AVVQ of 6, and SF-12 of 10.ConclusionNMES improves venous haemodynamic parameters in chronic venous disease, which is enhanced by regular use. NMES reduces leg oedema, improves blood supply to the skin of the foot, and may positively affect quality of life.Clinical TrialsThis trial was registered with www.clinicaltrials.org.uk (NCT02137499).

Do grape and black mulberry molasses have an effect on oral mucositis and quality of life in patients with head and neck cancer?

We aimed to investigate the effect of black mulberry and grape molasses on the prevention and treatment of oral mucositis and quality of life (QoL) in patients with head and neck cancer (HNC). Patients treated for HNC between 2010 and 2018 in our department were divided into three groups (group 1 = control (n = 14), group 2 = grape molasses (n = 40), and group 3 = black mulberry molasses (n = 40)). Oral mucositis, pain scoring, and weight loss were evaluated weekly. The European Organization for Research and Treatment of Cancer (EORTC) General QoL Questionnaire (QLQ-C30) and EORTC Head and Neck Cancer QoL Module (QLQ-HN35) were used to evaluate QoL. The mean body weight, scores of oral mucositis, and pain were similar among the groups throughout the treatment. Both groups 2 and 3 were associated with improved outcomes for swallowing, opening mouth, and weight loss in the EORTC HN35, and these parameters were not significantly different between groups 2 and 3. Global health score was higher in group 3 at the 6th week of RT compared to that of group 2. Both groups 2 and 3 had improved scores for role functioning, emotional and social functioning, fatigue, appetite loss, and pain throughout the treatment compared to group 1. Both grape and black mulberry molasses improved the QoL in HNC patients. No significant difference between black mulberry and grape molasses was found with regard to the healing of oral mucositis.

71-OR: Youth with Type 1 Diabetes and Their Parents Report Improved Quality of Life with the Omnipod 5 Automated Insulin Delivery System

Type 1 diabetes (T1D) can lead to significant emotional distress and impair quality of life (QoL). Hybrid closed-loop (HCL) technology seeks to relieve this burden, a goal with equal importance to improving glycemic outcomes. We evaluated change in QoL outcomes for children (6.0-11.9y) and teens (12.0-17.9y) with T1D and their parents/guardians before and after a 3-month study of HCL therapy with the Omnipod 5 System. Validated assessment tools administered included diabetes-related QoL (PAID and HCS) and generic QoL (PSQI and WHO-5) questionnaires. Children (n=83) and teens (n=42) were (mean±SD): age 9±2y and 14±2y, with T1D duration 4±2y and 7±3y and A1C 7.5±0.9% and 7.9±1.0%, respectively. Responses revealed significantly reduced diabetes distress for all groups (Table). Also, parents of children reported significant improvement in overall well-being (WHO-5), hypoglycemic confidence (HCS) and in 3 PSQI sleep subscales: quality (change: ‑0.43±0.83, p<0.01), disturbance (‑0.18±0.58, p<0.01), and duration (‑0.28±1.00, p<0.01). In this 3-month study, the Omnipod 5 System reduced diabetes distress for youth and their parents. The most striking improvements in QoL were seen in parents of children, a group in great need of solutions to help them care for their children without negatively affecting their own QoL.View largeDownload slideView largeDownload slide DisclosureK. K. Hood: Consultant; Self; Cecelia Health, Cercacor, LifeScan Diabetes Institute. W. H. Polonsky: Advisory Panel; Self; Intarcia Therapeutics, Inc., Consultant; Self; Abbott Diabetes, ADOCIA, Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Insulet Corporation, Lilly Diabetes, Novo Nordisk, Onduo LLC., Sanofi US. S. A. Macleish: Advisory Panel; Self; Insulet Corporation. C. J. Levy: Advisory Panel; Self; Dexcom, Inc., Eli Lilly and Company, Employee; Spouse/Partner; AbbVie Inc., Other Relationship; Self; Dexcom, Inc., Research Support; Self; Abbott Diabetes, Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care. L. M. Huyett: Employee; Self; Insulet Corporation, Stock/Shareholder; Self; Insulet Corporation. T. Vienneau: Employee; Self; Insulet Corporation, Stock/Shareholder; Self; Insulet Corporation. T. T. Ly: Employee; Self; Insulet Corporation.FundingInsulet Corporation

Assessing atrial fibrillation ablation priority during COVID-19 -does use of patient questionnaires help in stratification above physician assessment?

Funding AcknowledgementsType of funding sources: None.IntroductionCatheter ablation for atrial fibrillation (AF) is largely offered for symptomatic relief. The ORBIT registry has shown that patients with a higher EHRA class and lower quality of life (QoL) scores (AFEQT score <65.7) are more likely to suffer emergency hospital admissions. To help prevent unplanned AF admissions and to best utilise the reduced capacity for elective work during the COVID-19 pandemic, it has become even more important to prioritise the most symptomatic AF patients for ablation. Purpose: To evaluate the accuracy of a subjective symptom-based clinician prioritisation schema compared to objective patient-completed quality of life (QoL) scores. Methods: In July 2020, all elective cases awaiting AF ablation at our institution were categorised by their cardiologist as either category 1 (C1-urgent), category 2 (C2–priority, procedure to be done during the ongoing COVID-19 pandemic) or category 3 (C3–routine, procedure may be delayed until post pandemic). This categorisation was based on review of clinic letters where EHRA AF symptom class or PROMS are not routinely recorded. All patients in C2 and C3 were then posted an AF specific (AFEQT) and a generic (EQ5D) QoL questionnaire to complete. Physicians were blinded to patient responses on the QoL questionnaires. Results: Details of physician prioritisation and completed questionnaires were available for 85 patients (62 ± 10 years, PAF in 61%, males 66%). The 18 patients that had been categorised in C2 (priority) group were found to have a significantly lower AFEQT score (30.4, IQR 17.2-51.9) compared to the 67 patients classed in C3 (routine) group (56.5, IQR 32.1-74.1; p < 0.01)(Figure 1a). EQ5D scores also tended to be lower in the C2 patients (0.7, IQR 0.4-0.8) compared to C3 (0.8, IQR 0.6-0.9; p = 0.056) (Figure 1c). 16 (89%) patients in C2 had significant AF-related impact on QoL (as defined as AFEQT score <65.7) compared to 42 (63%) of patients in C3. However, there was significant overlap between groups (Figure 1b). 4 patients in C3 had unplanned AF related hospital admissions while awaiting ablation, as compared to none in C2. The median AFEQT score of these 4 patients was 23.3, indicating that they were highly symptomatic despite being classified in C3 by their cardiologist. Conclusion : Physician assessments are moderately accurate in prioritising patients awaiting AF ablation. The addition of formal patient-completed QoL assessment such as with AFEQT, helps to identify the most symptomatic patients at risk of emergency hospital admission, and physicians should consider using these as part of routine assessment, especially during the COVID pandemic. Figure 1

Psychometric properties of the Persian translation of maternal postpartum quality of life questionnaire (MAPP-QOL)

Background and objectiveMany studies have been conducted in Iran on the postpartum quality of life, and the majority have used the general quality of life questionnaire. With a specific tool in this context, the dimensions of maternal postpartum quality of life can be more accurately determined. The present study was conducted to determine psychometric properties and validate the Persian version of the Maternal Postpartum Quality of Life Questionnaire (MAPP-QOL).Materials and methodsThe present methodological study was conducted in 2018. The original version of MAPP-QOL was translated into Persian by both forward and backward translation. In a cross-sectional study, the Persian version was completed by 407 eligible postpartum women aged 18 to 47 and living in Tehran. Reliability of the questionnaire was assessed using Cronbach's alpha coefficient and test–retest. For construct validity, exploratory and confirmatory factor analyses were used.ResultsThe MAPP-QOL showed good content validity; content validity ratio (CVR) ranged from 0.6 to 1.00, and content validity index (CVI) ranged from 0.7 to 1.00. Using exploratory factor analysis, five factors, including Socioeconomic; Relational/Family-Friends; Psychological/Baby; Health & functioning; and Relational/Spouse-Partner, were extracted, which together explained 78.84% of the total variance. After modifications of CFA, the confirmatory factor analysis showed an acceptable goodness-of-fit. AVE value Above 0.5 exhibited appropriate convergent validity, and AVE greater than MSV confirmed divergent validity. The Cronbach's alpha, McDonald's Omega, Composite reliability and maximum reliability H of the five extracted factors were excellent (> 0.9). Also, the AIC values of the factors were good (between 0.721 to 0.859).ConclusionThe 38-item Persian version of the postpartum quality of life questionnaire is adequately reliable for postpartum women in Iran. Given its appropriate psychometric properties, this scale is fit to be used in future studies on postpartum women.

Associations Between Voice and Gestural Characteristics of Transgender Women and Self-Rated Femininity, Satisfaction, and Quality of Life.

Purpose Client-based subjective ratings of treatment and outcomes are becoming increasingly important as speech-language pathologists embrace client-centered care practices. Of particular interest is the value in understanding how these ratings are related to aspects of gender-affirming voice and communication training programs for transgender and gender-diverse individuals. The purpose of this observational study was to explore relationships between acoustic and gestural communication variables and communicator-rated subjective measures of femininity, communication satisfaction, and quality of life (QoL) among transfeminine communicators. Method Twelve acoustic and gestural variables were measured from high-fidelity audio and motion capture recordings of transgender women (n = 20) retelling the story of a short cartoon. The participants also completed a set of subjective ratings using a series of Likert-type rating scales, a generic QoL questionnaire, and a population-specific voice-related QoL questionnaire. Correlational analyses were used to identify relationships between the communication measures and subjective ratings. Results A significant negative relationship was identified between the use of palm-up hand gestures and self-rated satisfaction with overall communication. The acoustic variable of average semitone range was positively correlated with overall QoL. No acoustic measures were significantly correlated with voice-related QoL, and unlike previous studies, speaking fundamental frequency was not associated with any of the subjective ratings. Conclusions The results from this study suggest that voice characteristics may have limited association with communicator-rated subjective measures of communication satisfaction or QoL for this population. Results also provide preliminary evidence for the importance of nonverbal communication targets in gender-affirming voice and communication training programs.

Microablative Fractional CO2 Laser for Vulvovaginal Atrophy in Women With a History of Breast Cancer: A Pilot Study at 4-week Follow-up

BackgroundBreast cancer (BC) is the most common female cancer worldwide. Menopausal symptoms are a well-known side effect in women with BC and have a significant negative impact on quality of life (QoL) and sexuality. Nowadays, hormonal replacement therapy and local estrogens are the most common prescriptions to treat vulvovaginal (VVA) symptoms. However, in women with a history of BC, proper therapy for such conditions remains an often inadequately addressed clinical problem. A treatment with microablative fractional CO2 laser (MLT) can produce a remodeling of the vaginal connective tissue without causing damage to the surrounding tissue. The aim of this pilot study is to assess the efficacy and safety of MLT for treating VVA symptoms in women with a history of BC at 20-week follow-up since the first laser treatment. Patients and MethodsWomen with BC and VVA symptoms were enrolled in the study and treated with 5 laser applications (one every 4 weeks). The rate of satisfied patients at 20 weeks of follow-up was evaluated with a 5-point Likert scale. Changes of the Vaginal Health Index (VHI) after treatment was compared with baseline. Effects of the laser treatment on VVA symptoms was measured using a 10-cm visual analog scale (VAS). Changes in overall QoL were assessed with a generic QoL questionnaire: the Short Form 12 (SF-12) that we analyzed considering its physical (PCS12) and mental (MCS12) domains. Sexual function was evaluated by the Female Sexual Function Index (FSFI). ResultsIn this prospective cohort study, we enrolled 40 women with a history of BC and who currently were or (Group 2) who had been (Group 1) on treatment with endocrine therapy for their condition. Six (15.0%) women were very satisfied, 25 (62.5%) were satisfied, 6 (15.0%) were uncertain, and 3 (7.5%) were dissatisfied with the MLT. VVA symptoms and VHI improved significantly at 20 weeks from baseline (P < .05) with no differences between the 2 groups (P > .05). In terms of QoL measured by the SF-12, the PCS12 and the MCS12 significantly improved at the 20-week follow-up. A significant improvement in total FSFI and in all domains was reported in both study groups (P < .05) with no differences between groups (P > .05). ConclusionMLT was safe and effective in treating VVA symptoms in women with a history of BC, irrespective of being previously or currently on endocrine therapies.