Health Quality Of Life Scores Research Articles

Phenotypic features in MECP2 duplication syndrome: Effects of age.

MECP2 Duplication syndrome (MDS) is a rare X-linked genomic disorder that is caused by interstitial chromosomal duplications at Xq28 encompassing the MECP2 gene. Although phenotypic features in MDS have been described, there is a limited understanding of the range of severity of these features, and how they evolve with age. The cross-sectional results of N = 69 participants (ages 6 months-33 years) enrolled in a natural history study of MDS are presented. Clinical severity was assessed using a clinician-report measure as well as a parent-report measure. Data was also gathered related to the top 3 concerns of parents as selected from the most salient symptoms related to MDS. The Child Health Questionnaire was also utilized to obtain parental reports of each child's quality of life to establish disease burden. The results of linear regression from the clinician-reported measure show that overall clinical severity scores, motor dysfunction, and functional skills are significantly worse with increasing age. Top concerns rated by parents included lack of effective communication, abnormal walking/balance issues, constipation, and seizures. Higher levels of clinical severity were also related to lower physical health quality of life scores as reported by parents. The data suggest that increasing levels of clinical severity are noted with older age, and this is primarily attributable to motor dysfunction, and functional skills. The results provide an important foundation for creating an MDS-specific severity scale highlighting the most important domains to target for treatment trials and will help clinicians and researchers define clinically meaningful changes.

Biopsychosocial variations in quality of life outcome following microdiscectomy.

Background: Lumbar microdiscectomy is one of the most frequently performed neurosurgical procedures. In this review, we ask why patients’ outcomes vary so widely even within the same unit, with the same surgeon performing the procedure and utilizing the technique?Methods: In a cohort of 87 patients, we investigated how/whether multiple patient variables impacted outcomes following single-level lumbar microdiscectomy. We studied whether early surgical intervention improved the patients’ quality of life (QOL) versus late intervention. Furthermore, we assessed other variables that could influence patient-perceived improvement. Preoperatively and postoperatively, we additionally utilized the following internationally standardized questionnaires (EQ-5D, Oswestry, and Core Outcome Measures Index [COMI]).Results: A generalized substantial improvement in QOL was identified throughout the cohort population (<0.05). There was no difference in health measurement scores for those undergoing early versus late surgery. However, there was a statistically significant improvement in all QOL scores for privately insured patients versus publicly insured patients (e.g., on COMI, EQ-5D, and ODI Scores).Conclusion: There was no objective statistically significant difference in QOL health scores between patients undergoing early versus late surgical lumbar microdiscectomy. This would suggest that the length of time patients is symptomatic before surgery did not significantly impact postoperative outcome. Of interest, however, was the difference in QOL health scores for private versus public patients suggesting that there are more subjective, complex, and psychosocial issues that influence outcome.

The Prediction of Quality of Life Based on Self-esteem, Mental Health and Sleep Quality Variables in Obese and Overweight Girl Students

Background: Obesity of children and adolescents has many different detrimental effects on body image, self-esteem (SE), depression and social isolation that are effective on their mental and social health. Objectives: The purpose of this study was to predict the quality of life (QOL) of obese and overweight girl students in Kermanshah city based on self-esteem, mental health and sleep quality variables. Methods: The research is a descriptive-analytical study that 419 obese and overweight girl students were selected using multi-stage cluster sampling and simple random sampling. For collection of needed data, several questionnaires including demographic, Rosenberg self-esteem, Goldberg general health, Pittsburgh sleep quality questionnaires and quality of life questionnaire related to word health organization were used. The BMI estimation method of the centers for disease control was used to determine overweight and obesity. Obtained data were analyzed using regression analysis in SPSS (Ver. 19) software environment. Results: The result of simple linear regression analysis showed that self-esteem, sleep quality and mental health variables, predict 0.11, 0.20, and 0.25 of the variance of total score for QOL, respectively. Multiple regression results indicated that mental health and sleep of quality variables had a significant effect on all dimensions and overall QOL scores (P &lt; 0.01) simultaneously. The increasing effect of self-esteem on the dimensions of social relationships (P &lt; 0.005), environmental health (P &lt; 0.01) and overall QOL score (P &lt; 0.01) was significant. According to obtained results, QOL has a direct and significant correlation with self-esteem (P &lt; 0.01) mental health (P &lt; 0.001) and, sleep quality (P &lt; 0.001). Conclusions: Based on the obtained results, it can be concluded that mental health is the most important and influential factor on the quality of life of obese adolescent girls. The results of this study indicated that a planning is need to promote girls’ mental health.

A web-based daily care training to improve the quality of life of mothers of children with cerebral palsy: A randomized controlled trial

BackgroundMothers of moderately to severely affected children with cerebral palsy (CP) have to spend a long time to take care of their children. This time-consuming responsibility affects their physical and psychosocial health. Therefore, mothers as caregivers are required to receive special training to take care of their children. AimsThe aim of this study was to evaluate the effectiveness of a developed web-based intervention for daily care training of children with CP on their mothers’ quality of life (QOL), anxiety, depression, stress, and their musculoskeletal pain. Methods and proceduresThis study was a single blind randomized controlled trial. 91 mothers of children with CP with Gross Motor Function Classification System (GMFCS) levels III, IѴ, and Ѵ, who aged from 4 to 12 years were assigned to the intervention and control groups using block randomization. Mothers in the control group received their routine face to face occupational therapy intervention and mothers in the intervention group received 12 weeks web-based intervention. QOL, depression, anxiety, stress, and pain were measured before and after the intervention in both groups. Outcomes and resultsThe results of analysis of covariance showed that after controlling the mean score of pretest of pain, the mean score of post-tests in the intervention and control groups was significantly different (P < 0.05). The mean scores of physical health and total QOL scores of post-tests in the intervention group were significantly higher than the control group with controlling pretest scores. Conclusions and implicationsDesigned web-based intervention affects the caregivers’ QOL and pain significantly. This intervention can be used to provide daily care training for mothers of children with CP.

Is Asian type MS an MS phenotype, an NMO spectrum disorder, or a MOG-IgG related disease?

BackgroundA specific particularity of neurological diseases in Asia is the relative commonality of neuromyelitis optica (NMO) and Asian type MS (OSMS). Both conditions also occur in South American patients. The Brazilian population differs from the European and the Asian populations due to the mixture of ancestralities between European colonizers and African slaves. To better know the clinical characteristics of Brazilian patients with Asian type MS this study aimed to analyze the clinical, radiological and serological data that would help to distinguish between OSMS and NMO and clarify, in a Non-Asian population, if OSMS is an MS phenotype, an NMO spectrum disorder by 2015 classification, or a complement activating antibody to myelin oligodendrocyte glycoprotein (MOG-IgG) antibody-related disease. MethodsWe selected cases retrospectively with NMO and OSMS in the medical registry of patients with idiopathic inflammatory demyelinating diseases under follow-up since 1997 in Federal Hospital da Lagoa, the principal reference center for MS treatment in Rio de Janeiro, Brazil. OSMS has selective involvement of the optic nerve and spinal cord with no cerebral or cerebellar symptoms associated with small spinal cord lesions and negativity for the aquaporin-4 antibody (AQP4-IgG). NMO full-filled the revised criteria (2006) associated with longitudinally extensive transverse myelitis (LETM). We recorded the following data: ethnicity/skin color, neurologic impairment “at nadir” and “at recovery” of the index events (optic neuritis and transverse myelitis), long term disability, mortality, health quality of life scores by the SF-36 questionnaire, CSF IgG oligoclonal bands and serological AQP4-IgG and MOG-IgG antibodies tested by Cell-based assay. The last brain MRIs were classified as either satisfying or not satisfying MAGNIMS radiologic criteria for MS or typical or not typical for NMOSD. The new classification of NMO spectrum disorders (2015) was applied. ResultsForty-one OSMS and 122 NMO cases were analyzed. OSMS affected mainly young white women, causing unilateral optic neuritis and partial myelitis with excellent recovery. After a mean disease duration of 20 years, 90% of the patients had free ambulation, and 70% had a mild disability or no disability. Only 7.2% presented a secondary progressive course, and no deaths occurred. All cases had negativity to AQP4-IgG and MOG-IgG biomarkers. 95% had resonance criteria for MS. OSMS differed from NMO by ethnicity, morbidity, and mortality: most were African descendants, with severe motor and visual dysfunction, and one third died. Only NMO cases full-filled the new NMOSD classification (52 AQP4-IgG positive, 29 AQP4-IgG negative, and 41 AQP4-IgG unknown). ConclusionIn Brazilian patients, OSMS and NMO are different immune-mediated diseases. OSMS is a milder MS phenotype.

Quality of Life in Adolescent and Young Adult Women With Dyspareunia and Endometriosis

PurposeThe purpose of this study is to quantify the prevalence of dyspareunia and its impact on quality of life (QOL) in adolescent and young adult women (AYA) diagnosed with endometriosis. MethodsEligible participants from the Women’s Health Study: From Adolescence to Adulthood, a longitudinal cohort study, were AYA 18–25 years who reported having had sexual intercourse. We included n = 151 AYA with a surgical diagnosis of endometriosis and n = 287 without known endometriosis. Participants completed a questionnaire including the Short Form-36 (SF-36) QOL survey, on which lower scores indicate impairment. Dyspareunia was defined as answering “yes” to having had pain during/within 24 hours following sexual intercourse. Normative-based scores for SF-36 subscales were calculated and compared between groups using linear regression adjusted for age, body mass index, educational level, and race. ResultsParticipants with endometriosis experienced dyspareunia twice as often (79%) than AYA without endometriosis (40%, p < .0001). In participants with and without endometriosis, all SF-36 subscale scores were significantly lower in AYA with dyspareunia than without. For six subscales, the negative impact was significantly stronger in AYA with endometriosis than those without, and mean scores were all less than the normative score, indicating impairment. ConclusionsMore than three quarters of AYA with endometriosis and two thirds without experience dyspareunia that negatively impacts both physical and mental health QOL scores. This impairment is stronger in those with endometriosis. Given the importance of relationships and peer engagement for identity formation during adolescence, dyspareunia could be particularly impactful. Clinicians should ask patients not only about contraception and prevention of sexually transmitted infections, but inquire about how dyspareunia may impact mental and physical well-being.

Quality of Life (QoL) among medical students in Saudi Arabia: a study using the WHOQOL-BREF instrument

BackgroundPoor Quality of Life (QoL) among medical students is associated with an unhealthy lifestyle, psychological distress, and academic failure, which could affect their care for patients in the future. This study aimed to evaluate the reliability and validity of the Arabic WHOQOL-BREF tool among Saudi medical students and to assess the effect of gender, educational level, and academic performance on their QoL.MethodsThis was a cross-sectional study among medical students of King Abdulaziz University in February 2016, using the Arabic version of the WHOQOL-BREF instrument.ResultsSix-hundred-thirty medical students were included, where females constituted (51.1%). Cronbach’s α coefficient for the overall domains of WHOQOL-BREF was 0.86. Students’ self-reported QoL mean score was 3.99 ± 0.95, and their mean score for the overall satisfaction with health was 3.66 ± 1.06. The environmental domain had the highest mean score (67.81 ± 17.39). High achievers showed lower psychological health, while poor academic performance was associated with better psychological health and social relationship QoL scores (P < 0.013 and P < 0.014, respectively).ConclusionsThe WHOQOL-BREF is valid and reliable for assessing QoL among Saudi medical students. Although gender and academic year had no impact on the students’ QoL, better-performing students reported lower psychological health and social relationships scores.

Quality of Life in Jugular Paraganglioma Following Radiosurgery.

The treatment paradigm for jugular paraganglioma (JP) has changed considerably over time with the wider adoption of stereotactic radiosurgery (SRS). To the best of the authors' knowledge, there are no published studies that use validated patient-reported outcome measures to ascertain quality of life (QoL) outcomes following SRS for JP when used in single or combined modality treatment regimens. Cross-sectional survey. Tertiary referral center. Adult patients with JP treated with primary SRS or SRS following primary surgery between 1990 and 2017. Surgery and/or Gamma Knife SRS. Global and treatment-related QoL and differences in QoL based on treatment approach. Sixty-nine surveys were distributed and a total of 26 completed surveys were received (38% response rate). Among respondents, the median age at SRS was 53 years and 16 of the 26 patients (62%) were female. Median follow-up was 97 months. Nineteen patients (73%) were treated with primary SRS or staged SRS following intentional subtotal resection (STR; hereafter referred to as "staged SRS"), while the remainder (n = 7, 27%) were treated with SRS for recurrent JP. Median physical and mental health QoL PROMIS-10 T-scores regardless of treatment strategy were 39.8 and 38.8, respectively, while median SF36 physical and mental component subscores were similar to national averages and non-tumor controls. When comparing general physical and mental health QoL scores, there was no significant difference between patients treated with primary or staged SRS and those treated with SRS for recurrent JP. However, age-adjusted swallowing function among patients treated with primary or staged SRS was better than in those patients treated with SRS for recurrent JP (p = 0.05). Patients treated with primary or staged SRS for JP tend to exhibit better swallowing outcomes than those treated with SRS for recurrent JP. However, the majority of overall and disease-specific quality of life measures were not different between groups. Based on the low incidence of new cranial neuropathy following SRS, it is likely that initial surgical morbidity is the primary contributor to this outcome. Disease-specific overall quality of life measures, akin to those already used for other benign skull base tumors, are necessary to better gauge physical and mental health outcomes following treatment for JP. Though limited by small sample size, this represents the first study to gauge QoL outcomes following treatment for JP.

Changes in quality of life after surgery or radiotherapy in early-stage lung cancer.

Although surgical resection is considered the standard of care for early-stage non-small cell lung cancer, radiotherapy [stereotactic body radiation therapy (SBRT)] has been proposed as a minimally invasive treatment alternative. Studies have not examined differences in quality of life (QoL) between surgery and radiotherapy, despite important implications for patient and provider decision making. The Surveillance, Epidemiology, and End Results Medicare Health Outcomes Survey (1998-2014) was used to assess changes in physical QoL score [Physical Component Summary (PCS)] and mental health QoL score [Mental Component Summary (MCS)] from baseline (prior to cancer diagnosis) to follow-up after treatment with surgery only or radiotherapy only. QoL was measured using the 36-item Short Form Health Survey (SF-36) until 2006, when it was replaced by the Veterans RAND 12-Item Health Survey (VR-12). Data from 184 patients (28 SBRT, 156 surgery) was included. There was a significant decline in PCS score from baseline to follow-up (surgery: -4.81; 95% CI: -6.31, -3.30; P<0.0001; SBRT: -5.6; 95% CI: -9.96, -1.24; P=0.0137). Similarly, MCS scores declined for both groups although the change was significant for surgery patients only (surgery: -2.96; 95% CI: -4.55, -1.37; P=0.0003; SBRT: -1.86; 95% CI: -5.4, 1.68; P=0.2902). Surgical patients had higher baseline PCS (P=0.0061) and MCS (P=0.0056) than SBRT patients. There was no significant difference in the change over time between the two treatment options for PCS or MCS. Although both treatments negatively impact QoL, the impact of SBRT on QoL may be comparable to surgery and therefore SBRT should be given consideration as an alternative treatment, especially when surgery is not an option.

The impact of housing type on low-income asthmatic children receiving multifaceted home interventions.

This study sought to evaluate whether government-assisted vs market-rate housing type influences the frequency of asthma symptoms or the quality of life scores among low-income urban children. In addition, the study sought to evaluate whether housing type influenced the success of in-home environmental and educational interventions in improving children's asthma symptoms or quality of life scores. This was a before-and-after intervention design. Comprehensive health and environmental assessments and subsequent interventions were completed in 176 low-income households with 257 asthmatic children living in government-assisted housing and market-rate housing in Lowell, Massachusetts. We collected environmental and health data with questionnaires at a baseline and a 12-month follow-up visit using the Children's Health Survey for Asthma and a walk-through environmental checklist. Education, tools to remove asthma triggers from the home, and home repairs and remediation were included in the interventions. As in other studies of multifaceted home interventions, there were significant improvements in all asthma symptoms, reductions in healthcare utilization related to asthma, and improvements in quality of life domains for children in both housing types. Environmental indices also improved from the baseline to the final assessment for both housing types. However, the housing type was an important factor in predicting a child's asthma status at the start of the study, with children living in government-assisted housing having significantly better physical health scores (76.8 of 100) and family emotional health scores (74.8 of 100) and fewer overnight hospital stays (mean of 0.02 in the previous 4 weeks) than children living in market-rate housing (67.6, 71.6, and 0.06, respectively). Examination of the change in the health status over the 1-year study period found that children living in market-rate housing had significantly larger reductions in the number of asthma attacks (0.43 in the previous 4 weeks versus 0.24 in assisted housing) and overnight hospital stays (0.06 in the previous 4 weeks versus 0.01 in assisted housing) and larger improvements in physical health quality of life scores (54% improved versus 25.5% in assisted housing). Public assistance for low-income urban housing is associated with better health among children with asthma, and may influence the impact the in-home interventions have on health outcomes because children in market-rate housing have more prospects for improvement in their asthma-related health.

A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED)

Objectives: We investigated whether a Mediterranean-style diet (MedDiet) supplemented with fish oil can improve mental health in adults suffering depression.Methods: Adults with self-reported depression were randomized to receive fortnightly food hampers and MedDiet cooking workshops for 3 months and fish oil supplements for 6 months, or attend social groups fortnightly for 3 months. Assessments at baseline, 3 and 6 months included mental health, quality of life (QoL) and dietary questionnaires, and blood samples for erythrocyte fatty acid analysis.Results: n = 152 eligible adults aged 18–65 were recruited (n = 95 completed 3-month and n = 85 completed 6-month assessments). At 3 months, the MedDiet group had a higher MedDiet score (t = 3.95, P < 0.01), consumed more vegetables (t = 3.95, P < 0.01), fruit (t = 2.10, P = 0.04), nuts (t = 2.29, P = 0.02), legumes (t = 2.41, P = 0.02) wholegrains (t = 2.63, P = 0.01), and vegetable diversity (t = 3.27, P < 0.01); less unhealthy snacks (t = −2.10, P = 0.04) and red meat/chicken (t = −2.13, P = 0.04). The MedDiet group had greater reduction in depression (t = −2.24, P = 0.03) and improved mental health QoL scores (t = 2.10, P = 0.04) at 3 months. Improved diet and mental health were sustained at 6 months. Reduced depression was correlated with an increased MedDiet score (r = −0.298, P = 0.01), nuts (r = −0.264, P = 0.01), and vegetable diversity (r = −0.303, P = 0.01). Other mental health improvements had similar correlations, most notably for increased vegetable diversity and legumes. There were some correlations between increased omega-3, decreased omega-6 and improved mental health.Discussion: This is one of the first randomized controlled trials to show that healthy dietary changes are achievable and, supplemented with fish oil, can improve mental health in people with depression.

Effects of a Mediterranean-style diet on mental health and quality of life in people with depression

Background/Aims: Poor diets are an independent risk factor for depression while healthy diets are protective. Traditional Mediterranean diets (MedDiet) are associated with reduced cardiovascular disease risk which overlaps with depression. We investigated whether MedDiet can improve mental health. Methods: A total of 163 adults aged 18-65 with self-reported depression participated in a randomised controlled trial (RCT) providing nutrition education and fortnightly food hampers and cooking workshops for 3 months with 6 months follow-up. The control group attended fortnightly social groups. Participants completed mental health, quality of life (QoL) and dietary questionnaires. Data were analysed using linear mixed modelling and Pearson correlations. Results: In comparison to the control group at 3 months the treatment group had a higher MedDiet score (t = 4.27, p < 0.001), consumed more vegetables (t = 3.95, p < 0.001), fruit (t = 2.11, p = 0.037), nuts (t = 2.43, p = 0.016), wholegrains (t = 2.39, p = 0.018) and legumes (t = 2.45, p = 0.016), greater diversity of vegetables (t = 3.46, p = 0.001) and fruit (t = 2.08, p = 0.040) and less unhealthy snacks (t = -2.20, p = 0.030) and red meat/chicken (t = -2.25, p = 0.026). The treatment group had reduced depression scores (t = -2.02, p = 0.045), and higher mental health QoL scores (t = 2.17, p = 0.032). Reduced depression scores were correlated with increased MedDiet (r = -0.275, p = 0.006), consumption of nuts (r = -0.251, p = 0.011), legumes (r = -0.233, p = 0.018), and greater diversity of vegetables (r = -0.284, p = 0.004). Similar correlations were seen with other mental health and QoL improvements, particularly for legumes and diversity of vegetables and fruit. All changes were sustained at 6 months. Conclusions: This is one of the first RCTs to show a benefit of diet for mental health.;

Epigenetic modifications and glucocorticoid sensitivity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

BackgroundMyalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating idiopathic disease characterized by unexplained fatigue that fails to resolve with sufficient rest. Diagnosis is based on a list of symptoms and exclusion of other fatigue-related health conditions. Despite a heterogeneous patient population, immune and hypothalamic-pituitary-adrenal (HPA) axis function differences, such as enhanced negative feedback to glucocorticoids, are recurring findings in ME/CFS studies. Epigenetic modifications, such as CpG methylation, are known to regulate long-term phenotypic differences and previous work by our group found DNA methylome differences in ME/CFS, however the relationship between DNA methylome modifications, clinical and functional characteristics associated with ME/CFS has not been examined.MethodsWe examined the DNA methylome in peripheral blood mononuclear cells (PBMCs) of a larger cohort of female ME/CFS patients using the Illumina HumanMethylation450 BeadChip Array. In parallel to the DNA methylome analysis, we investigated in vitro glucocorticoid sensitivity differences by stimulating PBMCs with phytohaemagglutinin and suppressed growth with dexamethasone. We explored DNA methylation differences using bisulfite pyrosequencing and statistical permutation. Linear regression was implemented to discover epigenomic regions associated with self-reported quality of life and network analysis of gene ontology terms to biologically contextualize results.ResultsWe detected 12,608 differentially methylated sites between ME/CFS patients and healthy controls predominantly localized to cellular metabolism genes, some of which were also related to self-reported quality of life health scores. Among ME/CFS patients, glucocorticoid sensitivity was associated with differential methylation at 13 loci.ConclusionsOur results indicate DNA methylation modifications in cellular metabolism in ME/CFS despite a heterogeneous patient population, implicating these processes in immune and HPA axis dysfunction in ME/CFS. Modifications to epigenetic loci associated with differences in glucocorticoid sensitivity may be important as biomarkers for future clinical testing. Overall, these findings align with recent ME/CFS work that point towards impairment in cellular energy production in this patient population.

The Burdens, Concerns, and Quality of Life of Patients with Gastroparesis.

The impact of gastroparesis on patients from the patient's viewpoint is needed to better address treatment priorities. The aims of this study were to: (1) Delineate burdens and concerns of patients with gastroparesis; (2) investigate specific symptoms contributing to impaired quality of life (QOL) in gastroparesis. The International Foundation for Functional GI Disorders gastroparesis survey questionnaire was developed to describe patients' viewpoint about their experience with gastroparesis and included Patient Assessment of Upper GI Symptoms (PAGI-SYM) and SF-36 QOL survey. A total of 1423 adult patients with gastroparesis completed the survey. Average duration of gastroparesis symptoms was 9.3years with time from onset to diagnosis 5.0years. Patients felt that they receive good information regarding treatment options from physicians, the Internet, and Facebook. Patients rated their satisfaction with available treatment for their gastroparesis as dissatisfied (33%), somewhat dissatisfied (27%), neutral (14%), somewhat satisfied (15%), and satisfied (4%). Patients felt that gastroparesis symptoms that are most important to improve with treatment are nausea, stomach pain, and vomiting. Overall, there was a decreased quality of life by SF-36. Physical health QOL score was negatively correlated with symptoms including nausea (r=-0.37), upper abdominal pain (r=-0.37), and early satiety (r=-0.37). This large series of patients with gastroparesis describes their burdens, concerns, and QOL. Nausea, vomiting, early satiety, and abdominal pain are important symptoms for treatment. Many patients are not satisfied with current treatments, wanting specific treatments for their disorder. Interestingly, a large number of patients find out about treatments, not only from their physician, but also using the Internet including social media.

Understanding How Postnatal Depression Screening and Early Intervention Works in the Real World – A Singaporean Perspective

Postnatal depression is a major public health problem with clearly established adverse effects in child outcomes. This study examines the 4-year outcomes of a screening and early intervention programme, in relation to improvement in symptoms, functioning and health quality of life. Women were prospectively recruited up to 6 months postdelivery, using the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool. High-scorers (EPDS &gt;13), were offered psychiatric consultation, and those with borderline scores (EPDS 10-12) were provided counselling, and offered follow-up phone counselling by the assigned case manager. Outcome measures were obtained at baseline, and at 6 months or discharge if earlier, for levels of symptoms, functioning, and health quality of life. From 2008 to 2012, 5245 women were screened, with 307 (5.9%) women with EPDS &gt;13 receiving intervention. Of these, 70.0% had depression, 4.6% anxiety and 3.4% psychosis. In the depression subgroup, the net change was improvement of 93.4% EPDS symptom scores, 92.2% Global Assessment of Functioning (GAF) scores, and 88.3% visual analogue scale (EQ VAS) health quality of life scores. Outcome scores across diagnostic categories demonstrated median changes of 10 points on EPDS, 20 points on GAF, and 25 points on EQ VAS, reflecting 73.9%, 36.4% and 41.7% change from baseline scores. Women with psychosis showed the biggest (80.0%) relative change in GAF functioning scores from baseline to discharge but had the lowest median change in EPDS symptom scores. A screening and intervention programme rightly-sited within an obstetric setting can improve clinical outcomes because of early detection and intervention. Key words: Early detection, Maternal mental health, Postpartum mood

Abstract P1-09-27: High serum levels of 25-hydroxyvitamin D are associated with better quality-of-life, and lower levels of perceived stress, depression, and fatigue among breast cancer survivors

Abstract Background: Recent evidence suggests a role for vitamin D in breast cancer etiology and survival. Although data are not definitive, breast cancer survivors might derive additional benefits from adequate vitamin D levels, including better quality-of-life (QoL) and psychosocial well-being. Objective: Using a prospective study design, we examined associations between QoL and psychosocial functioning among breast cancer survivors and circulating 25(OH)D levels at the time of initial breast cancer diagnosis and 1 year post diagnosis. Methods: Women (n=504) with incident breast cancer (stages 0-III) were recruited prior to initiating breast cancer treatment at Roswell Park Cancer Institute (RPCI), with 372 patients also providing data 1 year later. Demographic and clinical data were obtained from the RPCI Surgical Oncology Breast Database. At each time point, participants provided blood samples and completed surveys on mental and physical health (SF36 Health Survey), perceived stress (Perceived Stress Scale), depression (Center for Epidemiologic Studies Depression Scale), and their experiences with fatigue (Multidimensional Assessment of Fatigue Scale). Serum 25(OH)D levels were measured by immunochemiluminometric assays. Results: Median 25(OH)D levels at diagnosis and 1 year post were 23.8 ng/ml (range 0.1-67.4) and 26.6 ng/ml (range 3.0 – 80.0), respectively. At the time of diagnosis, multivariate logistic regression analyses indicated that women with sufficient levels of 25(OH)D (≥ 30 ng/ml) had ∼50% lower odds of reporting poor physical health (OR=0.52, 95% CI: 0.29, 0.90) or poor mental functioning (OR=0.54, 95% CI: 0.31, 0.95) compared to women with deficient levels (&amp;lt;20 ng/ml). Women with higher 25(OH)D were also less likely to report high levels (&amp;gt;median) of perceived stress (OR=0.45, 95% CI: 0.26-0.80), depression (OR=0.46, 95% CI: 0.25-0.83) or fatigue (OR=0.54, 95% CI: 0.31, 0.92). Findings were similar 1 year later, with reduced odds of poor physical health (OR=0.47, 95% CI: 0.24-0.93), poor mental health (OR=0.62, 95% CI: 0.33, 1.13), high levels of perceived stress (OR=0.67, 95% CI: 0.36, 1.25), depression (OR=0.33, 95% CI: 0.15, 0.71), and fatigue (OR=0.45, 95% CI: 0.24, 0.84). Changes in vitamin D levels over the 1 year period were also assessed. While none of the relationships were significant, women in the upper tertile of vitamin D change (&amp;gt;3.99 ng/ml) were more likely to report low mental health and higher levels of perceived stress at 1 year compared to patients with declines in 25(OH)D of &amp;gt;0.95 ng/ml, but were less likely to report poor physical health or fatigue. This may have been due, in part, to women being somewhat more likely to use vitamin D supplements if they reported lower mental health QoL scores. Changes in circulating 25(OH)D levels during this 1 year period were strongly associated with use of supplements (p=0.001). Conclusions: Breast cancer survivors with adequate vitamin D levels were less likely to report poor QoL compared to women with deficient vitamin D levels. Maintenance of optimal vitamin D levels may help improve breast cancer patients’ QoL as they go through breast cancer treatment. Citation Format: Chi-Chen Hong, Song Yao, Yali Zhang, Shicha Kumar, Christine Ambrosone. High serum levels of 25-hydroxyvitamin D are associated with better quality-of-life, and lower levels of perceived stress, depression, and fatigue among breast cancer survivors [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-27.

A pre-test and post-test study of the physical and psychological effects of out-of-home respite care on caregivers of children with life-threatening conditions

Background: Respite services are recommended as an important support for caregivers of children with life-threatening conditions. However, the benefits of respite have not been convincingly demonstrated through quantitative research. Aim: To determine the impact of out-of home respite care on levels of fatigue, psychological adjustment, quality of life and relationship satisfaction among caregivers of children with life-threatening conditions. Design: A mixed-methods, pre-test and post-test study Setting/participants: A consecutive sample of 58 parental caregivers whose children were admitted to a children’s hospice for out-of-home respite over an average of 4 days. Results: Caregivers had below-standard levels of quality of life compared to normative populations. Paired t-tests demonstrated that caregivers’ average psychological adjustment scores significantly improved from pre-respite (mean = 13.9, standard error = 0.71) to post-respite (mean = 10.7, standard error = 1); p < 0.001, 95% confidence interval: 1.25–5.11). Furthermore, caregivers’ average fatigue scores significantly improved from pre-respite (mean = 14.3, standard error = 0.85) to post-respite (mean = 10.9, standard error = 1.01; p < 0.001, 95% confidence interval: 1.69–7.94), and caregivers’ average mental health quality of life scores significantly improved from pre-respite (mean = 44.2, standard error = 1.8) to post-respite (mean = 49.1, standard error = 1.6; p < 0.01, 95% confidence interval: −9.56 to 0.36). Qualitative data showed caregivers sought respite for relief from intensive care provision and believed this was essential to their well-being. Conclusion: Findings indicate the effectiveness of out-of-home respite care in improving the fatigue and psychological adjustment of caregivers of children with life-threatening conditions. Study outcomes inform service provision and future research efforts in paediatric palliative care.

FACTORS INFLUENCING QUALITY OF LIFE OF PATIENTS WITH CHRONIC SCHIZOPHRENIA IN A LONG-STAY PSYCHYATRIC FACILITY

Introduction : Many factors concomitantly influence quality of life of the patients with chronic schizophrenia in a long-stay psychiatric facility. Appropriate selection of antipsychotics and intensity of their harmful effects have significant influence on life quality of these patients. The aim of this study was to identify the most significant factors which have effect on the life quality of the patients with chronic schizophrenia. Methods: The study included 102 beneficiaries at the Institution for Accommodation of Adults “Male Pcelice” Kragujevac. The patients were interviewed in a single, selected day by using the questionnaire issued by World Health Organization. The specified data were obtained from health files of the beneficiaries. Results: The patients who were receiving only atypical antipsychotic had better physical health quality of life score in comparison to those who received the combination of antipsychotics (77.14 vs. 68.57; U = 332.0; p = 0.02) There was statistically significant difference in the domain of mental health quality of life depending on the group of antipsychotics which were administered (31.96 vs. 55.27 vs. 49.46; c2 = 7.02; p = 0.03). Conclusion : the patients who were receiving atypical antipsychotics had better life quality in comparison to those who received typical antipsychotics, possible due to better safety profile of atypical antipsychotics and better feeling of individual pleasure.

The relationship between psychological symptoms, lung function and quality of life in children and adolescents with non-cystic fibrosis bronchiectasis

ObjectivesThe aim of this study was to evaluate the relationship between psychological symptoms and quality of life (QOL) and clinical variables in a cohort of children and adolescents with non-cystic fibrosis (non-CF) bronchiectasis. MethodsSeventy-six patients (aged 8–17years) participated in this study. Questionnaires were used to evaluate the psychological status and QOL of the patients and healthy controls. The patient and control groups were divided into child and adolescent groups to exclude the effect of puberty on psychological status. ResultsNo significant difference was found between patient and control groups for mean depression and trait anxiety scores. Only the child-rated physical health QOL scores were significantly lower for patients than the controls. Also, excepting physical health scores in adolescent group, all of the parent-rated QOL scores were significantly lower in both group and total subjects. Regarding determinants of QOL, age of children and FEV1/FVC percent predicted had positive effects, while dyspnea severity and trait anxiety had negative effects, for the sample as a whole. ConclusionsNon-CF bronchiectasis is associated with poorer QOL in childhood. The impact of the disease on QOL occurs through both clinical and psychological variables.

The Influence of Antipsychotics on the Quality of Life of Patients with Schizophrenia in a Long-stay Psychiatric Facility

ABSTRACT Introduction: Many factors concomitantly influence the quality of life of patients with schizophrenia in a long-stay psychiatric facility. Th e appropriate selection of antipsychotics and the intensity of their adverse effects exert a significant influence on the quality of life of these patients. Th e aim of this study was to identify the influence of antipsychotic-related factors on the quality of life of patients with schizophrenia. Methods: Th e study included 102 beneficiaries at the Institute for Accommodation of Adults “Male Pčelice” in Kragujevac. Th e patients were interviewed on in one day using the questionnaire issued by the World Health Organization. The specified data were obtained from the health files of the beneficiaries. We performed a comparison between patients receiving only atypical antipsychotics, typical antipsychotics or a combination thereof. Results: Th e patients who were receiving only atypical antipsychotics demonstrated better physical health quality of life scores in comparison to those who received combined antipsychotics (77.14 vs. 68.57; U = 332.0; p = 0.02). A statistically significant difference in the mental health quality of life domain was observed between groups of patients receiving various antipsychotic treatments (31.96 vs. 55.27 vs. 49.46; c2 = 7.02; p = 0.03). Conclusion: Patients in a long-stay psychiatric facility who received atypical antipsychotics demonstrated a better quality of life in comparison to those who received typical antipsychotics, possibly due to the superior safety profile of atypical antipsychotics and a greater feeling of individual contentment.