Mean Physical Component Summary Scores Research Articles

Quality of life and mental health due to COVID-related lifestyle changes and sociodemographic characteristics among Asian Indians

PurposeTo examine quality of life (QoL) and mental health among Asian Indians in Southwest and Central-west Florida by COVID-related lifestyle changes, and demographic characteristics.MethodsQoL was assessed using SF-12 questionnaire while mental health/healthcare was assessed using the household pulse survey. Face-to-face interviews and self-administered online surveys were conducted among 151 participants in 2021–22. F and Chi-square statistics were used to examine the differences in QoL scores and mental health/mental healthcare by sociodemographic factors and COVID-related lifestyle changes.ResultsMental Component Summary (MCS) scores were lower for those who experienced changes in work expectations (p 0.041), sleep (p 0.002), exercise (p < 0.001), meditation (p.004) and connecting with family (p 0.007) and among those with family testing COVID positive (p.012). Mean Physical Component Summary (PCS) scores were lower for caregivers (p .008). PCS scores were lower for certain income groups (p 0.006), retired (p 0.004), older age groups (p 0.002). Lower MCS scores with college education (p .005), those who were students (p <0 .001), younger age groups (p < 0.001). Those who helped with homeschooling felt anxious (p 0.049), couldn’t stop worrying (p 0.046) and took medications (p < 0.001). Participants’ families who tested COVID positive were anxious (p = 0.019) and worried (p = 0.015). Those with greater work expectations sought counseling (p = 0.009) and those who connected more with their family were anxious (p = 0.008).ConclusionThe pandemic affected QoL, especially the mental component and increased anxiety and worrying. Mental health services for younger individuals, those with caregiving responsibilities and facing increased job demands must be prioritized.

The impact of stroke and bleeding on mortality and quality of life during the first year after TAVI: A POPular TAVI subanalysis.

Bleeding and stroke are frequent complications after transcatheter aortic valve implantation (TAVI). The mortality risk associated with these events has been reported before, but data regarding their impact on health-related quality of life (QoL) is limited. To evaluate the impact of bleeding and stroke occurring within 30 days after TAVI, on mortality and QoL during the first year after TAVI. POPular TAVI was a randomized clinical trial that evaluated the addition of clopidogrel to aspirin or oral anticoagulation in patients undergoing TAVI. Besides clinical outcomes, QoL was assessed using the Short Form-12 and EuroQoL Five Dimensions questionnaires before, and at 3, 6, and 12 months after TAVI. Major or life-threatening bleeding occurred in 81 patients (8.3%) and was associated with an increased risk of death (hazard ratio [HR] 1.95 [95% confidence interval (CI) 1.00-3.79]); minor bleeding occurred in 104 patients (10.6%) and was not associated with mortality (HR 0.75 [95% CI 0.30-1.89]). Stroke occurred in 35 patients (3.6%) and was associated with an increased risk of death (HR 2.90 [95% CI 1.23-6.83]). Mean mental component summary (MCS-12) scores over time were lower in patients with major or life-threatening bleeding (p = 0.01), and similar in patients with minor bleeding, compared to patients without bleeding; mean physical component summary (PCS-12) scores, EQ-5D index, and visual analog scale (VAS) were similar between those patients. Mean MCS-12 scores were lower in patients with stroke (p = 0.01), mean PCS-12, EQ-5D index, and VAS were similar compared to patients without stroke. Major or life-threatening bleeding and stroke were associated with an increased risk of death and decreased mental QoL in the first year after TAVI.

Patient-Reported Quality of Life at Diagnosis in Adolescent and Young Adults With Cancer.

The overall landscape of health-related quality of life (HRQoL) has not been thoroughly investigated in adolescents and young adults (AYAs) with cancer. Data are also lacking on how well HRQoL at the time of cancer diagnosis can prognosticate long-term survival in AYA survivors. We included 3,497 survivors of AYA cancer (age 15-39 years at diagnosis) who completed the Short-Form 12 Health Survey (SF-12) HRQoL questionnaire at diagnosis. Physical component summary (PCS) and mental component summary (MCS) scores were generated, with scores <50 representing poor HRQoL. Differences in HRQoL by patient characteristics and tumor type were investigated using violin plots and t tests/analysis of variance. The effect of HRQoL on overall survival was assessed using Kaplan-Meier plots and Cox proportional hazards models. Overall mean PCS and MCS scores in this racially/ethnically diverse cohort (64% White, 19% Hispanic, 10% Black, and 7% other race/ethnicity) were 43.6 and 46.7, respectively. Women with breast cancer reported the most favorable PCS (50.8), and those with cervical cancer reported the lowest MCS (42.8). Age at diagnosis was associated positively with PCS (P<.001) and inversely with MCS (P<.001). Females had higher PCS yet lower MCS than males (both P<.001). Marginalized racial and ethnic populations reported lower PCS than White patients (P<.001). Physical and mental HRQoL were prognostic and associated with increased risk of poor survival (hazard ratio, 1.95; 95% CI, 1.72-2.21 for physical HRQoL, and 1.26; 95% CI, 1.13-1.40 for mental HRQoL). Physical and mental HRQoL at diagnosis vary across patient characteristics in AYA cancer survivors. Poor HRQoL at diagnosis may be a prognosticator of diminished overall survival among AYA cancer survivors.

Quality of life of patients one month after open heart surgery according to the sf-36 health scale

ABSTRACT Introduction: Quality of life after open heart surgery shows the level of impact on the patients; moreover, it also reflects physical, functional, and psychosocial decline caused by diseases of the entity. This study evaluates the characteristics of quality of life of patients one month after open heart surgery according to the SF-36 health scale at Hue Central Hospital. Methods: This was a cross - sectional descriptive study of 217 patients who underwent open heart surgery at the Cardiovascular Center, Hue Central Hospital, from August 1, 2022, to April 30, 2023. Results: The mean general quality of life score was 64.21 ± 15.71, and the mean physical and mental component summary scores were 69.44 ± 16.08 and 58.98 ± 15.74, respectively. The average of eight health domains scores was physical functioning (84.42 ± 12.21); role physical (86.17 ± 22.41); bodily pain (46.77 ± 20.47); general health (60.38 ± 14.17); vitality (62.05 ± 27.01); role emotional (58.54 ± 11.27); mental health (64.22 ± 12.74); social functioning (51.09 ± 14.51). The mean anxiety disorder and perceived level of social support scores were 9.28 and 65.14, respectively. Conclusion: The quality of life of patients after open heart surgery is quite good, anxiety disorders and perceived levels of social support are high.

#1051 Association between anemia/iron deficiency and health-related quality of life in patients with advanced CKD: the Reach-J CKD cohort study

Abstract Background and Aims Low Hb and low TSAT levels are associated with worse health-related quality of life (HRQOL) in patients from Brazil, France and USA in the CKD outcomes and Practice Patterns Study (CKDopps). However, there is little evidence for those in Asian countries. We aimed to evaluate the association between anemia/iron deficiency and HRQOL in Japan. Method We conducted a nationwide cohort study of Japanese patients with advanced CKD. We recruited 2249 patients with stage G3b-5 CKD receiving nephrologist care from 31 representative facilities throughout Japan, randomly selected with stratification by region and facility size, aligned with the CKDopps. The association between Hb and TSAT levels at enrolment and HRQOL derived from KDQOL-36 was evaluated. Results Mean age was 69.1 ± 12.6 years; 35.2% were female; mean body mass index was 23.6 ± 4.8 kg/m, mean eGFR was 23.2 ± 10.5 mL/min/1.73 m2. Mean Hb was 11.7 g/dL, mean TSAT was 31.4% and ferritin was 147.4 ng/mL. The mean physical component summary (PCS) scores, mental component summary (MCS) scores and scores on the three KDQOL subscales were worse with Hb &amp;lt;10, compared to ≥10 g/dL. Few differences in PCS and MCS scores were seen between the TSAT levels. Conclusion In Japanese patients with CKD, HRQOL was worse with Hb &amp;lt;10 g/dL and not associated with TSAT levels. These data will provide important information for international comparisons and the clinical practice of Asian patients with CKD.

CO2 Laser Frenuloplasty: Advancing Minimally Invasive Techniques for Rapid Healing and Improved Patient Outcomes

This study explores the innovative use of CO2 laser technology in frenuloplasty, a significant shift from classic methods like scalpel surgery or electrocautery towards a minimally invasive approach. The research involved 15 patients aged 25 to 50, undergoing frenuloplasty with a CO2 laser system equipped with a 7-inch defocused handpiece, set at 20 Hz and 0.3 W. This method diverges from conventional laser techniques, focusing on controlled laser passes combined with manual traction to elongate the fibrous tissue of the frenulum. The results demonstrated that the CO2 laser technique allowed for a precise and progressive modification of the frenulum, significantly reducing the risks of hemorrhage and secondary intention fibrosis. The healing process was notably expedited, with patients reporting satisfactory outcomes within a two-week period. Statistically significant improvements were observed in patient-reported outcomes, as evidenced by the increases in the Short Form Health Survey (SF-12) scores, with the mean Physical Component Summary (PCS) score rising from 32.5 to 47.5 and the mean Mental Component Summary (MCS) score from 39.3 to 52.3 (p &lt; 0.001 for both). The study concludes that CO2 laser frenuloplasty is an effective and safe technique, offering substantial benefits in terms of reduced healing time and enhanced patient satisfaction. The significant improvements in SF-12 scores underscore the positive impact on patient quality of life, advocating for the broader application of this technique in clinical practice. Further research is warranted to explore its potential in a wider clinical context.

Long-term outcomes of pectoralis major transfer for scapular winging due to long thoracic nerve palsy: results after a median follow-up of 17 years

A pectoralis major (PM) transfer is a viable treatment option for patients with scapular winging due to long thoracic nerve (LTN) palsy not responding to nonsurgical management. However, the long-term outcomes remain unknown. Therefore, the purpose of this study was to evaluate the long-term outcome of shoulder function (ie, minimum follow-up of 10 years) and quality-of-life (QoL) of patients treated for scapular winging due to LTN palsy with a PM transfer. This observational cohort study included 15 patients (16 shoulders) who underwent PM transfer, using a tendoachilles allograft, between 1995 and 2012. Shoulder forward flexion and abduction were analyzed preoperatively, 1 year after surgery and at the final follow-up. SF-36 component scores (physical component summary (PCS) and mental component summary (MCS)) were used to evaluate the QoL. Shoulder forward flexion and abduction measured in degrees improved from 86 (SD 14.5) and 82 (SD 33.8) preoperatively to 140 (SD 27.3) and 138 (31.3) at 1 year postoperatively. After a median follow-up of 17 years, mean shoulder functions were slightly lower than at 1 year postoperatively, but still better than preoperative function, ie, forward flexion 121 (SD 41.9) and abduction 122 (SD 44.5). The mean PCS score at the final follow-up was 41.9 (SD 9.7), and the mean MCS score was 49.9 (SD 12.5). Better shoulder function at the final follow-up was significantly associated with higher QoL in terms of PCS scores (P=.023), but not MCS scores (P=.287). The results of the present study indicate that PM transfer augmented with an achilles tendon allograft for scapular winging due to LTN palsy leads to functional improvements that persist in long term. These functional improvements likely translate to better QoL based on their association.

Postoperative outcome of 30patients with navicular bone fractures-In connection with AOFAS-Score, SF-12 and fracture classifications

Fractures of the navicular bone are rare and the number of those treated surgically is even smaller. Moreover, scientific analyses on this topic are only sporadically present in the literature, therefore this retrospective and monocentric study was initiated. Atotal of 30patients with 30fractures were included. With the exception of one primary fusion, all patients underwent open reduction with internal osteosynthesis. Clinical and radiological follow-up was performed at least 2years postoperatively using AOFAS-Score, SF-12 and a radiological examination. The primary objectives were the clinical and radiologic outcomes as mid-term to long-term outcomes. The secondary objective was to compare these results with two existing computed tomography (CT) fracture classifications in terms of their association with the outcome. The median follow-up was 7.8years (range 2-16.2 years) postoperatively. One patient suffered an infection, four patients required secondary arthrodesis and eight patients had to change their occupation. The mean AOFAS-Score was 80.8/100 and the mean physical and mental SF-12 component summary scores were 47.1 and 55.7 points, respectively. Male sex and arthrodesis were associated with worse outcomes in both scores but not patient age or ipsilateral concomitant injuries. Both CT fracture classifications showed low predictive value. The severity of the injury in the preoperative CT showed no connection with the clinical outcome in the AOFAS-Score and SF-12 scores. Posttraumatic osteoarthritis and secondary arthrodesis are associated with apoor outcome. In the course of the observational period the reduction results improved, which was accompanied by abetter clinical outcome.

Assessing Health-Related Quality of Life in Non-Directed Versus Directed Kidney Donors: Implications for the Promotion of Non-Directed Donation.

Living kidney donation has increased significantly, but little is known about the post-donation health-related quality of life (HRQoL) of non-directed donors (NDs) vs. directed donors (DDs). We thus examined the outcomes of 112 living kidney donors (82 NDs, 30 DDs). For the primary outcomes-namely, the mean physical component summary (PCS) and mental component summary (MCS) scores of the 12-item Short Form Survey (SF-12) questionnaire-scores were significantly higher for the NDs vs. the DDs (PCS: +2.69, MCS: +4.43). For secondary outcomes, NDs had shorter hospital stays (3.4 vs. 4.4days), returned to physical activity earlier (45 vs. 60days), exercised more before and after donation, and continued physical activity post-donation. Regression analyses revealed that donor type and white blood cell count were predictive of the PCS-12 score, and donor type was predictive of the MCS-12 score. Non-directed donation was predictive of a shorter hospital stay (by 0.78days, p < 0.001) and the odds of having PCS-12 and MCS-12 scores above 50 were almost 10 and 16 times higher for NDs, respectively (p < 0.05). These findings indicate the safety and potential benefits of promoting non-directed donation. However, careful selection processes must be maintained to prevent harm and exploitation.

Impact of COVID infection on lung function test and quality of life

Post-COVID-19 pulmonary sequalae are well-recognized early in the pandemic. Survivorship clinics are crucial for managing at-risk patients. However, it is unclear who requires pulmonary function test (PFT) and when PFTs should be performed. We aim to investigate for whom and how these interval PFTs should be performed. We performed a single-centre, prospective cohort study on COVID-19 survivors between 1st May 2020 and 31st April 2022. These patients were followed up at 6, 9 and 12 months with interval PFT and Short Form-36 (SF-36) Health Survey. Those with PFT defects were offered a computed tomography scan of the thorax. Of the 46 patients recruited, 17 (37%) had severe/critical illness. Compared to those with mild/moderate disease, these patients were more likely to experience DLCO defects (59% versus 17%, p = 0.005) and had lower SF-36 scores (mean physical component summary score of 45 ± 12 versus 52 ± 8, p = 0.046). These differences were most notable at 6 months, compared to the 9- and 12-months intervals. DLCO defects were also associated with older age, raised inflammatory markers and extensive CXR infiltrates. Besides interstitial-like abnormalities, obesity and undiagnosed lung conditions accounted for 39% of the PFT abnormalities. Interval PFTs can be performed earliest 6 months post-COVID-19. Patients with normal tests were unlikely to develop new abnormalities and would not require repeat PFTs. Abnormal PFTs can be followed-up with repeat PFTs 6 monthly until resolution. Non-COVID-19 differentials should be considered for persistent PFT abnormalities.

#2814 WHAT ABOUT THE IMPACT ON INFORMAL CAREGIVERS? EFFECTS OF DIALYSIS PATIENTS' HEALTH-RELATED QUALITY OF LIFE AND SYMPTOM BURDEN ON CAREGIVERS

Abstract Background and Aims Starting dialysis has a major impact on patients’ lives. Dialysis patients experience impairments in health-related quality of life (HRQoL) and high symptom burden. Informal caregivers are crucial for dialysis patients’ well-being, as patients often rely on their support and care. However, informal caregivers who provide long-lasting, intensive care may also experience a significant burden. This, in turn, may lead to impaired HRQoL of both the informal caregiver and the patient. To date, little research has been done among informal caregivers of dialysis patients, even though they may experience negative effects of the impaired functioning of the patient. Therefore, the aim of this study was to assess the impact of dialysis patients’ HRQoL and symptom burden on HRQoL of their informal caregivers. We hypothesize that impaired HRQoL and high symptom burden of dialysis patients have a significant impact on informal caregivers’ mental HRQoL, but little to no impact on their physical HRQoL. Method We conducted a cross-sectional study with 193 dyads of adult dialysis patients and their informal caregivers. Data at dialysis initiation were obtained from the ongoing multicenter, observational cohort study on informal caregivers of dialysis patients, which is an extension of the Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes (DOMESTICO). The 12-item Short Form Health Survey (SF-12), which provides mental component summary (MCS) and physical component summary (PCS) scores (range 0-100), was used to measure HRQoL in both informal caregivers and dialysis patients. The number of symptoms (range 0-30) and symptom burden (range 0-150) were measured with the Dialysis Symptom Index (DSI). Data were analyzed using linear regression and adjusted for possible confounders. Results Mean age of informal caregivers was 60 ± 15 years, 72.0% were female, and 77.2% were spouses of the dialysis patient. Mean age of patients was 65 ± 14 years, 32.1% were female, and 62.7% were on in-centre hemodialysis. Mean MCS and PCS scores of informal caregivers were 47.8 ± 9.7 and 48.7 ± 9.8, respectively. Mean MCS and PCS scores of patients were 47.9 ± 9.0 and 35.7 ± 10.3, respectively, and mean symptom number and burden were 11.3 ± 5.9 and 31.5 ± 17.6, respectively. After adjustment for confounders, significant effects of patients’ (1) MCS score (β = 0.305; p = 0.003), (2) symptom number (β = -0.434; p = 0.002), and (3) symptom burden (β = -0.151; p &amp;lt; 0.001) were found on caregivers’ MCS score. No significant effects on caregivers’ PCS score were found. Conclusion Lower mental HRQoL, higher symptom number, and higher symptom burden of dialysis patients are associated with lower mental HRQoL of their informal caregivers. These findings underline the importance of maintaining patients’ HRQoL and reducing symptom burden, as these also affect informal caregivers. In addition, given that improving patients’ HRQoL and reducing symptom burden are not always within reach, these findings emphasize the importance of supporting informal caregivers of dialysis patients.

Health-related quality of life in Hong Kong physicians up to 20 years post-graduation: A cross-sectional survey.

Problems with health-related quality of life can affect physicians' ability to work effectively. This study compared the health-related quality of life of Hong Kong physicians to the general population and explored the factors associated with mental and physical health-related quality of life. This cross-sectional study was conducted from January to April 2016. Medical graduates from the University of Hong Kong participated in a survey containing the Short Form-12 Item Health survey version 2, Patient Health Questionnaire-9, Copenhagen Burnout Inventory, and items on lifestyle behaviors, career satisfaction, and socio-demographics. 496 responses were received. The mean physical component summary score was 53.2 (SD = 7.6), similar to the general population. The mean mental component summary score was 43.6 (SD = 11.8), significantly worse than the general population (P<0.01). Compared to the general population, all Short-Form 12 Health Survey version 2 domains were worse in doctors, aside from bodily pain and general health. Regular exercise was positively associated with physical component summary scores (Coeff 2.024; P = 0.047); but having children and higher personal burnout scores were negatively associated with it (Coeff -1.890; P = 0.036; and Coeff -0.045; P = 0.027, respectively). Poorer mental component summary scores correlated with worse personal (Coeff -0.284; P< 0.001), work-related (Coeff -0.135; P = 0.040), and patient-related burnout (Coeff -0.060; P = 0.041), and higher Patient Health Questionnaire-9 scores (Coeff -9.170; P<0.001). There were significant differences in mental health (P = 0.042) and mental component summary scores (P = 0.012) across age groups, but not with gender. Hong Kong physicians are less impacted by physical health than mental health. Compared to the general population, doctors' mental health has a more significant impact on their lives. Interventions aimed to improve burnout and depression rates in physicians may improve physicians' mental health-related quality of life.

Health-Related Quality of Life in Adults With Adolescent- and Adult-Onset Systemic Lupus Erythematosus: A Longitudinal Study of a Multiethnic US Cohort.

The long-term impact of childhood-onset systemic lupus erythematosus (SLE) on health-related quality of life (HRQoL) in adult SLE patients in comparison to those with adult-onset SLE is unknown. We aim to examine and compare HRQoL trajectories in adults with adolescent- and adult-onset SLE. Patients enrolled in the LUpus in MInorities: NAture versus Nurture cohort were included. Adolescent-onset SLE were those diagnosed before 24 years of age, and adult-onset SLE were those diagnosed otherwise. Sociodemographic, clinical, medications, behavioral/psychological, and functioning data were obtained. Longitudinal trajectories of the physical component summary (PCS) and the mental component summary (MCS) Short Form 36 health survey scores were compared between the groups using a linear mixed model accounting for time-dependent and independent covariates. A total of 470 SLE patients were included (95 with adolescent-onset SLE and 375 with adult-onset SLE). The mean ± SD age at diagnosis was 19.7 ± 2.8 years in the adolescent group and 39.3 ± 11.0 years in the adult group. The baseline PCS scores were higher (better physical functioning) in adolescent-onset SLE than in adult-onset SLE (38.9 versus 34.3, respectively; P < 0.001); however, the baseline MCS scores were comparable between the groups (41.4 versus 40.5, respectively; P=0.53). The HRQoL improved equally in both groups with no statistically significant difference within and between the groups (last mean PCS and MCS scores 43.9 and 45.3 in adolescent-onset SLE; 38.1 and 43 in adult-onset SLE). Adults with adolescent-onset SLE exhibited better physical functioning than those in the adult SLE group, despite more severe disease; noteworthy, HRQoL was below the general US population, despite clinically meaningful improvement in HRQoL over time in both groups.

Long-Term Change and Predictors of Change in Physical and Mental Function after Rehabilitation: A Multi-Centre Study

To investigate changes and predictors of change in physical and mental function over a 3-year period after rehabilitation. Prospective cohort. Patients, across diseases, living in western Norway, accepted for somatic specialized interprofessional rehabilitation (n = 984). Physical and mental function were assessed at admittance (baseline), and after 1 and 3 years using the Medical Outcome Study Short Form 36 (SF-36). Associations between changes in SF-36 component summary scores and sense of coherence, pain, disease group (musculoskeletal, neoplasm, cardiovascular, neurological, other), exercise habits and demographic variables were analysed using linear mixed modelling. In the total group, mean (standard deviation) physical component summary scores improved by 2.9 (8.4) and 3.4 (9.3) points at 1 and 3 years, respectively. Mental component summary scores improved by 2.1 (9.7) and 1.6 (10.8) points. Improvement in physical component summary was significantly greater for patients with higher sense of coherence (b = 0.09, p = 0.001) and for the neoplasm disease group (b = 2.13, p = 0.046). Improvement in mental component summary was significantly greater for patients with low sense of coherence (b = -0.13, p = < 0.001) and higher level of education (b = 3.02, p = 0.0302). Interaction with age (physical component summary: b = 0.22, p = 0.039/mental component summary b = 0.51, p = 0.006) indicated larger effect at 1 year than at 3 years. Physical and mental function improved in the total study group over the 3-year period. Sense of coherence at baseline was associated with improved physical and mental function, suggesting that coping resources are important in rehabilitation.

Differences in quality-of-life scores across injury categories by mental health status among injured U.S. military service members and veterans.

Posttraumatic stress disorder (PTSD) and depression are strong predictors of poor health-related quality of life (HRQOL) among injured U.S. military service members (SMs). Patterns of HRQOL between injury categories and injury categories stratified by mental health (MH) symptoms have not been examined. Among deployment-injured SMs and veterans (n = 4353), we examined HRQOL and screening data for PTSD and/or depression within specific injury categories. Participants included those enrolled in the Wounded Warrior Recovery Project with complete data for HRQOL (SF-36) from June 2017 to May 2020. Injuries were categorized using the Barell Injury Diagnosis Matrix (Barell Matrix). Mean physical component summary (PCS) and mental component summary (MCS) scores were calculated for each injury category and stratified by the presence or absence of probable PTSD and/or depression. The average follow-up time that participants were surveyed after injury was 10.7years. Most participants were male, non-Hispanic White, served in the Army, and enlisted rank. Mechanism of injury for 77% was blast-related. Mean PCS and MCS scores across the entire sample were 43.6 (SD = 10.3) and 39.5 (SD = 13.3), respectively; 50% screened positive for depression and/or PTSD. PCS and MCS scores were significantly lower within each injury category among individuals with probable PTSD and/or depression than those without. Among deployment-injured SMs, those with probable PTSD and/or depression reported significantly lower HRQOL within injury categories and HRQOL component (i.e., physical or mental) than those without. Findings are consistent with prior reports showing mental health symptoms to be strongly associated with lower HRQOL and suggest integration of mental health treatment into standard care practices to improve long-term HRQOL.

Average and individual differences between the 12-item MOS Short-form Health Survey version 2 (SF-12 V.2) and the veterans RAND 12-item Health Survey (VR-12) in the Chinese population

BackgroundThe 12-item MOS Short-form Health Survey version 2 (SF-12v2) and the Veterans RAND 12-item Health Survey (VR-12) are generic health-related quality of life measures. They are fairly similar, but their differences in scores have not been assessed. Therefore, this study aimed to assess the differences between the SF-12v2 and the VR-12 in a Chinese population.MethodsWe conducted a household survey of 500 Chinese adults in Hong Kong. Both the SF-12v2 and the VR-12 were self-administered. The physical component summary score (PCS) and the mental component summary score (MCS) of each instrument were computed using well established algorithms. Their mean differences were assessed using 95% confidence interval (CI), and their individual differences were assessed by Bland–Altman analysis.ResultsThe participants had a mean age of 38 years (range: 18–80 years). The mean PCS and MCS scores of the SF-12v2 were 50.3 (SD = 6.5) and 49.0 (SD = 9.0), while those of the VR-12 were 49.6 (SD = 6.2) and 49.7 (SD = 8.8), respectively. The corresponding paired differences (SF-12v2—VR-12) of the PCS and MCS were 0.8, 95% CI (0.4–1.1) and − 0.7, 95% CI (− 1.2 to − 0.2), respectively. All confidence limits fell within the minimal clinical important difference (MCID) of 3. The 95% limits of agreement were − 7.0, 8.5 for PCS and − 11.2, 9.9 for MCS, which fell outside the corresponding MCID for individual responses.ConclusionThe SF-12v2 and the VR-12 reached mean equivalence at the group sample level, but there was a range of individual differences.

Effects of a laughter program on body weight and mental health among Japanese people with metabolic syndrome risk factors: a randomized controlled trial

BackgroundWhile there have been several intervention studies on the psychological effects of laughter, few have examined both the psychological and physical effects. This study investigates the effects of a laughter program on body weight, body mass index (BMI), subjective stress, depression, and health-related quality of life (HRQOL) among Japanese community-dwelling individuals using a randomized controlled trial with a waitlist.MethodsOverall, 235 participants (37 men and 198 women) aged 43–79 years (mean 66.9, median 67.0) were randomized into laughter intervention and control groups (n = 117 and n = 118, respectively) to participate in a 12-week laughter program. Body weight, subjective stress, subjective well-being, and HRQOL were measured at the baseline, with a 12-week follow-up. The laughter program intervention’s effects on these factors were analyzed using an analysis of covariance adjusted by age, sex, risk factors, medication, and area. Furthermore, Pearson’s correlation and a general linear model analyzed the relationship between participants’ BMI and psychological index changes.ResultsThe comprehensive laughter program significantly improved the mean body weight (p = 0.008), BMI (p = 0.006), subjective stress (p = 0.004), subjective well-being (p = 0.002), optimism (p = 0.03), and physical component summary (PCS) scores of HRQOL (p = 0.04). A similar tendency occurred for the mean changes in BMI and subjective stress score by area, sex, and age. Moreover, there was a significant and negative correlation between the change in BMI and PCS change (p = 0.04).ConclusionThe comprehensive 12-week laughter intervention program, mainly comprising laughter yoga, significantly improved physical and psychological functions such as body weight, BMI, subjective stress, subjective well-being, and HRQOL among predominantly elderly Japanese community-dwelling individuals with metabolic syndrome risk factors. Moreover, PCS improved among participants who reduced BMI after the intervention. These results suggest that the laughter program may help reduce body weight in participants with metabolic syndrome risk factors by reducing stress and improving HRQOL and mental health factors, such as subjective well-being and optimism.Trial registrationRegistered with the University Hospital Medical Information Network Clinical Trials Registry UMIN-CTR000027145 on 27/04/2017.

Poorer Self-Reported Physical Health and Higher Anxiety Trait in Young Adults With Previous Coarctation Repair

Little is known about the impact of a coarctation repair on the functional outcomes of young adults. This study aimed to determine (1) the functional and mental health status in young adults with previous coarctation repair, and (2) the impact of late hypertension on their quality of life. A cross-sectional study using validated self-reported questionnaires (Short Form 36 version 2 [SF-36v2], Beck Depression Inventory [BDI], and State-Trait Anxiety Inventory [STAI]) was performed in 54 patients aged 15-47 years with previous paediatric coarctation repair. Questionnaire scores were compared to healthy age- and gender-matched controls. Patients' previously published 24-hour blood pressure monitoring results were included. Late hypertension was present in 64% (34/54) at a mean of 29±8 years after coarctation repair. SF-36v2 mean physical component summary score was significantly lower in coarctation patients compared with controls (53.1±6.8 vs 56.0±4.7, p=0.02), but there was no significant difference in mean mental component summary score (p=0.2). SF-36v2 mean role emotional score tended to be associated with 10 mmHg increases in mean 24-hour systolic blood pressure (regression coefficient 4.3 p=0.06). STAI mean trait anxiety score tended to be higher in coarctation patients compared with controls (36.6±9.0 vs 33.5±7.8, p=0.06). There was no significant difference in BDI scores between patients and controls. Young adults with previous coarctation repair report poorer physical health and tended towards higher anxiety trait compared to healthy controls. Strategies to improve self-reported physical health and anxiety should be explored. Long-term assessment of quality of life outcomes in coarctation patients is warranted.

Cauda Equina Syndrome—retention type (CESR): Outcome after delayed discectomy and decompression for lumbar disc herniation

Background: The objective of this study was to evaluate the functional outcome after lumbar discectomy in Cauda equina syndrome—retention type (CESR) patients with delayed presentation. Materials and Methods: Fourteen patients with CESR presenting after 48 h (i.e., 2–42 days) from the onset of symptoms were included in the study. Acute lumbar disc prolapse was the cause of CESR in all patients. A detailed history including age, sex, onset of back pain, bladder and bowel symptoms, neurological signs, level of lesion, timing of surgery, and neurologic recovery (resolution of pain, sensory and motor deficits, and urinary, rectal, and sexual dysfunction [SD]) were recorded and analyzed. Bladder dysfunction was assessed using the urinary symptom profile (USP) questionnaire. Bowel dysfunction was assessed using the neurogenic bowel dysfunction (NBD) questionnaire. SD in men was analyzed using the international index of erectile function (IIEF) questionnaire and Female SD was analyzed using the female sexual function index (FSFI) questionnaire. Physical and mental health was assessed by short-form 12 (SF-12). Results: 9M:5F with a mean age of 35 years (range 26–45 years) presented with back and leg pain, parasthesia in the limbs, and retention of urine. Nine patients had acute backache and five had chronic back pain. All patients were catheterized on admission. The disc herniation levels were L4/L5 (seven patients), L5/S1 (six patients), and one had L3/4. The mean time of onset of symptoms to presentation at the hospital was 9.7 days (range 2–42 days). Preoperative mean Oswestry disability index (ODI) was 67.4 (range 58–80), mean visual analog score (VAS) for back pain was 2.8 (range 0–7) and mean VAS for leg pain was 6.5 (range 5–9). Preoperatively, motor power was affected in 12 patients. At presentation, perianal sensation (PAS) was labeled as “decreased,” in 12 patients (85.7%), and “absent” in two patients (14.3%). Voluntary anal contraction (VAC) was reported as “weak” in 10 patients (71.5%) and “absent” in 4 patients (28.5%).At a mean follow-up of 30 months, five patients had complete and five patients had partial recovery of motor and sensory deficit. Complete restoration of bladder status was experienced in eight patients after a mean duration of 6 months following surgery (ranging from 3 to 10 months). Three patients had partial recovery of bladder function (stress or nocturnal incontinence or signs of post-voiding residual urine) after a mean duration of 10 months following surgery (range 7–15 months). The return of bowel functions was determined as “complete” in seven (50%), “partial” in five (35.7%) and “no recovery” in two patients (14.3%). All patients had varying grades of SD. The mean SD scores in the nine male patients were 36.1 ± 20.4. In the five female patients, the mean SD scores were 22.9 ± 6.2. The mean physical component summary (PCS) and mental component summary (MCS) scores were 44.7 ± 8.8 and 40.1 ± 10.7, respectively. The group mean was significantly lower (P < 0.0001) as compared to the population norm for age groups 25–45 years. Conclusion: Late presentations of patients with CESR had variable long-term outcomes following lumbar discectomy. The recovery of the bladder and sexual function probably is the worst affected after late decompression. Validated questionnaires provide the clinicians a guide to prognosticate.

Estimating the minimal clinically important difference for the Physical Component Summary of the Short Form 36 for patients with stroke.

ObjectiveTo determine the Physical Component Summary (PCS) score's minimal clinically important difference (MCID) on the Short Form 36 (SF-36) for people with stroke.MethodsWe conducted secondary analysis of data from a large randomized controlled trial (N = 400) in the post-hospital discharge phase of stroke rehabilitation with outcome measurement 6 and 12 months following stroke. Three methods were used for estimating the MCID: two anchor and one distribution. Method 1 compared SF-36 PCS scores at 12 months for responses to the SF-36’s Perceived Health Change (PHC) question. Method 2 compared the change in PCS score between 6 and 12 months for responses to the PHC question. Method 3 used Cohen’s method to estimate the MCID from the PCS score distribution.ResultsMethod 1: the mean PCS score increased by 3.0 units (95% confidence interval [CI] 2.2–3.9) for each unit change in the PHC question. Method 2: the mean change in PCS score increased by 2.1 units (95% CI 1.4–2.8) for each unit change in the PHC question. Method 3: the MCID was estimated to be 1.8 units.ConclusionsOur estimate of the MCID for the PCS in patients with stroke was 1.8 to 3.0 units.