Influence Health-related Quality Research Articles

A graphical LASSO analysis of global quality of life, sub scales of the EORTC QLQ-C30 instrument and depression in early breast cancer

We aimed to (a) investigate the interplay between depression, symptoms and level of functioning, and (b) understand the paths through which they influence health related quality of life (QOL) during the first year of rehabilitation period of early breast cancer. A network analysis method was used. The population consisted of 487 women aged 35–68 years, who had recently completed adjuvant chemotherapy or started endocrine therapy for early breast cancer. At baseline and at the first year from randomization QOL, symptomatology and functioning by the EORTC QLQ-C30 and BR-23 questionnaires, and depression by the Finnish version of Beck's 13-item depression scale, were collected. The multivariate interplay between the related scales was analysed via regularized partial correlation networks (graphical LASSO). The median global quality of life (gQoL) at baseline was 69.9 ± 19.0 (16.7–100) and improved to 74.9 ± 19.0 (0–100) after 1 year. Scales related to mental health (emotional functioning, cognitive functioning, depression, insomnia, body image, future perspective) were clustered together at both time points. Fatigue was mediated through a different route, having the strongest connection with physical functioning and no direct connection with depression. Multiple paths existed connecting symptoms and functioning types with gQoL. Factors with the strongest connections to gQoL included: social functioning, depression and fatigue at baseline; emotional functioning and fatigue at month 12. Overall, the most important nodes were depression, gQoL and fatigue. The graphical LASSO network analysis revealed that scales related to fatigue and emotional health had the strongest associations to the EORTC QLQ-C30 gQoL score. When we plan interventions for patients with impaired QOL it is important to consider both psychological support and interventions that improve fatigue and physical function like exercise.Trial registration: http://www.clinicaltrials.gov/ (identifier number NCT00639210).

Syrian Refugee Youth Resettled in Norway: Mechanisms of Resilience Influencing Health-Related Quality of Life and Mental Distress.

Background: The importance of resilience factors in the positive adaptation of refugee youth is widely recognised. However, their actual mechanism of impact remains under-researched. The aim of this study was therefore to explore protective and promotive resilience mechanisms to inform future interventions and policy. Promotive resilience is seen as a direct main effect and protective resilience as a moderating effect.Methods: This was a cross-sectional study of Syrian youth recently resettled in Norway, aged 13–24 years. Regression and moderation analyses were used to explore different interactions, including moderated mediation using the PROCESS macro for SPSS.Result: A direct main effect of promotive resilience was found for health-related quality of life (HRQoL) and general mental distress, but not for post-traumatic stress disorder (PTSD). No moderating effects of protective resilience were found. Post-migration stressors mediated the effects of potentially traumatic events (PTE) from war and flight, and this indirect effect was present at all levels of resilience.Conclusion: Despite high risk exposure and mental distress, resilience was also high. Broad resilience interventions targeting multiple factors would likely benefit the group, but these should include both individual assets and building supportive environments. Additionally, reducing current stress and providing treatment for those in need could enable recovery and increase the efficacy of resilience factors already present.

Neural networks associated with quality of life in patients with Parkinson's disease

IntroductionThe neural underpinnings of health-related quality of life in Parkinson's disease remain unclear. This study was conducted to unravel which motor and non-motor symptoms in Parkinson's disease influence health-related quality of life and reveal neural networks most likely linked to it. MethodsComprehensive clinical assessments were conducted for 247 Parkinson's disease patients and image analyses were performed for 181 patients. Clinical scores commonly used to assess various symptoms related to health-related quality of life were investigated. Factor and resting-state functional magnetic resonance imaging analyses were reviewed to reveal health-related quality of life-associated brain networks. ResultsThe Spearman's rank correlation coefficient for the Parkinson's disease Questionnaire-39 summary index was high in the Activities-specific Balance Confidence Scale, Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part 2, Freezing of Gait Questionnaire, and Self-reported Autonomic Symptoms in Parkinson's disease. Multiple regression and Random Forest regression analyses indicated that health-related quality of life-associated factors were Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part 1, Depression Rating Scales, and the above-mentioned scales. The resting-state functional magnetic resonance imaging analysis revealed decreased functional connectivity between the anterior cingulate cortex and right temporo-parietal junction as health-related quality of life worsened. ConclusionFear of falling, daily living activities, gait freezing, and autonomic dysfunction have notable effects on health-related quality of life in Parkinson's disease. Brain networks consisting of the anterior cingulate cortex and temporo-parietal junction may be associated with the emotion-related and social factors of health-related quality of life in Parkinson's disease.

Health-related quality of life in refugee youth and the mediating role of mental distress and post-migration stressors

PurposeThe aim of this study is to explore how potentially traumatic events (PTEs) from war and flight influence health-related quality of life (HRQoL) in young refugees after recent resettlement. In a model based on earlier theory, we tested if post-migration stressors and mental distress mediated the effect of PTEs on HRQoL, individually and in serial. We also explored how different types of post-migration stressors influenced different dimensions of HRQoL.MethodsThis study used a cross-sectional design where 160 Syrian youth recently resettled in Norway completed questionnaires at school between May and December 2018. Correlations between types of post-migration stressors and dimensions of HRQoL were explored and a serial multiple mediator model was tested. Models were adjusted for age and gender, using two types of mental distress; post-traumatic stress disorder (PTSD) and general mental distress.ResultsHigher levels of PTEs reduced experienced HRQoL, but this direct effect was mediated by post-migration stressors alone and in serial with mental distress. Despite high levels of mental distress, this did not affect HRQoL independently, only in serial mediation with increased post-migration stressors. Economic concerns and discrimination were types of post-migration stressors affecting several dimensions of HRQoL.ConclusionQuality of life in refugee is affected by past events from war, stressors in current resettlement and elevated mental distress through complex interrelations. The study reiterates the importance of considering structural and everyday post-migration stressors in policy and intervention to improve the health and wellbeing of refugee youth.

Factors Influencing Health related Quality of Life in Older Women with Low Muscle Strength in Korea: The Convergence Study Using 7 th KNHANES

Factors Influencing Health related Quality of Life in Older Women with Low Muscle Strength in Korea: The Convergence Study Using 7 th KNHANES

Patient reported outcomes and quality of life in Chinese patients with implantable cardioverter defibrillators✰

ObjectivesPatient reported outcomes in Implantable Cardioverter Defibrillator (ICD) patients can describe the experience of living with heart disease and with an ICD. However, very little is known about patient outcomes among Chinese patients which may limit effective patient discussions and interventions for these patients. The purposes of this study were to examine device related experiences (e.g., device acceptance, shock anxiety) in Chinese ICD patients and identify potential variables that influence health related quality of life (HRQOL) and to compare HRQOL outcomes to healthy and heart failure populations. MethodsThis study used a cross-sectional research design with serially recruited ICD patients (N = 100) from clinics in China. Participants completed surveys including: the 12-Item Short-Form Health Survey Questionnaire (SF-12), Florida Patient Acceptance Survey (FPAS), Florida Shock Anxiety Scale (FSAS), Type D Scale (DS-14), and general information questionnaire. ResultsParticipants were 100 ICD patients in China with a mean age of 53.32(SD = 13.70). The mean scores of the SF-12 physical component summary (PCS) and mental component summary (MCS)of ICD patients (43.55 and 47.07, respectively) were lower than the Chinese general population (P<0.001) and general health, social functioning, and role emotional scores were lower than chronic heart failure patients (P<0.001). Multiple linear regression analysis indicated that LVEF, positive shock history, age and shock anxiety were significant predictors of physical function and accounted for 24.5% of the adjusted variance. Type D personality, shock history, and shock anxiety were predictors of the mental health component and accounted for 25.9% of the variance. Shock history, age, type D personality, and shock anxiety significantly predicted device acceptance (FPAS-Total) and accounted for 32% of variance. ConclusionsICD patients reported health outcomes were generally lower than the Chinese general population and patients with heart failure in relation to general health, social functioning, and role emotional. Both generic and disease specific HRQOL were influenced by both medical and psychosocial predictors. This suggests that current Western society based comprehensive models of patient HRQOL and patient care needs may extend to Chinese patients with ICDs.

A Comparative Study of Health-related Quality of Life among Working and Non-working Married Women in an Urban area in South Goa

Background: It is believed that job is one of the most effective factors in improving a women’s quality of life. However, working women often suffer from physical as well as psychological health problems due to dual responsibilities they have to perform i.e. at workplace as well as maintaining their traditional roles at home. This pressure at workplace and house may have an influence health-related quality of a woman. Objectives: This study was conducted with the following objectives: To determine the health related quality of life among working and non working women. To compare the quality of life among working and non working women. To study certain factors associated with health related quality of life among them. Materials and Methods: This was a cross sectional study conducted among 50 working and 50 non working married women between 25 to 45 years of age, in an urban area in South Goa. Simple random sampling was used to select the households and data was collected through face to face interview and the health related quality of life was assessed using SF-36 questionnaire. Data was summarized using frequencies, percentages, means and standard deviations. Student’s T test was used to compare the quality of life scores between working and non-working women. Result: The working women had higher SF-36 scores in all the 8 categories. The mean score of general health domain in working women was 63.80±15.17 among working women compared to 50.20±10.50 among non working women (p<0.001). Similarly in the domain of role limitations due to physical health, working women had a significantly higher mean score (90.50±15.06) compared to non working women (58.67±23.69).This implied that working women had better quality of life in comparison to non working women. The lowest means were in energy/fatigue category. Conclusion: Findings of this study suggest working women to have better quality of life. This may be due to a sense of self esteem, security and independence of a working woman. How to cite this article:Vernekar SP, Shah HK. A Comparative Study of Health-related Quality of Life among Working and Non-working Married Women in an Urban area in South Goa. Int J Preven Curat Comm Med 2019; 5(3): 1-7.

Unmet needs influence health-related quality of life in people with multiple sclerosis

BackgroundPeople with MS are a heterogeneous population with varying difficulties and needs that are influenced by the individual experience of the disease, symptoms and disease course. The aim of the present study was to identify factors that influence health-related quality of life in a sample of subjects with MS, specifically health and social care-related needs and demographic and disease characteristics. MethodsIndividuals with a definite diagnosis of MS were identified through MS out-patient clinics and local branches of the Italian MS Society. The EQ-5D-3L utility index was used to describe health profiles and as an overall measure of perceived HRQoL. The number of unmet health and social care-related needs was used to describe the impact of unmet needs on HRQoL. Multiple regression analyses were performed using a hierarchical approach. ResultsData was analyzed from 1013 subjects. Overall, 83% of subjects reported at least one health or social care-related need as being unmet and subjects with a higher number of unmet needs had lower HRQoL (p < 0.001). The number of unmet needs was entered at the first step with a statistically significant effect (Cox-Snell R2 0.15, BIC 870.9, AIC 851.2). Clinical variables, included in the second step, contributed significantly to explaining the variability between models (Cox-Snell R2 0.43, BIC 481.0, AIC 446.6), and the addition of socio-demographic factors further accounted for variability (Cox-Snell R2, 0.46, BIC 461.0, AIC 402.0). ConclusionsThe study demonstrated that a higher number of both health and social care-related unmet needs predicted lower HRQoL. The health profile of the sample identified all domains of the EQ-5D-3L as being important in determining HRQoL. Data confirms that unmet needs alone are significantly related to reduced HRQoL, although the multifactorial and complex nature of MS makes it a challenge to identify the combination of aspects that fully predict variability in quality of life.

Does Smoking Status Influence Health-Related Quality of Life Outcome Measures in Patients Undergoing ACDF?

Study design:Retrospective comparative study.Objective:Whereas smoking has been shown to affect the fusion rates for patients undergoing an anterior cervical discectomy and fusion (ACDF), the relationship between smoking and health-related quality of life outcome measurements after an ACDF is less clear. The purpose of this study was to evaluate whether smoking negatively affects patient outcomes after an ACDF for cervical degenerative pathology.Methods:Patients with tumor, trauma, infection, and previous cervical spine surgery and those with less than a year of follow-up were excluded. Smoking status was assessed by self-reported smoking history. Patient outcomes, including Neck Disability Index, Short Form 12 Mental Component Score, Short Form 12 Physical Component Score (PCS-12), Visual Analogue Scale (VAS) arm pain, VAS neck pain, and pseudarthrosis rates were evaluated. Outcomes were compared between smoking groups using multiple linear and logistic regression, controlling for age, sex, and body mass index (BMI), among other factors. A P value <.05 was considered significant.Results:A total of 264 patients were included, with a mean follow-up of 19.8 months, age of 53.1 years, and BMI of 29.6 kg/m2. There were 43 current, 69 former, and 152 nonsmokers in the cohort. At baseline, nonsmokers had higher PCS-12 scores than current smokers (P = .010), lower VAS neck pain than current (P = .035) and former (P = .014) smokers, as well as lower VAS arm pain than former smokers (P = .006). Postoperatively, nonsmokers had higher PCS-12 scores than both current (P = .030) and former smokers (P = .035). Smoking status was not a significant predictor of change in patient outcome in multivariate analysis.Conclusions:Whereas nonsmokers had higher function and lower pain than former or current smokers preoperatively, smoking status overall was not found to be an independent predictor of outcome scores after ACDF. This supports the notion that smoking status alone should not deter patients from undergoing ACDF for cervical degenerative pathology.

Aging in A Changing World – the Impact of Social Contact and Physical Activity on Health-Related Quality among Older People from Austria – A Biological Perspective

Background: All over the world we are confronted with an absolute and relative increase of the portion of elderly people. In order to develop strategies to keep old aged people healthy and as long as possible independent, analyses of factors influencing health related quality of life (HRQL) during old age are necessary. The aim of this review was the presentation of the results projects focusing on the impact of social contacts and physical activity on HRQL carried out in Austria Methods: The standardized WHOQOL BREF and the Geriatric depression scale was used to estimate HRQL and prevalence of geriatric depression in Austrian elderly. Physical fitness was estimated by hand grip strength, Sarcopenia and bone loss were determined by DEXA measurements. Results: A higher number of offspring, but first of all a higher face to face contact frequency increased HRQL and reduces geriatric depression. Sarcopenia and reduced bone density which might increase the risk of frailty syndrome were significantly interrelated. Conclusions: The ongoing change of life circumstances increases psychosocial problems such as loneliness and depression among old people who no longer live embedded in their families. Childlessness and reduced contact frequency have adverse consequences for health related quality of life during old age. This is also true of reduced physical activity in daily life, which increases the risk of sarcopenia and osteoporosis and may be invalidity during old age.

Relationships between body image, sexual dysfunction, and health-related quality of life among middle-aged women: A cross-sectional study

ObjectivesTo examine whether body image, sexual function, and relationship with a partner influence health-related quality of life (HRQoL) among middle-aged women, as well as to identify the association with menopausal symptoms. Main outcome measuresPhysical component summary and mental component summary of HRQoL. MethodsThis was an analysis of 1026 women (2013–2014); data regarding demographic characteristics, sexual function, body image, relationship with partner, menopausal symptoms and HRQoL during middle age were collected. HRQoL, sexual function, body image, relationship with partner, and menopausal symptoms were measured using the Medical Outcomes Study SF-12, Female Sexual Function Index (FSFI), Multidimensional Body-Self Relations Questionnaire-Appearance Scale, the Relationship Assessment Scale, and the Greene Climacteric Scale, respectively. A multivariate regression was used to examine factors influencing HRQoL. ResultsAfter adjusting for covariates, significant factors predicting the physical component summary (PCS) of HRQoL among middle-aged women included the orgasm domain of the FSFI (β = 0.69; p = 0.023), appearance evaluation (β = 0.93; p = 0.037), and menopausal symptoms (β = −0.25; p < 0.001). The factors predicting the mental component summary (MCS) of HRQoL included the satisfaction domain of the FSFI (β = 0.70; p = 0.014), appearance evaluation (β = 2.09; p < 0.001), self-classified weight (β = 1.21; p < 0.001), relationship with partner (β = 0.16; p = 0.034), and menopausal symptoms (β = −0.36; p < 0.001). ConclusionThe results indicated that negative appearance evaluation and menopausal symptoms predicted poor HRQoL among middle-aged women. Higher frequency of orgasm predicted better PCS; sexual satisfaction and satisfaction with relationship with a partner predicted better MCS of HRQoL.

Long-term Benefit of Unilateral Cochlear Implantation on Quality of Life and Speech Perception in Bilaterally Deafened Patients.

Cochlear implantation (CI) is a common treatment modality for unilaterally and bilaterally deafened patients as well as patients with severe to profound hearing loss. The aim of our study is the complex evaluation of the improvement and influence of health related quality of life (HRQoL) and auditory performance in cochlear implant patients during a long-term follow-up. Sixty-one bilaterally, postlingually deafened patients with unilateral CI were included in this prospective study. Assessment tools for auditory performance and HRQoL included the Freiburg Monosyllabic Speech test, Oldenburg Inventory (OI) questionnaire, Nijmegen Cochlear Implant Questionnaire (NCIQ) and 36-item Short Form Survey (SF-36). Data were collected before CI, at 6, 12, and 24 months postoperatively. The assessment tools for speech perception yielded a statistically significant improvement in the Freiburg Monosyllabic Speech test scores and of all subdomain scores of the OI during the 6-month follow-up period. The subdomain scores of the NCIQ and the psychological score of the SF-36 also improved significantly during this follow-up period. All results remained stable thereafter during the 12- and 24-month follow-up. There was a statistically significant correlation between subjective speech perception and HRQoL after CI. This is the first prospective study to show results in regard to speech perception and HRQoL and their correlation during a 2-year follow-up after unilateral CI in bilaterally deafened patients. Our results for speech perception and HRQoL showed a significant improvement during the 6-month follow-up that remained stable thereafter during a 24-month follow-up, even after finishing the hearing rehabilitation program.

Factors Influencing Health related Quality of Life in Patients with Major Depression

Factors Influencing Health related Quality of Life in Patients with Major Depression

Health-related quality of life in adult heart-transplant recipients-asystematic review.

Health-related quality of life is amultidimensional concept to assess the impact of medical interventions from an individual perspective. This concept is important to evaluate benefits of heart transplantation. This systematic review was conducted to determine (1)posttransplant health-related quality of life in heart transplantation patients and (2)influencing factors of health-related quality of life. Asystematic review of cross-sectional, prospective and mixed methods studies published from November 2007 to November 2017 was conducted on PsycINFO, PSYNDEX and PubMed using acombination of the keywords heart transplantation, heart transplantation patient, quality of life, and health-related quality of life. A total of 14studies with across-sectional design, 6studies with aprospective design and 2mixed-methods studies were identified. The stability of health-related quality of life up to 10years after transplantation has been reported. Most often generic scales, such as SF-36(8) and WHOQoL-BREF(7) were used for data collection. Demoralization, depression, pain, gastrointestinal symptoms, sexual dysfunction, and poor oral health influence health-related quality of life negatively, whereas social and family support have apositive impact. Although health-related quality of life is positively influenced by transplantation, further research regarding gender differences is needed. Disease-specific scales were rarely used.

The influence of preoperative determinants on quality of life, functioning and pain after total knee and hip replacement: a pooled analysis of Dutch cohorts

BackgroundPrevious research has identified preoperative determinants that predict health related quality of life (HRQoL), functioning and pain after total knee or hip arthroplasty (TKA/THA), but these differed between studies and had opposite directions. This may be due to lack of power and not adjusting for confounders. The present study aims to identify the preoperative determinants that influence health related quality of life (HRQoL), functioning and pain after total knee or hip arthroplasty (TKA/THA).MethodsWe pooled individual patient from 20 cohorts with OA patients data (n = 1783 TKA and n = 2400 THA) in the Netherlands. We examined the influence of age, gender, BMI and preoperative values of HRQoL, functioning and pain on postoperative status and total improvement. Linear mixed models were used to estimate the effect of each preoperative variable on a particular outcome for each cohort separately. These effects were pooled across cohorts using a random effects model.ResultsFor each increase in preoperative point in HRQoL, the postoperative HRQoL increased by 0.51 points in TKA and 0.37 points in THA (SF-36 scale). Similarly, each point increase in preoperative functioning, resulted in a higher postoperative functioning of 0.31 (TKA) and 0.21 (THA) points (KOOS/HOOS-ADL scale). For pain this was 0.18 (TKA) and 0.15 (THA) points higher (KOOS/HOOS-pain scale) (higher means less pain). Even though patients with better preoperative values achieved better postoperative outcomes, their improvement was smaller. Women and patients with a higher BMI had more pain after a TKA and THA. Higher age and higher BMI was associated with lower postoperative HRQoL and functioning and more pain after a THA.ConclusionsPatients with a better preoperative health status have better outcomes, but less improvement. Even though the independent effects may seem small, combined results of preoperative variables may result in larger effects on postoperative outcomes.

Does ancestry influence health-related quality of life in type 1 diabetes patients? A nationwide study in Brazil.

The aim of the present study was to evaluate the relationship between self-reported color/race and genomic ancestry with HRQoL of patients with type 1 diabetes in a highly admixed population. This was a nationwide, cross-sectional study conducted with 1760 patients with type 1 diabetes from 2011 to 2014 at public clinics in all five Brazilian geographical regions. Information on HRQoL was obtained from two self-completed questionnaires: Short Form-6 Dimensions (SF-6D) and EuroQol-5 Dimensions (EQ-5D) with a visual analogue scale (EQ-VAS). Genomic ancestry was assessed using a Multiplex PCR methodology. Utility scores generated from the questionnaires were analyzed with multivariate logistic regression models. We included 1698 patients. Those patients who self-reported as black had lower EQ-VAS scores compared to the patients who self-reported as white (67.46±18.45; 72.37±16.44, respectively, p=0.02). In a linear regression model, each 1% increase in African ancestry resulted in a 9.5 point decrease in EQ-VAS score (p<0.001). In a multivariate logistic regression, after adjusting for demographic, socioeconomic status and diabetes-related variables, African ancestry remained associated with lower EQ-VAS scores. A higher level of African ancestry implicates on lower quality of life even after adjustments for sociodemographic and diabetes-related data. Gender, physical activity and diabetes-related microvascular complications were strongly associated with low HRQoL in all three questionnaires used. This fact highlights the importance of social aspects when assessing quality of life, as well as the need for regular practice of physical activity and prevention of chronic complications to improve patients' quality of life.

It's more than dryness and fatigue: The patient perspective on health-related quality of life in Primary Sjögren's Syndrome - A qualitative study.

ObjectivesIn Primary Sjögren’s Syndrome (PSS), there is an apparent lack of data concerning the perspectives of patients, their needs, preferences and difficulties of daily life. This qualitative study was conducted to explore perspectives and needs of patients with PSS that influence health related quality of life (HRQL).MethodsWe recruited 20 PSS patients fulfilling the American-European consensus classification criteria out of the PSS cohort of the Medical University Graz, Austria. In total, 6 focus group sessions (with three to four patients per group) were performed. A modified meaning condensation procedure was used to analyse the data.ResultsThe interview analysis resulted in 484 meaning units, 254 subconcepts and 86 concepts. The identified concepts were grouped into three dimensions: physical dimension, psychological & emotional challenges and social life & daily living. A dependency between the three categories was identified.The concepts most commonly reported by patients were related to the physical dimension: pain and dryness as well as complaints associated with/provoked by these symptoms. Patients also reported shortness of breath, fatigue und constipation.ConclusionsThis qualitative study underpins that HRQL in PSS patients is affected by several factors. The problems are not limited to dryness, pain and fatigue while the complaints secondary to these symptoms are important to patients with PSS significantly affecting physical, psychological and social life components of HRQL. A disease-specific patient related outcome measures for clinical practice and trials should be developed considering the different aspects of HRQL in PSS.

Understanding Children’s Physical Activity and Health-Related Quality of Life: An Expectancy-Value Approach

This review paper explores the motivational processes in physical education related to physical activity and health-related quality of life among children and adolescents. First, we review the existing body of literature relating to children’s health-related quality of life. Next, we present the expectancy-value model of achievement choice as a framework for investigating how children’s motivation in physical activity settings interacts with physical activity and health-related quality of life. In the following section, we discuss social-contextual factors within the motivational climate, and how they can enhance or constrain decisions to be physically active and influence health-related quality of life. We conclude by identifying emerging research issues, implications for practice, and suggestions for future research directions.

Does Race Influence Health-related Quality of Life and Toxicity Following Proton Therapy for Prostate Cancer?

Objective:This matched-paired analysis explores disparities in health-related quality of life (QOL) and common toxicities between African American (AA) and white patients following proton therapy for prostate cancer at our institution.Materials and Methods:A total of 1536 men with clinically localized prostate cancer were treated from 2006 to 2009 with definitive proton therapy to a median dose of 78 Gy +/− androgen deprivation therapy. A cohort of 92 consecutively treated AA men was matched to a cohort of 92 white men on the basis of National Comprehensive Cancer Network risk category and age. The 2 groups were compared with regard to comorbidities, demographics, and treatment regimen. Differences in genitourinary and gastrointestinal (GI) toxicity according to the Common Terminology Criteria for Adverse Events scale and QOL data from the Expanded Prostate Index Composite 26-question questionnaire were reported.Results:Median follow-up was 2.1 years. Baseline patient and treatment characteristics were similar between the 2 groups with the exception of prostate-specific antigen ≥10 (32% for AAs vs. 20% for whites; P=0.068) and use of androgen deprivation therapy (26% for AAs vs. 21% for whites; P=0.38). No difference in Expanded Prostate Index Composite 26-question sexual summary, urinary incontinence, urinary obstruction, or bowel summary scores was detected between the 2 groups, nor was there a difference in grade 2 or higher GI toxicity (P=0.45). AAs had a statistically nonsignificant higher absolute incidence of late grade 3 genitourinary toxicity (4.4% vs. 0%; P=0.12).Conclusions:After 2 years, there were no disparities in health-related QOL, physician-reported Common Terminology Criteria for Adverse Events GI toxicity, or biochemical relapse. Longer follow-up is needed to confirm these findings.

고혈압 환자의 건강관련 삶의 질에 영향을 미치는 요인: 제5기 국민건강영양조사를 이용하여

고혈압 환자의 증가와 함께 건강관련 삶의 질 향상을 위한 노력이 이루어지고 있다. 따라서 건강관련 삶의 질에 영향을 미치는 요인을 확인하는 것은 고혈압 환자의 건강증진을 위한 전략을 제시하는데 주요한 근거가 된다. 본 연구는 고혈압 환자의 건강관련 삶의 질에 영향을 미치는 요인을 건강관련 삶의 질 수준에 따라 파악하고자 2차자료 분석을 수행하였다. 본 연구의 대상은 고혈압으로 의사에게 진단받은 1,240명의 고혈압 환자이며, 자료분석은 SPSS 23.0 및 STATA 13.0 프로그램을 이용하여 기술통계, 다중회귀분석, 분위회귀분석을 실시하였다. 다중회귀분석 결과에서는 활동제한, 우울감, 주관적 건강상태가 포괄적인 건강 상태를 나타내는 건강관련 삶의 질에 유의하게 영향을 미쳤다. 그러나 분위회귀분석 결과에서는 건강관련 삶의 질 수준이 낮은 고혈압 환자 그룹과 건강관련 삶의 질이 높은 고혈압 환자 그룹에서 건강관련 삶의 질에 영향을 미치는 요인이 상이한 것으로 나타났다. 우울감과 주관적 건강상태는 건강관련 삶의 질 상위 60%까지 유의한 영향요인으로 나타났고, 평소 인지된 스트레스와 3일 이상의 규칙적 운동은 건강관련 삶의 질 하위 20%에서 유의한 영향요인으로 나타났다. 현재 음주상태는 건강관련 삶의 질 하위 20%와 상위 80%에서 유의한 영향요인으로 나타났다. 이러한 연구결과는 고혈압 환자의 건강관련 삶의 질 수준별 건강 행태 개선을 위한 맞춤형 건강중재 계획에 실제적인 근거가 될 것이다. Purpose: The purpose of this study was to examine factors influencing health related quality of life(HRQOL) in patients with hypertension. Methods: This study carried out secondary analysis using the data from the <TEX>$5^{th}$</TEX> Korean National Health and Nutrition Examination Survey. Subject samples who were selected are 1,240 hypertension patients. The data were analyzed by using descriptive statistics, traditional classic regression, and quantile regression. Results: Restriction of activity, depressive mood, and subjective health status had only significant effects on HRQOL(p<.001). After quantile regression, depressive mood and subjective health status had only significant at 20%(p<.001), 40%(p<.001), and 60%(p<.01) of HRQOL. Perceived stress(p<.001) and regular exercise(p<.01) had only significant at 20% of HRQOL. Current drinking status had only significant at 20%(p<.001) and 80%(p<.01) of HRQOL. Conclusions: Quantile regression maybe a better statistical tool in understanding the heterogeneous effect of hypertension patient's HRQOL as health outcome. Therefore interventions are needed for patients with hypertension to manage each of the factors affecting the patient's perceived health status by each quantile.