Health-related Quality Of Life Index Research Articles

S1093 Assessment of Physical and Mental Health Before and After Protocolized Endoscopic Necrosectomy for Walled-Off Pancreatic Necrosis in a Prospective Multi-Center Trial

Introduction: A regulatory FDA IDE prospective multi-center clinical trial (G170261-NCT03525808) was performed to evaluate rigorous protocolized management of walled off necrosis (WON) ≥ 6 cm in size with > 30% necrotic material using endoscopic ultrasound (EUS) guided lumen apposing metal stent (LAMS) placement with/without endoscopic necrosectomy. Few studies have examined changes in health related quality of life (HRQOL) before and after endoscopic management for WON. The SF-12 is a validated measure of HRQOL containing 12 items which yield a Mental Components Score (MCS) and a Physical Components Score (PCS). Higher scores correspond to a greater perceived quality of life. Methods: The pre-specified target sample of 40 consecutive eligible patients was enrolled by multiple centers from September 2018 to March 2020. Patients with radiographic WON resolution (as demonstrated by size ≤ 3 cm on CT or MRI) and/or 60 days LAMS indwell time had stent removal followed by an end of study visit 6 months later. SF-12 quality of life questionnaires were completed by patients at baseline, stent removal and at the end of study visit. Results: Mean SF-12 Physical Components Score (PCS) was 27.5±21.1 at baseline, 54.4±19.5 at the time of LAMS removal, and 77.9±22.3 at end of study. Mean SF-12 Mental Components Score (MCS) was 44.9±20.1 at baseline, 64.7±16.5 at the time of LAMS removal, and 79.0±17.2 at end of study. The mean improvement in PCS score from baseline to LAMS removal was 26.0±24.8 (p< 0.0001), with the mean improvement in score from baseline to end of the study being 49.1±29.6 (p< 0.0001). The mean improvement in MCS was 19.6±20.1 from baseline to LAMS removal (p< 0.0001) and 32.0±22.3 from baseline to the end of study (p< 0.0001). The mean improvement from the time of stent removal to the end of study was 25.2±18.0 (PCS, p< 0.0001) and 15.5±18.5 (MCS, p=0.0002) (Figure). Conclusion: These data suggest that patients undergoing protocolized endoscopic necrosectomy for walled-off pancreatic necrosis experience significant improvement in both physical and mental HRQOL. Improvement in the physical score domain appeared to be greater than for the mental score domain. HRQOL indicators continued to improve over a mean follow-up of 180 days.Figure 1.: SF-12 Physical and Mental Components Score.

PSYCHOEMOTIONAL INDICATORS OF PATIENTS WITH PURULONECROTIC COMPLICATIONS OF THE DIABETIC FOOT SYNDROME WHO USED DEVICE FOR OFFLOADING OF FOOT DURING MARTIAL LAW

Abstract. Aim. To study the psychoemotional state of patients with purulent-necrotic complications of diabetic foot syndrome (DFS), who used the device for offloading of foot developed by us during the martial law in Ukraine and to compare it with the results of health-related quality of life indicators in peacetime.&#x0D; Materials and methods. All operated patients had stage 3 or 4 of the pathological process on the foot according to the Meggitt-Wagner classification, a neuroischemic form of DFS. The first group includes 28 patients who received prescribed treatment before the introduction of martial law in the country; the second group – 24 patients who were treated during martial law. The psychoemotional state of patients with purulent-necrotic complications of DFS was studied on the 1st and 20th days using the «Emotions» subscale from the «Illness Impact Profile» questionnaire; index of general (good) well-being/ WHO, version 1999; hospital anxiety and depression scale.&#x0D; Results and discussion. The indicators of patients of the first group according to the subscale «Emotions» on the 1st day — (85.7±14.3) points, and of the second group — (104.6±16.1) points. In the group of patients who were interviewed before martial law, the result of the general well-being index was (48.4±1.2). Patients of the second group have (43.5±1.1). Anxiety level: (7.5±0.3) points and (8.7±0.4) points; level of depression: (6.4±0.5) points and (7.6±0.4), respectively. Although the indicators remain unsatisfactory on the 20th day, the tendency towards the improvement of the psychoemotional state is already becoming obvious. The difference in indicators between the two groups remains, which is explained by the influence of military events.&#x0D; Conclusions. In the second group, worse indicators were found for the psychoemotional component of health-related quality of life, both on the 1st and 20th days. The worse dynamics of the improvement of the specified indicators on the 20th day were recorded. In the first group, according to the «Emotions» subscale, there was an improvement of 63.1 %, in the second group — by 36.2 %; the general well-being index increased by 40.1 % and 25.1 %, respectively. If in the first group, the anxiety index decreased by 16 %, and depression by 20.3 %, then in the second group, the anxiety index decreased by 12.6 %, and depression — by 10.6 %.

Показатели «качества жизни, связанного со здоровьем» как предикторы перевода пациентов с COVID‑19 в реанимационное отделение

Understanding the results of self-assessment of health-related quality of life in patients with COVID‑19 is an important part of the full and objective picture of the medical condition on the first day of hospitalization when making decisions to start early intensive care in the resuscitation and intensive care unit. H y p o t h e s i s : the values of health-related quality of life indicators in patients with COVID‑19 on the first day of hospitalization are interrelated with the fact of their stay in the resuscitation and intensive care unit. P u r p o s e : a retrospective study of the relationship of health-related quality of life in patients with COVID‑19 on the first day of hospitalization and the necessity of treatment in the resuscitation and intensive care unit. M a t e r i a l s a n d m e t h o d s . The study was conducted on the basis of the “Kommunarka” Moscow Multidisciplinary Clinical Center of the Moscow City Health Department from March 2021 to April 2022. Data collection was carried out using a paper-and-pencil Russian version of the EQ‑5D‑5L questionnaire (Tracking Number: 41183). Additional patient data was extracted from electronic medical records. Two types of EQ‑5D‑5L questionnaire results were evaluated: the EQ index and the visual-analog EQ scale. All calculations of the regression model were carried out using the language R4.2.1 in the software environment RStudio 2022.02.3 Build 492. F i n d i n g s . This study is the first work where health-related quality of life indicators measured during the first 24 hours of hospitalization in order to predict the transfer of patients with COVID‑19 to the intensive care unit. The best results of self-assessment of their medical condition in the course of hospitalization were revealed in those patients who did not require further treatment in the intensive care unit. The worst results of self-assessment of their medical condition were revealed in lethal patients hospitalized in the intensive care unit on the first day. Two logistic regression models demonstrated a significant relationship of the EQ Index and the Mobility domain with the probability of transferring patients to the intensive care unit. The results obtained prove that subjective indicators of health-related quality of life reflecting the perception of one’s illness “here and now” along with objective clinical indicators are independent predictors of the transfer of patients with COVID‑19 to the resuscitation and intensive care unit. C o n c l u s i o n . Health-related quality of life indicators (EQ Index and MO) can be used to predict the early use of preventive measures to prevent the deterioration of patients’ condition and reduce the load on the intensive care unit.

Behavior without beliefs: Profiles of heteronormativity and well-being among heterosexual and non-heterosexual university students in Chile.

Heteronormativity comprises essentialist, binary beliefs about sex and gender, and normative behaviors derived from those beliefs. There is scarce literature on how heteronormative attitudes and well-being variables are concurrent among individuals who are heterosexual or gay, lesbian, bisexual, and of other queer sexual identities (LGBQ). The objective of this study was to distinguish profiles of university students based on essentialism and normative behavior, two dimensions of heteronormativity, and to characterize these groups by sexual orientation and gender, perceived social support, physical and mental health, and life satisfaction. A sample of 552 university students in Temuco, Chile, responded to an online questionnaire consisting of sociodemographic questions, the Scale of Heteronormative Attitudes and Beliefs, the Life Satisfaction Scale, the Health-Related Quality of Life Index, and the Multidimensional Scale of Perceived Social Support. We used Latent profile analysis to distinguish profiles based on significant score differences in Essentialism and Normative behavior. We identified four heteronormativity profiles: High heteronormativity (34.85%), with a significant proportion of heterosexuals and men; Low heteronormativity (25.59%), comprising a significant proportion of students who were non-binary, and LGBQ; Heteronormativity focused on normative behavior (20.42%), with a significant proportion students who were men or non-binary, and who were lesbian, gay or bisexual or preferred not to disclose their sexual orientation; and Heteronormativity focused on essentialism (19.14%), with a significant proportion of heterosexuals and women, and individuals who preferred not to disclose their sexual orientation. The four profiles differed in the proportions of students by faculty and area of residence (urban/rural), and by life satisfaction, self-perceived mental health, and perceived social support. These results show that patterns of association between heteronormativity and subjective well-being are heterogeneous among heterosexual and non-heterosexual individuals. Some of these patterns may respond to the COVID-19 pandemic, which has disrupted daily life and social dynamics. These findings expand our understanding of advantageous and disadvantageous conditions associated with maintaining heteronormativity attitudes, particularly among non-heterosexual individuals.

Comorbid Depression and Diabetes Are Associated with Impaired Health-Related Quality of Life in Chronic Kidney Disease Patients.

Given the increasing prevalence of chronic kidney disease (CKD) and its impact on health care, it is important to better understand the multiple factors influencing health-related quality of life (HRQOL), particularly since they have been shown to affect CKD outcomes. Determinants of HRQOL as measured by the validated Kidney Disease Quality of Life questionnaire (KDQOL) and the Patient Health Questionnaire depression screener (PHQ-9) were assessed in a routine CKD patient sample, the Greifswald Approach to Individualized Medicine (GANI_MED) renal cohort (N = 160), including a wide range of self-reported data, sociodemographic and laboratory measures. Compared to the general population, CKD patients had lower HRQOL indices. Dialysis was associated with (1) low levels of physical functioning, (2) increased impairments by symptoms and problems, and (3) more effects and burden of kidney disease. HRQOL is seriously affected in CKD patients. However, impairments were found irrespective of eGFR decline and albuminuria. Rather, the comorbid conditions of depression and diabetes predicted a lower HRQOL (physical component score). Further studies should address whether recognizing and treating depression may not only improve HRQOL but also promote survival and lower hospitalization rates of CKD patients.

Прогнозирование исходов заболевания пациентов с COVID‑19 на основе оценки качества жизни

In order to provide effective medical care to patients with COVID-19 in hospitals, the disease outcome prognosis is of considerable importance. The authors of the study suggested a relationship between health-related quality of life indicators and the outcomes of the disease of patients hospitalized because of COVID-19. P u r p o s e . Retrospective study of the relationship between health-related quality of life in patients with COVID-19 on the first day of hospitalization with the outcomes of the disease in a hospital and at the stages of rehabilitation up to 180 days following the discharge to predict outcomes at the early stages of the disease. M a t e r i a l s a n d m e t h o d s . The study was conducted at the “Kommunarka” Moscow Multidisciplinary Clinical Center of the Moscow City Health Department from March 2021 to April 2022. Data collection was carried out using a paper-and-pencil Russian version of the EQ-5D-5L questionnaire (Tracking Number: 41183), on the first day of admission of patients to the hospital. Additional patient data was extracted from electronic health records. Two types of EQ-5D-5L questionnaire results were evaluated: Index EQ and the Visual Analog scale (VAS) EQ. All calculations of the regression model were carried out using the R 4.2.1 language in the RStudio 2022.02.3 Build 492 software environment. F i n d i n g s . In the obtained logistic regression model, the extremely high statistical significance of the variable “Index EQ” (p&lt;0.01) was demonstrated, the greater the value of the variable “Index EQ” is, the less the probability of a fatal outcome is. At the same time, there is no statistically significant relationship between the variable VAS EQ under study and the probability of a fatal outcome. C o n c l u s i o n s . An extremely significant relationship between the calculated health-related quality of life index, Index EQ, and outcomes of COVID-19 when patients were admitted to the hospital was revealed, which makes it possible to use it as a predictor of disease outcomes at early stages. No significant relationship between the VAS EQ and the outcomes of the disease in patients with COVID-19 on the first day of hospitalization was revealed, which makes it impossible to use it as a predictor of disease outcomes at the early stages. Application of the health-related quality of life index, Index EQ can be used to make medical decisions in order to early predict tactics of patient management in hospital treatment and rehabilitation.

Health-Related Quality of Life and Its Socio-Demographic and Behavioural Correlates during the COVID-19 Pandemic in Estonia.

The aim of the study was to analyse health-related quality of life (HRQoL) among the Estonian general population and its socio-demographic and behavioural correlates during the COVID-19 pandemic. Longitudinal data on 1781 individuals from an Estonian rapid-assessment survey on COVID-19 were used. HRQoL was assessed with the EQ-5D-3L in June 2020 (baseline) and in May 2021 (follow-up). The HRQoL index score and its socio-demographic and behavioural variations were analysed using paired t-tests and Tobit regression modelling. Statistically significant declines in mean EQ-5D index scores were observed for all socio-demographic and behavioural variables considered. Most of these changes were due to increased reporting of problems in the pain/discomfort and anxiety/depression health domains. Older age, being unemployed or economically non-active and having financial difficulties were significantly associated with lower HRQoL in both baseline and follow-up measurements. In the follow-up data, women had significantly lower HRQoL compared to men, whereas higher education proved to be the only protective factor regarding HRQoL. Unhealthy dietary habits and low physical activity had a negative impact on the HRQoL score in the follow-up data. These results indicate that the COVID-19 pandemic has had a substantial impact on HRQoL in the Estonian population.

The influence of adverse drug effects on health-related quality of life in chronic obstructive pulmonary disease patients.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Concerns have been raised about the influence of adverse drug effects on patient's health-related quality of life (HRQoL) in COPD patients. This study aimed to evaluate the impact of COPD treatment-related adverse effects on HRQoL in COPD patients. In a cross-sectional study, COPD patients aged 40 years or older were identified and interviewed during their hospital visits. The EuroQol 5 Dimension 5 Level (EQ-5D-5L) questionnaire was used for evaluating HRQoL. Potential treatment adverse effects were evaluated as experienced by participants during the last 2 weeks preceding the interview. The intensity of adverse effects was reported in the following categories: never, mild, moderate and severe. Multivariable linear regression model was performed to evaluate the influence of adverse drug effects on utility scores as an indicator of HRQoL. A total of 203 patients diagnosed with COPD were recruited in the current study. The mean utility score of the study sample was 0.68 (SD = 0.36). Moderate-severe constipation, moderate-severe confusion, mild urinary hesitation, moderate-severe urinary hesitation, moderate-severe dry eyes and moderate-severe drowsiness were significant predictors/determinants for the average utility scores (coefficients were -0.099, -0.191, -0.111, -0.157 and -0.144, respectively). In addition, having higher COPD Assessment Test scores and severe disease was negatively associated with average utility scores (coefficients were -0.287 and -0.124, respectively). Higher intensity of COPD treatment-related adverse effects has a negative influence on HRQoL in COPD patients. Anticholinergic drug effects are of concern in COPD adults' population.

A-12 Mental Health Outcomes for CFL Athletes with ADHD

Abstract Purpose: Current research suggests that athletes with Attention Deficit Hyperactivity Disorder (ADHD) are at risk for poorer outcomes arising from sport related concussions (SRC). There is limited research related evaluating mental health outcomes in athletes diagnosed with ADHD. The purpose of the study is to evaluate mental health outcomes among Canadian Football League (CFL) athletes with (ADHD) and to measure outcomes based upon a history of concussion. Methods: Professional football players from the CFL (n = 784) were administered a baseline mental health measure, the Health-Related Quality of Life (HRQL), as a component of pre-season evaluations as part of a larger cohort study (Active Rehabilitation). Diagnosis of ADHD was the independent variable and HRQL index scores measuring physical functioning, depression, cognitive functioning, were dependent variables. A second analysis compared ADHD athletes with no history of concussion to those with a history of concussion on the HRQL indexes. Results: Participants diagnosed with ADHD (n = 80) had statistically significant differences on the Physical Functioning (t(782) = −3.359, p &amp;lt; 0.001), Depression ((t(782) = −2.820, p = 0.002) and Cognitive (t(782) = −3.570, p &amp;lt; 0.001) domains of the HRQL, compared to athletes without ADHD. Among the athletes who are diagnosed with ADHD, no mental health differences were found between those who have at least one concussion and those who do not. Conclusions: This study did not find a significant effect of concussion on mental health outcomes in participants with ADHD. However, athletes with ADHD present with higher mental health symptoms which may merit closer monitoring.

The Persian Version of Skindex-29 Health-related Quality of Life Index: Translation and Psychometric Validation

Background: Dermatologic diseases have considerable effects on patients’ health-related quality of life (HRQoL). The assessment of diseases’ effects on patients’ lives is an important component of disease management. Although Skindex-29 is one of the most utilized measures for assessing dermatology-specific HRQoL, there is no Persian version of it in Iran. This study aimed to translate Skindex-29 into Persian and assess its psychometric properties. Methods: The study was a methodological study, carried out to examine the psychometric properties and factor structure of the Persian version of Skindex-29. The translation was conducted based on Mapi guidelines. In total, 200 dermatologic patients filled in the dermatology life quality index and the Persian version of Skindex-29. Internal consistency reliability was assessed using Cronbach alpha. Convergent validity and known-group validity were evaluated. Exploratory and confirmatory factor analyses were conducted to test construct validity. Results: The final translated version was comprehensible and Cronbach alpha was 0.967. Skindex-29 total score and its subscales exhibited strong correlations with the dermatology life quality index. Known-group validity was supported by the difference between the mild and severe disease groups (P&lt;0.05). Factor analyses identified three well-fitting factors like the original version, which accounted for 69.95% of the variance of the instrument. Conclusion: This study developed an adequate Persian version of Skindex-29, which can be used as a valid and reliable HRQoL instrument to study Iranian dermatologic patients.

Relationship among health-related quality of life and global ancestry, clinical and socioeconomic factors in type 1 diabetes in an admixed Brazilian population

We aimed to evaluate the Health-related quality of life (HRQoL) of Type 1 diabetes mellitus (T1D) patients in an admixed Brazilian population. This is a cross-sectional study with 152 T1D patients. HRQoL information was obtained from two self-completed questionnaires: Short Form-6 dimensions and EuroQol-5 dimensions with visual analog scale. For inference of global ancestry, the panel of 46 autosomal informational insertion/deletion ancestry markers was used. Demographic and socioeconomic data, presence of chronic complications, glycemic control level, and type of treatment were obtained. Patients with good HRQoL were: male, under 18 years old, had health insurance, less than 5 years of diagnosis, practiced physical activity, without hypoglycemia in the last 30 days, absence of retinopathy and nephropathy, a participant in educational activities, used analogous insulin, monitoring blood glucose, observed maximum adherence to treatment and came from the secondary service. Global ancestry and self-reported color/race did not influence HRQoL indexes. Our study is the first to measure HRQoL, global ancestry and recognize the impact of T1D on the lives of patients in the State of Maranhão, Brazil. The results validate the need to provide T1D patients with continuous training on self-management and self-monitoring, aiming for better results in metabolic control and, subsequently, in the prevention of acute and chronic complications, in order to generate positive impacts on the quality of life of this population. We understand that global ancestry in a highly mixed population such as ours did not influence the HRQoL of these patients.

Quality of life assessment in chronic viral hepatitis

Chronic viral hepatitis has a significant impact on morbidity, quality of life and mortality and is characterized by a growing economic and social burden in the context of disability of the population and an increase in life expectancy. Chronic viral hepatitis can significantly worsen health-related quality of life indicators (HRQoL), which are a reflection of the influence of the disease and therapy on the physical and emotional components of the patient's health, especially in patients with progressive liver disease and/or active viral activity. To assess the quality of life related to health, you can use general tools and tools for specific diseases. Common tools available in the scientific literature include the Short Form 36 questionnaire (SF-36) and the Euroqol five-point questionnaire (EQ-5D). However, since general instruments cannot always detect the subtle effects of a particular condition on the quality of life, the use of special instruments is of great value, due to their ability to clinically characterize the quality of life in patients with chronic viral hepatitis. The use of recently developed special tools for assessing the quality of life will greatly assist in the verification of preventive and therapeutic interventions in this area. One of the priorities of any measures for the prevention and treatment of chronic viral hepatitis is to improve the quality of life in this category of patients.

Health-Related Quality of Life of Patients with Cervical Cancer According to the Duration of Treatment and Cancer Progression

Objective:The purpose of this study was to assess health-related quality of life (HRQoL) in Korean patients with cervical cancer according to the duration of treatment and cancer progression of cervical cancer. Methods:This study included 452 outpatients with cervical intraepithelial neoplasia (CIN) or invasive cervical cancer from six tertiary hospitals in South Korea. The questionnaire included the EQ-5D-3L instrument, patients’ age, cancer progression (CIN or invasive cervical cancer), treatment duration (<1 year, ≥1 year but <2 years, and ≥2 years), treatment method (surgery, chemotherapy, radiation therapy), and presence of recurrence. HRQoL indices were calculated for these independent factors, and the mean was compared using ANOVA. Multiple regression analysis was performed to analyze factors affecting HRQoL in patients with cervical cancer. Results:The EQ-5D index was 0.93 for patients with CIN, 0.87 for patients with invasive cervical cancer, and 0.78 for patients with recurrent invasive cervical cancer. HRQoL was significantly lower as the CIN progresses to cervical cancer. HRQoL of patients with invasive cervical cancer was lowest within 1 year of treatment in all stages. In addition, the HRQoL of patients with CIN or invasive cervical cancer who received chemotherapy and radiotherapy was lower than that of patients who underwent surgery. Multiple regression analysis showed that the HRQoL decreased significantly as increasing age, the first year of treatment after diagnosis, cancer recurrence, or chemotherapy. Conclusion:The HRQoL of patients with cervical cancer is affected not only by the stage of cancer progression but also by the duration of treatment and the type of treatment. As a result, when trying to apply the quality of life of patients with cervical cancer to cost-utility analysis, it is necessary to consider the duration and the type of treatment they receive.

Encouraging older adults with pre-frailty and frailty to "MoveStrong": an analysis of secondary outcomes for a pilot randomized controlled trial.

This 8-week pilot stepped-wedge randomized controlled trial evaluated the MoveStrong program for teaching adults who have frailty/pre-frailty about balance and functional strength training and sufficient protein intake to prevent falls and improve mobility. We recruited individuals aged 60 years and over, with a FRAIL scale score of 1 or higher and at least one chronic condition, who were not currently strength training. The program included 16 exercise physiologist-led hour-long group sessions and two dietitian-led hour-long nutrition sessions. We analyzed secondary outcomes-weight, gait speed, grip strength, physical capacity (fatigue levels), sit-to-stand functioning, dynamic balance, health-related quality of life (HRQoL), physical activity levels and protein intake-using a paired t test and a generalized estimating equation (GEE). Of 44 participants (mean [SD] age 79 [9.82] years), 35 were pre-frail and 9 were frail. At follow-up, participants had significantly improved grip strength (1.63 kg, 95% CI: 0.62 to 2.63); sit-to-stand functioning (2 sit-to-stands, 95% CI: 1 to 3); and dynamic balance (1.68 s, 95% CI: 0.47 to 2.89). There were no significant improvements in gait speed, HRQoL index scores, self-rated health, physical activity levels (aerobic activity and strength training) or protein intake. GEE analysis revealed an interaction between exposure to MoveStrong and gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores. The total cost to administer the program and purchase equipment was CAD 14 700, equivalent to CAD 377 per participant. Exploratory analyses suggest MoveStrong exercises may improve gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores in older individuals who are frail and pre-frail.

Factors associated with change over time in quality of life of people with dementia: longitudinal analyses from the MODEM cohort study

BackgroundResearch to date offers mixed evidence about the relationship between quality of life and severity of cognitive impairment in people with dementia. We aimed to investigate longitudinal changes in patient- and proxy-rated health-related quality of life (HRQL) by severity of dementia and explore factors associated with changes in HRQL over a one-year period. We used data from the MODEM longitudinal cohort study which recruited dyads of persons with clinically diagnosed dementia and their principal carer and interviewed them face-to-face at baseline and again 1 year later.MethodsQuota sampling was used to generate balanced numbers (target n = 100 for each severity level) of people with mild cognitive impairment (20+ on the standardised Mini-Mental State Examination (sMMSE)), moderate cognitive impairment (score 10 to 19), and severe cognitive impairment (score 0 to 9). Persons with dementia without an identifiable family carer or other informant (e.g., a formal/professional/paid carer) were excluded from the study. Participants answered a series of questions measuring their HRQL: DEMQOL, DEMQOL-proxy, EQ-5D-3 L, EQ-5D-3L proxy. Multiple regression models were built to understand the effects of baseline demographics and dementia symptoms (cognitive impairment, neuropsychiatric symptoms) on change in HRQL over 1 year.ResultsTwo hundred and forty-three dyads of people with clinically diagnosed dementia and carers completed baseline and follow-up interviews. Most measures of HRQL remaining relatively stable between time-points, but one index of HRQL, EQ-5D proxy, significantly declined. Depending on the HRQL measure, different factors were associated with change in HRQL. The only factor consistently associated with decline in HRQL (when compared to improvement) was having a diagnosis of a non-Alzheimer’s dementia.ConclusionsDeterioration in HRQL is not an inevitable part of the dementia journey. However, people with non-Alzheimer’s dementias may be more susceptible to HRQL decline. This may indicate that those with non-Alzheimer’s dementia may benefit from specific support focussed on maintaining their quality of life.

Multimorbidity among midlife women in India: well-being beyond reproductive age

BackgroundCurrently, inequality in life expectancy across gender makes women outlive men. Adult women transit towards menopause around midlife accompanied by a series of natural physiological changes leading to several conditions such as osteoporosis, depression, and urinary incontinence, which puts them at a higher risk of having multimorbidity. Multimorbidity is often associated with poorer quality of life, leading to deteriorated work productivity and associated economic loss in midlife. Hence, this study aimed to determine the magnitude and correlates of early onset of multimorbidity and explore its linkages with health-related quality of life (HRQoL) among middle-aged women in India.MethodsWe have utilized data from the first round of the Longitudinal Ageing Study in India, 2017–19. We included women aged 45–65 years (n = 23,951) for analysis. Descriptive data were presented. An ordered logistic regression was conducted and proportional odds were reported to identify the correlates of multimorbidity. To explore the linkages between multimorbidity and selected indicators of HRQoL, an array of regression models were executed.ResultsMultimorbidity was reported amongst 29.8% of women in midlife. Chandigarh (PR-54.8 PER 100 women) and Punjab (PR-52.8 per 100 women) reported the highest prevalence of multimorbidity. Women with multimorbidity reported compromised HRQoL indicators such as self-rated health, work-limiting health conditions, mobility, and activities of daily living.ConclusionsMultimorbidity is increasingly prevalent in midlife women associated with inferior quality of life. The reproductive health programs for women should consist of midlife women focusing on multimorbidity and overall well-being.

Evaluating health related quality of life among hypertensive patients: An educational intervention study

The health care sector has shown increased interest in humanistic outcomes of therapy. Health related quality of life (HRQOL) evaluation among patients receiving treatment for chronic diseases is now widely applied. Hence, the effect of education on the HRQOL of hypertensive patients was evaluated in two tertiary health facilities; FMC, Yenagoa and NDUTH, Okolobiri in Bayelsa State, Nigeria. Trained Pharmacist interviewed willing hypertensive patients between 21-80 years of age at the cardiology clinics of the health facilities using the MINICHAL questionnaire which is specific for hypertension. A convenient sampling technique was adopted. Demographic characteristics were also obtained. The responses (425) were analyzed and observed. To evaluate the effect of drugs and educational intervention, an interactive health talks on hypertension was held at their cardiology clinic weekly for six weeks. Two months later the questionnaire was re-administered. The responses post intervention (297) was analyzed. The results were then compared. The MINICHAL rates HRQOL as best=0 to worst=51. HRQOL score of 12.96 to 8.00 in FMC Yenagoa and 8.70 to 8.55 in NDUTH Okolobiri, pre and post intervention respectively was observed. Though not significant (P=0.3998), the study revealed that educational intervention brought about a positive trend in demographic characteristics. Age, marriage and education were indicated as strong indicators of HRQOL. Educational intervention on hypertension improves patient’s HRQOL. Patients’ education and counseling should be a continuous tool in patient management.

Post-Migration Stressors and Health-Related Quality of Life in Refugees from Syria Resettled in Sweden.

The link between post-migration stressors and mental ill health is well documented in refugees resettled in high-income host countries, but the consequences of these stressors on refugees’ health-related quality of life (HRQoL) are less known. This study examined the association between post-migration stressors and HRQoL among Syrian adult refugees resettled in Sweden using a preference-based value set obtained from the general Swedish population. A total of 1215 Syrian adults, ages 18–64 years, granted residency in Sweden, responded to a postal questionnaire in 2016 regarding various aspects of their resettlement. The European Quality of Life Five Dimensions Five Level (EQ–5D–5L) questionnaire was used to assess HRQoL through an EQ–5D–5L index score (range; 0=dead to 1=full health). The index score was preference weighted using a Swedish population value set. Predictors were four self-reported post-migration stressors related to daily living in the host country: financial strain, social strain, competency strain and perceived discrimination divided into low, medium and high levels of experienced stress. Multivariable linear regression models were employed to assess the association between post-migration stressors and HRQoL index score, adjusting for potentially traumatic events in the pre- and peri-migration phase as well as sociodemographic confounders/covariates (sex, age, education, civil status, immigration year). The Syrian refugees had a mean EQ–5D–5L index score of 0.863 (SD = 0.145). There was strong evidence of a negative dose-response association in both unadjusted and adjusted models between HRQoL and the post-migration stressors financial strain and social strain—i.e., there was a stepwise, and statistically significant, decrease in HRQoL when going from low to medium to high strain. Competency strain and discrimination were only associated with lower HRQoL when experienced at high levels in fully adjusted models. High exposure to potentially traumatic experiences before or during flight was also associated with lower HRQoL. Syrian refugees resettled in Sweden reported a lower HRQoL than the general Swedish population and lower than age-matched Swedish adults. The present study results point to the possible adverse effects of post-migration stressors on HRQoL.

Do clinical severity scores correlate with the quality of life in children with psoriasis? A cross-sectional study of Iranian pediatric patients.

Psoriasis is a common chronic dermatosis that can negatively affect patients' lives. To obtain more insight about how having psoriasis and how the various clinical and physical characteristics of the disease impact the health-related quality of life (HRQoL) of pediatric patients. A retrospective cross-sectional study was designed with 40 pediatric patients with psoriasis. HRQoL was evaluated using the Children Dermatology Life Quality Index (CDLQI). A total of 40 patients enrolled in this study. The mean age of participants was 12.42±7.1years (age range: 4-16years), 21males (52.5%), and 19 females (47.5%). The mean Psoriasis Area Severity Index (PASI) score was 8.03±9.31 with a range of 0.4-25. Mean CDLQI score was 18.87±8.15, indicating a considerable burden on health-related QoL. There was a strong positive correlation between CDLQI and PASI scores (p<.001, r: .653). The negative effect of psoriasis on HRQoL in pediatrics was confirmed, and a strong correlation between disease severity scores and HRQoL in children with psoriasis was found in this study. Taking HRQoL indices into account while managing adolescent patients will improve our insight into the patient's experience and may provide better patient adherence to treatment.

Physical function and health-related quality of life of community-dwelling older adults with locomotive syndrome and pre-frailty.

[Purpose] To consider the effective rehabilitation approaches for locomotive syndrome (LS) and pre-frailty, we examined the characteristics of physical function and health-related quality of life (HRQoL) in community-dwelling older adults. [Participants and Methods] Eighty-three individuals (age 71.8 ± 5.5 years, 29 males and 54 females) were divided into robust (R), LS, and locomotive syndrome with pre-frailty (LSP) groups. We compared the subscale and summary scores of the 36-Item Short-Form Health Survey (SF-36) as HRQoL indices. The grip strength, five-chair stand up test (SS-5), and normal walking speed were the physical function indices. [Results] The LS group had lower two-step scores and normal walking speed but there was no significant difference in the SF-36. The two-step score and 25-question geriatric locomotive function scale, SS-5, seven SF-36 subscales, and mental component summary (MCS) scores were lower in the LSP group. Compared to that of the LS group, the LSP group did not show significant difference in physical function but showed lower values in overall health, vitality, mental health, and MCS in the SF-36 subscales. [Conclusion] The subjective evaluation of one’s health was lower than that of the deterioration of physical function as a characteristic of the LSP.