Important Predictors Of Quality Of Life Research Articles

Participation as a Predictor of Quality of Life among Japanese Children with Neurodevelopmental Disorders Analyzed Using a Machine Learning Algorithm.

Participation is important for children's quality of life (QOL). This study aimed to identify participation factors that influence QOL among Japanese children with neurodevelopmental disorders. Ninety-two Japanese parents of children with neurodevelopmental disorders participated in this study. The parents completed the parent version of the Kid- and Kiddo-KINDL health-related QOL questionnaire and the Participation and Environment Measure for Children and Youth. The data were examined using the random forest algorithm to analyze the participation factors that affected the children's QOL. The analyses revealed that school and community environmental factors that affected participation were the most important predictors of QOL among children. As school and community environments can significantly impact the QOL of children with neurodevelopmental disorders, greater focus should be placed on participation in environmental contexts.

Therapeutic Strategies in Children with Epilepsy: A Quality-of-Life-Related Perspective.

Back ground: Children with epilepsy are affected by several factors, including clinical and social variables. Among these variables, cognitive decline and behavioral disturbances, perceptions of stigma, and fatigue can lead to reductions in quality of life (QOL). Epileptic activities, including seizure severity, frequent seizures, and status epilepticus (SE), have been identified as important predictors of QOL. In addition, the frequency of interictal epileptiform discharges (IEDs) on electroencephalogram (EEG) may also be an important predictor of QOL, because IEDs can lead to cognitive decline and behavioral disturbances. Moreover, frequent seizures and/or IEDs may play a role in emotional mediators, such as stigma and fatigue, in childhood epilepsy. Seizure severity and/or IEDs are, therefore, important QOL-related factors in childhood epilepsy. Seizure severity as a QOL-related factor: Frontal lobe dysfunctions, such as cognitive decline and behavioral disturbances, can result in reduced QOL for both the child and their family. Frontal and prefrontal lobe growth disturbances can be present during active-phase epilepsy in some children with neuropsychological impairments. Recovery from prefrontal lobe growth disturbances may depend on the active seizure period. Children with a shorter active seizure period can recover from disturbances in prefrontal lobe growth more rapidly. In contrast, recovery may be delayed in children with a longer active seizure period. Moreover, frequent seizures can lead to seizure-associated headaches, perceptions of self-stigma and parental stigma, and fatigue. Accordingly, severe seizures can lead to neuropsychological impairments in association with prefrontal lobe growth disturbances in children with epilepsy. EEG abnormalities as QOL-related factors: IEDs on EEG, representing persistent pathological neuronal discharges, may be associated with several pathological aspects. Frontal IEDs can be a risk factor for recurrent seizures, cognitive decline, and behavioral disturbances, and they may also play a role as emotional mediators similar to stigma. In addition, behavioral disturbances may result in the presence of secondary bilateral synchrony (SBS) on EEG. Behavioral disturbances can be improved in association with a reduction in IEDs in children with frontal IEDs and SBS. Therefore, EEG abnormalities, such as frontal IEDs and SBS, can also lead to neuropsychological impairments in children with epilepsy. Therapeutic strategies in children with epilepsy: Seizure severity and IEDs on EEG may be associated with neuropsychological impairments, leading to QOL reduction. Therapeutic management may be desirable to reduce seizures and EEG abnormalities, such as frontal IEDs and SBS, as early as possible to improve QOL in children with epilepsy. During antiseizure medication (ASM) selection and adjustment, physicians should strategize the therapeutic approach to controlling seizures and suppressing EEG abnormalities in children with epilepsy. Among various ASMs, novel ASMs, such as levetiracetam and perampanel, may suppress both clinical seizures and IEDs on EEG; thus, these novel ASMs may represent an important addition to the treatments available for epileptic children presenting with frontal IEDs and SBS.

Quality of Life in Multiple Sclerosis: The Predictive Roles of Positive Body Image and Meaning in Life

Multiple sclerosis (MS) is a chronic neurological disease with a global prevalence that has risen over the past decade. The literature suggests that in comparison with a healthy control (HC) group, people with MS experience lower levels of quality of life (QoL). The purpose of this study was (1) to investigate the differences in QoL and a set of psychosocial variables between MS patients and an HC group; (2) to examine the correlations between QoL and psychosocial, sociodemographic, and clinical variables; and (3) to assess the predictive value of a set of psychosocial, sociodemographic, and clinical variables for the QoL of patients with MS. Participants in the clinical group (n = 135) and the HC group (n = 170) filled in a sociodemographic questionnaire and self-report assessments measuring QoL, body appreciation, body acceptance by others, functionality appreciation, body responsiveness, meaning in life, and difficulties in emotion regulation. The results show that the MS group had lower general, physical, psychological, and social QoL than the HC group and that body appreciation, body acceptance by others, body functionality, meaning in life, and difficulties in emotion regulation are important predictors of QoL.

Quality of Life among Ethiopian Cancer Patients: A Systematic Review of Literatures.

Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients. A systematic review was conducted using the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle-Ottawa Scale. In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL. The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL.

Quality of Life of Children and Adolescents with Multiple Sclerosis-A Literature Review of the Quantitative Evidence.

Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system that also develops in patients under 18 years of age. The disease negatively affects the quality of life (QoL) of children and adolescents. We conducted a literature review. The aim of the review was to identify the QoL of pediatric patients with MS and assess the factors determining their QoL. Methods: We analyzed studies published between 2000 and 2020 in PubMed, Scopus, Science Direct, Web of Science, and EBSCO databases. Results: In all, 17 studies were included in the review. The most common tool in assessing QoL was the generic module PedsQL. The range of mean/median global score of QoL was 53.8–81.7. The worst QoL was dominantly reported in the school and emotional spheres, on the contrary, the disease’s least determined area of QoL was the social and physical dimension. In particular, disability and fatigue were important predictors of QoL. Conclusions: MS negatively affects the school and emotional spheres in particular, so it is important to pay greater attention to these spheres of life of MS patients. As the review studies pay insufficient attention to the analysis of positive factors and their impact on the QoL of MS patients, research should integrate these phenomena. The use of MS-targeted tools in future research in the pediatric MS population is also appropriate.

Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available. Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion. Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples. Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.

Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available.Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion.Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples.Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.

Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension.

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available. Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion. Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples. Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.

PB2265 THE RELATIONSHIPS BETWEEN QUALITY OF LIFE AND DISEASE MANAGEMENT AWARENESS, PREFERENCES AND SATISFACTION: NATION‐WIDE SURVEY OF MULTIPLE MYELOMA PATIENTS IN BELARUS

Background:Health‐related quality of life (QoL) is an important humanistic outcome of multiple myeloma (MM) management. While QoL in MM is studied in controlled clinical trials, predominantly in the European Union communities, QoL level and components data are scarcer in real‐world clinical settings. Moreover, QoL level and changes to QoL under different treatment modalities may be confounded by other patient factors which require clarification.Aims:To cover the information gaps regarding the level and patient‐ and disease‐related predictors of QoL in MM patients residing in Belarus.Methods:A cross‐sectional survey of a country‐representative sample of 300 MM patients of Belarus was performed. The survey consisted of 42 multiple choice questions including the whole EORTC QoL Core Questionnaire (EORTC QLQ‐C30, version 3.0), 3 questions from EORTC QoL Questionnaire – MM Module (EORTC QLQ‐MY20) related to attitude toward the disease course and perspectives, and additional items related to patients’ preference toward place and route of drug administration, their disease awareness, and overall satisfaction with healthcare services. Descriptive analyses were conducted.Results:Global health status/QoL of MM patients was 55.3 (95%CI 52.8 – 57.8). The main components deteriorating QoL were physical functioning, fatigue, pain and sleep disorders. QoL functional scales scores decreased and QoL symptomatic scales scores increased across age and disease duration distributions, with the QoL scores drop in patients with 3‐4 years of disease duration. Higher scores for almost all QoL functional domains were noted in patients preferring oral treatment. Majority (54%) welcomed combination (intravenous + per os) therapy, but only 28% of patients preferred sole parenteral administration of drugs. 72% of respondents considered the quality of diagnostics & treatment as good or excellent, while 45% preferred to be treated in ambulatory settings and/or at home. Global and functional but not symptomatic QoL scores were directly related to the level of patients’ satisfaction with disease management. Worries about dying were revealed as a predominant negative factor for all EORTC QLQ‐C30 scores. The level of patients’ awareness (on their health status and the course of the disease, possible treatment options and side effects) significantly and positively related to their QoL levels.Summary/Conclusion:QoL of MM patients in Belarus corresponds to EORTC reference data which makes possible inter‐country comparisons and translation of humanistic outcomes of clinical trials. MM duration, patient attitude toward the disease course and overall patient satisfaction with healthcare services are important predictors of QoL. The evidence suggests that successful patient education activities per se can improve QoL of MM patients and hence their engagement in ambulatory treatment modalities. It should be better addressed in quality control and improvement measures of MM management.

Sleep determines quality of life in autistic adults: A longitudinal study.

Many individuals with autism report generally low quality of life (QoL). Identifying predictors for pathways underlying this outcome is an urgent priority. We aim to examine multivariate patterns that predict later subjective and objective QoL in autistic individuals. Autistic characteristics, comorbid complaints, aspects of daily functioning, and demographics were assessed online in a 2‐year longitudinal study with 598 autistic adults. Regression trees were fitted to baseline data to identify factors that could predict QoL at follow‐up. We found that sleep problems are an important predictor of later subjective QoL, while the subjective experience of a person's societal contribution is important when it comes to predicting the level of daily activities. Sleep problems are the most important predictor of QoL in autistic adults and may offer an important treatment target for improving QoL. Our results additionally suggest that social satisfaction can buffer this association. Autism Research 2019, 12: 794–801. © 2019 International Society for Autism Research, Wiley Periodicals, Inc.Lay SummaryMany individuals with autism report generally low quality of life (QoL). In this study, we looked at factors that predict long‐term QoL and found that sleep problems are highly influential. Our results additionally suggest that social satisfaction can buffer this influence. These findings suggest that sleep and social satisfaction could be monitored to increase QoL in autistic adults.

Beyond depression: The impact of executive functioning on quality of life in patients with temporal lobe epilepsy

ObjectiveIndividuals with temporal lobe epilepsy (TLE) often experience diminished quality of life (QoL). Although comorbid depression is one of the most recognized predictors of poor QoL in TLE, impairments in verbal memory (VM) and executive functioning (EF), have also been identified as risk factors, independent of other biological and psychosocial factors. In this study, we examine the contribution of depression, VM, and EF to QoL in 52 well-characterized medically-refractory TLE patients. MethodsQuality of life was assessed with the Quality of Life in Epilepsy (QOLIE-31) questionnaire and depression symptomatology was evaluated with the Beck Depression Inventory-II (BDI-II). Tests of VM included the California Verbal Learning Test-Second Edition and the Wechsler Memory Scale-Third Edition, Logical Memory and Verbal Paired Associates subtests. Tests of EF included the D-KEFS Category Switching and Color Word Interference Tests, and the Trail Making Test. Using these measures, a principal component (PC) was derived for VM and for EF. Hierarchical multiple linear regression analysis was used to evaluate the unique contributions of BDI-II Score, VM PC, and EF PC to the QOLIE-31 Total Score, while controlling for important clinical and demographic variables. Post-hoc analyses were also performed to examine the contribution of each variable to specific QOLIE subscales. ResultsOf the clinical variables, only number of antiepileptic drugs contributed to QOLIE scores. As expected, severity of depressive symptoms was the most significant predictor of QOLIE Total Score, explaining 43.4% of the variance in total QoL. The VM PC did not contribute to the QOLIE Total Score. Rather, our EF PC emerged as an important predictor of QoL, explaining an additional 5% of the variance, after controlling for clinical variables, depression severity, and VM performance. SignificanceThese findings suggest that a combination of clinical, affective, and cognitive factors influence QoL in patients with TLE. Designing interventions with careful attention to depression and EF may be needed to optimize QoL in patients with refractory TLE and potentially other epilepsy syndromes.

Quality of life, effects on Asian Lifestyle, and perceived satisfaction after total hip arthroplasty in Japan and Korea

BackgroundThe Asian lifestyle requires deep hip flexion, which increases the risk of dislocation. Hence, Asian total hip arthroplasty (THA) patients may have problems postoperatively. This study aimed to 1) document quality of life (QoL), Asian lifestyle-related items (five postures that require deep hip flexion), and perceived satisfaction in patients who underwent THA in Japan versus Korea, 2) assess the differences in QoL and Asian lifestyle-related items by patient lifestyle, and 3) identify the factors predicting QoL. MethodsThis cross-sectional study included 222 THA patients. Korean patients completed the questionnaires. Japanese patients were then matched with Korean patients by age, sex, and post-THA period. Assessed parameters included QoL measured by the EuroQoL, Oxford hip score (OHS), Asian lifestyle (measured by the Asian lifestyle-related items), and perceived satisfaction (measured by the five items of postoperative satisfaction). Multiple regression analysis was used to determine the predictors of QoL. ResultsCompared with Korean patients, Japanese patients had better QoL, but more difficulty performing postures requiring deep hip flexion. Greater QoL was associated with greater satisfaction. The predictors of decreased QoL after THA were lower OHS in both countries, worse squatting ability in Japan, and worse leg-crossing ability in Korea. ConclusionsIn Japan and Korea, the OHS is an important predictor of QoL after THA.

Multicentre cross-sectional clinical evaluation study about quality of life in adults with disorders/differences of sex development (DSD) compared to country specific reference populations (dsd-LIFE)

BackgroundPrevious studies in quality of life (QOL) in individuals with disorders/differences of sex development (DSD) have been restricted to subpopulations of the condition. We describe QOL in adult persons with DSD compared to country specific references and assess the impact of diagnosis.MethodsThe multicentre cross-sectional clinical evaluation (dsd-LIFE) took place in 14 specialized clinics in six European countries. Adolescents (≥16 years) and adults having a DSD condition were included from 02/2014 to 09/2015. The main outcome QOL was measured by the WHOQOL-BREF (domains of physical health, psychological, social relationships, and environment). QOL was compared to country specific reference populations by using unpaired t-tests. Linear regression models explained the additional variance of the diagnosis on QOL.ResultsThree hundred one individuals with Turner Syndrome, 219 with Klinefelter Syndrome (including XYY), 226 with 46,XX CAH and 294 with rare DSD conditions (gonadal dysgenesis, androgen insensitivity syndrome, severe hypospadias, and androgen synthesis errors or other diagnosis) took part. Compared to healthy European populations, QOL was similar in psychological, slightly worse in physical health, and slightly better in environment. In social relationships, QOL was significantly poorer compared to healthy and non-healthy reference populations. In linear regression models health status was the most important predictor of QOL; additional variance was explained by feelings about household’s income in all domains, and the relationship status in social relationships. Diagnosis explained nearly no additional variance.ConclusionsExcept for social relationships, most people with DSD adapt well to their life circumstances and report a good QOL. Not diagnosis, but the individual’s health status is much more important than previously thought. Therefore care for people with DSD should focus more on chronic physical or mental health problems both related and unrelated to the diagnosis itself.Trial registrationGerman Clinical Trials Register DRKS00006072.

Measurement Scale Development for Mobility-Related Quality of Life among Older Malaysian Drivers

Quality of Life (QoL) is frequently understood as subjective well-being at both individual and population levels and specific to a country or context. For individuals, mobility afforded by transport is an important predictor of QoL. This paper aims to provide an overview of theoretical approaches, particularly the selection, optimization, compensation (SOC) model, the scales used to measure quality of life, and the scale development of Mobility-related Quality of Life (M-QoL) among older drivers. A pool of items was developed from three sources: i) literature review, ii) Instrumental Activities of Daily Living (IADL) scale and iii) focus group discussion with older drivers. A survey amongst 498 older Malaysian drivers was administered to confirm internal consistency of the scale. Exploratory factor analysis revealed that the developed M-QoL scale consists of 12 items with good internal consistency (α = 0.90), and consists of two subfactors addressing functions of driving and accessibility for independent living. Implications of the findings are discussed, including encouraging continuation of driving for those who are able to drive safely, and provision and use of alternatives to driving to help them achieve maximum mobility. Suggestions for future research are also recommended.

Fatigue in patients with neuromyelitis optica spectrum disorder and its impact on quality of life.

Fatigue is a prevalent symptom and major burden in neuroimmunological diseases. In neuromyelitis optica spectrum disorder (NMOSD), a severe autoimmune central nervous system (CNS) inflammatory disease with autoantibodies reactive to aquaporin-4, there are few reports about fatigue and quality of life (QOL). We aimed to evaluate the severity of fatigue and its relationship with QOL in patients with NMOSD. We prospectively studied patients with NMOSD who were in remission and seropositive for anti-aquaporin-4 antibody, and they were divided into 2 groups based on the presence of fatigue assessed using the Functional Assessment of Chronic Illness Therapy-fatigue score. Sleep quality, depression, pain, and QOL were also evaluated. A total of 35 patients were enrolled (mean age, 46.5 ± 14.1 years; female: male = 29:6), and the median Expanded Disability Status Scale (EDSS) score was 2.0 (range, 0 to 8.0). The patients with fatigue (N = 25, 71.4%) had poorer sleep quality and more severe depression than those without fatigue (p = 0.009 and p = 0.001). Both the physical and mental QOL scores were lower in patients with fatigue than in those without fatigue (p = 0.033 and p = 0.004). Multiple linear regression analyses showed that the degree of fatigue with EDSS score and pain were independent predictors of physical aspects of QOL (B = 0.382, p = 0.001), whereas depression was the only predictor of the mental components of QOL (B = -0.845, p = <0.001). Fatigue is a common symptom and an important predictor of QOL in patients with NMOSD.

Proxy-reported quality of life in adolescents and adults with dyskinetic cerebral palsy is associated with executive functions and cortical thickness

Quality of life (QOL) is a key outcome for people with cerebral palsy (CP), and executive functioning is an important predictor of QOL in other health-related conditions. Little is known about this association in CP or about its neural substrate. We aim to analyze the influence of executive functioning (including cognitive flexibility) as well as that of other psychological, motor, communication and socioeconomic variables on QOL and to identify neuroanatomical areas related to QOL in adolescents and adults with CP. Fifty subjects diagnosed with dyskinetic CP (mean age 25.96years) were recruited. Their caregivers completed the primary caregiver proxy report version of the CP QOL-Teen questionnaire. Motor status, communication, IQ, four executive function domains, anxiety/depression and socioeconomic status were evaluated. Correlations and multiple linear regression models were used to relate CP QOL domains and total score to these variables. Thirty-six participants underwent an MRI assessment. Correlations were examined between cortical thickness and CP QOL total score and between cortical thickness and variables that might predict the CP QOL total score. Executive functions predict scores in four domains of CP QOL (General well-being and participation, Communication and physical health, Family health and Feelings about functioning) in the regression model. Among the cognitive domains that comprise executive function, only cognitive flexibility measured in terms of performance on the Wisconsin card sorting test (WCST) predicts the CP QOL total score. Monthly income, fine motor functioning and communication ability predict scores on the domains Access to services and Family Health, Feelings about functioning and School well-being, respectively. The clusters resulting from the correlation between cortical thickness and both CP QOL total score and WCST performance overlapped in the posterior cingulate and precuneus cortices. Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.

Quality of Life Among Breast Cancer Survivors 2 Years After Diagnosis: The Relationship With Adverse Childhood Events and Posttraumatic Growth.

Quality of life (QoL) is an important patient outcome in oncology. Many breast cancer survivors report difficulties with QoL. Adverse childhood events (ACEs) and posttraumatic growth (PTG) may influence QoL in breast cancer survivors after diagnosis. The aim of this study was to determine the association of QoL with ACEs and PTG among breast cancer survivors 2 years after diagnosis. This was a cross-sectional study, conducted on 93 Chinese breast cancer survivors diagnosed at least 2 years prior to the study. Measures included a self-reported demographic questionnaire, the Adverse Childhood Experiences questionnaires, the Posttraumatic Growth Inventory, and the Functional Assessment of Cancer Therapy-Breast Cancer QoL questionnaire. Among the 93 participants, more than one-third (34.4%) experienced childhood adversity. We found a negative relationship between ACEs and QoL and a positive relationship between PTG and QoL. The findings suggest that childhood adversity and PTG are important predictors of QoL among breast cancer survivors at least 2 years after diagnosis. Women who had experienced ACEs had poorer health-related QoL than did those who did not. Individuals who experienced PTG following a cancer diagnosis also reported better QoL than did those who did not. A better understanding of how ACE and PTG contribute to breast cancer survivors' QoL will help in tailoring and therefore enhancing the efficacy of interventions aimed at improving QoL.

Predictors of quality of life in head and neck cancer survivors up to 5years after end of treatment: a cross-sectional survey.

This study aimed to assess quality of life (QoL) in head and neck cancer (HNC) survivors and determine factors predictive of poor QoL in the first 5years after the end of treatment. A cross-sectional survey, including the Quality of Life in Adult Cancer Survivors (QLACS) measure, was sent to HNC survivors in three Scottish health regions, with responses linked to routinely collected clinical data. Independent sample t tests, ANOVAs, Pearson correlations and multiple hierarchical regressions were used to explore associations between and to determine the contribution made by demographic, lifestyle and clinical factors to predicting 'generic' and 'cancer-specific' quality of life. Two hundred eighty patients (65%) returned questionnaires. After adjustment, multivariate analysis showed that younger age, lower socio-economic status, unemployment and self-reported comorbidity independently contributed to poorer generic and cancer-specific quality of life. In addition to these factors, having had a feeding tube or a diagnosis of oral cavity cancer were independently predictive of poorer cancer-specific quality of life. Socio-economic factors and comorbidity are important predictors of QoL in HNC survivors. These factors and the detrimental long-term effects of feeding tubes need further attention in research and practice.

Long-term changes in quality of life after endoscopic resection of sinonasal and skull-base tumors.

Minimally invasive endoscopic resection (MIER) has emerged as the new standard for surgical treatment of sinonasal and skull-base tumors. The objective of the present study was to evaluate quality of life (QOL) 2 years after MIER. Prospective 20-item Sino-Nasal Outcome Test (SNOT-20) data was accrued on 104 patients over 4 years. The study cohort included 72 patients with sinonasal malignancy, while 32 patients with inverted papilloma (IP) served as controls. The overall and rhinologic subdomain SNOT-20 scores for cancer patients did not statistically improve at 2 years (p = 0.12). They had statistically significant improvement in the psychological subdomain scores at 1 year (p = 0.03) and 2 years (p = 0.03). Similarly, the sleep subdomain scores improved at 1 year (p = 0.04) and 2 years (p = 0.03). In contrast, IP patients had statistically significant improvement in overall SNOT-20 (p = 0.01), rhinologic (p = 0.01), and sleep (p = 0.05) subdomain scores at 6 months, which remained stable at 2 years. Analysis of various factors demonstrated that history of prior smoking adversely affected QOL scores in cancer patients, with higher total SNOT-20 scores than nonsmokers (p = 0.01). Smokers also had higher psychological (p = 0.04), sleep (p = 0.01), and ear/facial (p = 0.001) domain scores than nonsmokers at 2 years. The long-term effects of MIER for sinus cancer showed improved psychological and sleep scores at both 1 year and 2 years. Unfortunately, rhinologic QOL did not statistically improve at any of the measured time points. History of smoking was noted to be the most important predictor of QOL 2 years after MIER for sinonasal malignancy.

Predictors of quality of life in patients with heart failure

To understand quality of life (QOL) and the effects of sociodemographics, disease severity, physical symptoms (dyspnea and fatigue), and depression on QOL of heart failure (HF) patients in Taiwan. Adult HF patients with history of cerebral vascular accident, myocardial infarction within the previous 6 months, major diseases, concurrent cancers, and coexisting terminal diseases, cognitive impairments, or residence in institutions, were excluded in this study. Quality of life, physical symptoms, and depression were measured by the Minnesota Living with Heart Failure Questionnaire, Pulmonary Function Status and Dyspnea Questionnaire, and Brief Symptom Inventory depression subscale, respectively. Hierarchical regression analyses were used to examine the correlations of demographics, disease severity, physical symptoms, and depression with QOL in HF patients. One hundred and thirty-three HF patients (64.2 ± 12.7 years, 78.2% male, 36.1% NYHA III/IV) were recruited in the study. In the final regression model, age, duration of HF, physical symptoms, and depression had a significant impact on global QOL, ultimately accounting for 37.6% of the variance of QOL. Age, duration of HF, physical symptoms, and depression are important predictors of QOL in HF patients. Interventions targeting physical symptoms and depression are expected to improve QOL of HF patients.