Lower Overall Quality Of Life Research Articles

Assessing the Effectiveness of Voice Therapy Techniques in Treating Dysphonia: An Otolaryngological Review.

Dysphonia is a prevalent condition that can impact individuals across all age groups. It occurs when normal voice quality is altered, caused by structural and/or functional issues. Evaluation and assessment from clinicians are warranted if dysphonia persists for more than four weeks and/or is coupled with risk factors or other concerning clinical manifestations. Additionally, voice disorders can increase the risk of depression and anxiety disorders, as well as raise stress levels and lower self-reported health indicators. Dysphonia can have a substantial influence on interpersonal interactions and lower overall quality of life since effective communication relies significantly on spoken language. Hence, managing dysphonia is essential for enhancing communication abilities, improving quality of life, maintaining vocational functioning, promoting psychological well-being, and addressing underlying health concerns. Speech and language therapy, medical management, surgery, or a combination of the aforementioned are all possible treatments for dysphonia. Speech and language therapy is often the first-line treatment option for dysphonia patients who do not meet the criteria for surgical intervention. Voice therapy is often beneficial and remains the first line of treatment, even when patients approach with benign vocal fold nodules. A well-designed voice therapy program improves both the quality of life and vocal performance. The majority of the studies in the existing literature advocate for and report beneficial outcomes associated with voice therapy; however, more research is needed to provide evidence-based findings to guide clinical practice and achieve optimal outcomes. This comprehensive review elaborately highlights the utilization and efficacy of various voice therapeutic modalities utilized for the management of dysphonia in light of current literature.

Abstract PO4-27-08: A Phase II Multi-Institutional Study of Concurrent Radiotherapy, Palbociclib, and HormoneTherapy for Treatment of Bone Metastasis in Breast Cancer Patients

Abstract Background: This Phase II study aimed to determine the efficacy and safety of administering palliative radiotherapy (RT) to bone metastases (mets) in patients (pts) receiving concurrent palbociclib and hormone therapy (HT) for hormone receptor positive, Her2/neu negative breast cancer. The primary endpoint was response rate 3 months after RT. Methods: Pts with painful bone mets or asymptomatic bone mets with risk for impending clinical event were treated with RT to 30 Gy in 10 fractions or 20 Gy in 5 fractions with concurrent palbociclib and HT. Change in maximum pain score on the Brief Pain Inventory was used to assess pain response 3 months post RT relative to baseline. Among pts with asymptomatic bone lesions, response was defined as prevention of a clinical event (e.g., bone fracture) without evidence of local tumor growth on surveillance imaging. Patient reported outcomes (PROs) of fatigue, depression, anxiety, and quality of life were collected. Blood-based biomarkers were examined to determine their relationship with response and PROs. Using a non-inferiority study design, a sample size of at least 33 pts was needed to achieve 80% power to detect a non-inferiority proportion of 60% using a one-sided binomial test and assuming a Type I error of 0.05. Results: Among 38 patients enrolled, 79% had painful bone mets. 35 pts completed baseline and 3-month post RT assessments. 61% and 37% of pts received aromatase inhibitors and fulvestrant, respectively, with palbociclib. Median age was 60 years (31-83) and 25% of pts were non-Hispanic Black. The majority (72%) of pts received 5 fraction RT and 69% received RT to one bone region. 29 patients (83%) were responders [95% CI: 66%-93%, p=.003]. Median progression free survival (PFS) was 30.4 months (1.3 - 44.0). Three-year PFS and overall survival were 45.6% and 67.2%, respectively. Grade 3 neutropenia developed in 4 (11%), 4 (11%), and 7 (20%) pts at end of RT, 1 month, and 3 months post RT, respectively. No pts developed Grade 4 neutropenia. One patient developed Grade 3 gastrointestinal toxicity during RT, another developed Grade 3 dyspnea 1 month post XRT, and another developed a bone fracture 6 months after RT. >While patient reported measures of fatigue, depression, and overall quality of life did not significantly change during or after RT relative to baseline, pain scores (i.e., BPI pain severity and interference, BM22 pain characteristics and pain site subscales, EORTC C15 pain) significantly decreased 3 months post XRT relative to baseline. Heightened inflammatory marker levels (e.g., TNFRII, IL1ra, CRP, TNF alpha) were significantly associated with worse symptoms of fatigue (MFI) and depression (HADS), increased pain interference (BPI), and lower overall quality of life (SF-36), controlling for age and time using mixed effect models. Patients with improved pain symptoms and lower pain scores had significantly lower inflammatory marker levels relative to baseline (e.g., interleukin-6). Conclusions: Our study demonstrated high rates of response to concurrent RT with palbociclib and HT with acceptable levels of toxicity. These results suggest that RT to bone mets effectively alleviates pain in patients taking palbociclib and pain response to treatment is associated with decreased inflammatory markers. RT may be given to pts receiving palbociclib and HT for breast cancer. Clinical Trial Identification: NCT03691493 Citation Format: Mylin Torres, Jolinta Lin, Sarah Friend, Canhua Xiao, Yichun Cao, Shannon Kahn, Karen Godette, Sheela Hanasoge, David Yu, Tony Eng, Matthew Cheney, Nancy Wiggers, Andrew Pippas, Keerthi Gogineni, Jane Meisel, David Schuster, Aditya Bardia, Andrew Miller, Jennifer Felger, Jeffrey Switchenko, Amelia Zelnak, Kevin Kalinsky, Manali Bhave. A Phase II Multi-Institutional Study of Concurrent Radiotherapy, Palbociclib, and HormoneTherapy for Treatment of Bone Metastasis in Breast Cancer Patients [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-27-08.

Very long-term effects of conservatively treated blunt thoracic trauma: a retrospective analysis

IntroductionDespite the high incidence of blunt thoracic trauma and frequently performed conservative treatment, studies on very long-term consequences for these patients remain sparse in current literature. In this study, we identify prevalence of long-term morbidity such as chronic chest pain, shortness of breath, and analyze the effect on overall quality of life and health-related quality of life. MethodsQuestionnaires were send to patients admitted for blunt thoracic trauma at our institution and who were conservatively treated between 1997 and 2019. We evaluated the presences of currently existing chest pain, persistence of shortness of breath after their trauma, the perceived overall quality of life, and health-related quality of life. Furthermore, we analyzed the effect of pain and shortness of breath on overall quality of life and health-related quality of life. ResultsThe study population consisted of 185 trauma patients with blunt thoracic trauma who were admitted between 1997 and 2019, with a median long term follow up of 11 years. 60 percent still experienced chronic pain all these years after trauma, with 40,7 percent reporting mild pain, 12,1 percent reporting moderate pain, and with 7,7 percent showing severe pain. 18 percent still experienced shortness of breath during exercise. Both pain and shortness of breath showed no improvement in this period. Pain and shortness of breath due to thoracic trauma were associated with a lower overall quality of life and health-related quality of life. ConclusionChronic pain and shortness of breath may be relatively common long after blunt thoracic trauma, and are of influence on quality of life and health-related quality of life in patients with conservatively treated blunt thoracic trauma.

Effectiveness of individually tailored nutritional guidance on the quality of life of family caregivers experiencing subjective poverty

ABSTRACT Family caregivers’ social determinants of health are little assessed in previous intervention studies. We assess the extent to which diet-related disparities and inequalities in quality of life occur among family caregivers of different financial groups and if individually tailored nutritional guidance can narrow these inequalities. Data were collected between June 2019 and June 2020 at family caregivers’ households. The sample included 113 family caregivers from Finland. They were divided into intervention (n = 63) and control (n = 50) groups. The intervention group was further divided by those experiencing subjective poverty (n = 36) or financial security (n = 77) and subgroups of rural or urban participants. Family caregivers were interviewed on quality of life, nutritional variables, and sociodemographic factors. The intervention group received individually tailored nutritional guidance. Family caregivers experiencing subjective poverty had a lower overall quality of life, and physical, psychological, and environmental state of quality of life, and slightly poorer nutritional status at baseline than those who were financially secure. However, nutritional guidance improved the quality of life among family caregivers experiencing subjective poverty and somewhat narrowed inequalities in nutritional status among financial groups. Therefore, individually tailored nutritional guidance may improve the quality of life and, to some extent, the nutritional status of family caregivers experiencing subjective poverty, reducing inequalities. However, the issue requires increasing attention in caregiving research and healthcare to narrow family caregivers’ social and health inequalities.

Quality of Life in Hungarian Parents of Autistic Individuals.

Parents of autistic individuals have been known to have a lower overall quality of life (QQL) than those of typically developing children. We present the first Hungarian large-sample study whose objective was to explore the differences in QOL between parents of autistic individuals (AS) and those of neurotypical (NT) persons. Based on the ABCX model we developed a questionnaire comprising standardized scales to characterize the life of parents involved. Our data came from parents of 842 individuals (ASD = 521, NT = 321) between 0 and 49 years. Battery deployed standardized instruments to examine quality of life (WHO-QQL BREF and Quality of Life in Autism questionnaire, QOLA). We assessed the families' socio-economic/demographic characteristics, parents' psychological well-being, the autistic/neurotypical individuals' characteristics, and the interventions. Our data showed significantly lower QOL in parents of autistic individuals in all domains of questionnaires. We analyzed 20 relevant factors to uncover the predictors of parental QOL. We confirmed the existence of most but not all predictors present in earlier literature and identified intervention-related predictors. Our study confirms the importance of supporting parents in their role, and of providing health and social supports that focus on quality of life, in addition to child care.

Assessing the Quality of Life, Coping Strategies, Anxiety and Depression Levels in Patients with Long-COVID-19 Syndrome: A Six-Month Follow-Up Study.

This longitudinal study investigates the psychosocial effects of long-COVID Syndrome, a domain still not extensively researched. It specifically evaluates the quality of life, coping mechanisms, anxiety and depression levels in COVID-19 survivors, differentiating between those with and without long-COVID Syndrome. Conducted at the Victor Babes Hospital for Infectious Diseases and Pulmonology in Timisoara, Romania, the study utilized a cohort of patients diagnosed with mild to moderate COVID-19. The following standardized tools: WHOQOL-BREF for quality of life, COPE-60 for coping strategies, and the Hospital Anxiety and Depression Scale (HADS), were employed for the assessment. The sample consisted of 86 patients displaying persistent post-acute symptoms and 432 asymptomatic patients at the 6-month post-discharge mark. Patients with frequent post-acute symptoms reported significantly higher levels of fatigue (8.2 ± 1.4), cognitive difficulties (7.5 ± 1.6), and respiratory challenges (7.8 ± 1.3), along with a markedly lower overall quality of life (7.0 ± 1.5) compared to their asymptomatic counterparts. HADS scores revealed elevated depression (6.8 ± 1.9) and anxiety (7.1 ± 2.3) in the symptomatic group. Quality of life, as evaluated through the use of WHOQOL-BREF, showed lower scores in the symptomatic cohort across physical (58.8 ± 15.8), mental (56.3 ± 16.4), and social domains (50.2 ± 17.5). COPE-60 findings indicated a higher prevalence of disengagement (56.4%) and emotion-focused coping strategies (61.8%) in the symptomatic group, in contrast to 30.1% and 37.0%, respectively, in the asymptomatic group. The study highlights that long-COVID Syndrome significantly deteriorates the quality of life and is associated with increased depression and anxiety levels. The prevalent use of disengagement and emotion-focused coping strategies among patients with persistent symptoms suggests a need for enhanced psychosocial support tailored to this subgroup.

The impact of fatigue severity and depression level on the quality of life in individuals with Parkinson's disease in Taiwan.

Patients diagnosed with Parkinson's disease undergo alterations in physical, psychological, and social functionality, with the psychological domain being particularly predisposed to inducing fatigue and depressive symptoms. Understanding the alterations occurring within a patient's body and mind and how these influence their overall quality of life is crucial. This study sought to explore the predictive capacity of fatigue severity, the presence of depressive symptoms, and diverse demographic factors on the quality of life among individuals with Parkinson's disease. A cross-sectional correlational study was conducted at a teaching hospital in southern Taiwan. The research utilized a questionnaire survey to interview 133 study participants, focusing on the Quality of Life Scale, Depression Scale, Fatigue Severity Scale, Social Support Scale, and demographic attributes. A total of 130 valid questionnaires were obtained. The results showed that Hoehn and Yahr stage, fatigue severity, and depression status could predict quality of life, explaining 51.1% of the total variance. These findings suggest that patients at advanced Hoehn and Yahr stages, experiencing more severe fatigue, and exhibiting higher levels of depression, tended to report a lower overall quality of life. Our findings suggest that, in addition to Hoehn and Yahr stage, the severity of fatigue and levels of depression significantly impact the quality of life in individuals with Parkinson's disease. Nurses need to understand the "stressful life events" and the changes in appearance and physical function that patients with Parkinson's disease face due to chronic degenerative diseases. Hence, apart from addressing patients' physiological needs, healthcare professionals should also offer appropriate care for psychological issues, such as depressive symptoms. Encouraging patients to participate in "counseling groups" can further bolster their social support networks, enhancing their overall well-being and addressing comorbidities associated with chronic degenerative diseases.

Neuropsychiatric Developmental Disorders in Children Are Associated With an Impaired Response to Treatment in Bladder Bowel Dysfunction: A Prospective Multi-Institutional European Observational Study.

Bladder and bowel dysfunction is a common but underdiagnosed pediatric entity which may represent up to 47% of pediatric urology consults. The objectives of this observational study were to determine functional 1-year outcomes following standard treatment of bladder and bowel dysfunction in both control and neuropsychiatric developmental disorder groups using validated questionnaires, and to perform an initial cost analysis. This was a prospective observational study conducted across a number of academic European centers (July 2020-November 2022) for new bladder and bowel dysfunction patients. Parents completed a sociodemographic survey, information pertaining to prior neuropsychiatric developmental disorder diagnoses, as well as a number of validated functional scores. A total of 240 patients were recruited. In the control bladder and bowel dysfunction group, the baseline Dysfunctional Voiding Scoring System and Childhood Bladder and Bowel Dysfunction Questionnaire scores were 20% and 17.% lower, respectively, after 1 year compared to the neuropsychiatric developmental disorder group. The change in improvement was diminished for the neuropsychiatric developmental disorder cohort in both Dysfunctional Voiding Scoring System and Childhood Bladder and Bowel Dysfunction Questionnaire scores. The odds ratio of full symptom resolution was 5.7 in the control cohort compared to the neuropsychiatric developmental disorder cohort. A cost analysis on prescribed medications at referral led to a total cost of €32,603.76 (US $35,381.00) in the control group and €37,625.36 (US $40,830.00) in the neuropsychiatric developmental disorder group. This study demonstrates that pediatric patients with a neuropsychiatric developmental disorder exhibit more severe bladder and bowel dysfunction at baseline and throughout treatment with a lower overall quality of life, as well as 15.4% higher medication costs at referral. It is also important that parents' and caregivers' expectations are managed regarding higher levels of treatment resistance for functional bladder and bowel issues.

Family caregivers’ subjective poverty: the effect of nutritional guidance on their quality of life

Abstract Background Family caregiving may increase the risk of poverty, whereas poverty increases the risk of adverse health outcomes, creating health inequalities. Although the issue is significant, family caregivers’ social determinants of health are little assessed in the previous intervention studies. Therefore, we aimed to assess the effects of individually tailored nutritional guidance on financially vulnerable family caregivers’ quality of life and nutritional status. Methods The data were collected between June 2019 to June 2020. Study participants (n = 113) were randomized into intervention (n = 63) and control (n = 50) groups and further divided into those experiencing subjective poverty (n = 36) or financial security (n = 77). The intervention group received individually tailored nutritional guidance. Paired samples t-test, McNemar's test, or alternatives were used to assess the intervention's effectiveness on quality of life and nutrition. Results The preliminary results show that family caregivers who experienced subjective poverty had a lower overall quality of life (p <.001, 95% CI -12.1, -5.3), physical health (U = 1824, p = .004), psychological health (U = 1780, p = .013), and environmental quality of life (U = 2262, p <.001) at baseline. However, after the intervention, their overall quality of life improved (p = .010, 95% CI -15.9, -2.3). Similarly, there was an improvement in their psychological health (Z= -2.0, p = .047) and environmental quality of life (Z= -2.4, p = .017). Their risk of malnutrition also slightly decreased, and daily fruit and vegetable servings increased without statistical significance. Conclusions Individually tailored nutritional guidance improved the quality of life of family caregivers experiencing subjective poverty. The results may guide healthcare in narrowing health inequalities. Key messages • Individually tailored nutritional guidance can narrow quality of life inequalities among family caregivers of different financial groups. • Healthcare should enable nutritional guidance to family caregivers.

Predictors of persisting pain in children with Juvenile Idiopathic Arthritis: a case control study nested in the ReACCh-Out cohort

BackgroundTo identify baseline predictors of persisting pain in children with Juvenile Idiopathic Arthritis (JIA), relative to patients with JIA who had similar baseline levels of pain but in whom the pain did not persist.MethodsWe used data from the Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) inception cohort to compare cases of ‘moderate persisting pain’ with controls of ‘moderate decreasing pain’. Moderate pain was defined as a Visual Analogue Scale (VAS) for pain measurement score of > 3.5 cm. Follow-up was minimum 3 years. Univariate and Multivariate logistic regression models ascertained baseline predictors of persisting pain.ResultsA total of 31 cases and 118 controls were included. Mean pain scores at baseline were 6.4 (SD 1.6) for cases and 5.9 (1.5) for controls. A greater proportion of cases than controls were females (77.4% vs 65.0%) with rheumatoid factor positive polyarthritis (12.9% vs 4.2%) or undifferentiated JIA (22.6% vs 8.5%). Oligoarthritis was less frequent in cases than controls (9.7% vs 33%). At baseline, cases had more active joints (mean of 11.4 vs 7.7) and more sites of enthesitis (4.6 vs 0.7) than controls. In the final multivariate regression model, enthesitis count at baseline (OR 1.40, CI 95% 1.19–1.76), female sex (4.14, 1.33–16.83), and the overall Quality of My Life (QoML) baseline score (0.82, 0.69–0.98) predicted development of persisting pain.ConclusionsAmong newly diagnosed children with JIA with moderate pain, female sex, lower overall quality of life, and higher enthesitis counts at baseline predicted development of persisting pain. If our findings are confirmed, patients with these characteristics may be candidates for interventions to prevent development of chronic pain.

A pragmatic, clinically optimized approach to characterizing adolescent irritability: Validation of parent- and adolescent reports on the Multidimensional Assessment Profile Scales-Temper Loss Scale.

Heightened irritability in adolescence is an impairing symptom that can lead to negative outcomes in adulthood, but effective screening tools are lacking. This study aimed to derive clinically-optimized cutoff scores using the Multidimensional Assessment Profile Scales-Temper Loss (MAPS-TL) to pragmatically identify adolescents with impairing irritability. A diverse sample of 79 adolescents and their parents completed the MAPS-TL-Youth version. Stepwise logistic regression analyses were used to determine the items associated with impairment, and receiver operator characteristic (ROC) analyses were conducted to derive optimal cutoff scores. Three parent-report items (become frustrated easily, angry/irritable/grouchy throughout the day, difficulty calming down when angry) and two youth-report items (hit/shove/kick when lost temper, difficulty calming down when angry) were strongly associated with impairment. Optimal cutoff scores garnered very good sensitivity (91%, 73%) and specificity (77%, 75%) for the parent- and youth-report versions respectively. Scores above these cutoffs were associated with increased internalizing and externalizing problems and lower overall quality of life. The MAPS-TL clinically optimized irritability scores show preliminary validity for implementation in practical settings to efficiently identify adolescents who need additional evaluation and/or intervention. Further research is important to validate these cutoff scores with larger population-based samples and real-world settings.

A narrative review of the socioeconomic burden associated with generalised pustular psoriasis.

Generalised pustular psoriasis (GPP) is a rare, chronic and life-threatening inflammatory skin disease characterised by widespread eruption of sterile pustules. With the approval of a GPP flare treatment in several countries occurring only recently, the socioeconomic burden associated with GPP is not well established. To highlight current evidence for patient burden, healthcare resource utilization (HCRU) and costs associated with GPP. Patient burden results from serious complications including sepsis and cardiorespiratory failure causing hospitalization and death. HCRU is driven by high hospitalization rates and treatment costs. The mean duration of a GPP hospital stay ranges from 10 to 16 days. A quarter of patients require intensive care, and the mean intensive care stay is 18 days. In comparison to patients with plaque psoriasis (PsO), patients with GPP have: a 64% higher score on the Charlson Comorbidity Index; higher hospitalization rates (≤36.3% vs. ≤23.3%); lower overall quality of life, and higher symptom scores for pain, itch, fatigue, anxiety and depression; direct costs associated with treatment 1.3- to 4.5-fold higher; higher rates of disabled work status (20.0% vs. 7.6%); and increased presenteeism (i.e. worse impairment at work), impaired daily activities, and medically related absenteeism. Current medical management and drug treatment utilising non-GPP-specific therapies impose a significant patient and direct economic burden. GPP also imposes an indirect economic burden by increasing work productivity impairment and medically related absenteeism. This high level of socioeconomic burden reinforces the need for new therapies with proven efficacy in the treatment of GPP.

OUTC-01. ESTABLISHING THE PSYCHOMETRIC VALIDITY OF ATTENTIONAL MEASURES APPLIED TO THE PAEDIATRIC NEURO-ONCOLOGY POPULATION: A SYSTEMATIC REVIEW

Abstract BACKGROUND: Associated with hydrocephalus, cranial irradiation, and certain chemotherapeutic agents, impairment in attention is a common feature of childhood brain tumour survivorship. Attentional processes are implicated in a number of cognitive functions, supporting sustained and selective attention, inhibition of competing stimuli, and management of divided attention (multi-tasking). Acquired attentional deficit reported in childhood survivors of brain tumour is correlated with reduced academic attainment, slowed intellectual development, poor peer relationships, and lower overall quality of life. Accurate identification of tumour-related attentional impairment is a prerequisite to access appropriate rehabilitative intervention. Despite this, no attentional measures have been adequately normed on the paediatric brain tumour population. As such, there exists little agreement as to which measure is most suitable for current research or clinical practice. AIM: This prospective study will assess the utility of common measures of childhood attention used in the paediatric Neuro-Oncology population. METHOD: Comprehensive database searches will be conducted to identify relevant articles that address the validity, reliability, and capability of attentional measures currently used within paediatric Neuro-Oncology populations. The psychometric properties and clinical utility of each measure will be reviewed using a purpose-developed evaluative tool. The strengths and limitations of particular measures when applied to this clinical population will be discussed. Recommendations for the utility for and against measures in future research or clinical application will be provided. FINDINGS: Analyses of these data continues with an aim to present initial findings by May 2023.

0446 Sleep Disordered Breathing Treatment is Associated with Improved Mental Health Symptoms and Quality of Life in Women Veterans

Abstract Introduction Sleep disordered breathing (SDB) is associated with poor mental health and lower overall quality of life (QOL); however, research examining these outcomes after positive airway pressure (PAP) therapy for SDB in women is limited. We studied a 6-session PAP adherence program that included behavioral sleep improvement strategies plus concepts of Acceptance and Commitment Therapy (ACT) to promote sustained PAP use, and evaluated the impact of this ACT-based program on daytime and mental health symptoms and quality of life in a sample of women veterans with SDB who were prescribed PAP. Methods Women veterans with SDB (n=90, mean = 53.2 years [range 26-80]) receiving care in an urban VA healthcare system were randomly assigned to a “control” SDB/PAP education program or the “Acceptance and Behavioral Changes to treat Sleep Apnea” (ABC-SA) program. All received PAP therapy. Measures included: Epworth Sleepiness Scale (ESS), Flinders Fatigue Scale (FFS), Patient-Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder Questionnaire 7-item (GAD), and The World Health Organization Quality of Life Scale, Brief (WHOQOL BREF). Mixed-effect models assessed the main effect of time across groups and between-group changes in these measures at post-treatment and 3 month-follow up compared to baseline. Results For the main effect of time, participants in both groups had significant improvements at post-treatment and 3-month follow-up in sleepiness, fatigue, depression, anxiety, and QOL (all p< 0.05). Compared to controls, women who received ABC-SA reported greater improvements in daytime sleepiness (ESS) at post treatment (p=0.04) and in fatigue (FFS) at 3-month follow-up (p=0.008). Conclusion PAP treatment in women with SDB was associated with improvements in measures of mental health and QOL. There was some evidence of even greater benefits with ABC-SA. Further work is needed to understand the relationship between SDB treatment and improved mental health outcomes in women and other underrepresented populations. Support (if any) VA HSR&D IIR 16-244 and RCS 20-191; NIH/NHLBI K24 HL143055, HRS&D COIN; VAGLAHS GRECC and VA Office of Academic Affiliations

Quality of life of patients with Parkinson’s disease and their families

Abstract Aim. The purpose was to determine the quality of life of Parkinson’s disease patients and their family members and to identify the factors that affect it. Material and methods. The research sample included 183 patients with Parkinson’s disease and 78 family members. Quality of life was assessed using the Czech Quality of Life Questionnaire of Patients with Progressive Neurological Disease. Results. Patients with a longer duration of the disease had a lower overall quality of life. The connection between higher dependence of patients on daily activities, and higher degree of motor disability was associated with a poorer quality of life in patients. In family members, an association was demonstrated between older age and a lower quality of life in the domain of normal daily activity, social and spiritual area. With older age, the higher burden of symptoms also increased and deteriorated overall quality of life. The connection between higher dependence of patients on daily activities and a worse quality of life of caregivers in the three domain was confirmed. Conclusions. Regular assessment of the impact of Parkinson’s disease on the quality of life of patients and their family and the identification of factors that affect it can help prioritize the treatment planning phase.

The Religious Schizophrenic: Why Spirituality is Crucial for Recovery

Up to 80% of schizophrenic patients use religion to cope with their illness. These positive spiritual coping strategies are the primary predictor of mental wellness in patients with schizophrenia. Yet, most medical professionals have no religious training and are often ill-equipped to guide their schizophrenic patients in spiritual matters. Typically, religious institutions and modern medicine are not associated together, but what happens when mental health professionals lack the training to assist 80% of their schizophrenic patients who use religion as a coping strategy? Schizophrenic patients whose beliefs are not respected have a higher rate of suicide, face increased stigma and report a lower overall quality of life. Such patients are more likely to decline mentally and drop out of treatment. Some scholars, psychologists and philosophers are now arguing that ignoring the connection between religion and mental wellness is unethical because practitioners are failing to take patient diversity into account. This paper will attempt to answer the following questions: In an increasingly diverse world, is it the responsibility of mental health professionals to learn about their patients’ religious beliefs, especially when their beliefs are so closely intertwined with their chances at successfully managing their illness, such as the case with schizophrenics? Why is it a good idea to consider combining religion and healthcare? Should the increase in diverse patients require additional training for mental health professionals? Is it unethical for a mental health care professional to be ignorant of diverse cultures and religions? What are the dangers of allowing medical professionals, who largely have no training in religious affairs, to guide mentally ill patients? What are the potential solutions for this problem? Which solutions are more effective and why? Are the current practiced healthcare models, which combine medicine and religion, effective? Keywords: schizophrenia, religion, treatment, therapy, psychosis, stigma

Depressive symptoms in adolescence and quality of life 17 years later - follow-up study.

The answer to the question to what extent depressive symptoms which occur in the middle and late adolescence period affect the quality of life in adulthood. The sample group consisted of 308 adults out of 3,445 who had participated in a 2000 study of prevalence of depressive symptoms among students. 17 years later, letters were sent to all study participants with information about the purpose of the study and an original questionnaire, with quality of life and quality of social network scales (the Collaborative Research on Ageing in Europe Social Network Index - COURAGE-SNI and WHOQOL-AGE) attached. The presence of depressive symptoms in the untreated population of adolescents is associated, in the case of women, with poorer education and fewer opportunities to work in adulthood compared to their non-depressive peers. In contrast, the men who were not depressive in adolescence take jobs in which they are more likely to earn a high income. An analysis of the quality of life showed statistically significant differences between men and women. In the group of non-depressive men, greater satisfaction with owned financial resources was observed. In the case of adult women, those who had been depressive in adolescence declared a sense of lower overall quality of life and satisfaction with the way of spending free time, satisfaction with achievement of life goals and owned financial means. Non-depressive women presented higher quality of social networks 17 years later. Long-term observation in our prospective study supports the hypothesis of a developmental character of adolescent depression.

Shoulder-specific Outcome after Proximal Humerus Fracture Influences Medium-term Overall Quality of Life.

Surgical treatment of proximal humerus fracture is an established procedure. Postoperative complications have been shown to have a significant impact on shoulder-specific outcome. Little is known to date about an influence on injury-independent quality of life. The aim of this retrospective study is to analyse whether patients with a poor functional outcome after surgically treated proximal humerus fracture also show a reduced general quality of life in the medium term. Emphasis is placed on the analysis of patients with poor functional outcome due to postsurgical complications. Evaluation of all patients operated at one level 1 trauma centre with a proximal humerus fracture in the period 01.01.2005 to 31.12.2015 and follow-up using validated scores (Constant-Murley Score [CMS], EQ-5D). Two groups, group A with good outcome (∆CMS ≤15P.) and group B with poor outcome (∆CMS ≥16P.), were defined. Furthermore, descriptive variables including definition of a complication were defined in advance. 138 patients were included in the study (group A: 91, group B: 47). The mean follow-up was 93.86 months ± 37.33 (36-167). Group B had significantly more complications. Furthermore, patients with poor outcome regarding the shoulder (group B) were also found to have significantly lower EQ-VAS (78.9±19.2 [20.0-100] vs. 70.4±19.5 [15.0-98.0]; p=0.008) and EQ index (0.91±0.14 [0.19-1.00] vs. 0.82±0.17 [0.18-1.00]; p<0.001). In conclusion, in the present study, the patients with poor outcome of shoulder function in CMS have significantly lower overall quality of life after a mean of more than 6 years of follow-up. The poor outcome was due to a significantly higher postoperative complication rate. This was independent of the fracture morphology present and the surgical procedure used.

Persistent Symptoms, Quality of Life, and Correlates with Health Self-Efficacy in Adolescent and Young Adult Survivors of Childhood Cancer.

Purpose: The numbers of adolescent and young adult (AYA) survivors of childhood cancer are exponentially growing. To ensure suitable services are available to meet the needs of this growing population, understanding the experience of late effects, quality of life, and potentially modifiable factors, such as self-efficacy, is required. Methods: AYA survivors of childhood cancer recruited through an After Cancer Therapy Service at a Children's Hospital rated their symptoms experience, quality of life, and self-efficacy using the Patient Reported Outcome Common Terminology Criteria for Adverse Events, Functional Assessment of Cancer Therapy-General (FACT-G), and Patient-Reported Outcomes Measurement Information System (PROMIS®), respectively. Descriptive statistics were used to characterize the sample. Quality-of-life scores were compared with population norms. Regression analyses were used to explore the relationships between symptom experience, quality of life, and self-efficacy. Results: Thirty participants (mean age 22 ± 4.4 years) reported an average of nine symptoms as persistently experienced at moderate or higher rated intensity among participants (standard deviation ±8.7; range: 0-32; interquartile range: 2-16); over half (n = 17, 56.7%) had finished treatment 10 or more years ago. Participants scored lower on the FACT-G Physical Well-being and Emotional Well-being, and higher on Social Well-being subscales than the general population. Around two-thirds of participants were confident in their ability to self-manage their health based on their health self-efficacy score. Bivariate linear regression identified a statistically significant increase in the overall quality of life with increased self-efficacy, adjusted for age and sex (0.60, 95% confidence interval [CI] 0.30-0.90, p < 0.01). Higher symptom burden was associated with a lower overall quality of life after adjusting for age and sex (-0.95, 95% CI: -1.35 to -0.54, p < 0.001). Conclusion: Young cancer survivors experience a substantial number of persistent symptoms related to their cancer treatment that may negatively impact aspects of their quality of life. Health self-efficacy is a potential target for future interventions.

Even miracle takes a little time; you have to believe what are the factors associated with quality of life of infertile couple?

Pregnancy and childbirth plays an important role for women all over the globe but Infertility put unfavorable effects on quality of life (QoL) of couple. The current study aims to evaluate factors associated with Quality of life of infertile couple. This study is a systematic review of research studies conducted on factors associated with Quality of life of infertile couple. The current literature review search was undertaken using multiple databases selected from articles pertinent to the study. The selection of subjects was undertaken from 2011 through 2019. We searched for reviews that reported the quality of life of infertile couple and factors that affect their physical as well as mental health status which include original studies on Quality of life and general health of infertile couple. Sample obtained from the general population, clinics and hospitals (3) cross sectional, comparative or longitudinal studies. Studies that are published and available for free access from 2011 to 2019. The studies utilizes the WHOQOL, Ferti QOL and SF 36 questionnaire to assess the quality of life ; along with this other domains like general health of Infertile women (GHQOL 28), Linda berg Questionnaire for sexual Satisfaction, Social Support Scaling, Beck’s inventory for depression. In addition, the mean age of males and females in the review studies were 34.54±8.54 and 29.28±6.71 years respectively and the mean duration of infertility of couples were 5.66±3.54 years. It was observed that Women had lower overall quality of life than men. Women and men who were married for fewer than 10 years had a significantly lower emotional score. Women who had a history of infertility treatment, men who have lived in the town or village men with primary infertility and men who have had primary education or lower, had lower scores for mind/body subscale. Social scores were found lower in women under the age of 30, women with middle or low income, men who were married for fewer than 10 years, men who did not have children for 5 years or more and men with primary infertility. Also Self-esteem scores were lower in the couples with longer infertility duration. Infertility had influenced all the domains of infertile couples but it had major impact on the emotional domain and the factors were found that affect the QOL status in infertile couples were Higher Education, Monthly Income, Urban residence, Number of IVF Treatment, Duration of Infertility, Increased Age, Self-esteem, social support, sexual satisfaction and marital satisfaction.