Health Quality Of Life Scores Research Articles

Do body esteem and quality of life scores change with puberty signs or precocious puberty treatment?

Body esteem (BE) and quality of life (QOL) of girls aged 9-11 years may change depending on their puberty. We aimed to examine The Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) and the Body Esteem for Adolescents and Adults Scale (BESAA) for children. The groups were determined as those whose puberty signs had not yet started (Group 1), those having with breast development stage 3 and/or larger (Group 2), and those who had received gonadotropin-releasing hormone agonist (GnRHa) treatment for at least 6months (Group 3). A total of 145 girls (Group 1: 41, Group 2: 56, Group 3: 48), were included. The PedsQL scores of the Group 1 was higher than Group 2 (78.5±10.3 vs. 70.1±14.2; p=0.008). The PedsQL scores of the Group 1 was higher but not statistically different from Group 3 (78.5±10.3 vs. 74.2±14.3; p=0.401). The PedsQL scores of Group 2 was not statistically different from Group 3 (p=0.354). There was no statistical difference in BESAA scores between groups (p=0.291). Group 1's PedsQL Health and Activity subscale score was higher than Group 2 (p=0.002). The QOL of the girls with PP was found to be lower than their healthy peers. Health and Activity-related QOL scores were found to be lower in the untreated group, indicating that girls with PP were probably significantly disturbed by their puberty-related physical development at the onset of the disease.

Effectiveness of a Digital Application-Based Self-Care Management Program in Patients with Type 2 Diabetes in Thai Nguyen Province, Vietnam

Purpose: To evaluate the effectiveness of educational communication intervention using SMDia software in improving knowledge, self-care activities, quality of life and glycemic control in patients with type 2 diabetes in Thai Nguyen province, Vietnam.
 Methodology: It was an intervention study with control group. Intervention study was conducted from March 2021 to May 2022 on 240 patient’s type 2 diabetes who was randomly assigned to the control group and intervention group, each group had 120 people. It was to evaluate the effectiveness of educational communication intervention using SMDia software for self-care knowledge, self-care activities, and quality of life, using the DSCKQ-30, SDSCA, and V.SF-36v2 toolkits for glycemic control by fasting blood sugar levels, HbA1c at times before and after intervention.
 Findings: After intervention, there was a clear improvement over time and level in the intervention group compared to the control group after 24 weeks. The self-care knowledge score in the intervention group’s 26.60 ± 2.96 points; the self-care activity score in the intervention group's 69.40 ± 9.31 points; the quality of life score for physical health in the intervention group's 73.25 ± 9.34 points; the mental health quality of life score in the intervention group's 72.74 ± 7.0 points. The intervention effect on change in self-care activities, quality of life and self-care knowledge were 167.8%, 163.6%, and 64.0%, respectively. After 24 weeks, the rates of patients with poor blood sugar control and poor HbA1c in the intervention group was 36.7% and 7.5%. The rate of blood sugar control achieved the target increased by 15.8%, HbA1c reached the target increased by 31.7%. Intervention effectiveness reached 8.2% for blood sugar control and 41.8% for HbA1c control.
 Unique contribution to theory, practice and policy: Educational communication intervention using SMDia software has shown to significantly improve self-care knowledge, self-care activities, quality of life and glycemic control for patients with type 2 diabetes.

Development of Quality of Life in Adolescents and Young Adults With Cancer Using a Patient Support Smartphone App: Prepost Interventional Study.

Adolescents and young adults often experience existential concerns in addition to side effects during a cancer trajectory, which they often carry alone. Thus, cohesion with other adolescents and young adults with cancer is essential but difficult due to the relatively small, widely dispersed nationwide population. In cocreation, a smartphone app has been developed and includes an information bank, a symptom tracker, and a social community platform, aiming to improve the quality of life (QoL) in this patient group. This nationwide, multicenter study aimed to investigate the QoL in adolescents and young adults undergoing a cancer trajectory as they used the app for 6 weeks. Via youth support initiatives, participants were recruited from hospitals in all regions of Denmark. Inclusion criteria were patients with cancer aged 15-29 years who either initiated any cancer treatment or started follow-up after cancer treatment within 30 days. Participants used the adolescents and young adults cancer app for 6 weeks. Before and after the 6 weeks of app use, they completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). The participants were divided into a treatment and a follow-up group for analysis. A high score for a functional scale or the global health or overall QoL represents a high or healthy level of functioning or high QoL, respectively; however, a high score for a symptom scale or item represents a high level of symptomatology. Overall, 81 participants were recruited. However, 4 participants did not answer the questionnaire and 6 participants did not use the app. In the treatment group (n=36), significant improvement was found in 2 domains: "Role functioning" (baseline median 33.33, IQR 16.67-83.33 vs 6 weeks median 66.67, IQR 33.33-83.33;P=.04) and "Pain" (baseline median 33.33, IQR 16.67-50.00 vs 6 weeks median 16.67, IQR 0.00-33.33;P=.04). The "Global health/Overall QoL" scale remained stable (baseline median 58.33, IQR 45.83-77.08 vs 6 weeks median 62.50, IQR 41.67-75.00;P=.25). In the follow-up group (n=35), significant improvement was found in 3 domains: "Physical functioning" (baseline median 79.23, IQR 73.33-93.33 vs 6 weeks median 82.86, IQR 73.33-100.00;P=.03), "Cognitive functioning" (baseline median 62.38, IQR 50.00-83.33 vs 6 weeks median 69.52, IQR 50.00-100.00;P=.02), and "Social functioning" (baseline median 76.19, IQR 50.00-100.00 vs 6 weeks median 85.71, IQR 83.33-100.00;P=.05), as well as in the "Global health/Overall QoL" scale (baseline median 57.14, IQR 83.33-100.00 vs 6 weeks median 75.0, IQR 62.91-85.73;P<.001). In this study, we found an improvement in specific QoL scales for both participants in treatment and follow-up when using the app for 6 weeks. The global health or overall QoL score improved significantly in the follow-up group. In the treatment group, it remained stable. RR2-10.2196/10098.

Short-Term Outcomes and Quality of Life Following Minimally Invasive Esophagectomy in a Tertiary Care Center in Southern India.

With the advent of multimodality therapy and minimally invasive surgical approaches, patients suffering from carcinoma esophagus are showing promising outcomes. Hence, the frontier needs to be widened to assess the postoperative quality of life (QoL) of those surviving carcinoma esophagus. The objective of the study was to determine the short-term outcomes of minimally invasive esophagectomy (MIE) /hybrid esophagectomies in carcinoma esophagus and the organ-specific QoL in survivors of MIE for carcinoma esophagus, and to compare health-related QoL in patients following MIE for carcinoma esophagus with the general population. A longitudinal study design was used to evaluate the short-term postoperative outcomes of patients undergoing MIE for carcinoma esophagus between July 1, 2021, to July 15, 2022, and analyze the QoL of those patients who survived at one year without tumor recurrence. QoL was assessed using the European Organization for the Research and Treatment of Cancer (EORTC) QoL Questionnaire (EORTC QLQ-C30) and the EORTC QoL Questionnaire - Oesophageal Cancer Module (EORTC QLQ-OES18). A total of 15 patients who underwent minimal invasive/hybrid esophagectomy for esophageal carcinomawere included. Of these, 13 patients underwent hybrid esophagectomy while two patients underwent thoraco-laparoscopic esophagectomy. Squamous cell carcinoma was observed as the most common histological variant (60%) while 33% were adenocarcinoma and 6.7% lymphoma. The most common site of the tumor was the lower one-third esophagus (60%). Nine out of 15 patients developed postoperative complications needing prolonged ICU stay. One major anastomotic leak as well as one conduit necrosis was observed among 15 cases operated. Median length of hospital stay was 16 (IQR 12-24). QoL was assessed among 12 patients at the one-year follow-up excluding mortality cases and patients with tumor recurrence. The patients following MIE for carcinoma esophagus were observed to have low scores in physical functioning, role functioning, and social functionwhen compared with the general population. Cognitive functioning and emotional function were not found to be significantly different. No statistically significant difference was observed in the global health status among the two groups. There was no significant difference found in the general symptoms score comparison of the MIE patients with the general population. When it comes to organ-specific symptom scales, reflux was observed as a major issue among the patients who survived carcinoma esophagus after undergoing MIE. Dysphagia and dry mouth received low scores suggestive of minor issues. Though analysis of global health QoL scores of those with postoperative complications and those who had uneventful recovery at one year revealed a higher score for the latter, it was not statistically significant. Postoperative complications can prolong hospital stay, delay resuming normal work, and affect the global QoL of patients compared with those who recovered uneventfully. Physical and role functions were observed to be deficient among survived patients when compared with the normal population. Nutritional prehabilitation, cutting-edge surgical practice including minimally invasive techniques, minimizing deviation from normal postoperative recovery by high-quality ICU care, and postoperative rehabilitation are the cornerstones to ensure better QoL.

Yanıkta Bakım Veren Yükü ile Yanık Hastasının ve Bakım Verenin Yaşam Kalitesi

Aim: This descriptive study aimed to determine the relationship between burn patients and their caregivers’ quality of life and care burden. &#x0D; Material and Methods: The study was conducted at two university hospitals. Thirty burn patients discharged from the hospitals between September 2015 and January 2016 and their 30 caregivers participated in the study. Data were collected face-to-face with the datasheet for patients, the Burn-Specific Health Scale, the datasheet for caregivers, the World Health Organization Quality of Life (QoL)-Brief, and the Zarit Caregiver Burden Interview Scale.&#x0D; Results: The patients’ mean QoL scores, and sub-scores were higher than 0.53. The highest caregivers’ mean QoL score was for the physical health domain (74.62±16.87). There was a negative correlation between the physical health scores of caregivers and the general health and overall QoL scores of patients (p

Factors Affecting the Quality of Life of Parents Caring for Pediatric Patients with a Tracheostomy.

Objectives This study aimed to evaluate factors affecting the quality of life (QOL) of parents of children who underwent placement of a tracheostomy while in the pediatric intensive care unit (PICU) through postdischarge use of a standardized questionnaire, Functional Status Scale (FSS) for patients, and WHOQoL-BREF (a QOL scale) for parents. Methods The parents were initially contacted by telephone, postdischarge, during which the standardized questionnaire was completed. The functional status of the patients was evaluated using the FSS, and the QOL of parents was determined through use of the WHOQoL-BREF scale. Results From 2011 to 2021, tracheostomy was performed in 119 PICU patients. Overall, 93 patients were excluded due to death in 66 (56%), decannulation in 24 (20%) and, 3 (2%) were not available for follow-up. The parents of 26 (22%) patients were available for follow-up and for which the standardized questionnaire FSS and WHOQoL-BREF QOL scales were completed. The mean FSS score of the patients was elevated at 17.84. In comparison, reduced mean scores were observed for parental physical health of 20.61, psychological health of 20.57, social health of 11.15, and environmental health of 29.00. As a result, a moderate ( r < 0.80), yet significant ( p ≤ 0.004) negative correlation was found between the FSS scores of patients and the physical, social relationships, environmental, and psychological health QOL scores of parents. Conclusion This study is unique in that, to our knowledge, it is the first to compare parental QOL with the FSS of pediatric patients who have undergone a tracheostomy while hospitalized in the PICU. Our findings indicate that the parental QOL was reduced in four areas and correlates with an elevation in FSS score (indicating a greater functional disorder) of pediatric patients who had previously undergone a tracheostomy while hospitalized in the PICU.

Effect of Mind-Body Skills Training on Quality of Life for Geographically Diverse Adults With Neurofibromatosis

Neurofibromatoses (NF; NF1, NF2, and schwannomatosis) are hereditary tumor predisposition syndromes with a risk for poor quality of life (QOL) and no evidence-based treatments. To compare a mind-body skills training program, the Relaxation Response Resiliency Program for NF (3RP-NF), with a health education program (Health Enhancement Program for NF; HEP-NF) for improvement of quality of life among adults with NF. This single-blind, remote randomized clinical trial randomly assigned 228 English-speaking adults with NF from around the world on a 1:1 basis, stratified by NF type, between October 1, 2017, and January 31, 2021, with the last follow-up February 28, 2022. Eight 90-minute group virtual sessions of 3RP-NF or HEP-NF. Outcomes were collected at baseline, after treatment, and at 6-month and 1-year follow-up. The primary outcomes were physical health and psychological domain scores of the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). Secondary outcomes were the social relationships and environment domain scores of the WHOQOL-BREF. Scores are reported as transformed domain scores (range, 0-100, with higher scores indicating higher QOL). Analysis was performed on an intention-to-treat basis. Of 371 participants who underwent screening, 228 were randomized (mean [SD] age, 42.7 [14.5] years; 170 women [75%]), and 217 attended 6 or more of 8 sessions and provided posttest data. Participants in both programs improved from baseline to after treatment in primary outcomes of physical health QOL score (3RP-NF, 5.1; 95% CI, 3.2-7.0; P < .001; HEP-NF, 6.4; 95% CI, 4.6-8.3; P < .001) and psychological QOL score (3RP-NF, 8.5; 95% CI, 6.4-10.7; P < .001; HEP-NF, 9.2; 95% CI, 7.1-11.2; P < .001). Participants in the 3RP-NF group showed sustained improvements after treatment to 12 months; posttreatment improvements for the HEP-NF group diminished (between-group difference for physical health QOL score, 4.9; 95% CI, 2.1-7.7; P = .001; effect size [ES] = 0.3; and psychological QOL score, 3.7; 95% CI, 0.2-7.6; P = .06; ES = 0.2). Results were similar for secondary outcomes of social relationships and environmental QOL. There were significant between-group differences from baseline to 12 months in favor of the 3RP-NF for physical health QOL score (3.6; 95% CI, 0.5-6.6; P = .02; ES = 0.2), social relationships QOL score (6.9; 95% CI, 1.2-12.7; P = .02; ES = 0.3), and environmental QOL score (3.5; 95% CI, 0.4-6.5; P = .02; ES = 0.2). In this randomized clinical trial of 3RP-NF vs HEP-NF, benefits from 3RP-NF and HEP-NF were comparable after treatment, but at 12 months from baseline, 3RP-NF was superior to HEP-NF on all primary and secondary outcomes. Results support the implementation of 3RP-NF in routine care. ClinicalTrials.gov Identifier: NCT03406208.

Dose response relationship between food insecurity and quality of life in United States adults: 2016–2017

BackgroundFood insecurity is associated with worse general health rating, but little research exists investigating whether there is a dose response relationship across levels of food security and mental and physical health domains at the population level.MethodsData from the Medical Expenditure Panel Survey (2016–2017) with US adults aged 18 years and older was used. The physical component score (PCS) and mental component score (MCS) of Quality of Life, served as the outcome measures. Four categories of food insecurity (high, marginal, low, very low food security) served as the primary independent variable. Linear regression was used to run unadjusted followed by adjusted models. Separate models were run for PCS and MCS.ResultsIn a sample of US adults, 16.1% reported some degree of food insecurity. For PCS, marginal (β = − 2.54 (p < 0.001), low (β = − 3.41, (p < 0.001), and very low (β = − 5.62, (p < 0.001) food security was associated with worse PCS scores, compared to adults with high food security. For MCS, marginal (β = − 3.90 (p < 0.001), low (β = − 4.79, (p < 0.001), and very low (β = − 9.72, (p < 0.001) food security was associated with worse MCS scores, compared to adults with high food security.ConclusionIncreasing levels of food insecurity were associated with decreased physical and mental health quality of life scores. This relationship was not explained by demographic factors, socioeconomic factors, insurance, or comorbidity burden. This study suggests work is needed to mitigate the impact of social risk, such as food insecurity, on quality of life in adults, and understand pathways and mechanisms for this relationship.

Quality of life and mood disorders of mild to moderate stroke survivors in the early post-hospital discharge phase: a cross-sectional survey study

BackgroundExploring sociodemographic and disease characteristics that contribute to patient-reported outcomes can inform targeting of strategies to support recovery and adaptation to stroke. This study aimed to examine among a sample of stroke survivors at three months post-hospital discharge: (1) self-reported physical and mental health quality of life scores; (2) self-reported depressive and anxiety symptoms; and (3) sociodemographic and clinical predictors of these outcomes.MethodsThis cross-sectional survey study recruited stroke survivors from eight hospitals in one Australian state. Adult survivors recently discharged from hospital stroke wards (within 3 months) were mailed a study information package and invited to complete a pen-and paper survey. Survey items assessed: quality of life (SF12v2), depression (PHQ-9), anxiety (GAD-7) and sociodemographic and clinical characteristics. Predictors were examined using multiple linear regression analysis.ResultsOf the 1161 eligible patients who were posted a recruitment pack, 401 (35%) returned a completed survey. Participants reported a mean SF-12v2 Physical Composite Score (PCS) quality of life score of 44.09 (SD = 9.57); and a mean SF-12v2 Mental Composite Score (MCS) quality of life score of 46.84 (SD = 10.0). Approximately one third of participants (34%; n = 132) were classified as depressed (PHQ-9 ≥ 10); and 27% (n = 104) were classified as anxious (GAD-7 ≥ 8). Lower PCS was associated with being female, not employed and having a comorbid diagnosis of diabetes and atrial fibrillation. Lower MCS was associated with a history of transient ischemic attack (TIA). Males and those with higher levels of education, had greater odds of having lower depression severity; those with a history of TIA or diabetes had lower odds of having lower depression severity. Males had greater odds of having lower anxiety severity; those with a history of TIA had lower odds of having lower anxiety severity.ConclusionSub-groups of stroke survivors may be at-risk of poorer quality of life and psychological morbidity in the early post-discharge phase. These findings support the role of early identification and prioritisation of at-risk survivors at discharge, as they may require modifications to standard hospital discharge processes tailored to their level of risk.

Patient-Reported Quality of Life in Adolescents and Young Adults with Cancer before, during, and after Radiation Therapy

<h3>Purpose/Objective(s)</h3> Adolescents and young adults (AYAs, 15-39 yo) with cancer have unique vulnerabilities that affect quality-of-life (QOL) during treatment and in survivorship. Yet, few studies have assessed QOL in AYAs with cancer who received radiation therapy (RT). Therefore, we performed a cross-sectional study in AYAs with cancer who completed patient-reported outcomes (PROs) assessing QOL before, during, or after RT. <h3>Materials/Methods</h3> We identified 265 AYAs with cancer who were treated with RT and completed an AYA PRO survey from 2019-2022. The survey containing ten validated PRO instruments from the PROMIS inventory: Global Physical and Mental Health, Anxiety, Depression, Fatigue, Sleep Disturbance, Social Roles, Pain Interference, and Cognitive Function (score of 50 represents the mean from the reference U.S. general population; higher score represents more of the concept being measured). Patients were stratified into 3 cohorts based on the date of PRO completion: before RT, peri-RT (during RT or within 6 months of RT completion), or after RT (6+ months following RT completion). Mean (standard deviation [SD]) PRO scores were calculated. Patient characteristics were extracted from the medical record. Kruskal-Wallis analysis was used to compare scores between cohorts. ANOVA and t-test analyses were used to compare scores between co-variates. <h3>Results</h3> 87 (33%) patients completed PROs before RT, 84 (32%) peri-RT, and 94 (35%) after RT; median [IQR] age was 28 [21-33], 26 [20-32], and 22 [17-27], respectively. Cancer types varied; most had sarcoma (26%) or CNS cancer (23%). Compared to the before RT cohort, the peri-RT cohort had worse Global Physical and Mental Health PRO scores [SD] (48.7 [8.9] vs. 44.9 [9.8] (p=0.03) and 50.9 [8.6] vs. 46.2 [10.3] (p<0.01), respectively). These PRO scores were similar between the peri- and after RT cohorts (44.9 [9.8] vs. 45.5 [9.8] (p=0.68) and 46.2 [10.3] vs. 47.9 [9.6] (p=0.26), respectively). Compared to the before RT cohort, the peri- and after RT cohorts had better Anxiety PRO scores [SD] (55.2 [9] vs. 52.6 [10.4] and 51 [10], respectively, p=0.02). Remaining PRO scores were similar between cohorts (p>0.05). In the peri-RT cohort, patients with any acute RT toxicity had worse Pain Interference PRO scores [SD] vs. patients with none (50.8 [8.9] vs. 44.7 [5.7], p=0.03). In the after RT cohort, adolescents (15-18 yo) and young adults (26-39 yo) had worse Global Mental Health PRO scores [SD] vs. emerging adults (19-25 yo) (46.9 [9.1] and 47.9 [11.2], respectively, vs. 53.8 [9.2], p=0.04); patients with any late RT toxicity had worse Sleep Disturbance PRO scores [SD] vs. patients with none (58.4 [8] vs. 52.4 [9.2], p<0.001). <h3>Conclusion</h3> AYAs with cancer reported lower general physical and mental health QOL scores during RT, which persisted into survivorship. Developmental age, stage, and presence of RT toxicities may contribute to differing scores. Future longitudinal analyses are needed to improve QOL for AYAs receiving RT.

Patient-Reported and Clinical Outcomes From 5-Fraction SBRT for Oligometastases: A Prospective Single-Institution Study

To describe the long-term outcomes of a 5-fraction normal tissue tolerance adapted strategy for the management of oligometastases (OM). Patients with histologically confirmed solid tumors, ≤5 extracranial metastases, suitable for a definitive approach for all metastatic lesions, at least one lesion suitable for Stereotactic Body Radiotherapy (SBRT), Eastern Coooperative Oncology Group Performance Status ≤2 were eligible. Treatment intervention was a 5-fraction (25-55 Gy) normal tissue adapted dosing strategy. The primary outcome was cumulative local progression rate at 12 months. Between March 2013 and January 2018, 137 patients started SBRT. Median follow-up was 35.7 months. In addition, 107 (78%) patients had a solitary OM. The mean planning target volume D95 was 39.6 (standard deviation, 8.8; biological effective dose using an alpha/beta ratio of 10, 70.8) Gy. Mean planning target volume D95 was highest for lung lesions (48.7 [standard deviation, 4.7]; biological effective dose using an alpha/beta ratio of 10, 96.1) Gy but was <40 Gy for all other anatomic sites. Two grade 3 toxicities (gastrointestinal bleed) were observed with stomach D0.05 30.3 Gy and 30.4 Gy. The cumulative local progression rate at 12 of 36 months was 16.1% (95% CI, 10-22) and 38.3% (95% CI 30-46.7); overall survival was 90% and 37%, and progression free survival was 58% and 19%, respectively. Mean symptom burden (Edmonton Symptom Assessment Total Score) worsened in patients with progressive disease (+8.8) at 12 months and was paralleled by changes in mean European Organization for Research and Treatment Quality of Life Core Questionnaire Summary Score and Global Health Quality of Life Score. Systemic therapy was initiated in 55% of patients at an average of 12.7 (standard deviation 12.4) months. If long-term progression free survival is the primary goal of therapy, SBRT for OM achieved this in <20% of patients attributable to a high risk of distant failure. Favorable local progression free survival is accompanied by preservation of quality of life, avoidance of symptom progression and reduced need of antineoplastic therapies at 12 months. Information on symptom burden, quality of life, as well as pattern of antineoplastic therapy use after progressive disease is useful to support conversations between patients, families, and health care providers. Strategies to improve patient selection and reduce distant progression rate remain a priority for further study.

The Van Gorder approach for total elbow arthroplasty.

Surgical management of the triceps during exposure for total elbow arthroplasty (TEA) is critical to a successful outcome. Previously described techniques include elevating the triceps insertion from one side or leaving the triceps insertion attached and dislocating the joint. Another approach to the elbow, first described in 1933 by Willis Campbell, MD, and subsequently modified by George Van Gorder, MD, involves turning down the triceps tendon without disrupting the triceps insertion. This approach offers complete visualization of the joint and provides excellent exposure for TEA. Only the original report of the technique and a small series of patients using this technique for TEA exist in the literature. The goal of this study was to evaluate outcomes of the Van Gorder approach in a large series of patients undergoing TEA. All patients who underwent TEA from 2008 to 2016 were retrospectively reviewed. Only patients who underwent primary TEA performed through the Van Gorder approach with at least 6 months' follow-up were included for analysis. Patients with prior elbow surgery were excluded. Demographic data, indication for surgery, postoperative range of motion, triceps function, and need for additional surgery were recorded. Prospectively collected visual analog scale (VAS) and Global Health Quality of Life scores were also analyzed. A total of 53 patients met inclusion criteria. The mean age was 62 years, 81% were female, and the average follow-up was 30.2 months. The most common surgical indications included inflammatory arthritis (47%), osteoarthritis (24%), and fracture (19%). Postoperatively, average elbow arc of motion was an 8°-137°. There was 1 patient (1.89%) who developed failure of their triceps extension mechanism. A total of 10 patients (19%) underwent additional elbow surgery most commonly for superficial wound complications. Preoperative VAS scores decreased significantly, starting at 3 months postoperatively (6.76 to 3.37, P < .001), and remained constant at the 12- and 24-month postoperative visits. This is the largest study evaluating the Van Gorder surgical approach to the elbow for primary TEA with an average follow-up of 32 months. Overall rates of triceps failure and reoperation are consistent with other approaches for TEA.

Biomedical students’ course preference and links with quality of life and psychological distress

Introduction: This study investigates psychological distress and quality of life (QoL) amongst first year premedical and health science students. The primary aim of this study was to investigate potential differences in QoL and psychological distress between students who sought entry into a medicine programme when compared to those opting for a non-medicine career. Methods: We examined participant responses to measures of QoL, psychological distress, and course preference (medicine or other). A structural equation model was conducted to consider the interrelationships among future course preference, gender, QoL, depression, anxiety and stress. Results: Three hundred and sixty-five students completed the online survey. An a priori conceptual model was developed and then evaluated using a structural equation model. The values obtained for RMSEA (0.027), CFI (0.999), and SRMR (0.016) indicated an excellent model fit. The overall model fit statistic, chi-square (χ2 = 7.626, df=6, p= .267), confirmed a good model fit. Students aiming to enrol in medicine generated higher psychological health and environmental QoL scores compared to their non-medicine oriented peers. In addition, physical QoL and psychological health QoL scores significantly predicted psychological distress measures. Conclusion: The study raises a potential debate regarding placing students with mixed career intentions into the same course and the potential implications this may have on teaching in interprofessional and large student groups in relation to wellbeing, pedagogy, equity, and expenditure. The findings clearly indicated that medical students are not as adversely impacted upon in terms of QoL and psychological distress compared with their non-medical peers.

Quality of life and associated factors among university students during the COVID-19 pandemic: a cross-sectional study

ObjectiveThis study aimed to evaluate the quality of life (QoL) and determine its association with various factors and social support among university students during the COVID-19 pandemic after the end...

PD25-03 THE INCIDENCE AND PREDICTORS OF FINANCIAL TOXICITY IN A PROSPECTIVE COHORT OF PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures II (PD25)1 Sep 2021PD25-03 THE INCIDENCE AND PREDICTORS OF FINANCIAL TOXICITY IN A PROSPECTIVE COHORT OF PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER Vidit Sharma, Katherine E Fero, Patrick M Lec, Valerie S Lee, Isaac J Ergas, Janise M Roh, Karim Chamie, Mark Schoenberg, David S Aaronson, Devon K Check, Reina Haque, Lawrence H Kushi, Li Tang, and Marilyn L Kwan Vidit SharmaVidit Sharma More articles by this author , Katherine E FeroKatherine E Fero More articles by this author , Patrick M LecPatrick M Lec More articles by this author , Valerie S LeeValerie S Lee More articles by this author , Isaac J ErgasIsaac J Ergas More articles by this author , Janise M RohJanise M Roh More articles by this author , Karim ChamieKarim Chamie More articles by this author , Mark SchoenbergMark Schoenberg More articles by this author , David S AaronsonDavid S Aaronson More articles by this author , Devon K CheckDevon K Check More articles by this author , Reina HaqueReina Haque More articles by this author , Lawrence H KushiLawrence H Kushi More articles by this author , Li TangLi Tang More articles by this author , and Marilyn L KwanMarilyn L Kwan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002018.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Even though non-muscle invasive bladder cancer (NMIBC) has high costs care, the patient-level impact of this cost (“financial toxicity”) has been understudied. We describe predictors and quality-of-life (QOL) implications of financial toxicity in a prospective cohort of NMIBC survivors. METHODS: The Bladder Cancer Epidemiology, Wellness, and Lifestyle Study is a prospective cohort of newly diagnosed NMIBC patients at Kaiser Permanente Northern and Southern California. Financial toxicity was assessed using the COST-FACIT questionnaire (scale 0 to 44, with lower score having more financial toxicity) at 2-years post-diagnosis. QOL was assessed using the PROMIS global health questionnaire’s physical and mental health domains at 2-years post-diagnosis. Demographic and oncologic associations with financial toxicity were examined using descriptive statistics and multivariable generalized linear regression models. RESULTS: In a cohort of 412 participants, the mean (SD) COST and PROMIS physical and mental health QOL scores at 2-years post-diagnosis were: 36.6 (7.3), 16.2 (2.3), 15.4 (2.7), respectively. The correlation between the COST and PROMIS physical and mental health scores was r=0.36 (p<0.01) and r=0.38 (p<0.01), respectively, suggesting a modest association between financial toxicity and QOL. Between 4–16% of participants reported some financial strain from NMIBC on specific COST questions (Figure 1). At 2-years, 5% of patients described the financial burden of NMIBC as being significant, and 2% of patients experienced financial distress from treating their cancer. On regression analysis, younger age (coefficient -0.12, p<0.01) and NMIBC progression (coefficient -2.9, p=0.04) were associated with increased financial toxicity (reduced COST score). Gender or race/ethnicity were not significantly associated with financial toxicity. CONCLUSIONS: In a vertically integrated health system, financial toxicity from NMIBC was less prevalent than reported in prior studies in conventional health systems. However, younger age and NMIBC progression were associated with increased financial toxicity, suggesting a need to identify mitigation strategies for such patients. Source of Funding: Vidit Sharma is supported by the VA HSRD fellowship © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e432-e432 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vidit Sharma More articles by this author Katherine E Fero More articles by this author Patrick M Lec More articles by this author Valerie S Lee More articles by this author Isaac J Ergas More articles by this author Janise M Roh More articles by this author Karim Chamie More articles by this author Mark Schoenberg More articles by this author David S Aaronson More articles by this author Devon K Check More articles by this author Reina Haque More articles by this author Lawrence H Kushi More articles by this author Li Tang More articles by this author Marilyn L Kwan More articles by this author Expand All Advertisement Loading ...

Impaired Health of Children Treated for Hirschsprung’s Disease

Impaired Health of Children Treated for Hirschsprung’s Disease

Low quality of life and activity levels persist in obese endometrial cancer survivors despite participation in a behavioral weight loss intervention

<h3>Objectives:</h3> Obesity is inversely related to quality of life (QOL) in endometrial cancer (EC) survivors. With over 600,000 EC survivors in the U.S., many women experience obesity-related comorbidities following cancer cure, including poor QOL. We previously reported no change in weight after 6 months participation in a randomized trial comparing a text-message-based behavioral intervention and enhanced usual care (brief meeting, pamphlets with food diary). Here, we assessed changes in validated psychosocial (PS) measures between intervention groups. Based on previous literature, we also evaluated the effect of other factors (BMI, income, race, cancer stage, recurrence status) and hypothesized that these may predict improvement in QOL among EC survivors, over the intervention. <h3>Methods:</h3> EC survivors with a BMI ≥30kg/m² participating in a randomized behavioral weight loss study in our gynecologic oncology clinic completed a survey of validated PS measures at baseline and at 6-month study exit. These included the generalized mental and physical health QOL 12-Item Short Form Health Survey (SF-12; score 0-100, higher numbers indicating better QOL), the International Physical Activity Questionnaire-short form (IPAQ) to assess activity levels, and the Patient Health Questionnaire 9-Item Version depression assessment (PHQ9; score 0-27, higher scores indicating greater depression). The Kruskal-Wallis test was used to identify significant changes. <h3>Results:</h3> Between May and December 2017, 80 women enrolled and completed the PS assessments. 42.5% of participants had a baseline BMI ≥40kg/m², including 16.3% with a BMI ≥50kg/m². Between intervention groups, there were no differences in mean scores or changes within any of the PS analyses. For all participants, median SF-12 scores were at or below 50, consistent with generally low perceived QOL. Activity levels were low; at baseline, 26% reported no walking, 49% no moderate physical activity and 65% no vigorous physical activity within the last 7 days. Median total PHQ9 scores (5.5) were consistent with mild depression. Among all study participants, women with BMI ≥40kg/m²had a mean change from baseline in PHQ9 scores of -0.07 (±3.8) compared to -1.86 (±3.7) for BMI<40kg/m²(p=0.02). The change in SF-12 physical health QOL scores in non-WhiteWhite participants was 4.04 (±7.7) compared to -2.1 (±9.0) for WhiteWhite women (p=0.04), and 0.72 (±7.9) in early stage compared to -5.55 (±10.6) for Stages III-IV (p=0.046).There were no differences in PS scores based on income or recurrence. <h3>Conclusions:</h3> A technology-based behavior intervention did not improve QOL over enhanced usual care. Women with a BMI <40 kg/m² had improvement in depression scores, and physical health QOL improved to a greater degree in early-stage and non-WhiteWhite participants. Overall, obese EC survivors remain minimally physically active, with generally low perceived QOL and mild depressive symptoms. Further studies aimed at improving QOL for this growing population of women are warranted.

Circadian rhythm and quality of life in older adults

Sleep is critical to physical and mental health for people of all ages, but older adults are particularly vulnerable to the consequences of poor sleep health. The purpose of this pilot study was to explore patterns of sleep and the relationships between circadian rhythm disorders and quantity of life in 34 community-dwelling older adults. Participants were primarily female, and single. Of participants, 44% reported poor sleep quality, and 29% had a circadian rhythm disorder. Those with circadian rhythm disorders had lower physical health quality of life score than other participants although this was not significant. No differences were seen in mental health quality of life scores. Further research is needed to explore sleep and circadian rhythm disorders in this population to target interventions to improve sleep quality.

Physical activity, ethnicity, and quality of life among breast cancer survivors and population-based controls: the long-term quality of life follow-up study.

To explore the relationship between physical activity (PA) and quality of life (QOL) among Hispanic and non-Hispanic white breast cancer (BC) cases and population-based controls from the New Mexico 'Long-Term Quality of Life Study'. Self-reported PA (low, moderate, vigorous MET hours/week) at baseline and follow-up interviews (12-15years) were available for 391 cases and controls and modeled using multiple linear regressions with SF-36 mean composite scores for physical and mental health. The change in PA from baseline to follow-up and interactions with ethnicity were also examined. Models were adjusted for age at diagnosis/baseline interview, education, comorbidities, body mass index, and change in PA. PA intensities at each timepoint did not differ by case/control status; however, the change in vigorous PA was lower among cases (p = 0.03). At follow-up, low intensity PA increased mental health QOL scores among cases; however, the interaction between low intensity PA and ethnicity was statistically significant among controls indicating decreased mental health among Hispanics (p = 0.02). Change in moderate PA was associated with increased physical and mental health among cases (physical: β = 0.186, p = 0.008; mental: β = 0.225, p = 0.001) and controls (physical: β = 0.220, p < 0.0001; mental: β = 0.193, p = 0.002), when controlling for confounders. Our results demonstrate that all levels of PA are important for mental health among BC cases, while activities of higher intensity are important for physical health among women overall. The statistical interaction observed between ethnicity and low intensity PA among controls for mental health warrants further research to provide a meaningful interpretation.

Real-world quality of life (QoL) in black, indigenous and people of color (BIPOC) treated with palbociclib (PAL) and endocrine therapy for hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2–) advanced breast cancer (ABC): A subgroup analysis from POLARIS.

1071 Background: Racial disparities in breast cancer incidence, mortality, and care are well documented. PAL plus endocrine therapy is indicated for patients (pts) with HR+/HER2− ABC. Findings from the PALOMA clinical trials have shown that pts receiving PAL maintained stable QoL; however, limited QoL data are available from real-world settings for BIPOC receiving PAL. Methods: POLARIS is a noninterventional, prospective, primarily US-based study in pts with HR+/HER2– ABC receiving PAL. QoL was assessed with the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at baseline, monthly for the first 3 mo of treatment (Tx) with PAL, and then every 3 mo. In this interim analysis, we report Tx patterns and QoL assessments at baseline and at 6 mo and 12 mo in BIPOC from POLARIS. Results: Of 1280 pts treated with PAL as November 10, 2020, 233 were included in the BIPOC subgroup of whom 159 (68.2%) completed PAL Tx for ≥6 mo and 112 (48.1%) for ≥12 mo. In the BIPOC cohort, 59.2% of pts were black, 35.2% Hispanic, 3.4% American Indian or Alaskan native, 2.1% Pacific Islander. PAL in combination with letrozole/anastrozole was received by 116 pts, 94 received PAL plus fulvestrant, 13 received PAL plus exemestane, and 10 received PAL plus another Tx; 175 pts (75.1%) received PAL as first-line Tx. Mean EORTC QLQ-C30 global health QoL and functional scales scores remained stable over the first 12 mo of PAL Tx, without any changes at or above the 10-point threshold considered clinically meaningful, and were similar to those previously reported in an earlier analysis of the entire POLARIS population (Table and Rocque et al SABCS 2019). Symptom scales scores, including nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, and diarrhea, also remained stable over 12 mo. Conclusions: In this subgroup analysis, PAL had no significant adverse impact on QOL in BIPOC with HR+/HER2– ABC, consistent with previous findings from the total POLARIS study population. Pfizer (NCT03280303). Clinical trial information: NCT03280303 .[Table: see text]