Health-related Quality Of Life Levels Research Articles

The use of youth healthcare services and its association with health-related quality of life, physical and mental health and over-the-counter analgesics use in 13–19-year-old adolescents: a cross-sectional study

BackgroundYouth healthcare services in Norway include a public health nurse (PHN) at school and local youth health centres (YHCs). They provide health services for all adolescents free of charge, focusing on health promotion and disease prevention. The present study aimed to assess possible associations between health-related quality of life (HRQoL), physical and mental health, over-the-counter analgesics (OTCA) use and use of youth healthcare services among 13–19-year-old adolescents.MethodsThis study was based on national, cross-sectional data from the Ungdata Survey conducted in 2022. The sample was comprised of 16 482 adolescents. Multiple logistic regression was used to analyse the associations between HRQoL, headaches, selected physical symptoms, psychological distress, use of OTCA, PHN availability, sociodemographic variables, and use of the PHN at school or at a YHC. The KIDSCREEN-10 was used to measure HRQoL, and the Hopkins Symptoms Checklist 10 was used to measure symptoms of psychological distress.ResultsGirls used the youth healthcare services more frequently than boys. Better HRQoL was significantly associated with fewer visits to the PHN at school. Girls reported lower HRQoL and mental health, and more pain and frequent OTCA use than boys. When having symptoms of psychological distress, boys had greater odds of visiting the PHN at school than girls. For girls in senior high school, headaches and OTCA use were strongly associated with visiting the PHN at school and the YHC. In senior high school, boys with an immigration background had greater odds of visiting the YHC than native Norwegian boys, while girls with an immigration background were less likely to visit the YHC than native Norwegian girls.ConclusionsOur results show that more girls than boys use youth healthcare services. When adolescents experience pain, have mental problems, use OTCA, or report low levels of HRQoL, they have greater odds of using youth healthcare services. Youth healthcare services offer excellent opportunities to support and follow up with adolescents. The findings provide important insights into youth healthcare services used by adolescents for various stakeholders, including PHNs and policy makers, with potential implications for future public health efforts.

Health-Related Quality of Life in Adolescents during Quarantines Due to COVID-19 Pandemic: The Effect of Physical Activity and Gender

Given that deterioration of adolescents’ health status during pandemic is well documented, health related quality of life (HRQoL) assessment is very important, as it contributes in adolescents’ development and maturation into healthy adults. The main purpose of the study was to assess adolescents’ HRQoL during the two strict lockdowns due to COVID-19. Secondary aims were to examine differences in HRQoL with regard to gender, and physical activity/sport participation before and during lockdowns. It was a cross-sectional study and conducted during first and second strict lockdowns. Three hundred and sixty-three adolescents (Ν=363) from secondary schools, in the Greek territory (108 boys and 255 girls) filled in the TNO-AZL Questionnaire for Children’s Health-Related Quality of Life Children’s Form, online, once. Also, demographic and anthropometric data were collected. For all TACQOL-CF subscales results showed that scores were lower, than the maximum subscales scores. Also, adolescents’ responses to open questions supported further the low subscales scores. In addition, adolescents who participated in sport before lockdowns reported better scores in motor functioning/performance during lockdowns than their non-physically active peers (p<0.05). Moreover, girls reported significantly lower scores compared to boys in general physical functioning/complaints subscale (p<0.05). The findings of this study highlighted that during the two strict quarantines adolescents’ HRQoL was deteriorated. Sport participation before the pandemic influenced positive HRQoL during quarantines and also quarantines affected differently adolescents by gender. Thus, the results should give information in adopting preventive strategies by policy makers to alleviate long-term negative consequences, in order adolescents to gain pre-pandemic HRQoL levels, in the transitional post-COVID-19 era.

Trends and regional distribution in health-related quality of life across sex and employment status: a repeated population-based cross-sectional study.

This study investigated the association between sex and health-related quality of life (HRQoL) based on employment status. This was a population-based cross-sectional study. Data were collected from 1 996 153 adults aged ≥19years who participated in the Korea Community Health Survey from 2011 to 2019. Low HRQoL was classified based on separate cutoff points (males: 0.92, females: 0.90) on the European Quality of Life-5 Dimensions index. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) and 95% CIs. From 2011 to 2019, the trend of the prevalence of low HRQoL levels was consistently high in the order of unemployed males, unemployed females, employed males, and employed females. Regarding the regional distribution of unemployed males, the prevalence of low HRQoL was 29.5% to 43.5%. Unemployed males had a higher prevalence of low HRQoL (OR: 1.15; 95% CI: 1.12-1.24) than employed males. This study suggests that the prevalence of low HRQoL levels among unemployed males was consistently high at the annual trend and regional levels. Further research considering comprehensive health determinants and multidimensional public health interventions is required to prevent deterioration of HRQoL during unemployment.

A153: The Relationships Between Physical Activity and Health-Related Quality of Life in Parent-Child Dyads with ASD

Purpose: Researchers have found that the core and combined symptoms of autism spectrum disorder (ASD) negatively influence the health-related quality of life (HRQoL) of autistic children and their parents. Although it is supported that participation in physical activity (PA) can enhance the HRQoL and well-being in general, few studies have addressed the relationship between HRQoL with PA in the population with ASD. This study examines how much leisure-time physical activity participation is correlated to HRQoL in parent-child dyads with ASD. Method: Participants were recruited from two Rehabilitation Centers for neurodevelopmental disability children. Eighty-five ASD children and their parents participated in this study. HRQoL for ASD children and their parents was measured with the World Health Organization Quality of Life short form (WHOQoL-26) and the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0, parent-report version) respectively, while leisure-time PA participation of both children and parents was assessed using the Godin Leisure-Time Exercise Questionnaire (GLTEQ). We first confirmed the psychometrics of the WHOQoL-26 and PedQL 4.0 and then analyzed the relationships between different levels of PA and HRQoL in dyads. Results: Descriptive statistics showed that 30.6% of ASD children (Mage=5.25±1.48; 85.9% boys) and 42.4% of their parents (75.3% between 31-40 years; 73 mothers and 12 fathers) were insufficiently active. For parents of children with ASD, the physical domain of HRQoL had a small positive correlation with light PA (r=0.27, p=0.013) while the psychology domain had a small to moderate positive correlation with moderate (r= 0.23, p=0.04), light (r=0.3, p=0.006), and total (r=0.23, p=0.032) PA. Also, the environment domain of HRQoL had a small positive correlation with moderate (r=0.28, p=0.011) and light (r=0.32, p=0.003) PA. Concerning ASD children, the physical domain of HRQoL had a small to moderate positive correlation with moderate (r= 0.24, p= 0.027) and total (r= 0.32, p= 0.004) PA. Furthermore, there were several interrelationships between parent-child dyads’ PA and parent-child dyads’ HRQoL. ASD children’s social domain in HRQoL was correlated to their parents’ light PA (r=0.25, p=0.021) whereas parents’ environment domain was correlated to their children’s mild PA (r=0.24, p=0.03). Conclusion: There are significant relationships between PA and HRQoL for both children with ASD and their parents. Particularly, the parent-child dyads’ HRQoL may benefit from each other’s leisure-time PA involvement. Due to ASD children’s restricted daily PA norm and their parent’s challenging caregiving environment, the designation of effective PA enhancement strategies may enhance the quality of life in both children with ASD and their parents.

Psychological factors and biochemical indicators influencing sleep disturbance of patients with primary biliary cholangitis in China: a cross-sectional survey analysis.

The impact of primary biliary cholangitis (PBC) on sleep disturbance is relevant to treatment decision-making processes. Studies on sleep disturbance in Chinese patients with PBC are still lacking. We analyzed and compared the health-related quality of life (HRQoL) of 107 PBC patients by using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire 9 (PHQ-9), Short Form (36) Health Survey Questionnaire (SF-36), Fatigue Visual Analog Scale (F-VAS). Patients' biochemical markers were also collected for correlation analysis with HRQoL. Receiver operating characteristic (ROC) curves and area under the curve (AUCs) were used to determine the diagnostic performance of PSQI, GAD-7, and biochemical markers for assessing the impaired liver function (Child-Pugh B-C) of PBC diagnosis. Sixty-two (57.9%) PBC patients suffered from poor sleep quality (PSQI >5). The global PSQI score was positively correlated with GAD-7 (r = 0.561, p < 0.001), and PHQ-9 scores (r = 0.652, p < 0.001). There was a negative correlation (r = -0.216, p = 0.025) between sleep quality and red blood cell (RBC) count. PBC patients with poor sleep quality had significantly higher GAD-7 scores (5 vs. 0, p < 0.001), PHQ-9 scores (5.5 vs. 0, p < 0.001), and lower albumin levels (39.6 vs. 37.6 g/L, p = 0.040) than those with good sleep quality. Based on the SF-36 scores, PBC patients with poor sleep quality had lower physical functioning scores (85 vs. 80, p = 0.022), role physical scores (100 vs. 75, p = 0.007), and worse mental health (60 vs. 56, p = 0.002) than those with good sleep quality. ROC analyses showed that the AUC and optimal cut-off values of the combination of PSQI, GAD-7, and RBC for assessing the impaired liver function in PBC diagnosis were 0.771 and 0.193, respectively. The sleep disturbance was strongly correlated with the severity of anxiety, depression, and RBC count in PBC patients. Meanwhile, PBC patients with poor sleep had poor HRQoL and lower albumin levels. It is feasible to use the combination of PSQI, GAD-7, and RBC for initial screening of the impaired liver function in PBC. Besides routine blood biochemical and imaging indicators, evaluating mental health-related indicators in PBC patients is imperative.

Efficacy and safety of thermobalancing therapy with Dr Allen's Device for chronic low back pain: A randomised controlled trial.

Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients' health-related quality of life (HRQoL). Although empirical evidence has demonstrated that novel Thermobalancing therapy and Dr Allen's Device can relieve chronic low back pain, there have been no randomised controlled trials for these indications. To evaluate the efficacy of Dr Allen's Device in lumbar disc herniation (LDH) and non-specific low back pain (NSLBP). A randomised clinical trial was conducted investigating 55 patients with chronic low back pain due to LDH (n = 28) or NSLBP (n = 27), out of which 15 were randomly assigned to the control group and 40 were assigned to the treatment group. The intervention was treatment with Dr Allen's Device for 3 mo. Changes in HRQoL were assessed using the Numerical Pain Rating Scale and the Japanese Orthopedic Association Back Pain Questionnaire. Thermobalancing therapy with Dr Allen's Device showed a significant reduction in pain in the treatment group (P < 0.001), with no recorded adverse effects. Both pain assessment scales showed a significant improvement in patients' perception of pain indicating improvement in HRQoL. The out-of-hospital use of Thermobalancing therapy with Dr Allen's Device for Low Back Treatment relieves chronic low back pain significantly and without adverse effects, improves the level of activity and HRQoL among patients with LDH and NSLBP. This study demonstrates the importance of this safe first-line therapy that can be used for effective at-home management of chronic low back pain.

Should we correct hypospadias during childhood? Decision Regret And QUality of Life Assessment (DRAQULA) study

To evaluate patient's satisfaction, Decision Regret And QUality of Life Assessment (DRAQULA) among adolescents (older than 15 years) and adults after hypospadias surgery in childhood. 234 Patients operated on hypospadias as children in our center and their parents were contacted after they reached the age of 15 years to complete a questionnaire survey to assess satisfaction with the operative result, the regret with the operative decision and the health related quality of life (HRQOL). The survey is based on the Decision Regret Scale available in the literature with a score of 100 meaning maximum dissatisfaction or regret, and on the Kidscreen10 index. Satisfaction was measured on a scale from 1 to 5 with 5 signifying full satisfaction. 81 of 234 patients from 15 to 43 years (mean age 19.7 years) completed the survey (34.6%). 44 Patients had distal, and 17 proximal hypospadias and the remaining 20 patients could not remember the type of hypospadias they had. The patient's satisfaction with the operative result was 5 (full satisfaction) in 74.1%, 4 in 18.5%, 3 in 6.2% and 2 in 1.2% (mean satisfaction score 4.7 of 5). Regarding decision regret among patients, 64/81 patients (79.0%) had no decision regret. Only 14.8% reported mild and 6.2% moderate decisional regret (mean decisional regret score 4.8). 71 of 234 parents answered the parents' questionnaire (30.0%). Fifty-eight (81.7%) had no decision regret. 13 parents (18.3%) had decision regret; 10 parents (14.1%) reported mild, 2 parents (2.8%) moderate, and only one parent (1.4%) reported strong decisional regret. The mean HRQOL T-score was 55.9 (SD 10, control Group of adolescent males from 12 to 18 years.) and thus corresponded to the average of the reference normal population. In this study, only 19.7% had decision regret as compared to 50-65% reported in literature. The decision regret scale of O'Connor needs to be revalidated as even candidates who approve of the decision of early surgery have a score less than 25 and considered to have decision regret. The results of the survey showed that 90% of the patients were satisfied with early hypospadias surgery with average HRQOL and low level of decisional regret in patients as well as parents. The findings support the current practice of operating hypospadias in early childhood.

UnitedStates Value Set for the Functional Assessment of Cancer Therapy-General Eight Dimensions (FACT-8D), a Cancer-Specific Preference-Based Quality of Life Instrument.

To develop a value set reflecting the United States (US) general population's preferences for health states described by the Functional Assessment of Cancer Therapy (FACT) eight-dimensions preference-based multi-attribute utility instrument (FACT-8D), derived from the FACT-General cancer-specific health-related quality-of-life (HRQL) questionnaire. A US online panel was quota-sampled to achieve a general population sample representative by sex, age (≥ 18 years), race and ethnicity. A discrete choice experiment (DCE) was used to value health states. The valuation task involved choosing between pairs of health states (choice-sets) described by varying levels of the FACT-8D HRQL dimensions and survival (life-years). The DCE included 100 choice-sets; each respondent was randomly allocated 16 choice-sets. Data were analysed using conditional logit regression parameterized to fit the quality-adjusted life-year framework, weighted for sociodemographic variables that were non-representative of the US general population. Preference weights were calculated as the ratio of HRQL-level coefficients to the survival coefficient. 2562 panel members opted in, 2462 (96%) completed at least one choice-set and 2357 (92%) completed 16 choice-sets. Pain and nausea were associated with the largest utility weights, work and sleep had more moderate utility weights, and sadness, worry and support had the smallest utility weights. Within dimensions, more severe HRQL levels were generally associated with larger weights. A preference-weighting algorithm to estimate US utilities from responses to the FACT-General questionnaire was generated. The worst health state's value was -0.33. This value set provides US population utilities for health states defined by the FACT-8D for use in evaluating oncology treatments.

Health-Related Quality of Life in Patients with Primary Adrenal Insufficiency

(1) Background: Patients with primary adrenal insufficiency (PAI) suffer from a reduced quality of life. However, clinical factors associated with this impairment remain unclear. The aim of this study was to assess the health-related quality of life (HRQoL) and to evaluate the associations with clinical and hormonal parameters in a group of patients with PAI. (2) Methods: The study included 32 patients with autoimmune PAI, who answered the quality of life in Addison’s disease questionnaire (AddiQoL). Clinical data and hormonal measurements were collected from the patients. (3) Results: The total AddiQoL score of males was significantly higher than that of females (p = 0.011). Furthermore, males reached significantly higher scores in each of the four subscales (fatigue—p = 0.013, emotional sphere—p = 0.048, adrenal insufficiency symptoms—p = 0.039, and miscellaneous questions—p = 0.034). There was a negative correlation between HRQoL and gonadotropin levels (FSH and fatigue r = (−)0.38, p = 0.032; FSH and emotional sphere r = (−)0.416, p = 0.018). This study found no significant associations between AddiQoL scores and the presence of autoimmune comorbidities; only fatigue scores were worse in the presence of autoimmune thyroiditis (p = 0.034). The doses of hydrocortisone and fludrocortisone in the replacement therapy were not associated with AddiQoL scores. AddiQoL scores correlated negatively with the age of diagnosis (p = 0.015). (4) Conclusions: Female sex, higher gonadotropins level, and older age at diagnosis were associated with impaired HRQoL in the studied group of patients with PAI.

Steps per day and health-related quality of life in schoolchildren: the mediator role of cardiorespiratory fitness.

To analyse the relationship between steps per day and health-related quality of life (HRQoL) and cardiorespiratory fitness (CRF) and to examine whether the relationship between steps per day and HRQoL is mediated by CRF in schoolchildren. This was a cross-sectional study including 501 schoolchildren (aged 9-12years, 47% girls), from Cuenca, Spain. Steps per day were measured using the Xiaomi Mi Band 3 Smart Bracelet, HRQoL was estimated by the KIDSCREEN-27 questionnaire, and CRF was assessed using the 20-m shuttle run test. Analysis of covariance and multivariate analysis of covariance models showed that children with a higher mean number of steps per day (> 9000 steps/day) had better HRQoL (global score, and physical and psychological well-being) and higher CRF levels than their peers with a lower number of steps per day (p < 0.05); however, these differences were no longer significant when controlling for sex, age, mother's education level, and CRF (p > 0.05). Linear regression models estimated that each 1000-step increment was associated with better CRF (β = 0.350; 95% CI, 0.192 to 0.508). In addition, the relationship between steps per day and HRQoL was mediated by CRF (p < 0.05). Conclusion: Steps per day are a good metric to estimate daily physical activity because of its positive relationship with CRF. Moreover, those children taking more than 9000 steps per day are associated with higher levels of physical and psychological well-being. Finally, a substantial part of the improvement in HRQoL achieved through the increase in physical activity (steps per day) is mediated by CRF. What is Known: • Physical activity is known to have a positive impact on health-related quality of life in children.Steps per day are commonly used as a measure of physical activity. • Cardiorespiratory fitness is a recognized indicator of overall health in youth. What is New: • Increments of steps per day were associated with better CRF, with a nonlinear association after approximately 9000 steps/day. • Schoolchildren with > 9000 steps/ day showed better HRQoL.

Global perceived improvement and health-related quality of life after physical therapy in Lebanese patients with chronic non-specific low back pain.

The effectiveness of physical therapy (PT) in patients with chronic non-specific low back pain (CNSLBP) is mainly evaluated through pain, disability, and health-related quality of life (HRQOL). However, recent studies have recommended the consideration of improvement from patients' perspectives. This study aimed to investigate the relationship between the global perception of improvement in Lebanese patients with CNSLBP who have undergone PT, the HRQOL levels, as well as pain intensity. 132 patients with CNSLBP who have undergone PT completed a questionnaire consisting of sociodemographic and CNSLBP characteristics questions, pain intensity numeric scale (NRS), 12-Item Short-Form Health Survey (SF-12), and the Global Perceived Effect scale (GPE). Binary logistic regressions and Pearson correlation coefficient were used for analyses. Global perceived improvement of PT varies according to HRQOL levels. A significant correlation was found between pain intensity after PT, perceived improvement from PT, and HRQOL. Educational level and pain irradiation have been shown to be predictive factors of perceived improvement after PT. Pain and HRQOL are interrelated and contributed to elucidating the global perception of improvement after PT in patients with CNSLBP. The findings suggest that patients' global perception of improvement should be considered in evaluating the benefits of physical therapy in addition to pain and HRQOL.

Abstract 13732: A Mobile Intervention to Support Self-Care of Patients With Coronary Artery Disease: Preliminary Analysis of a Randomized Controlled Trial

Background: Although cardiac rehabilitation is beneficial to all patients with coronary artery disease (CAD), due to the cost implications, such services are confined to those with an acute coronary event or heart failure exacerbation, which limits their accessibility and scalability. Hypothesis: Patients with CAD who receive the internet-based CArdiac Rehabilitation Enhancement (i-CARE) intervention would report better changes in self-care, functional status, health-related quality of life (HRQoL) and physiological biomarkers than those who receive usual care. Aims: This randomized controlled trial aimed to examine the effects of the i-CARE intervention on self-care behaviors, functional status, HRQoL, blood pressure, waist-to-height ratio and cholesterol level in patients with CAD. Methods: CAD patients were recruited in the cardiac clinic of two hospitals in Hong Kong. The intervention consisted of a single face-to-face orientation session and a mobile app consisting of three key user interfaces, including a self-monitoring dashboard with personalized interface according to their own risk profile, an interactive e-library covering various CAD-related self-care dimensions and a chat room for the nurse to provide continuous coaching. The control group received usual care. Results: A total of 132 patients with CAD were randomly allocated to the intervention (n = 68) or control group (n = 64). Compared to the control group, the intervention group showed greater improvements in self-care behaviors (β = 5.532, 95% CI: 1.735 - 14.241, p = 0.012), functional status (β = 2.235, 95% CI: 1.092 - 8.286, p = 0.033), HRQoL (β = 6.135, 95% CI: 1.830 - 12.843, p = 0.012), and blood pressure control (β = 12.584, 95% CI: 10.050 - 29.221, p = 0.041) at 12 weeks follow-up. No significant changes in cholesterol level and waist-to-height ratio were found. Conclusions: The i-Care intervention improves self-care behaviors, HRQoL, functional status and blood pressure control in patients with CAD. It is warranted to examine the longer-term effects of the i-CARE intervention.

Health-related quality of life and willingness to pay measurement among patients on warfarin in Thailand

BackgroundComplex dosage regimens and the high incidence of adverse events associated with warfarin therapy can affect the health-related quality of life (HRQoL) and willingness to pay (WTP) among patients on warfarin. No such previous study has been conducted to assess the HRQoL and WTP among Thai patients on warfarin; therefore, this study aimed to measure these parameters and identify some sociodemographic factors associated with those aspects among patients on warfarin in Thailand.MethodsThis cross-sectional survey study involving 260 patients on warfarin between June 2022 and June 2023 used a quantitative method for data collection. Face-to-face interviews with well-trained interviewers were conducted and patients were required to complete the questionnaires of both World Health Organization Quality of Life-BREF (WHOQOL-BREF) and EQ-5D-5L to assess and measure their HRQoL levels. WTP was assessed using a bidding game technique. Descriptive statistics with mean and standard deviations were used to report HRQoL scores and WTP, whereas a generalized linear model was employed to identify factors associated with both HRQoL and WTP.ResultsThe mean EQ-5D index and mean EQ-VAS score were 0.89 ± 0.15 and 76.92 ± 15.95, respectively, whereas the mean WHOQOL-BREF domain scores were 59.18 ± 14.13, 68.56 ± 15.47, 59.13 ± 19.64, and 65.23 ± 14.04 for the physical, psychological, social, and environmental domains, respectively. Elderly participants (age > 60 years) and those with comorbidities had lower HRQoL scores than their counterparts. The mean WTP was 22.25 ± 32.19 USD for one patient’s visit. The presence of comorbidities was the only factor significantly associated with WTP values.ConclusionsThai patients on warfarin have lower mean EQ-5D indexes and EQ-VAS scores than members of the general Thai population. Patients on warfarin with comorbidities have diminished HRQoL and WTP values. Therefore, all healthcare professionals should pay more attention to this group of patients on warfarin to achieve better outcomes.

Burnout and quality of life among healthcare professionals during the COVID-19 pandemic in Saudi Arabia

Background and Objectives. Healthcare professionals (HCPs) have had to deal with large numbers of confirmed or suspected cases of COVID-19 and were at a high risk of burnout and dissatisfaction regarding their work-life integration. This article aims to assess burnout, the work-life balance (WLB), and quality of life (QoL) among healthcare workers and the relationship between these aspects in Saudi Arabia. Methods. An analytical cross-sectional study was conducted among 491 HCPs from five secondary hospitals in Jazan, Saudi Arabia. Three standardized questionnaires were used to gather data, including WLB, burnout, and the WHO Quality of Life-BREF. Results. Healthcare professionals struggled to balance their work and personal lives during COVID-19 and reported many burnout symptoms and a low level of QoL. Two-thirds (68.8%) of HCPs arrived home late from work and (56.6%) skipped a meal. HCPs who worked through a shift without any breaks were found in 57.8%. It was reported that 39.3% of HCPs felt frustrated by technology while being exhausted from their work (60.5%). The correlation coefficients between the WLB and health-related QoL (HRQoL) showed a significant negative correlation for all items, which ranged from (-.099 to -.403, P&lt;0.05). The WLB and burnout scores were successful predictors of low levels of HRQoL (P&lt;0.001 for both explanatory variables). Conclusions. Work-life imbalances, high levels of burnout, and low QoL levels are common among healthcare professionals in Saudi Arabia during COVID-19. Hospital administration should address the WLB and reduce burnout symptoms among HCPs to increase satisfaction and improve the quality of care.

Health Related Quality of Life of Hypertensive Patients attending a Tertiary Level Hospital in Kathmandu

Background: Hypertension among cardiovascular disease is one of the major components of non-communicable disease emerging as a global public health problem leading the risk for disability and death globally impairing health related quality of life (HRQoL). The objective of study was to find out the health related quality of life of hypertensive clients attending a tertiary level hospital.&#x0D; Methods: A cross-sectional study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center among 153 hypertensive clients attending outpatient department. Simple random sampling technique was used to collect data. Face to face interview was done for data collection, using structured questionnaire that included socio-demographic variables, health related variables, lifestyle related variables and RAND Short Form (SF)-36 questionnaire. Data analysis was done by using descriptive statistics and inferential statistics.&#x0D; Results: More than half of respondents (61.4%) had good level of health related quality of life in physical component score while 86.3% had good level of health related quality of life in mental component score. The level of HRQoL was significantly associated with health related variables such as comorbidities, diabetes, cardiovascular diseases and lifestyle related variables such as sleeping pattern, type of exercise in physical component and sleeping pattern in the mental component.&#x0D; Conclusion: The level of HRQoL of hypertensive clients is found to be good. Hypertensive clients could improve HRQoL through prevention and treatment of diabetes and cardiovascular diseases.

Posttraumatic growth and health-related quality of life in cancer survivors: Does fatigue moderate the link?

Interest in post-traumatic growth (PTG) as a predictor of health-related quality of life (HRQoL) is currently gaining attention. However, current evidence is still inconclusive on the nature of this relationship. The first objective of this study was to investigate the relationship between PTG and global HRQoL among cancer survivors. We further investigated the moderating role of fatigue in the association between PTG and global HRQoL. In the FiX study (Fatigue in Germany - Examination of prevalence, severity, and state of screening and treatment) cancer-related fatigue (EORTC QLQ-FA12), PTG inventory and global HRQoL (EORTC QLQ-C30) were assessed four years after cancer diagnosis in 1316 cancer-free survivors (mean age=67.28, SD=11.05, 51.4% female). Multiple linear regression analysis and moderation analysis were performed. The results showed that PTG had a convex quadratic relationship with global HRQoL (p<0.001). Contrary to our hypothesis, fatigue did not moderate the relationship between PTG (linear and quadratic terms) and global HRQoL, neither when considering the overall PTG score nor for any PTG subdimension. In conclusion, PTG has a convex quadratic relationship with long-term global HRQoL that was not modified by persisting fatigue. Future statistical models investigating PTG and global HRQoL should take this non-linear relationship into account. Aiming to increase PTG might contribute to, but is likely not sufficient for high levels of global HRQoL in cancer survivors in the long run.

Distinct developmental trajectories of health-related quality of life for boys and girls throughout childhood and adolescence; a national level longitudinal study

BackgroundTo identify and describe distinct developmental trajectories of health-related quality of life (HRQoL) in a national level Australian population sample, overall and separately for boys and girls.MethodsData were from the Longitudinal Study of Australian Children (LSAC). Participants were children aged 4–5 years recruited in 2004 and followed through to age 16–17 years in 2016, and their caregivers. Group-based trajectory modelling was used to identify groups of children that follow qualitatively distinct developmental trajectories of HRQoL.ResultsThree distinct trajectories were identified for the total sample: (1) high-stable (52.2% of children); (2) middle-stable (38.0%); and (3) low-declining (9.8%). These trajectories differed for boys, who saw increasing HRQoL in the highest trajectory group; a middle-stable trajectory; and declining and rebounding HRQoL in the lowest trajectory group. In contrast, girls saw no increasing or rebounding trajectories; approximately half of girls had high-stable HRQoL and the remaining half had either steadily or rapidly declining HRQoL from age 4–5 to 16–17 years.ConclusionsOur results highlight the importance of considering the distinct trajectories for girls and boys and not relying on population mean levels of HRQoL for decision-making. The presence of developmentally distinct trajectories of HRQoL, and differences in the trajectories faced by boys and girls, should be considered when assessing the effectiveness of treatments and interventions impacting upon HRQoL throughout childhood and adolescence. Failure to account for these pre-existing trajectories may over- or under-estimate treatment effects.

Quality of life and healthcare costs of patients with allergic respiratory diseases: a cross-sectional study

BackgroundAllergic rhinitis (AR) and allergic asthma (AA) are chronic respiratory diseases that represent a global health problem. One aim of this study was to analyze the Health-related Quality of Life (HRQoL) of the patients in order to identify statistically significant influencing factors that determine HRQoL. Another aim was to assess and analyze data on cost-of-illness from a statutory health insurance perspective.Methods The EQ-5D-5L was used to evaluate the patients’ HRQoL. To identify the factors influencing the HRQoL, a multinomial logistic regression analysis was conducted using groups based on the EQ-5D-5L index value as dependent variable. Routine data were analyzed to determine total healthcare costs.Results The average EQ-5D-5L index was 0.85 (SD 0.20). A high age, the amount of disease costs, low internal health-related control beliefs and high ozone exposure in the residential area were found to be statistically significant influencing factors for a low HRQoL, whereas low age, male sex and a good possibility to avoid the allergens were found to be statistically significant factors influencing a high HRQoL. On average, the study participants incurred annual costs of €3072 (SD: 3485), of which €699 (SD: 743) could be assigned to allergic respiratory diseases.Conclusions Overall, the patients in the VerSITA study showed a high level of HRQoL. The identified influencing factors can be used as starting points for improving the HRQoL of patients with allergic respiratory diseases. From the perspective of a statutory health insurance, per person expenditures for allergic respiratory diseases are rather low.

The health–related quality of life in patients with diabetic foot ulcers in the Kingdom of Bahrain

AimsThe aims of this study were to assess the health-related quality of life (HRQoL) of adult Bahraini patients with diabetic foot ulcers (DFU) and to explore factors associated with poor HRQoL. MethodsCross-sectional HRQoL data were obtained from a sample of patients in active treatment for DFU at a large public hospital in Bahrain. Patient-reported HRQOL was measured using the following instruments: DFS-SF, CWIS and EQ-5D. ResultsThe patient sample included 94 patients, with a mean age of 61.8 (SD: 9.9) years, 54 (57.5%) were males, and 68 (72.3%) were native Bahrainis. Poorer HRQoL was found among patients who were unemployed, divorced/widowed, and those with a shorter duration of formal education. Additionally, patients with severe DFUs, persisting ulcers, and a longer duration of diabetes reported statistically significantly poorer HRQoL. ConclusionsFindings from this study demonstrate a low level of HRQoL among Bahraini patients with DFUs. A longer duration of diabetes, in addition to ulcer severity and status statistically significantly influence HRQoL.

Effects of Inpatient Rehabilitation in Leg Lymphedema: A Naturalistic Prospective Cohort Study With Intra-individual Control of Effects

ObjectiveTo quantify therapy-attributable effects of a comprehensive inpatient rehabilitation program for lower limb lymphedema (LLL) and to compare the levels of health-related quality of life (HRQL) to population-based norms. DesignNaturalistic prospective cohort study with intra-individual control of effects. SettingRehabilitation hospital. ParticipantsPatients with LLL (N=67; 46 women). InterventionsComprehensive, multidisciplinary inpatient rehabilitation with 45-60 hours of therapy. Main Outcome MeasuresShort Form 36 (SF-36) for HRQL, lymphedema-specific Freiburg Quality of Life Assessment for lymphatic disorders, Short Version (FLQA-lk), knee-specific Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), and Symptom Checklist-90Standard (SCL-90S). Observed pre/post rehabilitation effects were individually corrected by subtracting the home waiting-time effects and expressed as standardized effect sizes (ESs) and standardized response means (SRMs). Score differences to norms were quantified by standardized mean differences (SMDs). ResultsParticipants were on average aged 60.5 years, not yet obese, and had 3 comorbidities (n=67). The greatest improvement was in HRQL on the FLQA-lk with ES=0.767/SRM=0.718, followed by improvements in pain and function with ES/SRM=0.430-0.495 on the SF-36, FLQA-lk, and KOS-ADL (all P<.001). Vitality, mental health, emotional well-being, and interpersonal sensitivity improved most by ES/SRM=0.341-0.456 on all 4 measures (all P≤.003). Post rehabilitation scores were significantly higher than population norms on SF-36 bodily pain (SMD=1.140), vitality (SMD=0.886), mental health (SMD=0.815), and general health (SMD=0.444) (all P<.001), and comparable on the other scales. ConclusionsThose affected by LLL stages II and III benefited substantially from the intervention, attaining equal or higher levels of HRQL than expected compared with the general population norms. Multidisciplinary, inpatient rehabilitation should be recommended for LLL management.