Mean Quality Of Life Score Research Articles

Financial toxicity in patients with metastatic breast cancer on trastuzumab deruxtecan (T-DXd).

1112 Background: T-DXd is a targeted therapy shown to improve outcomes in patients with metastatic breast cancer (MBC) who progressed on prior HER2 targeted therapies, or in the “HER2-low” population as presented at ASCO 2022. It is given every 3 weeks and costs about $9,500 per cycle. Little is known about treatment courses for patients on T-DXd and the potential financial toxicity (FT) of treatment including unmet essential needs. Methods: Retrospective review identified all patients with MBC treated with T-DXd from 6/2022 to 8/2023 at a comprehensive cancer center. Cross-sectional patient surveys assessed FT (via validated COST tool), ability to meet essential needs, payment concerns, and quality of life (QOL). Logistic regression assessed factors associated with unmet needs. A cohort of patients with MBC who did NOT receive T-DXd but completed a FT survey during the study period were identified for comparison. Results: 429 patients with MBC received T-DXd during the study period with a median of 7 cycles (IQR 3-12), and median length on treatment of 4 months (IQR 1.5-8). 164 (38% of the full cohort) completed a FT assessment after receiving at least one T-DXd cycle. Mean age at assessment was 56.9 years (SD 10.9); 72% identified as non-Hispanic White (NHW). Mean FT score was 19.2 (SD 10.8) (scale 0-44, lower scores indicate worse FT). 68% had COST <26 diagnostic of FT. Mean QOL score was 6.3 [(SD 2.0) 0 “as bad as it can be” - 10 “as good as it can be]. QOL was correlated with FT score (r=0.48, p<0.001). 21% of those who complete FT assessment had used at least some of their savings to pay for cancer treatment (5% had used all); 5% did not have savings to begin with. 23% took on new loans or borrowed money. Unmet essential needs were identified for: housing (15%), transportation (15%), food (11%), and repairs to home (10%). 11% reported they did not have enough monthly income for medications. On adjusted analysis including age, race/ethnicity, and FT status, those aged 46-65 years (OR 3.94, 95% CI 1.34-11.53, p=0.012), non-NHW (OR 4.54, 95% CI 1.86-11.08, p=0.001), and those with FT (OR 11.52, 95% CI 3.90-34.07, p<0.001) were more likely to have an unmet essential need. Of those who screened positive for FT, 50% accepted referral for financial assistance. 440 patients with MBC completed a FT assessment but did NOT receive T-DXd. There was no difference in FT (COST: 19.9 vs. 19.2, p=0.492) or unmet needs (36% vs. 37%, p=0.850). Conclusions: After ASCO 2022, hundreds of patients with MBC received T-DXd at a large cancer center; however, most did not stay on treatment for long. Patients with MBC had significant FT, although this is not unique to treatment with T-DXd. This underscores the need to study and intervene upon FT across all MBC populations given negative influence on QOL and unmet essential needs identified. Additionally, improving the referral process is essential, as only half of those with identified needs accepted referral for assistance.

Financial toxicity and unmet essential needs in patients with gastrointestinal cancer.

3527 Background: Patients with gastrointestinal (GI) cancers face complex, multimodality treatment and often experience financial toxicity (FT), which can negatively affect both psychosocial and oncologic outcomes. Despite increased recognition of the role of the social determinants of health in driving cancer disparities, best practices in screening for FT and assessment of unmet essential needs in this population is still unknown. Methods: From 6/2022-8/2023, cross-sectional FT assessments were conducted at a comprehensive cancer center for all patients with gastrointestinal cancers. The Comprehensive Score for Financial Toxicity (COST) assessed FT; ability to meet essential needs, financial concerns, and quality of life (QOL) were also queried. Multivariate linear and logistic regression tested for predictors of FT and unmet needs and were adjusted for patient and clinical characteristics. Results: There were 8,335 patients with GI cancers who completed the FT and essential needs assessment. Mean age was 63.0 years (SD 12.6) and 76% were non-Hispanic white (NHW). GI subsites were most commonly colon (29%), rectum (21%), and pancreas (18%). 54% had active cancer treatment (chemotherapy, radiation, or surgery) within 120 days of assessment. Mean COST score was 24.3 (SD 10.7; scale 0-44, lower scores indicate worse FT). 63% had COST <26 diagnostic of FT. Regression analysis found greater FT was associated with non-NHW race/ethnicity (β 4.43, P<0.001), advanced disease [stage III (β 1.34, P<0.001), stage IV (β 1.68, P<0.001)], and recent treatment (β 3.23, P<0.001). Patients ≥65 years had lower FT (β -3.67, p<0.001). 28% reported difficulty meeting an essential need including paying for transportation (12%), housing (12%), food (11%), and medications (11%). Regression analysis found unmet needs were associated with non-NHW race/ethnicity (OR 2.34, 95% CI 2.09-2.62, p<0.001), advanced disease [stage III (OR 1.28, 95% CI 1.09-1.49, p=0.002), stage IV (OR 1.27, 95% CI 1.08-1.49, p=0.003)] and recent treatment (OR 1.25, 95% CI 1.12-1.39, p<0.001). FT and unmet needs did not vary significantly by disease subsite. 26% reported using savings to pay for cancer treatment; an additional 7% had no savings to begin with. 10% took less medications than prescribed due to cost. Mean QOL score was 7.2 [(SD 2.0) 0 “as bad as it can be” to 10 “as good as it can be”]. Regression analyses found greater FT was associated with lower QOL (β -0.98, p<0.001), increased amount of savings to pay for treatment (β 0.48, p<0.001), and taking less medications than prescribed due to cost (β 0.11, p<0.001). Conclusions: Screening for FT and essential needs is possible in a diverse cohort of patients with GI cancers. Over half were identified to have FT and over one fourth had unmet essential needs. Identifying and addressing the financial burdens of cancer treatment and essential needs may improve QOL, medication adherence, and cancer survivorship.

Lived Experiences of Patients After Colorectal Cancer and Permanent Colostomy: A Parallel-Design Mixed-Methods Study.

To identify the lived experiences, quality of life (QoL), and level of ostomy adjustment (OA) in patients after colorectal cancer with a permanent colostomy (PC). In this parallel-design mixed-methods study, the researchers interviewed 14 patients after colorectal cancer whose PC was created more than 1 year prior. Qualitative data were interpreted using hermeneutic interpretive phenomenological design. Quantitative data were collected with the Stoma QoL Scale and OA Inventory-23. The mean age of the participants was 61.5 (SD, 10.0) years, and the mean PC duration was 7.7 (SD, 5.0) years. Mean QoL and OA scores were just above the median. Three superordinate themes consisting of nine themes emerged from the analysis: (1) early experiences (acceptance, medical problems, and emotional changes); (2) long-term experiences (physiologic experiences, psychosocial experiences, economic experiences, and coping strategies); (3) feelings and expectations about the future (worries and expectations). Even individuals who have been living with a PC for a long time may not be fully adapted to the process and may not have internalized lifestyle changes. Nurses should provide support to individuals with a PC through routine follow-ups, social support, and facilitative healthcare strategies regardless of the length of time since PC creation.

Comparison of quality of life in patients with mitral valve replacement and mitral valve repair in Imam Ali Hospital during 2014 to 2020: a cross-sectional study

ObjectiveMitral valve failure is one of the most common valvular heart diseases worldwide. Valve replacement and repair have an impact on the quality of life of patients. Therefore, the present study was conducted to compare the quality of life in patients with mitral valve replacement and those who underwent mitral valve repair.MethodsIn this cross-sectional study, we considered all cardiac patients with ischemic mitral insufficiency who underwent mitral valve repair and patients with a history of valve replacement in Imam Ali Hospital of Kermanshah between 2014 and 2020. Two Minnesota and general quality of life questionnaires along with a checklist for demographic variables were used for data collection. Data analysis was performed using SPSS version 21 software.ResultsThe mean quality of life score based on the general quality of life scale in the valve repair group was 32.33 (SD = 2.29) and in the valve replacement group 32.89(SD = 2.60), (p = 0.917). Also, mean quality of life, as measured by the Minnesota MLHFQ was 60.89(SD = 17.67) in the valve repair group and 63.42 (SD = 12.13) in the valve replacement group (p = 0.308). The results showed that the average general quality of life was different in study groups regarding education. Tukey’s post hoc test showed that the average general quality of life in illiterate people is significantly lower than in people with academic degrees (P-value = 0.001).ConclusionThe quality of life of the patients in both the valve repair and replacement groups was at an average level. There was no significant difference between the general quality of life and the Minnesota scales, suggesting that both tools can be effectively used to measure patients’ quality of life. The study’s findings can be valuable for monitoring patients, screening for conditions, and enhancing communication between doctors and patients.

Quality of Life among Children with Cerebral Palsy in the Kingdom of Saudi Arabia and Various Factors Influencing It: A Cross-sectional Study

Many neurological disorders cause disabilities in children, and cerebral palsy (CP) is one of the most common neurodevelopmental disorders. Children with CP experience reduced quality of life (QOL). CP is the most prevalent cause of disability in Saudi Arabia. This study aims to establish quantitative evidence related to QOL and the factors influencing it among children with CP. We recruited 132 participants between 2 and 18 years of age diagnosed with CP from several hospitals and rehabilitation centers. Participants were classified according to age based on the Pediatric QOL Inventory CP Module (PedsQL 3.0 CPM), which was completed by parental proxies. The Gross Motor Functional Classification System—Expanded and Revised (GMFCS-E&R) divided participants based on their functional level. Of the 132 participants, 79 were male and 53 were female. We observed reduced mean score of QOL in all PedsQL 3.0 CPM dimensions. Parents reported the lowest QOL for movement and balance activities and the highest QOL for eating activities. There was a significant negative moderate correlation between QOL and GMFCS-E&R scores ( r s = −0.56, P = 0.01) and a significant moderate positive correlation between QOL and schooling ( r s = 0.4, P < 0.03) and socioeconomic status of the family ( r s = 0.42, P < 0.04). The parents of children with CP reported poor QOL for the children. Decreased functional levels were associated with reduced QOL, whereas schooling positively impacted QOL. More frequent rehabilitation services may be required to educate and encourage positive parental involvement during rehabilitation, further enhancing QOL among children with CP.

Quality of life among community-dwelling elderly in rural and urban areas of Himalayan region, Northeast India: An analysis of factors affecting well-being

ABSTRACT Background: There is a dearth of literature on the quality of life (QOL) experienced by the elderly population in the hilly terrains of the Himalayan region. The objective of this study was to highlight the QOL among community-dwelling elderly residing in rural and urban areas of the Himalayan region, Northeast India. Materials and Method: A cross-sectional study was conducted involving 450 participants (324 in rural and 126 in urban areas) aged 60 years and above. The QOL score was assessed with the help of the World Health Organisation Quality of Life-Brief Questionnaire (WHOQOL-BREF). Mann–Whitney U test was performed to find out the difference in QOL between rural and urban areas. Binary logistic regression was conducted to find the association of QOL with demographic variables. Results: The total mean QOL scores of elderlies in rural areas (39.4 ± 11.3) were significantly lower compared to urban areas (51.1 ± 11.5). QOL scores in all four domains were found to be low among elderly living in rural areas as compared to urban areas. Among the four domains, environmental QOL was found to be the lowest in both rural (29.5 ± 16.0) and urban areas (46.5 ± 17.2). Determinants of QOL differ in urban and rural areas. Conclusion: QOL was found to be significantly lower among the elderly residing in rural areas as compared to urban areas. Targeted interventions and policies are necessary to address environmental challenges to improve the overall QOL of the elderly.

Illness-related fatigue and its association with quality of life among people with chronic obstructive pulmonary disease: A cross-sectional survey from Jordan

Background & Aim: Fatigue is a commonly reported issue in individuals with chronic obstructive pulmonary disease (COPD), often overlooked or inadequately addressed in Jordan and globally. This study aimed to assess illness-related fatigue in COPD people, its contributing factors, and its impact on their quality of life (QOL). Methods & Materials: A cross-sectional correlational design was employed, recruiting 200 people from four hospitals in Jordan between April and May 2021. Participants completed Arabic versions of the self-administered Fatigue Severity Scale and the WHOQOL questionnaire. Results: The study revealed a high level of fatigue among COPD people, with an overall mean fatigue score of 5.07±0.62. Particularly noteworthy was the association between heightened fatigue levels and factors such as disease-related disability and interference with daily responsibilities. The overall mean QOL score was low (2.665±0.39), with the physical domain displaying the lowest mean score (2.6±0.47). Fatigue and QOL were significantly and negatively correlated. Conclusion: COPD people in Jordan experience substantial levels of fatigue, negatively impacting their QOL. Unfortunately, fatigue is often unnoticed in healthcare services. Addressing fatigue should be a crucial aspect of treatment plans for these people. Particularly during pandemics or service disruptions, additional attention is needed to manage fatigue among COPD people effectively. Digital health interventions may offer opportunities to enhance continuity and quality of care, especially during challenging times.

Exploring quality of life disparities among 177 families with children affected by cleft lip and/or palate: A comprehensive analysis using the Impact on Family Scale

Objective: This study aimed to assess the quality of life (QoL) of parents/caregivers of children with cleft lip and palate (CLP) using the Impact on Family Scale (IOFS).Methods: Families of children requiring primary or secondary CLP repair were recruited based on the inclusion criteria. The IOFS questionnaire was utilized to assess perceived QoL. Multiple logistic regression was employed to determine factors linked to impacted QoL.Results: Out of the 192 families contacted, 177 participated (92.2%). The patients had a mean age of 8.9 ± 5.4 months, with a majority of families residing in rural areas (67.2%). The questionnaires assessed QoL before surgery, revealing a mean total QoL score of 68.8 ± 19.4, with 49.7% of families experiencing affected QoL. The analysis demonstrated a significant association between the female sex of parents/caregivers and a more impacted QoL (p = 0.018), as well as between the absence of a history of CLP in the family and a more affected QoL (adjusted odds ratio = 3.0; 95% CI: 1.3 – 6.7; p = 0.008).Conclusion: Caring for a child with CLP significantly decreases parents/caregivers’ QoL in all domains. The results emphasize the significance of considering the family history of CLP and the gender of the parents in the comprehensive care of affected families.

Exploring quality of life disparities among 177 families with children affected by cleft lip and/or palate: A comprehensive analysis using the Impact on Family Scale

Objective: This study aimed to assess the quality of life (QoL) of parents/caregivers of children with cleft lip and palate (CLP) using the Impact on Family Scale (IOFS).Methods: Families of children requiring primary or secondary CLP repair were recruited based on the inclusion criteria. The IOFS questionnaire was utilized to assess perceived QoL. Multiple logistic regression was employed to determine factors linked to impacted QoL.Results: Out of the 192 families contacted, 177 participated (92.2%). The patients had a mean age of 8.9 ± 5.4 months, with a majority of families residing in rural areas (67.2%). The questionnaires assessed QoL before surgery, revealing a mean total QoL score of 68.8 ± 19.4, with 49.7% of families experiencing affected QoL. The analysis demonstrated a significant association between the female sex of parents/caregivers and a more impacted QoL (p = 0.018), as well as between the absence of a history of CLP in the family and a more affected QoL (adjusted odds ratio = 3.0; 95% CI: 1.3 – 6.7; p = 0.008).Conclusion: Caring for a child with CLP significantly decreases parents/caregivers’ QoL in all domains. The results emphasize the significance of considering the family history of CLP and the gender of the parents in the comprehensive care of affected families.

Changes in Quality of Life among Patients with Chronic Low Back Pain in the Iranian Traditional Medicine Clinics

Background: Chronic low back pain (CLBP) is regarded as one of the most frequent and costly conditions which can affect patients’ quality of life. The current study aims to investigate changes in quality of life among patients with CLBP. Methods: Prospective observational study was performed from December 2021 to February 2022 in Baharan, Sina and Asadabadi traditional medicine clinics, Tabriz, Iran. Patients were recruited using a convenience sampling method, who were aged 20 years or older and had low back pain symptoms for 12 weeks or more. Data were collected at baseline, one month and two month follow-up by interviewing the patients. The study tool was Short Form Health Survey (SF-12) questionnaire. Results: Out of 210 participants, 62.4% (131) were female. The change in mean score of life quality at the baseline, one- month and two-month follow-up was 23.76, 35.08 and 40.11, respectively (P = 0.0001).There were significant changes in all eight dimensions of life quality (P = 0.0001). Additionally, younger Patients (50 ≥) had 1.35 scores of life quality higher than older patients (P = 0.021). Retired, self-employed, housewife and unemployed patients had 6.41, 4.68, 4.18 and 5.38 scores of quality of life lower than office workers, subsequently (P = 0.001). Furthermore, illiterate patients, patients with primary and high school educations had 5.76, 2.61 and 1.33 scores of quality of life less than patients with university degree (p < 0.05). Conclusion: ITM treatment method could contain several effects on the dimensions of quality of life among patients with CLBP. More detailed investigation is required to achieve greater accuracy.

Assessment and factors affecting quality of life among patients with Wilson’s disease

Wilson’s disease is caused by abnormal copper metabolism resulting in deposition in various organs, including the brain, liver, and cornea, thus disrupting organ function. It is characterized by encephalopathy, extrapyramidal symptoms, progressive liver failure, and copper ring deposition in the cornea. Management of this disease should include quality of life maintenance; however, relevant studies on this topic are lacking. This study aimed to assess the factors affecting the quality of life (QoL) of patients with Wilson’s disease. A cross-sectional survey using convenience sampling was conducted between July 2020 and March 2021 at the hospital. Data on patient characteristics, 36-item Short-Form General Health Survey, Uniform Wilson Disease Rating Scale, and Hamilton Depression Rating Scale scores were collected. Associations among quality of life depression, anxiety, and Wilson’s disease progression were examined using Pearson correlation analysis. Factors affecting the quality of life of patients, including depression, anxiety, liver function, clinical symptoms, diet, liver function, brain magnetic resonance imaging (MRI) findings, disease duration, Barthel Index, and Morse scores were examined using multivariate linear regression analysis. This study included 134 patients with Wilson’s disease whose mean age was 29.12 ± 8.59 years. The mean QoL score in the patient group was 71.38 ± 9.55 points and was negatively correlated with anxiety (r = − 0.883, P = 0.000), depression (r = − 0.852 P = 0.000), and clinical symptoms (r = − 0.542, P = 0.000) scores. Anxiety, depression, and clinical symptoms severity are vital factors for the QoL of patients with Wilson’s disease. The study provides foundational evidence to design novel interventions, including symptom management, diet, and self-care ability, which can help in improving the quality of life in patients with Wilson’s disease and decreasing the burden associated with this disease.

The impact of living with assistance dog placements on quality of life in children and adults with autism spectrum disorder or a physical disability: A longitudinal service evaluation

Abstract Assistance dogs are highly trained animals to support individuals with disabilities and medical conditions. Evidence suggests the support provided by an assistance dog can extend beyond physical assistance to therapeutic and communicative domains. However, there is limited research exploring the lived experience of assistance dog placements in the United Kingdom (UK) over an extended period of time. This longitudinal service evaluation was designed to evaluate the placement of assistance dogs, trained by the charity Dogs for Good, with adults and children with autism or a physical disability in the UK. Goals and expectations of being matched with an assistance dog prior to placement, and perceptions of how these dogs have impacted the quality of life of adults and children with autism and/or a physical disability and their families were assessed. Service users who had applied for an assistance dog via the Dogs for Good charity (n = 307) were contacted and invited to complete questionnaires at five different time points (pre-dog placement, and 6-, 12-, 24-, and 36-months post dog-placement). Repeated-measures ANOVAs were conducted to determine if there were significant changes to quality of life over time. Mean quality of life scores improved significantly for all service users. Responses to free-text questions were thematically analysed, and three main themes were identified from the free-text responses: goals and expectations for assistance dog pre-placement (e.g., enhancing independence, physical functioning and wellbeing), the positive impact of the assistance dog post-placement (e.g., promoting independence, development of the human-animal bond, improving wider family dynamics, and reducing stigma), and satisfaction with the service. The findings complement and extend previous insights into the impact of assistance dogs on people with autism or a physical disability. They also highlight some challenges associated with the placement of assistance dogs and indicate the need to consider the development of further targeted support strategies.

Health-related quality of life and related factors in patients with colorectal cancer in Iran: a systematic review.

This systematic review aims to examine the health-related quality of life (QOL) in Iranian patients with colorectal cancer (CRC) and its related factors. A thorough, systematic search was conducted in different international electronic databases, including Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords such as "Colorectal neoplasm", "Colorectal tumors", "Colorectal cancer", "Quality of life", and "Life quality" from the earliest to 17 October 2022. The quality of the studies included in this systematic review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). There were 820 CRC patients in the five cross-sectional studies that made up this systematic review. The mean score of QOL in patients with CRC was 61.99 (SD=15.87) out of 100 based on EORTC-QLQ-C30, which indicates a moderate to good level of QOL. Factors such as age, gender, living conditions, level of education, occupation, monthly income, health insurance, physical activity, performance status, and comorbidities had a significant relationship with QOL in patients with CRC. In sum, the findings of the five studies that were a part of this systematic review revealed that Iranian patients with CRC had a moderate to good QOL. Therefore, managers and health policymakers can create psychological counseling programs with an emphasis on the factors affecting the QOL of patients in light of how crucial it is to raise patients' understanding of the long-term impacts of CRC and how they affect their QOL.

IJCM_327A: An assessment of quality of life among women working in public sector units

Background: Women hold unequal roles and prestige in practically every society and area of life; as a result, it is important to empower them by giving them equal opportunity. The growth of human capital is crucial for individual growth and performance, particularly in terms of productivity and quality of life. Occupational stress is a syndrome of emotional tiredness, dissociation, and decreased self-confidence. A healthy lifestyle requires good mental health, and depression is a major factor in the quality of life (QOL) condition as measured by self-reported assessment measures. The study’s objectives were to evaluate quality of life (QOL) among women working in public sector units, their level of empowerment in many spheres of life, and the factors influencing that empowerment and how it relates to QOL and demographic parameters. Objectives: To describe the socio-demographic profiles of women working in public sector unit and to evaluate the quality of life among them. Methodology: Between April to June 2023, a total of 100 women working in public sector units participated in this study by snowball sampling technique at Neyveli, Tamil Nadu. All qualitative variables were presented as frequencies and percentages. The prevalence rates were given in percentages. Mean and Standard deviation was used at calculate continuous variables example age. Results: The overall score obtained by the participants in the study conducted of which 32% has scored 75-85, 31% has scored <75, 30% has scored 85-95, and 7 % has scored >95 among the population of 100 participants. The women had a mean QOL score of 79.41 ± 11.52. Conclusion: Human health is integrally tied to quality of life (QoL), a complex and diverse concept that encompass the physical, psychological, spiritual, social, and economic realms. QoL is a dynamic, subjectively measured object.

Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids: A retrospective study.

Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery. They are venous clusters formed by congestion, expansion, and flexion of the venous plexus in the lower part of the rectum. Mixed hemorrhoids bleed easily and recurrently, and this can result in severe anemia. Hence, they may have a negative effect on the health of the patient and surgical treatment is required. Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids. However, most patients experience different degrees of postoperative pain that may cause anxiety. To assess the factors influencing pain scores and quality of life (QoL) in patients with mixed hemorrhoids post-surgery. The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively. The basic characteristics of the enrolled patients with mixed hemorrhoids were recorded, and based on the Goligher clinical grading system, the hemorrhoids were classified as grades III or IV. The endpoint of this study was the disappearance of pain in all patients. Quantitative data were presented as mean ± SD, such as age, pain score, and QoL score. Student's t-test was used to compare the groups. A total of 164 patients were enrolled. The distribution of the visual analog scale pain scores of all patients at 3, 7, 14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time. Fourteen days after the operation, the pain had completely disappeared in some patients. Twenty-eight days after the surgery, none of the patients experienced any pain. Comparing the World Health Organization Quality of Life - BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery, we observed that the quality-of-life scores of the patients post-surgery had significantly improved. There were six items that were compared at 14- and 28-d post-surgery. The mean QoL score 28 d after surgery (4.79 ± 0.46) was higher than that at 14 d post-surgery (3.79 ± 0.57). The mean health condition score 28 d after surgery (4.80 ± 0.41) was also higher than that at 14 d post-surgery (4.01 ± 0.62). The mean physical health score 28 d after surgery (32.10 ± 2.96) was significantly higher than that at 14 d post-surgery (23.41 ± 2.85). The mean psychological health score 28 d after surgery (27.22 ± 1.62) was significantly higher than that at 14 d post-surgery (21.37 ± 1.70). The mean social relations score 28 d after surgery (12.21 ± 1.59) was significantly higher than that at 14 d post-surgery (6.32 ± 1.66). The mean surrounding environment score 28 d after surgery (37.13 ± 2.88) was significantly higher than that at 14 d post-surgery (28.42 ± 2.86). The differences in quality-of-life scores at day 14 and day 28 post-surgery were observed to be statistically significant (P < 0.001). Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients. Age, sex, and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy.

Abstract 2256: Guideline-based physical activity and physical quality of life among individuals with nonmetastatic prostate cancer: A target trial emulation in the Health Professionals Follow-up Study

Abstract Introduction: Randomized trials have shown that physical activity can improve quality of life (QOL) among individuals with cancer. In the absence of a randomized trial of adequate size and follow-up to comprehensively evaluate this relationship for prostate cancer, we aim to emulate a target trial of guideline-based physical activity strategies and 6-year physical QOL. Methods: We will use observational data on individuals in the Health Professionals Follow-up Study diagnosed with nonmetastatic prostate cancer between 2010-2016 and free of conditions that could preclude following current physical activity recommendations at baseline (first post-diagnostic questionnaire). The physical activity strategies of interest are (1) engage in ≥150 minutes of moderate activity, or ≥75 minutes of vigorous activity per week, or an equivalent combination (i.e., ≥7.5 metabolic equivalent of task [MET]-hours/week of vigorous or moderate activity) and (2) no physical activity intervention. The outcomes of interest are 6-year mean physical QOL scores (based on EPIC-CP measures of bowel function, urinary incontinence, urinary irritation/obstruction, sexual function, and vitality/hormonal function). We will adjust for baseline and time-varying risk factors using the parametric g-formula. Conclusion: These findings may help to inform clinical recommendations to improve QOL among individuals with nonmetastatic prostate cancer. Further, the proposed approach will provide a framework for future studies designed to evaluate the effectiveness of any intervention strategies to improve patient-reported outcome measures in cancer survivorship research. Table 1. Specification and emulation of a target trial using observational data from HPFS Protocol component Target trial specification Target trial emulation Eligibility criteria (1) Individuals diagnosed with non-metastatic prostate cancer between 2010 and 2016; (2) No history of other cancers (Except nonmelanoma skin cancer); (3) No history of conditions that could preclude high levels of physical activity: myocardial infarction, stroke, congestive heart failure, amyotrophic lateral sclerosis, or functional impairment (defined as difficulty climbing a flight of stairs or walking eight blocks due to physical impairment) Same as for the target trial, except: We required complete data on physical activity, birth date, and other risk factors on the pre-diagnostic questionnaire and the first post-diagnostic (baseline) questionnaire. Physical activity strategies Each individual is assigned to one of the following strategies at baseline: (1) No intervention (usual physical activity) (2) Engage in ≥1.25 hours/week of vigorous activity or ≥2.5 hours/week of moderate activity or ≥7.5 MET-hours/week of vigorous or moderate activity (an equivalent combination). Strategies are initiated at baseline and continued over follow-up. Individuals are excused from following the physical activity intervention upon the development of myocardial infarction, stroke, congestive heart failure, amyotrophic lateral sclerosis, cancer metastasis, or functional impairment. Individuals must respond to surveys at every follow-up period to assess time-varying variables. Same as for the target trial, except: (1) Follow-up periods correspond to the questionnaire cycles in the cohort study. (2) We assumed that each 2-year physical activity questionnaire accurately reflects the individual's (1) average physical activity over the previous 2-year period and (2) intended physical activity that the individual would have reported at the start of the current period under no intervention. Strategy assignment Individuals are randomly assigned to a strategy at baseline and are aware of their assigned strategy. We assumed randomization conditional on the following baseline covariates: age; employment status; primary treatment; stage; Gleason score, and prostate-specifc antigen level at diagnosis; pre-baseline values of body-mass index and physical activity. Outcomes 6-year mean quality of life scores in the following physical domains: (1) Bowel function, (2) Urinary incontinence, (3) Urinary irritation/obstruction, (4) Sexual function, (5) Vitality/hormonal function. Individuals self-report their physical quality of life on EPIC (The Explanded Prostate Cancer Index Composite) questionnaires at every follow-up period. Same as for the target trial. Follow-up periods correspond to the questionnaire cycles in the cohort study. Follow-up For each eligible individual, follow-up starts at strategy assignment (baseline) and ends upon death, loss to follow-up, or the end of follow up in December 2018, whichever happens first. Same as for the target trial. Loss to follow-up was defined as questionnaire non-response. Causal contrasts Intention-to-treat and per-protocol effect. Observational analogue of per-protocol effect. Statistical analysis Intention-to-treat analysis. Per protocol analysis: Parametric g-formula to compare 6-year physical quality of life under each strategy via mean differences, with adjustment for pre- and post-baseline prognostic factors associated with adherence and loss to follow-up. Same as for the per-protocol analysis of the target trial. Citation Format: Naiyu Chen, Rachel C. Nethery, Lorelei A. Mucci, Barbra A. Dickerman. Guideline-based physical activity and physical quality of life among individuals with nonmetastatic prostate cancer: A target trial emulation in the Health Professionals Follow-up Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2256.

The Effect of an Exercise Program on the Quality of Life in Burn Patients

Background: Burn injuries are among the most significant causes of disability and death, having severe economic and social consequences in human societies. Objectives: This study aims to examine the effect of an exercise program on the quality of life of burn patients admitted to the burn department of Ali Ibne Abi Talib Hospital in Zahedan. Methods: In this quasi-experimental study, 30 patients with shoulder joint burns admitted to the burn department of Ali Ibne Abi Talib Hospital in Zahedan in 2021 participated. Patients meeting the inclusion criteria were selected via convenience sampling and then randomly assigned to intervention and control groups using permuted blocks. The intervention consisted of 4 individual training sessions and an exercise program. Patients in the intervention group performed exercises 3 times daily for 12 weeks, while those in the control group received only routine ward care. Data were collected using the Burn Specific Health Scale (BSHS), administered to groups 1- and 3-months post-intervention. Data analysis was conducted using SPSSv.21 software, employing the chi-square test, independent samples t-test, and repeated measures analysis of variance (ANOVA), with a significance level set at P &lt; 0.05. Results: One month post-intervention, the mean quality of life scores were 121.73 ± 7.52 in the intervention group and 122.93 ± 5.72 in the control group. After 3 months, these scores changed to 156.46 ± 9.53 in the intervention group and 122.82 ± 8.09 in the control group, indicating a significant increase in the intervention group (P = 0.001). Repeated measures ANOVA revealed no significant difference in quality of life between the 2 groups 1 month post-intervention (P = 0.37); however, a significant difference was observed at 3 months (P = 0.001). Conclusions: The study's findings suggest that exercise can improve the quality of life in patients with shoulder joint burns. Therefore, incorporating exercise and follow-up programs into the discharge plans of burn patients is recommended.

Enhancing Women's Quality of Life: Exploring the Impact of Mastectomy with and without Breast Reconstruction among Breast Cancer Survivors in Iraq.

Mastectomy, a common intervention for breast cancer, has substantial implications for a woman's quality of life (QoL). However, the literature on QoL outcomes following mastectomy-with or without breast reconstruction (BR) is scant. This study aims to assess and compare the QoL among Iraqi women post-mastectomy, examining the impacts of undergoing BR. We conducted a comprehensive cross-sectional study across multiple centers in Iraq from April to September 2021. Our cohort consisted of 404 women who had a mastectomy for breast cancer treatment, 154 of whom also chose to have BR. Utilizing the European Organisation for Research and Treatment of Cancer's (EORTC) tools specifically, select domains from EORTC QLQ-BR23, QLQ-C30, and QLQ-BRECON23-we evaluated various facets of their QoL. The mean QoL score was 54 out of 100, with patients who did not undergo BR reporting slightly higher scores (55) compared to those who did (52). Notably, social and sexual functioning scores were statistically superior in the non-BR group. Satisfaction with surgery, sexual function, and breast aesthetics were the lowest rated aspects among BR patients, indicating a considerable gap between expectations and outcomes. Marital status and the type of mastectomy notably influenced body image and sexual function. A significant portion of patients (100 out of 250) opted out of BR due to recurrence concerns, while 26.2% (106 out of 154) pursued BR to restore their pre-mastectomy physique. Contrary to the anticipated benefits of BR, our findings suggest that women who underwent the procedure reported a lower QoL compared to those who did not. The outcomes highlight the discrepancy between expected and actual benefits of BR, suggesting a pressing need for comprehensive rehabilitation programs. These programs should aim to enhance the QoL for post-mastectomy patients and provide in-depth counseling to align expectations with the potential realities of BR.

LSG vs OAGB: 7-Year Follow-up Data of a Randomised Control Trial and Comparative Outcome Based on BAROS Score.

This study aims to evaluate and compare long-term results of laparoscopic sleeve gastrectomy (LSG) and one anastomosis gastric bypass (OAGB) based on bariatric analysis reporting and outcome system (BAROS) score. Patients operated for morbid obesity between 2013 and 2015 were randomised to LSG and OAGB groups. Based on inclusion and exclusion criteria, 201 patients (100 LSG and 101 OAGB) were analysed for changes in total body weight (TBW), body mass index (BMI), percent excess weight loss (%EWL), percent total weight loss (%TWL), QoL (quality of life) scores, comorbidity resolution and outcome based on BAROS at 7years. Sixty-six LSG and 64 OAGB patients were followed up at 7years. Mean pre-operative TBW and BMI were 119 ± 28.2 and 44.87 ± 7.71 for LSG group and 113.25 ± 23.74 and 44.71 ± 8.75 for OAGB group respectively. At 7years after surgery, there was significant drop in mean TBW and BMI in both groups. Mean %EWL for LSG and OAGB patients was 50.78 ± 28.48 and 59.99 ± 23.32 and mean %TWL for LSG and OAGB patients was 23.22 ± 12.66 and 27.71 ± 12.27 respectively. Mean QoL scores at 7years were significantly higher than the pre-operative scores and most of the patients in both groups had remission or improvement in their comorbidities. 68.76% OAGB patients had very good or excellent outcome on BAROS score while only 36.37% LSG patients had similar outcome. LSG and OAGB are successful bariatric procedures over the long term. OAGB outperforms LSG and has significantly higher %EWL and %TWL over the long term.

"Better at home": Mixed methods report of intricacies in pediatric febrile neutropenia management.

Many febrile neutropenia (FN) episodes are low risk (LR) for severe outcomes and can safely receive less aggressive management and early hospital discharge. Validated risk tools are recommended by the Children's Oncology Group to identify LR FN episodes. However, the complex dynamics of early hospital discharge and burdens faced by caregivers associated with the FN episode have been inadequately described. An adapted quality-of-life (QoL) survey instrument was administered by a convergent mixed methods design; qualitative and quantitative data from two sources, the medical record and the mixed methods survey instrument, were independently analyzed prior to linkage and integration. Code book was informed by conceptual framework; open coding was used. Mixed methods analysis used joint display of results to determine meta-inferences. Twenty-eight patient-caregiver dyads participated with a response rate of 87%. Of the 27 FN episodes, 51.8% (14/27) were LR and 40.7% (11/27) had an early hospital discharge. The LR and early hospital discharge groups had higher mean QoL scores comparatively. Meta-inferences are reciprocal influencers and expand the complex situation; FN negatively affects the entire family, and the benefits of hospital management were outweighed by risks and worsened symptoms, so an individualized approach to management and care at home was preferred. Early discharge of LR FN episodes positively impacts QoL, yet risk-stratified management for FN is intricately complex. Optimal FN management should prioritize the patient's overall health; shared decision-making is recommended and can improve care delivery. These results should be confirmed in a larger, more heterogeneous population.