Lower General Quality Of Life Research Articles

Association of Stigma, Diabetes Distress and Self-efficacy with Quality of Life in Adolescents with Type 1 Diabetes Preparing to Transition to Adult Care.

In type 1 diabetes (T1D), psychosocial factors may impact quality of life (QOL) and clinical outcomes, but remain understudied, particularly during late adolescence. Our aim was to determine whether stigma, diabetes distress and self-efficacy are associated with QOL in adolescents with T1D as they are preparing to transition to adult care. We conducted a cross-sectional study of adolescents (ages 16-17 years) with T1D participating in the Group Education Trial to Improve Transition (GET-IT) in Montreal, Canada. Participants completed validated questionnaires on stigma using the Barriers to Diabetes Adherence [BDA] stigma subscale, self-efficacy (Self-Efficacy for Diabetes Self-Management Measure [SEDM], score 1 to 10), diabetes distress (Diabetes Distress Scale for Adults with Type 1 Diabetes) and QOL (Pediatric Quality of Life Inventory [PedsQL] 4.0 Generic Core Scale and PedsQL 3.2 Diabetes Module). We examined associations of stigma, diabetes distress and self-efficacy with QOL using multivariate linear regression models adjusted for sex, diabetes duration, socioeconomic status and HbA1c. Of 128 adolescents with T1D, 76 (59%) self-reported having diabetes-related stigma and 29 (22.7%) reported experiencing diabetes distress. Those with stigma had lower diabetes-specific and general QOL scores compared with those without stigma, and stigma and diabetes distress were both associated with lower diabetes-specific QOL and lower general QOL. Self-efficacy was associated with higher diabetes-specific and general QOL. Stigma and diabetes distress are associated with lower QOL whereas self-efficacy is associated with higher QOL in adolescents with T1D preparing to transfer to adult care.

Oral Health-Related Quality of Life and Mental Health Impairment in Patients Affected by Medication-Related Osteonecrosis of the Jaws: A Case-Control Pilot Study.

In the present case-control study, the impact of medication-related osteonecrosis of the jaws (MRONJ) on patients' oral health-related quality of life (OHRQoL), overall quality of life (QoL), and psychological status was evaluated using a set of questionnaires. These questionnaires included the Oral Health Impact Profile-14 (OHIP-14), the Short Form 36 Health Survey Questionnaire (SF-36), and the hospital anxiety and depression scale (HADS). A total of 25 MRONJ patients and 25 controls were included in the study. The results showed that MRONJ patients had a significantly poorer OHRQoL (OHIP-14 score p-value: 0.003) and lower general QoL, particularly in the domains of "physical functioning", "physical role", "body pain", "general health", and "vitality" in the SF-36 questionnaire (p-values: 0.001, 0.001, 0.013, 0.001, and 0.020). Although there were no significant differences between the groups in the SF-36 domains of "social functioning", "emotional role", and "mental health", the mean sub-scores of the HADS, specifically the depression and anxiety scores (HADS-D and HADS-A), were significantly higher in MRONJ patients (p-values: 0.002 and 0.009). However, the "mental health" domain of the SF-36 questionnaire showed a correlation with both HADS-A and HADS-D scores (p-values: 0.003 and 0.031). Therefore, a comprehensive clinical examination of MRONJ patients should include the assessment of OHRQoL, overall QoL, and psychological profile using different questionnaires. This approach aims to gather detailed information about patients' physical and psychological well-being, enabling the development of tailored treatments.

Neuropsychological assessment of Romanian burning mouth syndrome patients: stress, depression, sleep disturbance, and verbal fluency impairments.

Burning Mouth Syndrome (BMS) is a chronic condition characterized by a burning sensation in the oral mucosa, lasting more than 2 hours daily for more than 3 months, without clinical and/or laboratory evidence. BMS is often comorbid with mood, and psychiatric disorders, and a complex pathophysiology and interaction between impairments in nociceptive processing and psychologic function is occurring. In this work, we aimed to define the neuropsychological profile specific for BMS patients for a better management of this complex disease. We conducted a case-control study comparing 120 BMS patients and 110 non-BMS individuals (CTRL). Sociodemographic data and lifestyle habits, were collected, along with data regarding quality of life (SF-36 scale), stress (PSS), depression and anxiety (MADRS and HADS scales), sleep quality (PSQI scale), and cognitive functions (MoCA, SVF and PVF tests). The statistical analysis revealed a lower general quality of life (p < 0.001), worse sleep quality (p < 0.001) in BMS patients than CTRL. The BMS patients also displayed a higher prevalence of mild depressive symptoms than CTRL applying the MADRS (p < 0.001) and HADS-Depression scales (p = 0.001), whereas no differences in anxiety symptoms were found between the two groups (p = 0.174). Moreover, reduced scores semantic and phonemic verbal fluency tests (p < 0.05) were found, but no change in cognition was observed through MoCA (p = 0.551). Our results highlight that synergy between dentistry and neuropsychiatric assessment is essential for a successful management of BMS.

Socio-demographic and psychological factors associated with quality of life of women undergoing chemotherapy treatment for gynecological cancer

PurposeThis research aimed to investigate the socio-demographic, clinical, and psychological variables predictive of a greater functioning and quality of life in patients with gynecological cancer after their first cycle of carboplatin and taxol-based chemotherapy.MethodsThe sample of the present research consisted of 104 patients. The European Organization on Research and Treatment of Cancer QLQ-C30, the State-Trait Anxiety Inventory-Form Y, and the Multidimensional Scale of Perceived Social Support were administered to each participant.ResultsThe analyses showed that higher state anxiety levels predicted a lower role, emotional, and social functioning and a lower general quality of life. Higher trait anxiety levels and social support perceived from one’s friends predicted a greater role functioning. Similarly, having a relationship predicted a greater physical, cognitive, and social functioning. On the contrary, the presence of relapsed cancer was negatively associated with these patients’ quality of life.ConclusionsThe present study highlighted the importance of identifying patients at higher risk of experiencing lower levels of functioning and worse general quality of life to implement tailored interventions from the beginning of treatment, thus improving the quality of life of these patients throughout the chemotherapy treatment.

The Impact of Chronic Inflammatory Enteropathy on Dogs' Quality of Life and Dog-Owner Relationship.

This research was aimed at evaluating the impact of canine chronic enteropathies on dogs’ quality of life (QoL), their behavior, and owner–dog relationship. Forty-four dogs suffering from primary chronic enteropathies were assessed on the first visit with a veterinary gastroenterologist and on the first follow-up visit using a 1–10 visual scale to evaluate five features of QoL, the Canine Chronic Enteropathy Clinical Activity Index, the Lexington Attachment to Pet Scale, and the Canine Behavioral Assessment and Research Questionnaire. They were compared to a control group of 49 healthy dogs and to a group of 50 dogs suffering from cancer. QoL and severity of enteropathy were negatively associated; enteropathic dogs on the first visit had a lower QoL than healthy dogs for all features and a lower general QoL than cancer patients; enteropathic dogs on the follow-up visit improved significantly for general QoL, health QoL, and interaction QoL. Higher levels of attachment between the owner and the dog were obtained for dogs affected by chronic enteropathies. Finally, dogs showed higher scores for separation-related behaviors and contact/attention behaviors on the first visit than on the subsequent follow-up. As in human medicine, chronic enteropathies have a strong negative impact on dogs.

Reduction in anxiety and depression symptoms one year after knee replacement: a register-based cohort study of 403 patients

BackgroundAnxiety and depression are associated with patient dissatisfaction after total knee arthroplasty (TKA). Understanding whether preoperative knee-related symptoms could be a cause of anxiety and depression might help prevent unnecessary delay of surgery for this group of patients. We investigated changes in prevalence of anxiety and depression symptoms one year after TKA, and compared demographic data between patients with and without anxiety and depression symptoms preoperatively.MethodsThis was a prospective cohort study of 403 patients scheduled for TKA. Data on patient-related outcome measures and the prevalence of anxiety and depression symptoms were collected preoperatively and one year postoperatively. Before–after differences in anxiety/depression prevalence were compared with a chi-square test, and differences in demographic data between the groups with and without anxiety and/or depression symptoms were compared with an independent t test.ResultsAmong the 15% of patients with anxiety symptoms before surgery, 59% had improved in these symptoms one year after surgery; while among the 10% with depression symptoms before surgery, 60% had improved one year after surgery. Patients with preoperative anxiety and/or depression were younger, and had higher body mass index, lower general quality of life (EQ-5D-3L), higher pain scores (visual analog scale), and lower knee-related (KOOS) scores on all subscales except sport.ConclusionPresurgical symptoms of anxiety and depression seem to be partly caused by knee symptoms. Understanding of this issue would offer better strategies to prevent unnecessary delay of surgery in this group of patients.

Quality of Life and Mental Health of Infertile Women Affected by Endometriosis: A Narrative Review

Objective: Infertility has a severe impact on quality of life and mental health. This condition could be exacerbated by the existence of comorbid medical disease, like endometriosis. The aim of this critical narrative review is the examination of the state of the art about the quality of life and mental health in infertile women with endometriosis. Methods: We performed a rigorous and systematic search for studies on multiple electronic databases. A total of 6 papers were included in the review and were subjected to interpretative and critical narrative synthesis. Results and Discussion: Major findings are resumed in the following points: (a) infertile women with endometriosis when compared to infertile ones without endometriosis show higher depression, stress perception, and anxiety, and lower general quality of life; (b) quality of life specifically related to infertility is similar among women with and without endometriosis and seems to be related to personality and beliefs factors; (c) giving birth to a child is related to better mental quality of life; (d) during assisted reproductive treatment (ART) stimulation, infertile women with endometriosis have a decrease of dysmenorrhea and dyspareunia; (e) satisfaction of ART is related to the number of attempts, treatment accomplishment and pregnancy test outcomes. Clinical implications of these findings and suggestions for future researches were discussed. Conclusion: Concluding, it is crucial to assess the psychological factors related to endometriosis and infertility to reduce the impact of these diseases on quality of life and mental health, provide adequate support to these patients, improve their satisfaction and increase the change to get pregnant.

Qualidade de vida de estudantes de medicina e a dificuldade de conciliação do internato com os estudos

Introdução: Os anos finais do curso de graduação em Medicina estão cercados pelo aumento gradual de responsabilidades acumuladas durante o curso, que por muitas vezes, podem sobrecarregar os estudantes modificando a qualidade de vida dos mesmos. Objetivo: Analisar o perfil de qualidade de vida de formandos do curso de Medicina e a sua associação com a dificuldade em conciliar o internato e os estudos. Métodos: A amostra foi formada por 302 estudantes, de ambos os sexos, com média de idade de 25,4 anos, que frequentavam o internato obrigatório do curso de Medicina. Foram investigadas a qualidade de vida por meio do WHOQOL-bref, informações sociodemográficas e características do internato. Resultados: Os scores da qualidade de vida geral (63,52) e domínios Psicológico (73,17) e Físico (73,19) foram os indicadores de qualidade de vida com percepção mais negativa por parte destes estudantes. Da amostra, 29,1% relataram percepção neutra ou negativa destas questões. Os domínios Físico (p=0,004), Psicológico (p=0,008) e Meio ambiente (p=0,026) apresentaram poder preditivo de 15,8% da qualidade de vida geral. Além disso, os estudantes que possuíam dificuldades em conciliar o internato com o estudo tiveram menor qualidade de vida geral (p=0,026) e física (p=0,010). Conclusão: Os piores indicadores de qualidade de vida foram os domínios Psicológico, Físico e a qualidade de vida geral. Uma parcela da amostra relatou percepção neutra ou negativa de sua qualidade de vida. Alunos com dificuldade em conciliar o internato e os estudos apresentaram percepção mais negativa no domínio Físico e na qualidade de vida geral.

Gender differences in the perception of quality of life of patients with colorectal cancer.

To identify the gender differences in assessing quality of life of patients undergoing chemotherapy treatment for colorectal cancer. This is a cross-sectional investigation conducted with 144 patients (72 men and 72 women) undergoing chemotherapy treatment in a southeastern Brazilian hospital. Data were gathered trough a sociodemographic and clinical information form and the Health-related Quality of Life instrument from the European Organization for Research and Treatment of Cancer. Cognitive function leads to lower general quality of life, with higher effect in men when compared to women. Body image (p=0.023), abdominal pain (p=0.020) and dry mouth (p=0.001) produced lower quality of life in women. On other hand, men showed lower quality of life related to the following symptoms: fecal incontinency (p<0.001), sexual impotency (p=0.027) and sexual arousal (p<0.001). The illness symptoms and chemotherapy treatment effects that negatively impact on quality of life differ between men and women. Thus, healthcare needs to be focused on these specific factors that affect the quality of life according to the patient's gender.

T51 - Using Machine Learning To Build Individualized Prediction Models Of Future Quality Of Life In Psychosis Patients

Background Schizophrenia (SCZ), bipolar disorder (BD) and schizoaffective disorder (SCZA) are severe, chronic mental illnesses, characterized by a marked decrease in quality of life (QoL) and functioning in a great proportion of patients. QoL, subjective well-being and psychosocial functioning are important determinants of patient satisfaction and patient-physician relationship and improvement in these domains is often more important for the patients than the reduction of clinical symptoms. With the growing emphasis on personalized care in everyday clinical practice, there is an increasing need for tools that can provide individual predictions on the future course of these patient-centered domains and thus help clinicians in providing individually tailored interventions. Therefore, we used machine learning to predict general and psychological QoL 6-months after an initial assessment in individuals diagnosed with SCZ, BD and SCZA using a combination of clinical, demographic and genetic variables. Methods In an ongoing longitudinal naturalistic study (www.kfo241.de, www.PsyCourse.de), patients meeting DSM-IV criteria for BD, SCZ and SCZA were recruited at multiple sites across Germany and Austria. Information on their sociodemographic background, family history, current psychiatric symptoms, functioning and QoL (WHOQoL-BREF) was obtained with a battery of rating scales in 6-month intervals. For the current analysis results of T1 (N=764) and T2 (N=428) were used. Participants were genotyped on the PsychChip (Illumina) whole-genome SNP array and their SCZ polygenic risk scores (PRS) at 11 different p-value thresholds (pTs) (pT1=0.00000005, pT11=1) were calculated using data from SCZ PGC2 (excluding German participants) as training data set. The importance of the clinical and demographic features and the cumulative SCZ polygenic risk in predicting 6-month (T2) general and psychological QoL was tested using linear Support Vector Machines. The prediction algorithm was wrapped into a repeated-nested cross-validation setting to ensure good generalizability. Results Higher baseline scores on the negative symptoms subscale of the PANSS, higher levels of baseline depression (BDI), lower level of functioning (GAF) and being unemployed or having a part-time job were the most important determinants of impaired T2 general or psychological QoL (test-fold balanced accuracy 61.2% and 71.3%, respectively). The PANSS negative symptoms subscale items were more important in the prediction of general QoL, whereas items of the BDI depression scale had higher weight in predicting psychological QoL. Though having higher SCZ-PRS were associated with lower T2 general QoL, compared to the clinical variables, the SCZ polygenic risk seemed to play a less important role in determining future QoL and thus was not included in the final prediction model. Discussion Our results indicate that prognostic tools using clinical data can potentially be used to indicate future general and psychological QoL of SCZ, BD and SCZA patients. However, the predictive accuracy requires improvement to be clinically useful. Further research will investigate the association found here between SCZ-PRS and lower general QoL with more sensitive biological markers. Specifically, we are currently working on techniques which would allow us to add further genomic or transcriptomic data to the analysis.

Predicting the patients who will struggle with anal incontinence: sensitivity to disgust matters.

Quality of life varies in patients with anal incontinence. The severity of symptoms is a surprisingly modest predictor, but they reliably elicit disgust. The current work assessed prospectively whether dispositional sensitivity to disgust predicted the quality of life in patients with anal incontinence. Seventy-five patients with anal incontinence identified from the waiting list for the pelvic floor clinic at the Greenlane Clinical Centre, Auckland, New Zealand, completed questionnaires assessing symptom severity (Fecal Incontinence Severity Index) and disgust sensitivity (Disgust Sensitivity-Revised scale) prior to a first appointment. Three months later incontinence-specific (Fecal Incontinence Quality of Life Scale, FI QLS) and general quality of life (World Health Organization Quality of Life-BREF, WHOQOL-BREF) were assessed. Greater severity of symptoms prospectively predicted lower incontinence-specific quality of life (FI QLS lifestyle domain) and lower general quality of life (WHOQOL-BREF environmental domain). Greater disgust sensitivity predicted poorer psychological and environmental well-being, and moderated the link between symptom severity and outcome. Persons low in disgust sensitivity reported a higher quality of life when symptom severity was low, but those with a high disgust sensitivity had a low quality of life regardless of symptom severity. The functional status of patients with anal incontinence explains some but not all of the variation in quality of life. Emotional factors such as disgust appear to have a role. Disgust sensitivity warrants further attention.

Construct and concurrent validity of a patient-reported adverse drug event questionnaire: a cross-sectional study.

BackgroundDirect patient-reported information about adverse drug events (ADEs) is important since it adds to healthcare professional-reported information about the safety of drugs. Previously, we developed an instrument to assess patient-reported ADEs in research settings. The aim of this study is to assess the construct and concurrent validity of the questionnaire.MethodsPatients on at least an oral glucose-lowering drug completed the ADE questionnaire, the World Health Organization Quality of Life-BREF, and the Treatment Satisfaction Questionnaire for Medication (TSQM). The ADE questionnaire assesses ADEs for any drug that the patient uses. Construct validity was assessed by testing whether patients reporting an ADE had a lower general quality of life and physical health than those not reporting an ADE, using Mann–Whitney U-tests and t-tests (significance level <0.05). For concurrent validity, we tested whether ADEs that patients associate with particular drugs in the ADE questionnaire are documented in the Summary of Product Characteristics (SPC) of those drugs, and whether patients who report an ADE with the use of metformin on the TSQM, mention metformin as a drug associated with an ADE on the ADE questionnaire. Agreement of 70% with the SPC was considered satisfactory. Sensitivity and positive predictive value (PPV) were calculated for the comparison with the TSQM, where 70% was used as the cut-off level for sufficient concurrent validity.ResultsWe included 135 patients (mean age 64 years, 35% women). Patients who reported an ADE (N = 37) had a lower general quality of life and physical health than those not reporting an ADE (P < 0.05). For 78 of the 146 reported ADEs (53%), patients mentioned at least 1 particular drug associated with the ADE. After clustering related ADEs, this resulted in 56 patient-reported ADE-drug associations. Of these, 41 (73%) were in agreement with information in the SPC. Finally, the questionnaire had a sensitivity of 38% and PPV of 79% for assessing ADEs associated with metformin.ConclusionsThe construct validity of the patient-reported ADE questionnaire was sufficient for reporting any versus no ADE, but the concurrent validity was only partly demonstrated. Therefore, the questionnaire needs to be adapted before it can be used.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-014-0103-6) contains supplementary material, which is available to authorized users.

Pain Intensity, Psychological Inflexibility, and Acceptance of Pain as Predictors of Functioning in Adolescents with Juvenile Idiopathic Arthritis: A Preliminary Investigation

Juvenile Idiopathic Arthritis (JIA) is a chronic rheumatic disease associated with pain and maladjustment. This study investigated whether pain, acceptance of pain, and psychological inflexibility uniquely predicted functional disability, anxiety, general quality of life (QOL), and health-related quality of life (HQOL) among adolescents with JIA. Twenty-three adolescents with JIA and pain were recruited from a pediatric rheumatology clinic. Participants completed self-report measures pertaining to the key study variables. A series of multiple regression analyses demonstrated that higher pain uniquely predicted higher functional disability. Greater psychological inflexibility uniquely predicted higher anxiety, lower general QOL, and lower HQOL. Increases in acceptance of pain were found to be uniquely related to increases in general QOL. These data confirm prior findings that pain impacts functioning, and provide preliminary findings that psychological inflexibility and acceptance may be important targets of psychological intervention for youth with JIA and pain to improve functioning and QOL.