Levels Of Health-related Quality Research Articles

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.
 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.
 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.
 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.

Knowledge and Response to the COVID-19 Pandemic in People With Severe Mental Illness in Bangladesh and Pakistan: A Cross-Sectional Survey.

BackgroundPeople with severe mental illnesses (SMIs) are likely to face disproportionate challenges during a pandemic. They may not receive or be able to respond to public health messages to prevent infection or to limit its spread. Additionally, they may be more severely affected, particularly in low- and middle-income countries.MethodsWe conducted a telephone survey (May–June 2020) in a sample of 1,299 people with SMI who had attended national mental health institutes in Bangladesh and Pakistan before the pandemic. We collected information on top worries, socioeconomic impact of the pandemic, knowledge of COVID-19 (symptoms, prevention), and prevention-related practices (social distancing, hygiene). We explored the predictive value of socio-demographic and health-related variables for relative levels of COVID-19 knowledge and practice using regularized logistic regression models.FindingsMass media were the major source of information about COVID-19. Finances, employment, and physical health were the most frequently mentioned concerns. Overall, participants reported good knowledge and following advice. In Bangladesh, being female and higher levels of health-related quality of life (HRQoL) predicted poor and better knowledge, respectively, while in Pakistan being female predicted better knowledge. Receiving information from television predicted better knowledge in both countries. In Bangladesh, being female, accessing information from multiple media sources, and better HRQoL predicted better practice. In Pakistan, poorer knowledge of COVID-19 prevention measures predicted poorer practice.ConclusionOur paper adds to the literature on people living with SMIs and their knowledge and practices relevant to COVID-19 prevention. Our results emphasize the importance of access to mass and social media for the dissemination of advice and that the likely gendered uptake of both knowledge and practice requires further attention.

Исследование качества жизни, связанного со здоровьем у пациентов с covid -19 в первые сутки госпитализации в стационар

The COVID‑19 pandemic has resulted in exceptional social disruption and consequent changes in quality of life. Assessment of the health-related quality of life in patients infected with the SARS-CoV‑2 (2019-nCoV) virus in a covid hospital is an urgent public health issue that affects the organization of medical care processes and the planning of rehabilitation programs. Purpose of the study is to determine the level of health-related quality of life in patients with COVID‑19 on the first day of inpatient treatment for comparison with pre-pandemic norms and planning targeted rehabilitation programs. Materials and methods. A study of the quality of life was carried out using the EuroQol EQ‑5D‑5L questionnaire assessing the Index EQ and EQ VAS indicators. Using the method of simple random sampling, the data of patients were collected for three sets having following features: “Both sexes”, “Men”, “Women”. The analysis was carried out using descriptive statistics methods. Results. The indicators of health-related quality of life in patients with COVID‑19 on the first day after admission are lower than the pre-pandemic population norms for Moscow residents according to Index EQ by 20%, according to EQ VAS by 29%, on average. Women have more health limitations than men in all EQ‑5D‑5L domains, which is proportionally lower than population norms. In 3,7% of patients on admission to the hospital, the type of quality of life corresponded to “a condition worse than death”, which was practically not observed in the pre-pandemic period in Moscow residents. The greatest losses are observed in the “Self-Care” and “Mobility” domains, both for men and women. On admission to the hospital, no differences were found in the pre-pandemic and pandemic levels of health limitations in the “Anxiety/Depression” domain. Conclusions. The results of the study can be used by specialists from various branches to plan clinical, service, educational, economic, and other public health programs related to the rehabilitation of patients who have had COVID‑19. And it also represents an indispensable additional material for further sociological and clinical research.

Efficacy of Resource Facilitation on Health and Quality of Life for Individuals with Traumatic Brain Injury

<h3>Research Objectives</h3> This study tested the hypothesis that participants with acute traumatic brain injury (TBI) randomly assigned to Resource Facilitation (RF) would demonstrate decreased levels of disability and increased levels of health related quality of life (HRQOL) when compared to patients randomly assigned to the treatment as usual (TAU) control group. Medical comorbidities and health outcomes will also be compared across the groups. This study is the first to study the efficacy of RF for health outcomes and comorbidities. <h3>Design</h3> Randomized Controlled Trial. <h3>Setting</h3> Acute Care, Post-acute Rehabilitation Hospital, and Community. <h3>Participants</h3> A total of 48 participants with TBI were recruited prior to discharge from their acute care hospital. An unequal randomization ratio was used favoring the treatment group resulting in 30 participants randomized to the treatment group and 18 participants randomized to the control group. All participants, regardless of group assignment, received follow up calls every three months to collect outcome measures. <h3>Interventions</h3> Resource Facilitation is an evidence based service navigation intervention that has been shown to improve employment rates, level of disability, and decrease unmet needs in the post-acute brain injury population. In this study, we also employed a collaborative care resource facilitation model. <h3>Main Outcome Measures</h3> Level of disability was assessed with the Mayo-Portland Adaptability Inventory-IV (MPAI-4) which is a measure developed specifically for people with TBI and provides multiple indices of recovery and level of disability. HRQOL was measured with the Patient-Reported Outcomes Measurement Information System (PROMIS) resulting in a total score as well several individual measures of HRQOL including fatigue, physical functioning, emotional health, and pain. <h3>Results</h3> Final results will include comparisons between the RF and TAU groups on level and trajectory of disability, HRQOL, medical comorbidities, and health outcomes. <h3>Conclusions</h3> Pending completion of statistical analyses. <h3>Author(s) Disclosures</h3> None.

Trajectories of depression in sepsis survivors: an observational cohort study

BackgroundAdvances in critical care medicine have led to a growing number of critical illness survivors. A considerable part of them suffers from long-term sequelae, also known as post-intensive care syndrome. Among these, depressive symptoms are frequently observed. Depressive symptom trajectories and associated factors of critical illness survivors have rarely been investigated. Study objective was to explore and compare different trajectories of depressive symptoms in sepsis survivors over 1 year after discharge from ICU.MethodsData of a randomized controlled trial on long-term post-sepsis care were analyzed post hoc. Depressive symptoms were collected at 1, 6 and 12 months post-ICU discharge using the Major Depression Inventory (MDI), among others. Statistical analyses comprised descriptive analysis, univariate and multivariate, linear and logistic regression models and Growth Mixture Modeling.ResultsA total of 224 patients were included into this analysis. We identified three latent classes of depressive symptom trajectories: Over the course of 1 year, 152 patients recovered from mild symptoms, 27 patients showed severe persistent symptoms, and 45 patients recovered from severe symptoms. MDI sum scores significantly differed between the three classes of depressive symptom trajectories at 1 and 6 months after ICU discharge (p < 0.024 and p < 0.001, respectively). Compared with other classes, patients with the mild recovered trajectory showed lower levels of chronic pain (median sum score of 43.3 vs. 60.0/53.3 on the Graded Chronic Pain Scale, p < 0.010) and posttraumatic stress (4.6% with a sum score of ≥ 35 on the Posttraumatic Stress Scale 10 vs. 48.1%/33.3%, p < 0.003); and higher levels of health-related quality of life (HRQOL) using the Short Form-36 scale within 1 month after ICU discharge (p < 0.035).ConclusionsIn the first year after discharge from ICU, sepsis survivors showed three different trajectories of depressive symptoms. Course and severity of depressive symptoms were associated with chronic pain, posttraumatic stress and reduced HRQOL at discharge from ICU. Regular screening of sepsis survivors on symptoms of depression, chronic pain and posttraumatic stress within 1 year after ICU may be considered.Trial registration ISRCTN, ISRCTN 61744782. Registered April 19, 2011—Retrospectively registered, http://www.isrctn.com/ISRCTN61744782.

Why Being Physically Active or Inactive Affects Older Women's Physical Role?

Background Active aging is aimed at promoting quality of life in older adults. Nevertheless, the relationship between physical role and the practice of physical activity (PA) can be influenced by bodily pain feeling and by a low level of health-related quality of life (HRQoL). Passive and active strategies are susceptible to being modified and constitute an important psychological predictor of adaptation to pain. This cross-sectional study (1) analyzed the differences between inactive/active older adult women in terms of clinical and sociodemographic characteristics, pain coping strategies, and HRQoL; (2) studied the associations between pain coping strategies, the dimensions of the HRQoL questionnaire, and physical role; and (3) determined if passive strategies, bodily pain, physical function, and general health were significant mediators in the link between being inactive/active and physical role. Methods Participants of the present cross-sectional study completed measures of clinical and sociodemographic characteristics, HRQoL using the Short-Form Health Survey-36, and active and passive strategies using the Vanderbilt Pain Management Inventory (VPMI). Results A total of 157 inactive (69.9 ± 7.1 years) and 183 active (68.8 ± 5.3 years) women from rural areas were included in the study. Both groups significantly differed in the majority of the clinical and sociodemographic characteristics measured, pain coping strategies, and HRQoL. Bodily pain, physical function, and general health predicted physical role. Moreover, passive strategies, bodily pain, physical function, and general health mediated the link between inactive/active participants and physical role. Conclusions Being physically active or inactive contributes to a better understanding of the link between PA, pain coping strategies, and physical role in older women.

A cross-sectional assessment of health-related quality of life among healthcare providers in Alkharj, Saudi Arabia

Purpose: To determine the current level of health-related quality of life (HRQoL), and evaluate factors influencing it among health-care providers (HCPs) in Alkharj, Saudi Arabia.Methods: A prospective cross-sectional study was conducted among HCPs in Alkharj, Saudi Arabia, using the standardized research tool, BREF-WHOQOL. A self-administered questionnaire was distributed in hospitals, in the medical colleges of Prince Sattam Bin Abdulaziz University, andcommunity pharmacies in Alkharj, Saudi Arabia. Descriptive, comparative, and inferential statistics were performed using SPSS.Results: A total of 289 HCPs agreed to participate in the study, 52 % of whom were female. Most participants were married (69 %), and most had fewer than 10 years of experience (58 %). Statistically significant differences in marital status, education level, income, and year of practice were found that correlated with HCPs’ HRQoL (p ≤ 0.05). Overall, respondents reported an above-average score for all survey items.Conclusion: The results indicate that HCPs see their general quality of life as good - a particularly important consideration in view of the demanding nature of their job. This study will help the concerned authorities to exactly know the current level of HRQoL among HCPs in Alkharj, Saudi Arabia, as well as help in designing better healthcare policies in Saudi Arabia.&#x0D; Keywords: Healthcare providers (HCP), Health-related quality of life (HRQoL), Healthcare policies, Occupational stress

Examining the benefits and harms of Alzheimer\u2019s disease screening for family members of older adults: study protocol for a randomized controlled trial

BackgroundMultiple national expert panels have identified early detection of Alzheimer’s disease and related dementias (ADRD) as a national priority. However, the United States Preventive Services Task Force (USPSTF) does not currently support screening for ADRD in primary care given that the risks and benefits are unknown. The USPSTF stresses the need for research examining the impact of ADRD screening on family caregiver outcomes.MethodsThe Caregiver Outcomes of Alzheimer’s Disease Screening (COADS) is a randomized controlled trial that will examine the potential benefits or harms of ADRD screening on family caregivers. It will also compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening. COADS will enroll 1800 dyads who will be randomized into three groups (n = 600/group): the ‘Screening Only’ group will receive ADRD screening at baseline and disclosure of the screening results, with positive-screen participants receiving a list of local resources for diagnostic follow-up; the ‘Screening Plus’ group will receive ADRD screening at baseline coupled with disclosure of the screening results, with positive-screen participants referred to a dementia collaborative care program for diagnostic evaluation and potential care; and the control group will receive no screening. The COADS trial will measure the quality of life of the family member (the primary outcome) and family member mood, anxiety, preparedness and self-efficacy (the secondary outcomes) at baseline and at 6, 12, 18 and 24 months. Additionally, the trial will examine the congruence of depressive and anxiety symptoms between older adults and family members at 6, 12, 18 and 24 months and compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening between the two groups randomized to screening (Screening Only versus Screening Plus).DiscussionWe hypothesize that caregivers in the screening arms will express higher levels of health-related quality of life, lower depressive and anxiety symptoms, and better preparation for caregiving with higher self-efficacy at 24 months. Results from this study will directly inform the National Plan to Address Alzheimer’s Disease, the USPSTF and other organizations regarding ADRD screening and early detection policies.Trial registrationClinicalTrials.gov, NCT03300180. Registered on 3 October.

P216 WHAT IS THE TIME BURDEN AND RESPONSE RATE ASSOCIATED WITH WRITTEN OR ONLINE COMPLETION OF HEALTH-RELATED QUALITY OF LIFE QUESTIONNAIRES AFTER CANCER TREATMENT?

Abstract Background Patient reported outcomes are increasingly important assessments to be applied in the follow-up of patients after cancer treatment. The primary aim of this study was to clarify the patient related time burden associated with completing these questionnaires. Secondary aims was to assess completion rates, and to investigate how symptomatic outcome differs according to the response time. Method Patients who had undergone surgical management of esophageal cancer (1991-2018) and were disease-free at the time of assessment were asked to complete a total of six questionnaires: SF36, EORTC-QLQ-C30, EORTC-QLQ-OG25, EuroQol 5D, Digestive Symptom Questionnaire, and Dumping Syndrome Rating Scale. Patients were offered either paper or online questionnaires that were completed consecutively allowing for accurate quantification of the time taken to complete each online questionnaire. Results In total, 117 of 147 eligible patients (79.6%) responded to the questionnaires. In the online group 60 (90.9%) responded compared to 57 (70.4%) in the paper group (P=0.002). The median age was 74.5 years in the online group compared to 70.9 years in the paper group (P=0.022). In the patients completing their questionnaires online, the six questionnaires took on average 26.4 (range 10-55) minutes to complete. The fastest quartile of patients completed the six questionnaires in 17 minutes or less (N=14). There was no significant association between time to complete the questionnaires and age, gender, time from surgery or health-related quality of life scores. Conclusions The results of the study demonstrates that online questionnaires in some ways might be superior to paper questionnaires, and that patients are willing and able to complete online questionnaires irrespective of age. Time to complete questionnaires was not associated with level of health-related quality of life.

Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes \u2013 a nationwide cross-sectional study

BackgroundHealth-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting.MethodsIn this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18–80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36-item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes.ResultsCorrelation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures.ConclusionsAmong people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.

Classical Article Evaluation of health-related quality of life the women with human papillomavirus-associated lesions of the cervical epithelium

Objective - to evaluate the health-related Quality of life the women with “lesser” abnormalities of cervical epithelium and patients with high grade squamous intraepithelial lesions (HSIL) associated with human papillomavirus (HPV) infection. Materials and methods. The investigation was performed 274 women of reproductive age, divided into two main groups: HPV infection (“lesser” abnormalities 202 patients and with HSIL - 20) and healthy women - 20. All the studied women of health-related quality of life by using the EQ-5D-5L. Results. Revealed a significant reduction in the level of health-related quality of life in the psychological and emotional components of the patients with “lesser” abnormalities of cervical epithelium and patients with HSIL associated with HPV infection (p

Employees’ health related quality of life in medical education provider setting: Does academicians report higher scores?

Purpose: The objective of this study was to measure level of health-related quality of life among employees working in medical education provider’s setting and its association with type of jobs as academicians or non-academicians. Approach: A cross sectional study was conducted among employees in a medical education provider’s setting. Study instrument consisted of validated Medical Outcome 36-item Short Form Survey (MOS-36) questionnaire were distributed as online survey form. All employees in the study location were recruited. Significant difference in quality of life scores were compared between job types using chi square and Mann-U Whitney statistical test. Results: A total of 196 employees participated in this study. Majority of them were female employees (59%) with Master degree level of education (20%). Academicians were found to score higher in 6 out of 8 domains measured compared to non-academicians. Significant associations were observed between these 2 groups involving 3 domains which were physical functioning (Difference in scores= 10.0, U=2589, p=0.01), emotional health (Difference in scores= 12.0, U=2496, p=0.01) and general health (Difference in scores=10.0, U=2452, p=0.004) domains. Findings from this study supported existing evidence in literature which revealed that in general, academicians did have higher level of HRQOL when compared with their counterparts. These findings would add to existing but limited knowledge on the HRQOL status of healthy working population; because in the past, majority of previous HRQOL studies were emphasized towards patients’ population or population with special conditions. Conclusion: Future initiatives or strategies by policy makers and employers for ensuring good HRQOL among this healthy working population should focus on improving general, physical and emotional health of their employees.

Level of Health-Related Quality of life (HRQoL) According to age group among Korean adults

Background/Objectives: The purpose of this study was to identify the level of health-related quality of life (HRQoL) and the demographic factors influencing the HRQoL according to age group of Korean adults. Methods/Statistical analysis: This is a secondary analysis of the raw data from the Korean National Health and Nutritional Examination Survey (KHNANES) conducted from 2013 to 2015. An analysis was performed with data from 8,035 people (3,601 men, 4,434 women) who responded to research major variables among subjects with a condition of non-disease. Findings: Overall, the HRQoL for women was lower than men by age group (F=74.28, p<0.001). In the case of both men and women, the HRQoL scores decreased as their age increased (F=12.65 and F=30.42 with p<0.001 respectively). Controlling for age, factors affecting HRQoL among Korean adults were educational levels, marital status, household income levels, and occupation. Improvements/Applications: It is necessary to promote social work when considering the factors affecting people’s quality of life in order to develop programs and select a target population to receive the benefits of the programs.

The relationship between health-related quality of life and resilience of patients with inflammatory bowel disease

Objective To explore the relationship between health-related quality of life and resilience of patients with inflammatory bowel disease(IBD), and provide a new entry point to improve the quality of life. Methods The general information questionnaire, the Chinese version of inflammatory bowel disease questionnaire (IBDQ) and the Chinese version of Connor-Davidson mental resilience scale (CD-RISC) were used to investigate 102 patients with IBD. Results The average scores of IBDQ and CD-RISC of IBD patients were (157.6±31.7) and (62.5±15.0). Except for the correlation between the score of optimistic dimension and the social function dimension, the total score and the scores of other dimensions of IBDQ were significantly correlated with the total score and the scores of dimensions of CD-RISC(r=0.200-0.490, P<0.05). Multiple regression analysis showed that tenacity, residence, moderate and severe disease severity, and disease duration with more than 10 years could significantly predict the level of health-related quality of life (β=0.319, 0.268, -0.218, -0.373, -0.260, P<0.05). Conclusion The health-related quality of life of IBD patients has a strong relationship with resilience. Health care workers can help improve health-related quality of life of the patients through fostering resilience. Key words: Inflammatory bowel diseases; Quality of life; Resilience

Calidad de vida relacionada con salud de empleados de una universidad pública

Introduction: Health-related quality of life is the level of perception that people having of their subjective well-being, considering their health, with measures of physical and mental well-being. Aim: to determine the level of health-related quality of life of employees of a public university of Hermosillo, Mexico. Methodology: quantitative study, transversal and comparative. The sample consisted of 62 participants. Data collection instrument: Questionnaire of biosociodemographic variables and work, and SF 36. The IBM SPSS version 22 was used for the statistical analysis. The U Mann-Whitney test was used to compare two groups, and Spearman correlation was utilized to explore correlations between variables. The significance level admitted was 0.05. We had the support of the University Ethics Committee and an informed consent was elaborated. Results: 51.6% were men, mean age and age were 45.5 (SD = 10.3) and 17.2 (SD = 9.4) respectively, 40.3% perform administrative activities, 75.8% consumed tobacco. The dimension physical role was the best evaluated with an average of 96.8 (SD = 17.8) and general health was the one that had the lowest average with 73.4 (SD = 14.2), tobacco consumption and physical role are related (p = 0.0210), physical function (p = 0.0261) and social function (p = 0.0466) showed differences by sex. Conclusion: most of the dimensions of the health-related quality of life of employees are within the parameters of normality. However, the need for an intervention from the employees’ health services is evident, here the health team may contribute to increasing aspects of occupational health.

여성 문제음주자의 건강행태와 건강관련 삶의 질이 우울에 미치는 영향

The purpose of this study is to investigate the drinking status, health behaviors, health related quality of life and depression among female problem drinkers and to examine the impact of their health behavior and health related quality of life on depression. The data of this study were derived from the 5th Korea National Health and Nutrition Examination Survey conducted during January 2010-December 2012. As for the subjects of this study, 328 female problem drinkers were selected who were classified as those with 8 or higher scores in the AUDIT, and complex samples analysis was conducted using the IBM SPSS Statistics version 21.0 software package. The study result showed that the risk of experiencing depression increased among subjects with a high level of perceived stress and subjects with a low level of health related quality of life. In addition, the risk of experiencing depression increased among subjects with 1-4 hours of sleep time compared to subjects with 8 or more hours of sleep time. Accordingly, it would be necessary to pay attention to stress, sleep time and health related quality of life that are related influencing factors for the improvement of depression and mental health of Korean female problem drinkers.

Knowledge, attitudes and quality of life of type 2 diabetes patients in Saudi Arabia

ObjectiveThe purpose of this study was to investigate the association between knowledge and attitude with health related quality of life in patients with type 2 diabetes mellitus in Saudi Arabia. Method & settingA cross-sectional descriptive study was undertaken with a cohort of 75 patients attending the University Diabetic Centre at the King Abdulaziz University Hospital, Riyadh, Saudi Arabia. In addition to a questionnaire used to collect demographic and disease related information, the EuroQoL (EQ-5D) scale was used to assess the health related quality of life. EQ-5D was scored using values derived from the UK general population survey. The brief diabetic knowledge test in questionnaire format developed by the University of Michigan Diabetes Research and Training Centre (MDRTC) was used and the attitude towards self-care questionnaire based on the diabetic care profile was assessed. Descriptive statistics was used to display demographic and disease related information. Inferential statistics was applied to evaluate associations between study variables. The Statistical Package for Social Sciences version 20.0 was used for data analysis; p<0.05 was taken as significant. ResultsFifty-eight (77.35%) respondents were males with a mean age 12.6±8.4years of a history of diabetes. Thirty-four (45.3%) were in the age group of 45–55years with a mean age of 54±9.2years. A moderate level of health related quality of life (0.71±0.22) was recorded in the study cohort. The mean EQ-5D score was lower in females compared to male patients (0.58±0.23vs 0.74±0.20). The mean score of MDKT was 8.96±2.1 and the median score was 9.00. Out of 75 diabetic patients, 14.7% had poor knowledge; 72% had moderate knowledge; and only 13.3% had good knowledge. The average attitude score of all respondents was 6.38±2.11. There was a significant positive association between attitude and EQ-5D score. ConclusionHealth related quality of life and knowledge scores were moderate in type 2 diabetic patients in Saudi Arabia. Patient attitude towards the disease was positive and this was positively associated with HRQoL; most respondents believed that they are responsible for their care. It is likely that a high quality of Diabetes Self-Management Education programme will provide benefits and impact significantly on type 2 diabetes patients to change their lifestyle and habits, which will improve their quality of life.

Health-related Quality of Life Among Adult Migrant Garment Workers in Dhaka City

The objective of this cross-sectional study was to assess the health-related quality of life among adult migrant garment workers (age 18-59 years) in Dhaka city. The study was conducted with 400 workers for quantitative research, and two health care service providers for qualitative research. Data were collected during February to March 2009. Data were collected by face-to-face interviews using a constructed pre-tested questionnaire adapted from WHOQOL-BREF. Data were analyzed by applying descriptive statistics (frequency, percentage, mean, standard deviation, range and median) and inferential statistics (unpaired t–test and one–way ANOVA) to examine the relationship between health-related quality of life and socio-demographic characteristics, living and working conditions, and accessibility to health care services. Statistical significance was set as p&lt;0.05. The results revealed that 94.00% of workers reported low level of health-related quality of life. The rest were moderate and high, 3.25% and 2.75% respectively. For socio-demographic characteristics, workers' marital status, having family members, income, history of sickness and getting treatment when sick were discovered to have association with health-related quality of life. For living and working conditions, workers' living place, work permit, length of current job and satisfaction on work conditions were significantly associated with health-related quality of life. For accessibility to health care services, perception on difficulty to go to the health facility, crowdedness of the health facility and having health insurance card were found to be associated with health-related quality of life. Further longitudinal researches and policies are recommended to improve access to health care services and higher health-related quality of life for migrant garment workers in Dhaka city. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18651 Bangladesh Medical Journal 2011 Vol.40(3):14-17

Physical therapy after prophylactic mastectomy with breast reconstruction: A prospective randomized study

IntroductionThe rate of prophylactic mastectomies (PM) is increasing. Patients generally report high levels of health related quality of life and satisfaction after the procedure, whereas body image perception and sexuality may be negatively affected.The aim of the study was to evaluate the interest in physical therapy as a means of improving body image and sexuality in women after PM. Patients and methodsPatients undergoing PM at Karolinska University Hospital between 2006 and 2010 were eligible. The following patient-reported outcome measures were used at study baseline and 2 years postoperatively: the body image scale (BIS), the sexual activity questionnaire (SAQ), the short-form health survey (SF-36), the hospital anxiety and depression scale (HAD), and a study specific “pain/motion/sensation scale”. ResultsOut of 125 patients invited to participate in this prospective randomized study, 43 (34%) consented and were randomized into the intervention (n = 24, 56%) or control (n = 19, 44%) groups. There were no statistically significant between-group differences found with respect to BIS, SAQ, SF-36, HAD, and “pain/motion/sensation”. Two years postoperatively, more than half of the patients in both groups reported problems like feeling less attractive, less sexually attractive, their body feeling less whole, and being dissatisfied with their body. A majority marked a decreased sensation in breast area. ConclusionThe interest in a physiotherapy intervention was limited among women who had undergone PM. The intervention did not show any substantial effects. A large proportion of patients reported specific body image related and pain/motion/sensation problems postoperatively.

P218 Faecal calprotectin testing reduces need for paediatric colonoscopy

evidenced by lower levels of health-related quality of life (HRQOL) especially in children with high levels of abdominal pain. Research examining psychological and social factors related to IBD and associated HRQOL is critical. For children in particular, the family environment might play a crucial role in the their coping with IBD. Dysfunctional levels of overall functioning have been associated with lower HRQOL in chidlren with IBD, yet the impact of specific aspects of family functioning, such as cohesion (i.e., emotional bond or connectiveness), flexibility (i.e., balance between stability and change) and communication patterns (i.e., postive versus negative) is largely unexplored. The purpose of the present study was to investigate the influence of balanced levels of cohesion and flexbility and positive communication on the child’s pain experience and HRQOL. Methods: Thirty children with IBD (14 girls, 16 boys; N = 20 with Crohn’s disease, N = 10 with Ulcerative colitis; Mage = 13.73, SD = 2.30 years) and one parent (25 mothers, 5 fathersMage = 46.73, SD = 6.47 years) completed questionnaires regarding child’s level of pain and interference, HRQOL (i.e., IMPACT) and family functioning (i.e., Faces IV). Results: Linear regression analyses, controlling for child age, indicated that child report of positive communication and balanced level of cohesion and flexibility were positively associated with their HRQOL. Surprisingly, no significant associations were found between child level of pain and family functioning, while the level of interference in daily functioning due to pain was negatively associated with parent report of balanced cohesion and child report of balanced flexibility and positive communication. Conclusions: The current findings indicate that parent-reported cohesion was only associated with pain-related interference, while child-reported aspects of family functioning were related to HRQOL and pain-related interference. Results also suggest that family functioning is primarily associated with HRQOL and interference in daily functioning rather than the level of pain, adding to our understanding of how family functioning relates to children’s coping with IBD and associated pain. In future research, observational assesment of family functioning (e.g., by means of a conflict-discussion task) and parentchild communication patterns when faced with their child in pain (e.g., observation of parent child interaction during an experimental pain task), will contribute to our understanding of how family functioning influences child functioning and pain experiences.