Health-related Quality Of Life In Young Adults Research Articles

Characterizing Early Changes in Quality of Life in Young Women With Breast Cancer.

IntroductionYounger age at diagnosis is a risk factor for poor health-related quality of life (HRQOL) in long-term breast cancer survivors. However, few studies have specifically addressed HRQOL in young adults with breast cancer (i.e., diagnosed prior to age 40), nor have early changes in HRQOL been fully characterized.MethodsEligible female patients with breast cancer were identified through our local cancer center. To establish HRQOL, patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) around diagnosis and 12 months later. Sociodemographic factors, genetic susceptibility to cancer, tumor- and treatment-related factors, and comorbidities (e.g., depression/anxiety) were abstracted from medical records and the local oncology registry. Mixed-effects models were used to identify changes in FACT-B scores during the first year of treatment and to determine whether any demographic/treatment-related factors modulated changes in scores.ResultsHealth-related quality of life in young patients with breast cancer was within normal limits at baseline, with a FACT-B overall well-being score of 108.5 (95% confidence limits [CI] = 103.7, 113.3). Participants reported slight improvements over a 12-month period: FACT-B overall well-being scores increased 6.6 points (95% CI = 2.1, 11.1, p < 0.01), functional well-being improved 3.0 points (95% CI = 2.0, 4.1, p < 0.01), emotional well-being improved 1.9 points (95% CI = 0.9, 2.8, p < 0.01), and physical well-being improved 1.5 points (95% CI = 0.2, 2.8, p = 0.03), on average. Participants with anxiety/depression at baseline reported greater improvements in FACT-B overall well-being (change: 12.9, 95% CI = 6.4, 9.5) and functional well-being (change: 5.2, 95% CI = 3.5, 6.9) than participants who did not have anxiety/depression at baseline (change in FACT-B overall well-being: 4.9, 95% CI = 0.2, 9.7; change in functional well-being: 2.3, 95% CI = 1.1, 3.4). Marital status, reconstructive surgery, and baseline clinical staging were also significantly associated with changes in aspects of HRQOL, although their impact on change was relatively minimal.ConclusionYoung women with breast cancer do not report HRQOL concerns during the first year of treatment. Improvements in HRQOL during the first year of treatment may be attributable to a sense of relief that the cancer is being treated, which, in the short run, may outweigh the negative late effects of treatment.

Living with Atopic Dermatitis as a Young Adult in Relation to Health-related Quality of Life and Healthcare Contacts: A Population-based Study.

Most studies of health-related quality of life (HRQoL) and atopic dermatitis are based on data from dermatology clinics. The aim of this study was to determine whether atopic dermatitis affects HRQoL in adolescence and young adulthood, based on data from the population-based cohort BAMSE (Children, Allergy, Environmental, Stockholm, Epidemiology). A further aim was to determine if the use of topical corticosteroids and healthcare contacts affect HRQoL. Participants with data from birth to young adulthood (n=3,064) were included. Two generic instruments were used to measure HRQoL:General Health at age 12, 16 and 24 years and EQ-5D-3L, including EQ-visual analogue scale (EQ-VAS) at age 24 years. In addition, the disease-specific Dermatology Quality Life Index (DLQI) was used at 24 years. Healthcare consultations for atopic dermatitis were obtained from Stockholm Regional Healthcare Data Warehouse (n = 1,944). Participants with atopic dermatitis had an increased odds ratio (OR) of not feeling completely healthy (adjusted OR 1.50; 95% confidence interval (95% CI): 1.30-1.73). Participants with persistent atopic dermatitis, fulfilling atopic dermatitis criteria in the 12- and/or 16- and 24-year follow-ups reported worse EQ-VAS value 70.0 (95% CI 67.3-72.7) in the 25th percentile, than peers without atopic dermatitis. Over an 8-year period, contact with healthcare was limited (mean number 0.96). In conclusion, atopic dermatitis had a negative impact on HRQoL in young adults from adolescence to adulthood and healthcare consultations were few.

Association of changes in cardiorespiratory fitness with health-related quality of life in young adults with mobility disability: secondary analysis of a randomized controlled trial of mobile app versus supervised training

BackgroundYoung adults with mobility disability report lower health-related quality of life (HRQoL) than their able-bodied peers. This study aims to examine potential differences between the effects of mobile app versus supervised training and the association of cardiorespiratory fitness change with HRQoL in young adults with mobility disability.MethodsThis is a secondary analysis of a parallel randomized controlled trial of a mobile app (n = 55) and a supervised health program (n = 55) that was provided for 12 weeks to 110 adults (18–45 years) with self-perceived mobility disability. Recruitment took place at rehabilitation centers in Stockholm, Sweden. Cardiorespiratory fitness was estimated from the results of a submaximal cycle ergometer test and HRQoL was assessed with the SF-36 questionnaire. Follow up was at 6 weeks, 12 weeks, and 1-year and all examinations were performed by blinded investigators. Between group differences of changes in HRQoL at follow up were estimated in intention-to-treat analysis using linear regression models. Crude and adjusted mixed-effects models estimated the associations between cardiorespiratory fitness change and HRQoL. Stratified analysis by intervention group was also performed.ResultsIn total, 40/55 from the mobile app group and 49/55 from the supervised training group were included in the intention to treat analysis. No significant differences were observed between the effects of the two interventions on HRQoL. In both crude and adjusted models, cardiorespiratory fitness change was associated with the general health (adjusted β = 1.30, 95% CI: 0.48, 2.13) and emotional role functioning (adjusted β = 1.18, 95% CI: 0.11, 2.25) domains of SF-36. After stratification, the associations with general health (adjusted β = 1.88, 95% CI: 0.87, 2.90) and emotional role functioning (adjusted β = 1.37, 95% CI: 0.18, 2.57) were present only in the supervised group.ConclusionThis study found positive associations between cardiorespiratory fitness change and HRQoL in young adults with mobility disability who received supervised training. The effects of mobile app versus supervised training on HRQoL remain unclear.Trial registrationInternational Standard Randomized Controlled Trial Number (ISRCTN) registry ISRCTN22387524; Prospectively registered on February 4th, 2018.

Eating Together and Health-Related Quality of Life Among Korean Adults

ObjectiveTo investigate the association between frequency of eating together and health-related quality of life (HRQoL). DesignPopulation-based cross-sectional study. Participants and SettingA total of 13,920 adults (≥19 years). Data obtained from the Korea National Health and Nutrition Examination Survey conducted from 2014 to 2016. The European Quality of Life-5 Dimensions index was used to assess the HRQoL. Main Outcome MeasuresRelation between the frequency of eating together (eating alone, 1 time/d, and ≥2 times/d) and HRQoL. AnalysisANOVA, correlations, and multivariable logistic regression. ResultsA significantly positive association was observed between the frequency of eating together and the European Quality of Life-5 Dimensions index (P < .001). An increase in the frequency of eating together was associated with decreased odds ratios of having problems in subdimensions (self-care, usual activities, and anxiety or depression; P for trend <.005). Conclusions and ImplicationsA decreased frequency of eating together is associated with low HRQoL. Additional work is warranted to confirm the association between the frequency of eating together and HRQoL in young adults, aged 19–64 years. Further studies are required to identify whether an intervention to increase the frequency of eating together would improve HRQoL in individuals who usually eat alone.

Health-related quality of life, pain, and fatigue in young adults with cerebral palsy.

To describe health-related quality of life (HRQoL), pain, fatigue, and other health variables in young adults with cerebral palsy (CP), and to explore associations with the Gross Motor Function Classification System - Expanded and Revised (GMFCS-ER) and physical activity. This was across-sectional study of 61 young adults at a mean age of 21years 2months (standard deviation 8mo, range 20-22y) with CP, from a geographically defined area. Data collection included: Short Form 36 version 2 for HRQoL, Brief Pain Inventory - Short Form, Fatigue Severity Scale, level of physical activity, medical history, and physical examination. Overall HRQoL equalled that of population norms; however self-reported physical health was lower in GMFCS-ER levels III to V compared to GMFCS-ER levels I to II. Self-reported mental health was, inversely, lower in GMFCS-ER levels I to II compared to GMFCS-ER levels III to V. Pain prevalence was 49%, and pain was present across all GMFCS-ER levels. Fatigue, as well as sleep problems, had 41% prevalence, with fatigue severity decreasing with increasing level of physical activity. General HRQoL in young adults with CP was comparable to population norms. Pain and fatigue are important to address in high motor-functioning individuals also. Physical activity could be a possible protective factor against fatigue. Health-related quality of life in young adults with cerebral palsy (CP) was comparable to population norms. Pain, fatigue, and sleep problems occurred at all Gross Motor Function Classification System levels. There is a possible protective effect of physical activity on fatigue.

Health-Related Quality of Life (HRQoL) in Young Adults with Strabismus in India.

Strabismus has negative psycho-social and functional effects in adults. The impact can be minimised with surgery. However, in a low-income setting, it is important to evaluate the level of impact and prioritise the target population for intervention. The Adult Strabismus (AS-20) questionnaire is a reliable tool for assessment of Health-Related Quality of Life (HRQoL) in strabismic adults. To assess the HRQoL in young adults with manifest strabismus through psychosocial and functional scores according to gender and direction of deviation using the AS-20 questionnaire. In this cross-sectional cohort study, 132 young adults who manifest horizontal strabismus were recruited and the AS-20 questionnaire was administered. Patient's demographic profile and type of strabismus were noted and compared with the overall mean scores of psycho-social and functional subscales. Data was analyzed using SPSS 21 and p-value less than 0.05 was considered statistically significant. The participants comprised of 70 (53.03%) males and 62 (46.97%) females with a mean age of 24.5±3.57 years (range 18 to 38 years). The overall mean AS-20 score of young adults with strabismus was 61.62±12.61. The overall mean score for male and female were 65.54±13.53 and 57.68±13.46, respectively. Similarly, the mean scores for esotropes was 57.03±11.66 and 66.19±15.30 for exotropes. The overall mean scores were statistically significantly reduced (decreased QoL) in females as compared to males (CI 95%; p=0.002) and in esotropes as compared to exotropes (CI 95%; p=0.001). However, there was no significant difference between the psychosocial and functional score for all types of strabismus and genders (for all, p>0.05). The Quality of Life (QoL) is affected through psychosocial and functional factors in adults with strabismus. Females and adults with esotropia faced greater difficulties in the QoL. We recommend clinicians to consider the impact on QoL while managing adult with strabismus.

Thyroid Cancer-Specific Quality of Life and Health-Related Quality of Life in Young Adult Thyroid Cancer Survivors.

There is a lack of health-related quality of life (HRQOL) research in thyroid cancer (TC) survivors, especially young adults (YAs). This study aims to assess the socio-demographic and clinical factors that most influence TC-specific QOL domains and estimate the impact of different health conditions on HRQOL in a large cohort of YA TC survivors. TC survivors ≥17 years of age were recruited through the thyroid cancer survivor (ThyCa) Web site. Mean scores for the seven domains and six items of THYCA-QoL, MCS and PCS of SF-12v1, and derived SF-6D were compared between factors as well as age groups (YA: 17-39 years, adult ≥40 years), and to the normal population. Regression analyses estimated the relationship between the socio-demographic, clinical, and THYCA-QoL measures and HRQOL in YAs only. Of 1028 survivors, 277 (27%) were YAs. Most YAs were female (93.5%), white (86.6%), insured (96.8%), married or in a stable relationship (69%), and listed a comorbidity (43.7%); all reported their entire thyroid had been removed. Average survivorship time was 46.2 months (SD = 51.0). Almost every socio-demographic and clinical factor significantly influenced one or more domain of THYCA-QoL in both YAs and older adults. In both groups, a higher level of education, female sex, unemployment, and having a comorbidity resulted in significantly higher THYCA-QoL scores (more complaints) and lower SF-6D scores (lower HRQOL; p < 0.05). Current YAs had less neuromuscular, voice, sympathetic, and throat/mouth complaints but more grievances involving their scar, headaches, anxiety, and overall psychological state (p < 0.05). The average SF-6D for YAs was 0.70 (SD = 0.13), which was similar to the older adults but significantly different from the normal age-matched population in females (p < 0.01). All THYCA-QoL domains were strongly associated with a lower HRQOL (adj R(2) > 0.5) in YAs. The simplest, best regression model (adj R(2) = 0.53) in YAs included neuromuscular, concentration, and anxiety complaints, as well as having a comorbidity predicting lower HRQOL. TC-specific QOL is significantly influenced by many socio-demographic and clinical factors. HRQOL is lower in female YA TC survivors compared with the normal age-matched population. Neuromuscular, concentration, and anxiety complaints had the greatest impact on HRQOL in YA TC survivors.

Smoking status and health-related quality of life: a longitudinal study in young adults.

The possibility that tobacco use affects health-related quality of life (HRQoL) has attracted interest. However, a lack of prospective evidence weakens the case for a causal relationship. The aim was to examine the longitudinal relationship between change in smoking status and change in HRQoL in young adults. We conducted a population-based cohort study with data collected in 2004-2006 (aged 26-36) and 2009-2011 (aged 31-41). Exposure was change in self-reported smoking status during follow-up. Outcomes were changes in physical and mental HRQoL measured by SF-12. For physical HRQoL (n = 2080), quitters had a 2.12 (95 % confidence interval (CI) 0.73, 3.51) point improvement than continuing smokers, whereas former smokers who resumed smoking had a 2.08 (95 % CI 0.21, 3.94) point reduction than those who maintained cessation. Resumed smokers were 39 % (95 % CI 10, 75 %) more likely to have a clinically significant (>5 point) reduction of physical HRQoL than former smokers who maintained cessation. In contrast, quitters were 43 % (95 % CI 3, 98 %) more likely to have a clinically significant (>5 point) improvement in physical HRQoL than continuing smokers. Change in smoking status was not significantly associated with change in mental HRQoL (n = 1788). Smoking by young adults was cross-sectionally associated with lower physical HRQoL and longitudinally associated with reductions in physical HRQoL. The expectation of short- to medium-term gains in physical HRQoL as well as long-term health benefits may help motivate young adult smokers to quit.

Impact of Iyengar Yoga on Quality of Life in Young Women With Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic, disabling disease that can greatly compromise health-related quality of life (HRQoL). The aim of this study was to assess the impact of a 6-week twice/week Iyengar yoga program on HRQoL of young adults with RA compared with a usual-care waitlist control group. The program was designed to improve the primary outcome of HRQoL including pain and disability and psychological functioning in patients. Assessments were collected pretreatment, posttreatment, and at 2 months after treatment. Weekly ratings of anxiety, depression, pain, and sleep were also recorded. A total of 26 participants completed the intervention (yoga=11; usual-care waitlist=15). All participants were female (mean age=28 y). Overall attrition was low at 15%. On average, women in the yoga group attended 96% of the yoga classes. No adverse events were reported. Relative to the usual-care waitlist, women assigned to the yoga program showed significantly greater improvement on standardized measures of HRQoL, pain disability, general health, mood, fatigue, acceptance of chronic pain, and self-efficacy regarding pain at posttreatment. Almost half of the yoga group reported clinically meaningful symptom improvement. Analysis of the uncontrolled effects and maintenance of treatment effects showed improvements in HRQoL general health, pain disability, and weekly ratings of pain, anxiety, and depression were maintained at follow-up. The findings suggest that a brief Iyengar yoga intervention is a feasible and safe adjunctive treatment for young people with RA, leading to HRQoL, pain disability, fatigue, and mood benefits. Moreover, improvements in quality of life, pain disability, and mood persisted at the 2-month follow-up.

Health-Related Quality of Life After Treatment of Hodgkin Lymphoma in Young Adults

To describe changes in health-related quality of life (HRQOL) and to identify supportive care services used after treatment for Hodgkin lymphoma (HL) in young adults. A longitudinal, repeated-measures study design was used to test the feasibility of data collection at the conclusion of treatment for HL and at one, three, and six months post-treatment. Participants were identified from two large comprehensive cancer centers in New England. 40 young adults with newly diagnosed HL were enrolled in the study prior to the completion of chemotherapy or radiation. Data were collected by interviews, standardized questionnaires, and medical record reviews. HRQOL variables defined as symptom distress, functional status, emotional distress, and intimate relationships; use of specific supportive care services; and baseline demographic and disease-related information. Results indicate that symptom distress improved at one month post-treatment and remained low at three and six months. Similarly, functional status improved at one month post-treatment. Only 13% of the sample had significant emotional distress at baseline, and this decreased to 8% over time. Patients placed high value on their intimate relationships (i.e., family and friends or sexual partners). A variety of supportive care services were used after treatment, the most common of which were related to economic issues. However, by six months post-treatment, services shifted toward enhancing nutrition and fitness. The results from this study suggest that HRQOL in young adults with HL improved one-month post-treatment and that interest in using supportive care services was high. Facilitating the use of supportive care services at the end of cancer treatment appears to be an important part of helping young adults transition to survivorship. Supportive care services appear to be a vital component of the transition to survivorship and often change over time from an emphasis on economic issues to enhancing wellness through nutrition and fitness programs.

Quality of life of young adults with congenital hypothyroidism

The aim of the present study was to investigate health-related quality of life (HRQOL) and the living conditions of young adults with congenital hypothyroidism (CH) detected on newborn screening. Among medical institutions that care for CH patients in Japan and were approached to in the present study, 78 institutions agreed to participate. The World Health Organization Quality of Life-26 (WHO/QOL-26) was used for measurement of HRQOL. CH patients who gave consent after receiving an explanation from their physicians filled in questionnaires at home and sent them by mail. This survey involved 51 CH patients (15 male; 36 female) whose mean age was 21.1 +/- 2.7 years (+/-SD; range, 18-27 years). The data from WHO/QOL-26 forms completed by 43 patients (12 male; 31 female) were compared with those for healthy individuals. Mean WHO/QOL-26 scores were 3.51 +/- 0.43 for male patients and 3.59 +/- 0.42 for female patients, and there were no significant differences between them and healthy individuals (men, 3.32 +/- 0.42; women, 3.35 +/- 0.49). No significant difference was observed between patients and healthy individuals on any domain of the WHO/QOL-26. Their degree of educational attainment was not poor. The HRQOL of young adults with CH detected on newborn screening was not poor.

Self–proxy agreement and correlates of health-related quality of life in young adults with epilepsy and mild intellectual disabilities

This study investigated health-related quality of life (HRQOL) in young adults with epilepsy and intellectual disabilities. First, agreement between self-reports and proxy reports of HRQOL was examined. Second, medical and psychological contributions to HRQOL were explored. Thirty-six patients were interviewed using the Quality of Life in Epilepsy inventory (QOLIE-31), the Hospital Anxiety and Depression Scale, and the Neuroticism and Extraversion scales of the NEO Five-Factor Inventory. Medical data were taken from files. Professional caregivers completed rephrased QOLIE-31-questionnaires. The perspectives on HRQOL differed systematically: Caregivers underrated their clients’ HRQOL on average. Few correlations with medical characteristics emerged, whereas all psychological variables were strongly related to HRQOL. Neuroticism, Age at Disability Onset, and their interaction explained 71% of the HRQOL variance. Results indicate that proxy reports do not provide valid substitutes for most of the self-reported HRQOL subscales. Psychological treatment of negative affectivity and after critical life events in adolescence may improve HRQOL in young adults with epilepsy and mild intellectual disabilities.

A cardiac-specific health-related quality of life module for young adults with congenital heart disease: Development and validation

This study represents the development and validation of a cardiac-specific module of the generic health-related quality of life (HRQoL) instrument, the TAAQOL (TNO/AZL Adult Quality Of Life), for young adults with congenital heart disease (CHD). Items were selected based on literature, an explorative previous study in CHD patients, interviews with patients, and the advice of experts. The newly developed Congenital Heart Disease-TNO/AZL Adult Quality of Life (CHD-TAAQOL) was tested in 156 patients with mild or complex CHD and consisted of three hypothesised subject scales: 'Symptoms' (9 items), 'Impact Cardiac Surveillance' (7 items), and 'Worries' (10 items). Cronbach's alpha for the three scales were 0.77, 0.78, and 0.82, respectively. Scale structure was confirmed by Principal Component Analysis, corrected item-scale and interscale correlations. Overall, 55% of reported health status problems were associated with negative emotions, which is an argument for assessing HRQoL as a concept distinct from health status. Convergent validity with validated generic instruments (TAAQOL and Short Form-36, SF-36) showed satisfactory coefficients. Discriminant validity was proven by significantly higher scores for mild CHD patients compared with those with complex CHD. In conclusion, the CHD-TAAQOL module together with the generic TAAQOL can be used to assess group differences for cardiac-specific HRQoL in young adults with CHD. Testing psychometric properties of the CHD-TAAQOL shows satisfactory results. However, to detect changes in HRQoL over time, further research is needed.