Health-related Quality Of Life In Men Research Articles

Quality of life in patients with hemorrhoidal disease

BackgroundOperation for hemorrhoidal disease is one of the most common operations performed globally. However, we know little about the impact of the disease on health-related quality of life (HRQoL), or the importance of the observed clinical and anatomical changes. MethodThis was a single-center cross-sectional and cohort study. HRQoL was assessed using the Short Form 12 and 36 (SF12 and SF36), EuroQoL 5-dimensions 5-levels (EQ-5D), and a disease specific questionnaire; Short Health Scale for Hemorrhoidal Disease (SHSHD). SF12 and EQ-5D scores in 257 patients with symptomatic hemorrhoids referred to our proctologic outpatient clinic were compared to a Danish background population adjusting for age, gender, body mass index and educational status.Symptoms were assessed using the Hemorrhoidal Disease Symptom Score. The anatomical pathology was graded using Goligher's classification. The associations between clinical characteristics and HRQoL were tested. The impact of surgical treatment was assessed in 111 patients followed one year postoperatively. ResultsPatients reporting a high symptom load had lower SF12 physical health scores compared with the background population. The EQ-5D indexes indicated impaired HRQoL in men, women <50 years and patients with higher education. Improvements in all three HRQoL measures were seen after surgery.Symptom burden had a negative association with HRQoL measures, whereas the surgeon's grading of anatomical pathology had no association. ConclusionHemorrhoidal disease has a negative impact on HRQoL related to the degree of symptoms. Surgical treatment improve the QoL. The surgeon's grading of anal pathology had no association with QoL.

Influence of Different Exercise Types on Health-Related Quality-of-Life in Men With Depressive Disorder in South Korea.

The aim of the study was to determine the influence of different exercise types on health-related quality of life (QOL) in men with depressive disorder (DD) in South (S) Korea. The data of 385 men aged 19 with DD were collected in S. Korea. The Euro Quality of Life 5 Dimensions (EQ-5D) index and Korea National Health and Nutrition Examination Survey (KNHANES) questionnaires were used to establish the purpose of this study. Furthermore, the complex sampling model was applied to investigate the influence of different exercise types on health-related QOL in participants. When reviewing the outcomes, the strength exercise and walking had significant influences on health-related QOL in men with DD in S. Korea. However, the flexibility exercise did not have a significant influence on them. Based on the results, strength exercise and walking were effective exercise types to increase levels of health-related QOL in men with DD in S. Korea.

The health-related quality of life in patients with prostate cancer managed with active surveillance using the Expanded Prostate Cancer Index Composite survey: Systematic review and meta-analysis

ABSTRACT Objective To examine the health-related quality of life (HRQoL) of patients with prostate cancer managed with active surveillance (AS) compared with those who receive definitive treatment using the Expanded Prostate Cancer Index Composite (EPIC) Survey. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched PubMed and ScienceDirect for articles published between April 2010 and April 2020. Eligible studies reported original data on the HRQoL of men undergoing AS for prostate cancer, including studies comparing AS to curative methods particularly radical prostatectomy, radiotherapy, and brachytherapy. Results We identified nine eligible articles, all were non-experimental observational studies of which seven were longitudinal and two were cross-sectional studies. The EPIC questionnaire was the main instrument used in all studies to assess the HRQoL. AS was noted to show the highest calculated mean score among management groups in all comparative studies at study endpoints including cross-sectional studies (95% confidence interval 2.17–5.75, P < 0.001). The maximum score deterioration for patients who were managed with AS in all studies was only 7.5 points (12.2%) after 2 years follow-up. AS had the least mean score decline among all management groups. Patients with a normal testosterone level were found to have high HRQoL scores. The number of prostate biopsies did not correlate with the HRQoL score. Conclusion Patients with prostate cancer managed with AS report less impacts on their HRQoL compared to patients who receive definitive treatments. However, further high-quality research with long-term data are required to help both the patient and the physician in making a well-informed management decision.

Depression, Anxiety, and Their Association to Health-Related Quality of Life in Men Commencing Prostate Cancer Treatment at Tertiary Hospitals in Cape Town, South Africa.

BackgroundComorbid depression and anxiety in men with localised prostate cancer (CaP) largely go undiagnosed and untreated and their effects on health-related quality of life (HRQOL) in men with CaP should not be underestimated. We examined the prevalence of depression and anxiety and its association with HRQOL in men about to commence treatment for CaP and the differences between treatment groups, radical prostatectomy (RP) and radiation therapy (RT).MethodOne hundred and seven participants from a longitudinal prospective observational study assessing depression, anxiety and HRQOL in men with localised CaP (DAHCaP), were used in this cross-sectional analysis. Data were collected shortly before participants were scheduled to receive their treatment. The Centre for Epidemiologic Studies Depression Scale (CES-D), the State Trait Anxiety Inventory (STAI), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), the European Organisation for Research and Treatment in Cancer Quality of Life questionnaire (EORTC QLQ-C30) and (EORTC QLQ-PR25) were used in this analysis.ResultsSymptoms of depression pre-treatment were noted in 39.3%, state anxiety 28%, trait anxiety 31.4% and prostate cancer anxiety in 12.1% of participants. Statistically significant correlations (P ≤ .05) with the CES-D and a cluster of symptoms on the EORTC QLQ-C30 domains for Global Health (rs = −.35), fatigue (rs = .38), pain (rs = .32), dyspnoea (rs = .28), insomnia (rs = .30) and finance (rs = .26) and EORTC QLQ-PR25 domains for urinary symptoms (rs = .43), bowel (rs = .43) and hormone replacement therapy (HRT) (rs = .41) were observed.Statistically significant correlations were also noted between the STAI-S and EORTC QLQ-C30 and EORTC QLQ-PR25. No statistically significant difference was noted between treatments.ConclusionMore men were depressed than anxious with significant associations with HRQOL prior to commencement of treatment. CaP treatments should focus not only on the prevailing indisposition but include a psychooncological and HRQOL assessment at pre-treatment in high-risk individuals.

Cognitive Functioning and Its Relationship with Self-Stigma in Men with HIV Who Have Sex with Men: The Mediating Role of Health-Related Quality of Life

IntroductionThe human immunodeficiency virus (HIV) stills remains a serious public health problem. HIV acquisition has several negative health consequences, such as a cognitive deterioration or health-related quality of life (HRQoL) impairment. Although these negative consequences could be directly related to a significant increase in self-stigma in this population, few previous studies have analysed the possible associations between these variables. This is especially the case in specific groups of people living with HIV, such as men who have sex with men who could be at a greater risk of stigmatisation. The main aim of the present study was to evaluate the association between cognitive functioning, HRQoL and self-stigma in a group of men with HIV who have sex with men.MethodsThe present study was conducted in the Infectious Diseases Unit of the General University Hospital of Alicante (Spain). The final sample was composed of 70 participants who passed the inclusion and exclusion criteria. All were men with HIV who had sex with men and the sample’s mean age was 45 years. Each participant completed questionnaires on HRQoL and HIV self-stigma. Moreover, they completed an online cognitive assessment through the previously validated platform for cognitive evaluation CogniFit, Inc.ResultsThe obtained results showed a significant association between memory functioning impairment, lower levels of HRQoL and higher HIV self-stigma scores. Hence, HRQoL, in the mental summary domain, was shown to be a significant mediator in the relationship between low memory performance and higher HIV self-stigma.DiscussionNeurocognitive impairment could decrease HRQoL in men with HIV who have sex with men, and hence, reinforce the idea widespread in society that having HIV holds serious consequences. This fact, together with the reduced cognitive abilities to fight against their own self-stigma could represent plausible explanations of the obtained results. In this sense, intervention strategies, oriented towards reducing cognitive impairment, such as those based on cognitive training, and other psychological interventions to promote HRQoL could be effective approaches to prevent the negative effects of HIV self-stigma in this population.

Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial

PurposeTo investigate the effects of a supported home-based progressive resistance exercise training (RET) programme on indices of cardiovascular health, muscular strength and health-related quality of life (HR-QoL) in prostate cancer (PCa) patients after treatment with robot-assisted radical prostatectomy (RARP).MethodsThis study was a single-site, two-arm randomised controlled trial, with 40 participants randomised to either the intervention or control group over a 10-month period. In addition to receiving usual care, the intervention group completed three weekly RET sessions using resistance bands for 6 months. Participants performed 3 sets of 12–15 repetitions for each exercise, targeting each major muscle group. The control group received usual care only. Brachial artery flow-mediated dilatation (FMD) was the primary outcome and assessed at baseline, 3 and 6 months. Secondary outcomes included body weight, body fat, aerobic fitness, strength and blood-borne biomarkers associated with cardiometabolic risk.ResultsThere was no significant difference between the groups in FMD at 3 or 6 months. However, there were improvements in aerobic exercise capacity (P < 0.01) and upper- (P < 0.01) and lower-limb (P = 0.01) strength in favour of the RET group at 6 months, accompanied by greater weight loss (P = 0.04) and a reduction in body fat (P = 0.02). Improvements in HRQoL were evident in the RET group at 3 and 6 months via the PCa-specific component of the FACT-P questionnaire (both P < 0.01). Five adverse events and one serious adverse event were reported throughout the trial duration.ConclusionThis study demonstrates that home-based RET is an effective and safe mode of exercise that elicits beneficial effects on aerobic exercise capacity, muscular strength and HR-QoL in men who have undergone RARP.Trial registrationISRCTN10490647.

Gender differences in factors associated with resilience for health-related quality of life in persons with epilepsy

PurposeWe determined whether resilience factors such as self-efficacy, stress coping styles, and social support were differentially associated with health-related quality of life (HRQoL) in men and women with epilepsy after controlling for depression, anxiety, and daily-life stress. MethodsThis was a cross-sectional study of 129 adults with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), Epilepsy Self-Efficacy Scale, Way of Stress Coping Checklist, Social Support Scale, Beck Depression Inventory (BDI), Beck Anxiety Inventory, and Daily Hassles Scale were used. Stepwise linear regression analyses were performed. ResultsExcept for medication effects, there were no gender differences in the QOLIE-31 and its subscales. The medication effects score was higher in men than in women after controlling for BDI scores. The BDI scores were independently associated with the QOLIE-31 score in men and women. Epilepsy self-efficacy was associated with the QOLIE-31 in men, whereas social support was associated with the QOLIE-31 in women. Coping strategies were associated with the QOLIE-31 in neither men nor women. Seizure frequency, daily-life stress, and anxiety were also negatively associated with the QOLIE-31, but only in men. The coefficients of determination were 0.637 and 0.587 in the men’s and women’s models, respectively. ConclusionsThe influence of self-efficacy and social support on HRQoL differed between men and women with epilepsy even after controlling for psychological distress. These findings could contribute to the development of successful gender-specific psychosocial interventions to improve HRQoL in men and women with epilepsy.

Prevalence of whiplash injury and its association with quality of life in local residents in Japan: A cross sectional study

BackgroundAssociations between whiplash injuries and quality of life (QOL) have been previously published by conducting surveys among patients. This study aimed to investigate the prevalence of whiplash injuries in a Japanese community, and the association between whiplash injuries and QOL was also determined. MethodsIn all, 1140 volunteers participated in this study, filled out a questionnaire about whether they had experienced a whiplash injury, or had any neck pain or neck-shoulder stiffness in the previous 3 months, and completed the Medical Outcomes Study 36-Item Short-Form Health Survey. QOL was evaluated from the eight domain scores, and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. We compared the characteristics, habits, history, medication, body mass index, and health-related QOL (eight domains, PCS and MCS scores) between the groups with whiplash injuries and no whiplash injuries for each sex. Multiple linear regressions with the forced-entry procedure were performed to evaluate the effects of a whiplash injury on the PCS and MCS. A p-value of <0.05 was considered statistically significant. ResultsThe prevalence of whiplash injuries was 7.7% and 9.6% in men and women, respectively. The percentage of those who experienced whiplash injuries with symptoms persisting for more than 3 months was 34.3% and 24.2% in men and women, respectively. The prevalence of neck symptoms was significantly higher in the whiplash injury group than in the non-whiplash injury group. Multiple linear regression analysis showed that, although whiplash injuries were associated with poor health-related QOL in men, age was more associated with health-related QOL than whiplash injuries in both sexes. ConclusionThe prevalence of whiplash injuries was 7.7% and 9.6% in men and women in local residents in Japan, respectively. Whiplash injuries were poorly associated with a poor health-related QOL in men (P = 0.015).

Associations among working hours, sleep duration, self-rated health, and health-related quality of life in Korean men

BackgroundThis study aimed to examine the relationship between working hours and health-related quality of life (HRQOL) in men and to determine whether this relationship was mediated by sleep duration and self-rated health (SRH).Materials and methodsOur study population included 2141 working men aged 20 to 49 years old from the Korea National Health and Nutrition Examination Survey 2016–2017. Working hours, SRH, and HRQOL were measured by a structured questionnaire survey. Sleep duration was calculated based on self-reported data. We investigated the association between working hours and HRQOL and performed a mediation analysis to evaluate the contributions of sleep duration and poor SRH to this relationship.ResultsThis study identified a significant association between working hours and HRQOL. Long working hours directly and indirectly affected HRQOL through poor SRH. Men who overworked were more likely to report poor HRQOL due to worsened SRH. Poor SRH was responsible for 26.3% of this relationship. But sleep duration did not explain the relationship between working hours and HRQOL.ConclusionsWorking hours were directly associated with HRQOL in men. Furthermore, there was an indirect effect of working hours on HRQOL mediated by poorer SRH. An improved work-life balance is necessary to promote men’s health and quality of life.

Long-term health-related quality of life among men with prostate cancer in the Finnish randomized study of screening for prostate cancer.

BackgroundThe long‐term health‐related quality of life (HRQOL) impacts of PCa screening have not been adequately evaluated. We aimed to compare the generic and disease‐specific health‐related quality of life (HRQOL) among men with prostate cancer in the screening arm with the control arm of the PSA‐based prostate cancer screening trial in up to 15 years of follow‐up.Materials and methodsThis study was conducted within population‐based Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC). During 1996‐1999 80,458 men were randomized to the serum prostate‐specific antigen (PSA) screening arm (SA, N = 32 000) and the control arm (CA, N = 48 458). Men in the screening arm were screened at 4‐year intervals until 2007. HRQOL questionnaires were delivered to newly diagnosed prostate cancer patients in the screening and control arm 1996‐2006 (N = 5128) at the time of diagnosis (baseline), at 3‐month, 12‐month and 5, 10, and 15‐year follow‐up. Validated UCLA Prostate Cancer Index (UCLA‐PCI) and RAND 36‐Item Health Survey were used for HRQOL assessment. The data were analyzed with a random effects model for repeated measures.ResultsAt baseline, men with prostate cancer in the screening arm reported better Sexual Function, as well as less Sexual and Urinary Bother. Long‐term follow‐up revealed slightly higher HRQOL scores in the screening arm in prostate cancer specific measures at 10‐year post diagnosis, but the differences were statistically significant only in Urinary Bother (UCLA‐PCI score 77.9; 95% CI 75.2 to 80.5 vs. 70.9; 95% CI 66.8 to 74.9 P = .005). The generic HRQOL scores were comparable between the trial arms. The overall differences in disease‐specific or generic HRQOL scores by trial arm did not vary during the follow‐up.ConclusionNo major differences were observed in HRQOL in men with prostate cancer between the prostate cancer screening and control arms during five to 15‐year follow‐up.

Gender differences in the association between physical activity and health-related quality of life among community-dwelling elders.

Physical activity can improve health-related quality of life (HRQoL) in older adults. However, the differential effects of gender on quality of life are unclear. To determine the association between physical activity and HRQoL in men and women. This was a cross-sectional study conducted from March to August 2011. Community-dwelling older people aged 65years or older were eligible. Physical activity in kcal per week was measured with the International Physical Activity Questionnaire (IPAQ)-Taiwan version. HRQoL was measured with the 36-Item Short Form Survey (SF-36) questionnaire. Cognitive function and depression were assessed using the Mini-Mental State Examination (MMSE) and Patient Health Questionnaire-9 (PHQ-9). The relationship between physical activity and HRQoL in men and women was investigated by a multiple linear regression model. A total of 188 older people (M: 50.5%) participated in this study. The mean ages of men and women were 71.9 ± 5.3 and 77.1 ± 6.4years, respectively (p < 0.001). Older women had higher physical activity levels than men (4786.1 ± 1065.6 vs 4422.2 ± 1114.3kcal/week, p = 0.023). After adjusting for covariates, multiple linear regression analysis showed that older men with higher physical activity levels had better scores on both the physical component summary (PCS) (p = 0.031) and mental component summary (MCS) (p = 0.007) than men with lower levels. Furthermore, older men with higher moderate-vigorous physical activity levels had better scores on the PCS than older men with lower activity levels, and older men with higher walking physical activity levels had better scores on the MCS than older men with lower activity levels. In this study, older women were more physically active than older men. However, older men (but not older women) with higher physical activity had better HRQoL. The association between physical activity and HRQoL differed between men and women.

Association of leisure and occupational physical activities and health-related quality of life: Tehran Lipid and Glucose Study

BackgroundLittle is known about the association between different levels of physical activity (PA) and health-related quality of life (HRQoL) in the general Iranian population across sex groups. The current study aims to investigate the association between PA and HRQoL across sex groups, various types of physical activity (leisure time and occupational) and different dimensions of HRQoL in a large population of Tehranian adults.MethodsThis cross-sectional study was conducted using data from the Tehran Lipid and Glucose Study (TLGS). Data was collected from 7800 adults on their PA habits and HRQoL. Information on PA and HRQoL were assessed using the Modifiable Activity Questionnaire (MAQ) and Short-Form 12-Item Health Survey version 2 (SF-12v2), respectively. Poor HRQoL was defined as the first quartile of HRQoL scores and logistic regression analysis was used to assess the association between physical activity levels and poor HRQoL.ResultsThe mean age of participants was 46.4 ± 14.9 years and 45.6% of them were male. Levels of PA were significantly associated with most subscales of HRQoL in both men (p < 0.05) and women (p < 0.01). In both sexes, leisure time PA was significantly correlated to all subscales of HRQoL (p < 0.05) except for bodily pain in both sexes and for social functioning and role emotional in men. In adjusted models, men with both moderate (OR: 1.55, 95%CI: 1.18–2.04; p = 0.002) and low (OR: 1.46, 95%CI: 1.11–1.91; p = 0.007) levels of PA had a significantly higher chance of reporting poor mental component summary (MCS) compared to their counterparts with high levels of PA. Furthermore, women with low levels of PA had a significantly higher chance of reporting poor physical component summary (PCS) (OR: 2.39, 95% CI: 1.63–3.49; p < 0.001) compared to those with high levels of PA.ConclusionThe findings show an association between PA and both domains of HRQoL in men and mostly the physical domain in women, suggesting a sex-specific pattern for this association, which could be considered to motivate participation in PA programs in future health promotion interventions.

Association between nutritional status (NS) and health-related quality of life (HRQoL) in men with early metastatic castrate-resistant prostate cancer (mCRPC).

e16539 Background: HRQoL is of paramount importance in men with mCRPC. It is not known how NS affects HRQoL in this population of patients. We hypothesized that NS is associated with HRQoL in men with early mCRPC and that NS outperforms body mass index (BMI) in this association. Methods: We prospectively enrolled men with early mCRPC into this study. Patients were assessed, and on the basis of established criteria, four NS categories were defined: normal NS (nNS), nutritional risk without cachexia/sarcopenia (NR), sarcopenia (S) (handgrip strength &lt; 30 kg) and cachexia (C) (Evans`s criteria). HRQoL was assessed by the validated questionnaire Functional Assessment of Cancer Treatment (FACT-P); higher score reflects better HRQoL. After checking for normal distribution, we performed a linear regression model for HRQoL with NS as a dummy variable (with nNS as the reference group). Age, duration of previous androgen deprivation therapy (ADT), hemoglobin level (Hb), prostate-specific antigen (PSA) and BMI were included as covariates into the multivariate model. Results: One hundred forty-one patients were enrolled in our study. At presentation, their mean age was 74.2 years (SD 7.1), and 18 (12.4 %) had visceral metastases. Fifty-eight (41.3%) had nNS, 43 (30.8 %) had sarcopenia, 24 (16.8 %) NR and 16 (11.2 %) C. Mean FACT-P score [SD] in nNS was 115.3 points [22.2], following by 97 [24.6], 98.3 [22.4] and 78.8 [25] points in NR, S and C groups, respectively. We found a significant and consistent association between better NS and worse HRQoL (β [NR:nNS] = -18.2 points; β [S:nNS] = -17 points; β [C:nNS] = -36.5 points; p &lt; 0.001; R² = 0.2). The association remained significant after adjustments (R² = 0.27). Conclusions: Suboptimal NS but not BMI is significantly associated with worse HRQoL in men with early mCRPC. Interventional trials focused on the optimization of NS in men with mCRPC are warranted.[Table: see text]

Quality of life in men living with advanced and localised prostate cancer in the UK: a population-based study.

Little is known about the health-related quality of life (HRQOL) of men living with advanced prostate cancer. We report population-wide functional outcomes and HRQOL in men with all stages of prostate cancer and identify implications for health-care delivery. For this population-based study, men in the UK living 18-42 months after diagnosis of prostate cancer were identified through cancer registration data. A postal survey was administered, which contained validated measures to assess functional outcomes (urinary incontinence, urinary irritation and obstruction, bowel, sexual, and vitality and hormonal function), measured with the Expanded Prostate Cancer Index Composite short form (EPIC-26), plus questions about use of interventions for sexual dysfunction) and generic HRQOL (assessed with the 5-level EuroQol five dimensions questionnaire [EQ-5D-5L] measuring mobility, self-care, usual activities, pain or discomfort, and anxiety or depression, plus a rating of self-assessed health). Log-linear and binary logistic regression models were used to compare functional outcomes and HRQOL across diagnostic stages and self-reported treatment groups. Each model included adjustment for age, socioeconomic deprivation, and number of other long-term conditions. 35 823 (60·8%) of 58 930 men responded to the survey. Disease stage was known for 30 733 (85·8%) of 35 823 men; 19 599 (63·8%) had stage I or II, 7209 (23·4%) stage III, and 3925 (12·8%) stage IV disease. Mean adjusted EPIC-26 domain scores were high, indicating good function, except for sexual function, for which scores were much lower. Compared with men who did not receive androgen deprivation therapy, more men who received the therapy reported moderate to big problems with hot flushes (30·7% [95% CI 29·8-31·6] vs 5·4% [5·0-5·8]), low energy (29·4% [95% CI 28·6-30·3] vs 14·7% [14·2-15·3]), and weight gain (22·5%, 21·7-23·3) vs 6·9% [6·5-7·3]). Poor sexual function was common (81·0%; 95% CI 80·6-81·5), regardless of stage, and more than half of men (n=18 782 [55·8%]) were not offered any intervention to help with this condition. Overall, self-assessed health was similar in men with stage I-III disease, and although slightly reduced in those with stage IV cancer, 23·5% of men with metastatic disease reported no problems on any EQ-5D dimension. Men diagnosed with advanced disease do not report substantially different HRQOL outcomes to those diagnosed with localised disease, although considerable problems with hormonal function and fatigue are reported in men treated with androgen deprivation therapy. Sexual dysfunction is common and most men are not offered helpful intervention or support. Service improvements around sexual rehabilitation and measures to reduce the effects of androgen deprivation therapy are required. The Movember Foundation, in partnership with Prostate Cancer UK.

Racial and Ethnic Variation in Health-Related Quality of Life Scores Prior to Prostate Cancer Treatment.

IntroductionMany men diagnosed with prostate cancer are concerned with how the disease and its course of treatment could affect their health-related quality of life (HRQOL). To aid in the decision-making process on a course of treatment and to better understand how these treatments can affect HRQOL, knowledge of pretreatment HRQOL is essential.AimsTo assess the racial and ethnic variations in HRQOL scores in men newly diagnosed with prostate cancer before electing a course of treatment.MethodsMale members of the Kaiser Permanente of Southern California health plan who were newly diagnosed with prostate cancer completed the five-domain specific Expanded Prostate Index Composite–26 (EPIC-26) HRQOL questionnaire from March 1, 2011 through August 31, 2013 (N = 2,579). Domain scores were compared across racial and ethnic subgroups and multiple logistic regression analyses were used to assess the association after adjusting for sociodemographic and clinical characteristics.Main Outcome MeasuresThe five EPIC-26 domain scores (sexual, bowel, hormonal, urinary incontinence, and urinary irritation and obstruction).ResultsResults from the fully adjusted analyses indicated that non-Hispanic black men were more likely to be above the sample median on the sexual (odds ratio [OR] = 1.43, 95% CI = 1.09–1.88), hormonal (OR = 1.35, 95% CI = 1.03–1.77), and urinary irritation and obstruction (OR = 1.34, 95% CI = 1.03–1.74) domains compared with non-Hispanic white men. The Asian or Pacific Islander men were less likely to be above the sample median on the sexual domain (OR = 0.60, 95% CI = 0.44–0.83) compared with non-Hispanic white men. No additional statistically significant differences were identified.ConclusionsWithin an integrated health care organization, we found minimal racial and ethnic differences, aside from sexual function, in pretreatment HRQOL in men newly diagnosed with prostate cancer. These findings provide important insight with which to interpret HRQOL changes in men newly diagnosed with prostate cancer during and after prostate cancer treatment.Reading SR, Porter KR, Slezak JM, et al. Racial and Ethnic Variation in Health-Related Quality of Life Scores Prior to Prostate Cancer Treatment. Sex Med 2017;5:e219–e228.

LINGUISTIC VALIDATION OF JAPANESE VERSION OF EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER QUALITY OF LIFE QUESTIONNAIRE-TESTICULAR CANCER 26 (EORTC QLQ-TC26)

(Purpose) To translate the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 (EORTC QLQ-TC26) into Japanese and evaluate the linguistic validation of the translated EORTC QLQ-TC26. (Methods) Developing the EORTC QLQ-TC26 Japanese was performed strictly according to the EORTC Quality of Life (QOL) Group Translation Procedure. The translation process consisted of 3 steps: forward translation by 2 urologists and reconciliation (single forward translation), backward translation by 2 native English speakers and comparison with source questionnaire (intermediate version), and pilot testing of the intermediate version in 10 patients with testicular cancer and reconciliation with EORTC QOL Group. (Results) After forward translation by 2 experienced Japanese urologists, any disagreements were resolved via a reconciliation process, resulting in a single provisional forward translation. This translation was back-translated by two independent backward-translators (fluent in both, Japanese and English) in order to ensure that the provisional forward translation was an adequate representation of the English original. Based on the discussion with EORTC QOL group, the intermediate version was developed. Each translated item was pilot-tested on 10 patients diagnosed with testicular cancer. Most patients experienced no difficulties in completing the questionnaire. On the basis of the interview and reconciliation with EORTC QOL Group, two items of the provisional translation required adaptation. (Conclusions) The EORTC QLQ-TC26 Japanese was developed in a linguistically valid manner. This can be used for cross-cultural assessment of health related QOL in men with testicular cancer.

Symptoms predicting health-related quality of life in prostate cancer patients treated with localized radiation therapy.

ObjectivePatient-reported health-related quality-of-life (HRQOL) measures can provide guidance for treatment decision making, symptom management, and discharge planning. HRQOL is often influenced by the distress experienced by patients from disease or treatment-related symptoms. This study aimed to identify symptoms that can predict changes in HRQOL in men undergoing external beam radiation therapy (EBRT) for nonmetastatic prostate cancer (NMPC).MethodsFifty-one men with NMPC scheduled for EBRT were assessed at the baseline, at the midpoint of EBRT, and at the end of EBRT. All participants received 38–42 daily doses of EBRT (five times a week), depending on the stage of their disease. Validated questionnaires were administered to evaluate depressive symptoms, urinary and sexual functions, bowel issues, symptom-related distress, fatigue, and HRQOL. Pearson correlations, repeated-measures ANOVA, and multiple regressions examined the relationships among variables.ResultsIntensification of symptoms and increased symptom-related distress, with a corresponding decline in HRQOL, were observed during EBRT in men with NMPC. Changes in symptoms and symptom distress were associated with changes in HRQOL at the midpoint of EBRT (r=−0.37 to −0.6, P=0.05) and at the end of EBRT (r=−0.3 to −0.47, P=0.01) compared with the baseline. The regression model comprising age, body mass index, Gleason score, T category, androgen-deprivation therapy use, radiation dose received, symptoms (urinary/sexual/bowel problems, fatigue), and overall symptom distress explained 70% of the variance in predicting HRQOL. Urinary problems and fatigue significantly predicted the decline in HRQOL during EBRT.ConclusionIdentifying specific symptoms that can influence HRQOL during EBRT for NMPC can provide feasible interventional targets to improve treatment outcomes.

Pathways linking obesity to health-related quality of life.

Obesity is a well-recognized risk factor for impaired health-related quality of life (HRQOL). Nevertheless, few studies have investigated the mechanisms underlying the obesity-HRQOL associations. In this study, we explored potential mediators of the associations between obesity and HRQOL. Body mass index (BMI), an indicator of obesity, and HRQOL data were available for the 34,565 individuals 20years of age and older participating in the cross-sectional Korea National Health and Nutrition Examination Survey 2007-2012. HRQOL was measured by the EuroQol five-dimension descriptive system. Path analysis was performed to assess the contributions of obesity-related diseases and self-rated health (SRH) on the relationships between obesity and HRQOL. In men, obesity was negatively associated with HRQOL through diabetes mellitus, hypertension, and dyslipidemia and positively associated with HRQOL through SRH. These opposite indirect effects offset one another and produced a non-significant association between obesity and HRQOL in men. However, in women, obesity was directly associated with HRQOL and indirectly associated with HRQOL through diabetes mellitus and SRH. Since these associations were in the same negative direction, the negative obesity-HRQOL association was clearly observed in women. Obesity was negatively associated with HRQOL through obesity-related diseases in both genders. However, in men, the positive association between obesity and SRH resulted in a non-significant association of obesity with HRQOL.

A canonical correlation analysis on the relationship between functional fitness and health-related quality of life in older adults

ObjectiveThis study aimed to explore the relationship between the functional fitness (FF) and health-related quality of life (HRQoL) in older adults, and to identify the key subdimensions of FF and HRQoL influencing their overall relationship. MethodsThis cross-sectional study was performed among 851 independent community members (65–84 years; men=402). The Senior Fitness Test and the Short Form 36 Health Survey were used to measure FF and HRQoL, respectively. A canonical correlation analysis was conducted using seven fitness variables as predictors of eight HRQoL variables to examine the relationship between FF and HRQoL. ResultsThe overall FF was positively correlated with the overall HRQoL in both men (canonical correlation=0.350) and women (canonical correlation=0.456). The up-and-go and 2-min step contributed the most to FF, and physical functioning contributed the most to HRQOL among men. Conversely, the up-and-go and 30-s chair stand contributed the most to FF, and physical functioning contributed the most to HRQoL in women. ConclusionsThere were positive and moderate relationships between overall FF and overall HRQOL in older adults. The FF has a significant influence on HRQoL, particularly physical functioning. The main FF components influencing the relationship between FF and HRQoL in men are balance and agility and aerobic endurance, whereas in women they are balance and agility and lower extremity muscle strength. Results from this study facilitate comprehensively understanding the relationship between FF and HRQoL, and generating critical insight into HRQoL improvement from the perspective of FF enhancement.

Waist circumference is superior to weight and BMI in predicting sexual symptoms, voiding symptoms and psychosomatic symptoms in men with hypogonadism and erectile dysfunction.

Waist circumference is considered a useful predictor of obesity-associated cardiovascular risk, but its use as an indicator of sexual health status and quality of life (QoL) in hypogonadal men is unknown. We investigated whether three measurements of obesity, weight, body mass index and waist circumference, correlate with the International Index of Erectile Function-5 (IIEF-5), the Aging Males' Symptoms (AMS) and the International Prostate Symptom Score (IPSS) questionnaires. A total of 261 patients were enrolled in a prospective study on hypogonadism treatment with intramuscular long-acting testosterone undecanoate. Patients with total testosterone ≤3.5ngml-1 were enrolled, and baseline demographic data were recorded. Patient's response to IIEF, IPSS and AMS standardised questionnaires was recorded to evaluate health-related QoL. The mean length of treatment and follow-up was 4.7years (max 6years). ANOVA regression analysis showed that waist circumference was significantly inversely proportional to IIEF-5 and directly proportional to AMS and IPSS. Weight was inversely proportional to IIEF and directly proportional to IPSS but not associated with AMS. BMI had no proportionality to measurements of sexual function and quality of life. These results suggest that among weight, BMI and waist circumference, the latter is the best predictor of health-related QoL in men with hypogonadism.