Median Quality Of Life Score Research Articles

Quality of life and response to treatment in cats with hypersomatotropism: the owners' point of view.

The aim of this study was to collect clinical information from owners of cats with hypersomatotropism (HS) distributed worldwide, assessing the impact of HS and its treatments on cats' quality of life (QoL) and survival time. A survey focused on clinical presentation, diagnostic procedures, treatments, cats' QoL and disease progression was distributed worldwide to owners of cats with HS. The owner's perception of the cats' QoL before and after or during treatment was defined using a score ranging from 1 (poor) to 5 (excellent). Improvement following treatment (IFT) was quantified using a score ranging from 1 (absent) to 5 (obvious). Different treatment groups, including at least five cases, were compared. A total of 127 cats were included from at least 11 different countries. Among these, 120 (95%) were diabetic and 7 (5%) were not. Out of 120 diabetic cats, 55 (46%) were treated with insulin as a single treatment (INS). Other treatments were not mentioned to owners in 35/120 (29%) cases. The median QoL score at diagnosis was 2 (range 1-5) and improved after treatment in all groups. Cabergoline (4; range 1-5), radiotherapy (4; range 2-5) and hypophysectomy (5; range 4-5) showed better median IFT scores compared with INS (3; range 1-5) (P = 0.046, P <0.002 and P <0.0001, respectively). Hypophysectomy IFT proved superior to cabergoline (P = 0.047) and was equal to radiotherapy IFT (P = 0.32). No difference was found between cabergoline and radiotherapy IFT (P = 0.99). The median survival time (MST) was 24 months (range 0-75 months). Cats treated with INS showed shorter MST (22 months; range 0-69 months) compared with cats treated with causal treatments combined (36 months; range 3-75 months) (P = 0.04). Not all cats with HS will have diabetes mellitus. Causal treatments seem associated with the greatest improvements in perceived cats' QoL and survival; such treatments should therefore be discussed with owners. Cabergoline could be an effective alternative management option.

Empoderamiento y calidad de vida en adultos con enfermedad celíaca en El Salvador. Estudio transversal

Introduction. Celiac disease is a chronic disease with worldwide distribution. In the person-centered health approach to chronic diseases, the concepts of empowerment and quality of life become relevant. Aim. To determine the degree of empowerment and quality of life of adults with celiac disease in a sample from El Salvador, as well as the correlation between both measures. Materials y methods. Descriptive cross-sectional study. Salvadoran adults with diagnosis of celiac disease confirmed by duodenal biopsy were surveyed online. Sociodemographic and clinical data were required from the participants. A validated questionnaire in Spanish for the empowerment of people with chronic diseases was applied because there is no specific empowerment questionnaire for people with celiac disease. A validated quality of life questionnaire in Spanish for people with celiac disease was also used. Results. Thirty-six people were included in the study, of whom 86.1% were females, with a median time since diagnosis of 7.0 years [5.0-10.0]. Seventy-five percent reported a strict adherence to the gluten-free diet. The median empowerment score was 185.0 [176.25-195.0] out of 235 points and the median quality of life score was 72.5 [54.0-79.75] out of 100 points. The Spearman correlation between empowerment and quality of life was positive and statistically significant (rho = 0.444; p = 0.007). The people evaluated in this study have a good level of empowerment and quality of life. Conclusion. There is a moderate positive correlation between empowerment and quality of life for adults with celiac disease in this study.

A Quiet Unstable Sitting Test to quantify core stability in clinical settings: Application to adults with ventral hernia

BackgroundThe abdominal core is comprised of the diaphragm, abdominal wall, and pelvic floor, and serves several important functions for balance, movement, and strength. Injury to this area, such as hernia, can have substantial impact. The Quiet Unstable Sitting Test involves individuals seated on the rounded surface of a BOSU® balance trainer placed on top of a force plate and situated on a flat, elevated surface. MethodsAn ordinal Quiet Unstable Sitting Test core stability score was calculated from center of pressure measurements, with 0 representing “normal” and < 0 indicating worsening stability. Hernia-Related Quality of Life survey summary scores were assessed (higher scores indicating better quality). FindingsA developmental cohort of 32 was used to establish reliability and normative values for the Quiet Unstable Sitting Test. A control group of 32 participants (43.7 ± 16.2 yrs., BMI 29.0 ± 4.9, 66% Female) was then compared to 21 patients with hernia (56.2 ± 12.5 yrs., BMI 29.2 ± 6.3, 24% Female). Hernia patients had median composite score of −2 and median quality of life score of 66, versus median Quiet Unstable Sitting Test of −0.5 and median quality of life of 93 for controls (p ≤ 0.01). Quality of life and Quiet Unstable Sitting Test scores were not correlated (p > 0.05). InterpretationHernia patients demonstrated significantly worse core stability and quality of life. These assessments were independent of one another across the entire population, indicating each measure's unique constructs of patient function. Core stability can be reliably measured in a clinical setting and may help with patient activation and rehabilitation.

Quality of Life Associated with Open vs Minimally Invasive Pancreaticoduodenectomy: A Prospective Pilot Study.

This prospective study was designed to compare quality of life (QoL) among patients who underwent open (O-PD) vs minimally invasive pancreaticoduodenectomy (MI-PD), using a combination of validated qualitative and quantitative methodologies. From 2017 to 2019, patients scheduled for pancreaticoduodenectomy (PD) were enrolled and presented with Functional Assessment of Cancer Therapy-Hepatobiliary surveys preoperatively, before discharge, at first postoperative visit and approximately 3 to 4 months after operation ("3 months"). Longitudinal plots of median QoL scores were used to illustrate change in each score over time. In a subset of patients, content analysis of semistructured interviews at postoperative time points (1.5 to 6 months after operation) was conducted. Among 56 patients who underwent PD, 33 had an O-PD (58.9%). Physical and functional scores decreased in the postoperative period but returned to baseline by 3 months. No significant differences were found in any domains of QoL at baseline and in the postoperative period between patients who underwent O-PD and MI-PD. Qualitative findings were concordant with quantitative data (n = 14). Patients with O-PD and MI-PD reported similar experiences with complications, pain, and wound healing in the postoperative period. Approximately half the patients in both groups reported "returning to normal" in the 6-month postoperative period. A total of 4 patients reported significant long-term issues with physical and functional well-being. Using a novel combination of qualitative and quantitative analyses in patients undergoing PD, we found no association between operative approach and QoL in patients who underwent O-PD vs MI-PD. Given the increasing use of minimally invasive techniques for PD and the steep learning curve associated with these techniques, continued assessment of patient benefit is critical.

The Use of Oligo Fucoidan in Cancer Bearing Dogs Undergoing Chemotherapy: A Double-Blinded Study

We evaluated the effect of oligo fucoidan (Laminina Japonica) derived from oceanic brown seaweed on the quality of life in dogs with cancer undergoing chemotherapy in a double-blinded case control study. Included in this prospective study were 100 dogs with a confirmed diagnosis of cancer that were being treated with chemotherapy. Dogs were randomly assigned to be treated with oligo fucoidan (treated group; n = 68) or placebo (placebo group; n = 32). Dogs were evaluated every 2-3 weeks for 3 months with a complete blood count (CBC) and serum biochemistry profile, and a complete history and physical examination by blinded clinicians at The Veterinary Cancer Center. The owners of the dogs enrolled in the study were required at each visit to complete a Quality-of-Life Questionnaire specifically designed for cancer-bearing veterinary patients. The owners were also blinded as to whether their dog was receiving oligo fucoidan or placebo. There were no significant differences between the CBC parameters or the serum biochemical parameters of the dogs in the treated and placebo-controlled groups. There was no significant difference in the median quality of life scores between the 2 cohorts, however, when evaluating the individual quality of life metrics, 5 out of the 23 metrics showed statistically significant improvement, and none of the quality-of-life metrics declined in the oligo fucoidan group as compared to the placebo group. All of the dogs that had a positive change in overall quality of life scores were dogs that received oligo fucoidan. There were minimal adverse side effects of giving the oligo fucoidan to dogs. Treatment with oligo fucoidan was safe and improved some of the quality-of-life metrics in dogs who were being treated with chemotherapy for cancer.

O41 PREDICTORS OF LOW QUALITY AFTER OPEN INGUINAL HERNIA REPAIR USING THE EURAHS-QOL SCORE: PROSPECTIVE MULTICENTRIC COHORT STUDY

Abstract Aim Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to identify predictors of low Quality of Life (QoL) after open inguinal hernia repair, to guide practice and inform patients at high risk. Material and Methods Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October-December 2019). The primary outcome was Quality of Life at 3 months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors. Results 893 patients were included from 33 hospitals. The majority were men (89.9% [800/891]), had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein’s repair (52.9% [472/893]). The median QoL score was 24 (IQR 10-40) before surgery and 2 (IQR 0-10) at 3 months after surgery, showing significant improvement (p &amp;lt; 0.001). After adjustment, low QoL at 3 months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21-2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12-2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66-5.11, p &amp;lt; 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30-3.84, p = 0.004). Conclusions This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised.

Long COVID and COVID-19-associated cystitis (CAC).

PurposeThere is scarce literature regarding genitourinary symptoms in COVID-19, especially post-acute disease otherwise known as Long COVID. We identified recovered COVID-19 patients presenting with new or worsening overactive bladder symptoms, known as COVID-19-associated cystitis (CAC).MethodsWe used the American Urological Association Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to screen COVID-19 recovered patients presenting with urological complaints at our urban-located institution from 5/22/2020 to 12/31/2020. Patients 10–14 weeks post-discharge responded to 5 symptom and 4 quality-of-life (QoL) questions. We reported median symptom scores, as well as QoL scores, based on new or worsening urinary symptoms, and by sex.ResultsWe identified 350 patients with de novo or worsening OAB symptoms 10–14 weeks after hospitalization with COVID-19. The median total OAB symptom score in both men and women was 18. The median total QoL score for both men and women was 19. Patients with worsening OAB symptoms had a median pre-COVID-19 symptom score of 8 (4–10) compared to post-COVID-19 median symptom score of 19 (17–21). Median age was 64.5 (range 47–82). Median hospital length-of-stay was 10 days (range 5–30).ConclusionWe report survey-based results of patients suffering from new or worsening OAB symptoms months after their hospitalization from COVID-19. Future studies with larger sample sizes and more extensive testing will hopefully elucidate the specific pathophysiology of OAB symptoms in the context of long COVID so urologists can timely and appropriately treat their patients.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11255-021-03030-2.

Predictors of low quality of life after open inguinal hernia repair using the EuraHS-QoL score: prospective multicentric cohort study across 33 hospitals.

Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to assess patient's Quality of Life (QoL) after open inguinal hernia repair and to identify predictors of low QoL at 3 months after surgery, to guide practice and inform patients at high risk. Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October-December 2019). The primary outcome was Quality of Life at 3months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors. 893 patients were included from 33 hospitals. The majority were men [89.9% (800/891)], had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein's repair [52.9% (472/893)]. The median QoL score was 24 (IQR 10-40) before surgery and 2 (IQR 0-10) at 3months after surgery, showing significant improvement (p < 0.001). After adjustment, low QoL at 3months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21-2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12-2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66-5.11, p < 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30-3.84, p = 0.004). This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised.

Cardiovascular Abnormalities and Mental Health Difficulties Result in a Reduced Quality of Life in the Post-Acute COVID-19 Syndrome.

(1) Background: Post-acute COVID-19 syndrome, characterized by persisting symptoms up to 12 weeks after the acute illness, impairs numerous people’s physical and mental health. (2) Methods: 64 inpatients and 79 outpatients, aged under 55 years, with post-acute COVID-19, were evaluated by a transthoracic echocardiography (TTE), mental health examination, Quality of Life (QoL) questionnaire, post-COVID-19 functional status scale (PCFS) and Hospital Anxiety and Depression Scale (HADS). (3) Results: all inpatients had mild/moderate pulmonary injury during acute COVID-19, in contrast to 37.97% of outpatients. Inpatients who reported an average of 5 persisting symptoms, had, predominantly, level 3 PCFS and a median QoL of 62, compared to outpatients, who reported an average of 3 symptoms, level 1 PCFS and a median QoL score of 70. Increased pulmonary artery pressure was detected in 28.11% of inpatients, compared to 17.72% of outpatients, while diastolic dysfunction was diagnosed in 28.12% of inpatients, in comparison with 20.25% of outpatients (p = 0.02). Abnormal systolic function was assessed in 9.37% of inpatients, and 7.58% of outpatients. According to the HADS depression subscale, 46.87% of inpatients and 27.84% of outpatients had clinical depression. Concomitantly, anxiety was detected in 34.37% of inpatients and 40.5% of outpatients (4) Conclusions: cardiovascular and mental health difficulties were frequently detected in patients with post-acute symptoms of COVID-19, which correlated with the number and intensity of persisting symptoms and reduced QoL scores.

Quality of life among women with symptomatic, screen-detected, and interval breast cancer, and for women without breast cancer: a retrospective cross-sectional study from Norway

PurposeBreast cancers detected at screening need less aggressive treatment compared to breast cancers detected due to symptoms. The evidence on the quality of life associated with screen-detected versus symptomatic breast cancer is sparse. This study aimed to compare quality of life among Norwegian women with symptomatic, screen-detected and interval breast cancer, and women without breast cancer and investigate quality adjusted life years (QALYs) for women with breast cancer from the third to 14th year since diagnosis.MethodsThis retrospective cross-sectional study was focused on women aged 50 and older. A self-reported questionnaire including EQ-5D-5L was sent to 11,500 women. Multivariable median regression was used to analyze the association between quality of life score (visual analogue scale 0–100) and detection mode. Health utility values representing women’s health status were extracted from EQ-5D-5L. QALYs were estimated by summing up the health utility values for women stratified by detection mode for each year between the third and the 14th year since breast cancer diagnosis, assuming that all women would survive.ResultsAdjusted regression analyses showed that women with screen-detected (n = 1206), interval cancer (n = 1005) and those without breast cancer (n = 1255) reported a higher median quality of life score using women with symptomatic cancer (n = 1021) as reference; 3.7 (95%CI 2.2–5.2), 2.3 (95%CI 0.7–3.8) and 4.8 (95%CI 3.3–6.4), respectively. Women with symptomatic, screen-detected and interval cancer would experience 9.5, 9.6 and 9.5 QALYs, respectively, between the third and the 14th year since diagnosis.ConclusionWomen with screen-detected or interval breast cancer reported better quality of life compared to women with symptomatic cancer. The findings add benefits of organized mammographic screening.

What Predictors Reduce Quality of Life in Head and Neck Cancer Patients?

IntroductionHead and neck cancers (HNCA) encompasses about 4% of all cancers in the U.S. However, the disease has a disproportionate impact on patients’ quality of life (QOL). Surgical and medical therapies can result in deformities of the head and neck, leading to severe impairment in speech, swallowing, and psychosocial problems. There is a primary focus on disease-specific treatment and survival, but QOL is a treatment outcome that has been increasingly recognized as an important outcome parameter in HNCA. ObjectivePostoperative QOL may be overlooked when managing head and neck cancer patients. The purpose of this study is to identify patient and surgical factors influencing QOL of head and neck cancer patients in hopes to improve patient outcomes. Materials and methodsThe authors implemented a retrospective cohort study design and enrolled a sample composed of head and neck cancer patients treated between 2017 and 2018. The predictor variables were grouped into the following categories: risk factors (smoking, alcohol, past medical history), demographic (sex, age, marital status), anatomic (tumor location, tumor stage), perioperative (utilization of a feeding tube, tracheostomy, neck dissection) and postoperative factors (chemotherapy or radiation therapy utilization). The primary outcome variable was the Head and Neck Quality of Life (HNQOL) score with higher scores correlated with poorer QOL. Descriptive statistics were completed for all the variables. Association between the predictor variables and HNQOL scores were examined using bivariate statistics and statistical significance was set at P < .05. ResultsThe study sample composed of 78 patients presenting or referred to the Center of Head and Neck Maxillofacial and Reconstructive Surgery Clinic at Ascension Macomb-Oakland from January 1, 2017, to August 31, 2018. Surgeries were completed at Ascension Macomb-Oakland and Ascension St. John Hospitals by 1 primary surgeon in the metro Detroit area. Of the 78 patients meeting inclusion, 31 patients completed the validated University of Michigan HNQOL instrument. The sample's mean age was 66 (±1.7) and 71% were male. The median HNCA QOL score was 18 with a maximum score of 80. Variables associated with poorer QOL scores were: radiation therapy (21 vs. 5.5, P = .033), perioperative feeding tube (31 vs. 9, P = .012), utilization of chemotherapy (12.5 vs 9.0, P = .60), male gender (17 vs 9.5, P = .39), perioperative tracheostomy (26 vs. 14.5, P = .26), current/prior tobacco use (19.5 vs. 11.5, P = .81), single marital status (27 vs. 16, P = .48), neck dissection (17.5 vs. 15.5, P = .91), and alcohol use (18.5 vs. 16.0, P = .65). ConclusionThe study results suggest that the presence of a feeding tube and utilization of radiotherapy most significantly decreased QOL among HNCA. Additional factors associated with poorer QOL were radiation therapy, utilization of a feeding tube, chemotherapy, male sex, tracheostomy utilization, tobacco use, single/divorced marital status, neck dissection, and alcohol abuse.

Associations between markers of social functioning and depression and quality of life in survivors of head and neck cancer: Findings from the Head and Neck Cancer 5000 study.

To investigate associations between markers of social functioning (trouble with social eating and social contact), depression and health-related quality of life (QOL) among head and neck cancer survivors. This cross-sectional analysis included individuals with oral cavity, oropharynx, larynx, salivary gland and thyroid cancers from Head and Neck 5000 alive at 12 months. Trouble with social eating and social contact were measured using items from EORTC QLQ-H&N35 and QOL using EORTC QLQ-C30; responses were converted into a score of 0-100, with a higher score equalling more trouble or better QOL. A HADS subscale score of ≥8 was considered significant depression. Associations between tertiles of trouble with social eating and social contact and depression and QoL were assessed using multivariable logistic and linear regression (with robust errors), respectively. Of 2561 survivors, 23% reported significant depression. The median QOL score was 75.0 (interquartile range 58.3-83.3). For trouble with social eating, after confounder adjustment, those in the intermediate and highest tertiles had higher odds of depression (intermediate: OR=4.5, 95% CI 3.19-6.45; high: OR=21.8, 15.17-31.18) and lower QOL (intermediate:β=-8.7, 95% CI -10.35 to -7.14; high: β=-24.8, -26.91 to -22.77). Results were similar for trouble with social contact. We found strong clinically important associations between markers of social functioning and depression and QOL. More effective interventions addressing social eating and contact are required. These may help survivors regain their independence, reduce levels of isolation and loneliness, and depression, and improve QOL outcomes generally.

Late effects care for childhood brain Tumor Survivors: A Quality-Improvement Initiative

Childhood and adolescent brain tumor survivors are at risk for long-term consequences of therapy. We reviewed adherence to long-term follow-up (LTFU) guidelines, assessed provider perspectives, and studied the needs, experience and quality of life (QOL) of pediatric malignant brain tumor survivors in the McMaster Children’s Hospital Neuro-Oncology clinic. LTFU areas for improvement were evaluated using an anonymous health provider needs assessment questionnaire. The Cancer Care Experience Questionnaire (CCEQ), Cancer Worry Scale (CWS), Self-Management Skills Scale (SMSS), and PedsQL measured parents/patients’ needs and QOL. Individual care plans were based on the Children’s Oncology Group (COG) LTFU guidelines. Based on 17 responses, staff perceived areas for improvement included: increased multi-disciplinary participation, improved patient education and increased surveillance for therapy-related late effects. Thirty-two families participated, most felt they received high-quality care. Mean cancer worry scores were low (71.8 (± 28.4)). Survivors reported limited self-management skills (58.5 (±18.2)), requiring support with medical needs and activities of daily living. Overall median QOL scores were ‘good’ (parental report 72.3 (±17.7), survivor 68.2 (±16.6)). Utilizing survivorship guidelines and assessments from patients, caregivers and health providers, we implemented improvements in our provision of neuro-oncology survivorship care. Lessons learned may assist other LTFU programs.

Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery.

Background: The pedicled pectoralis major muscle flap (PMMF) is a well established flap for fistula prophylaxis after salvage laryngectomy. To reduce donor site morbidity, we established a modified muscle-sparing harvesting technique. We herein investigate postoperative shoulder function and health-related quality of life (HRQOL). Methods: A chart review of patients receiving the modified muscle-sparing pectoralis major muscle flap between 2013–2020 was performed. Nineteen patients (male = 18, female = 1) were potentially eligible and six male patients were ultimately enrolled. Postoperative shoulder function was assessed on both sides (flap side versus non-flap side) using the Constant Murley Score and the Bak criteria. Health-related quality of life was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire in cancer patients (EORTC QLQ-C30) and head and neck cancer patients (EORTC H&N35). Results: No Constant Murley Score subscale was statistically significant (p ≥ 0.180). Bak criteria was overall rated “Good“. Solely upper extremity adduction force was significantly altered on the flap side (p = 0.039). Median EORTC QLQ-C30 score was 82.2 (IQR 11.1) on the functional scale and 10.3 (IQR 2.6) on the symptomatic scale. Median quality of life score was 75.0 (IQR 33.3) and median EORTC QLQ-H&N35 was 20.6 (IQR 9.8). Conclusions: Postoperative shoulder function after modified muscle-sparing pectoralis major muscle flap surgery is comparable to function of the healthy side with a significant deficiency in adduction force not compromising daily life in this small study cohort.

PD04-09 DOES HEALTH LITERACY IMPACT PATIENT SATISFACTION FOLLOWING ARTIFICIAL URINARY SPHINCTER SURGERY?

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I (PD04)1 Sep 2021PD04-09 DOES HEALTH LITERACY IMPACT PATIENT SATISFACTION FOLLOWING ARTIFICIAL URINARY SPHINCTER SURGERY? Rohan Bhalla, William Furuyama, Madeleine Ball, Joshua Calvert, Benjamin Dropkin, Douglas Milam, Melissa Kaufman, and Niels Johnsen Rohan BhallaRohan Bhalla More articles by this author , William FuruyamaWilliam Furuyama More articles by this author , Madeleine BallMadeleine Ball More articles by this author , Joshua CalvertJoshua Calvert More articles by this author , Benjamin DropkinBenjamin Dropkin More articles by this author , Douglas MilamDouglas Milam More articles by this author , Melissa KaufmanMelissa Kaufman More articles by this author , and Niels JohnsenNiels Johnsen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001968.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Health care providers often overestimate a patient’s understanding of health conditions and treatments which can impact preoperative counseling, communication between providers and patients, and ultimately widen health care disparities. We sought to determine whether a patient’s health literacy impacts satisfaction following Artificial Urinary Sphincter (AUS) placement for male urinary incontinence. METHODS: Electronic medical records of men who underwent AUS surgery between January 1st 2016 and July 31st 2020 were retrospectively reviewed. We administered a patient satisfaction phone questionnaire that measured overall satisfaction with the procedure using a Likert scale, as well as whether patients would again undergo AUS surgery. The Brief Health Literacy Screen (BHLS), a validated 3 question Likert-style questionnaire, was administered to evaluate health literacy. Ordinal logistic regression was used to determine the association between health literacy and patient satisfaction, adjusting for the following predetermined confounders: patient age, preoperative American Urological Association Symptom Index (AUASI), time from surgery to phone questionnaire, and device functionality. RESULTS: Seventy-six men who underwent AUS surgery and met inclusion criteria were identified. The median age was 70 years with an interquartile range (IQR) of 66-74 years and 88.1% were Caucasian. The median preoperative AUASI was 13 (IQR: 9-19) with a median quality of life score of 5 (IQR: 4-6). Eighty-six percent of men were either satisfied or very satisfied with their surgical procedure, and 86% of men stated that they would again undergo AUS surgery. The median BHLS score was 15 (IQR: 12-15). After adjusting for predetermined confounders, BHLS score was significantly associated with patient satisfaction (OR 1.25, 95% CI 1.02-1.56; p=0.034); however, it was not associated with likelihood to again undergo surgery (p-value = 0.403) (Table 1). CONCLUSIONS: Lower health literacy is associated with lower satisfaction scores following AUS surgery. Understanding a patient’s baseline health literacy and level of comprehension of medical treatments and expectations can aid to individualize preoperative counseling, improve subjective patient outcomes, and reduce health disparities. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e53-e53 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rohan Bhalla More articles by this author William Furuyama More articles by this author Madeleine Ball More articles by this author Joshua Calvert More articles by this author Benjamin Dropkin More articles by this author Douglas Milam More articles by this author Melissa Kaufman More articles by this author Niels Johnsen More articles by this author Expand All Advertisement Loading ...

Teacher Teleworking during the COVID-19 Pandemic: Association between Work Hours, Work-Family Balance and Quality of Life.

Background: Teachers worldwide had to reinvent their work routine according to teleworking during the COVID-19 pandemic, a work format that negatively impacts individuals’ physical and mental health. This study evaluates the association between work hours, work–family balance and quality of life (QoL) among teachers during the Chilean health emergency of the COVID-19 pandemic. Teachers from across Chile were contacted via email and social media to answer an online survey. QoL was evaluated via the SF-36 questionnaire, work hours and work–family balance in the pandemic. A total of 336 teachers from across Chile participated in this study. Teachers had a low QoL score, associated with age (p < 0.05). Teachers who were ≤44 showed lower deterioration risks in the Physical Component Summary (OR: 0.54) than the ≥45-year-old age group; simultaneously, the younger group (≤44 years) had a greater risk (OR: 2.46) of deterioration in the Mental Component Summary than teachers over 45 years. A total of 78.7% of teachers reported having increased their work hours during the COVID-19 pandemic due to teleworking and 86% indicated negative effects on their work–family balance. Pandemic work hours and negative work–family balance increase the risk of reducing the Mental Component Summary (OR: 1.902; OR: 3.996, respectively). Teachers presented low median QoL scores, especially in the Mental Component Summary, suggesting that it would be beneficial to promote a better workload distribution for teachers in emergency contexts, considering the adverse effects of teleworking.

A national survey on COVID-19\xa0second-wave lockdowns on older adults\u2019 mental wellbeing, health-seeking behaviours and social outcomes across Australia

BackgroundThe impact of severe second lockdown measures on older adults’ wellbeing is unknown. We aimed to (i) identify the impact of the second lockdown that resulted from the second wave of COVID-19 cases on older Australians’ quality of life; (ii) compare the impact of second wave lockdowns in Victoria, Australia’s second most populous State, to those in other States and Territories not in lockdown.MethodsA national cross-sectional study of community-dwelling older adults completed online questionnaires for quality of life, social networks, healthcare access, and perceived impact of COVID-19 between July to September 2020. Tobit regression was used to measure the relationships of healthcare service access and social networks with quality of life of older adults in Victoria compared to those in the rest of Australia.ResultsA total of 2,990 respondents (mean [SD] age, 67.3 [7.0]; 66.8 % female) participated. At time of data collection, Victoria’s second COVID-19 lockdown had been in force for an average 51.7 days. Median quality of life scores were significantly higher in Victoria compared to the rest of Australia (t2,827=2.25 p = 0.025). Being female (95 % CI, -0.051–0.020), having lower educational attainment (95 % CI, -0.089–-0.018), receiving government benefits (95 % CI, -0.054–-0.024), having small social networks (95 % CI, 0.006–0.009) and self-reported physical chronic health conditions were all independent predictors of lower quality of life.ConclusionsLonger-term studies are required to provide more robust evidence of the impact as restrictions lift and normal social conventions return.

Clinical profile and outcomes of patients with clinical benign prostate hyperplasia treated by trans urethral resection of prostate at Bugando Medical Centre, Mwanza, Tanzania

Introduction: Benign Prostate Hyperplasia (BPH) is the most common prostatic pathology in elderly men with Trans Urethral Resection of the Prostate (TURP) still being considered as the gold standard surgical management. TURP is the commonest endoscopic surgery performed for BPH in developing countries including Tanzania, however its outcome in this part of the world has not been documented. Therefore, the study aimed to determine the clinical profile, outcome as well as predictors of outcome in patients with clinical BPH undergoing TURP at Bugando Medical Centre (BMC), a tertiary hospital in Mwanza, Tanzania. Methods: This was a cross sectional longitudinal hospital based study to evaluate the clinical profile as well as the outcome of patients with clinical BPH treated by TURP at BMC from November 2018 to April 2019. All participants scheduled for TURP for the diagnosis of clinical BPH who signed informed consent for the study were included, their international prostate symptom score (IPSS) with the 8th question for quality of life (QoL) was scored, social demographic data and clinical profile information were obtained from their files. Participants were followed in the theatre to document any intraoperative complications and other necessary data required by this study. Progress in the ward was recorded and following discharge, patient was scheduled for follow up at 6 and 12 weeks. During follow up, IPSS and QoL scores as well as complication was recorded. Results: A total of 210 participants met the eligibility criteria. The median age was 69 (IQR 63-75) years. Prostate size ranged from 15 – 200 grams with median size of 77 (IQR 51-107) grams. Acute urine retention was the most common indication 69 (33%), followed by lower urinary tract symptoms 52 (25%). Urologist operated most of the patient 122 (58.1%) with the rest operated by either resident alone or finished up by urologist, and the median weight resected was 20 (IQR 13.5 –28.3) grams. About 66 (31.4%) developed perioperative complication with majority having clot retention. During follow up, the median IPSS score was 9 (IQR 7 – 12) and 2 (IQR 0 – 6) and median QoL score of 3 (IQR 1 – 3) and 0 (IQR 0 – 1) with improvement of 93 (45.4%) and 184 (89.8%) on 1st and 2nd follow up visits respectively. There were a total of 9 (4.3%) patients whom developed Trans urethral resection (TUR) syndrome, with overall mortality of 3 (1.4%). Conclusion: BPH is common from 6th decade of life onwards. Though most participants were operated because of either acute urine retention or severe lower urinary tract symptoms (LUTS), some presents late already with renal insufficiency. Despite the fact that most of the participants had severe symptoms and their quality of life was poor at presentation, TURP improved symptoms in most of the participants. The improvement is even better in the hands of experienced surgeon, for the participants with small prostate and in absence of UTI prior to surgery.

Predictors of Improvement in Quality of Life When Treating Hypothyroidism.

Background Primary hypothyroidism is characterized by reduced quality of life (QoL). Although thyrotropin (TSH) is utilized as the primary indicator of thyroid disease and treatment adequacy, no simple correlation between QoL and TSH has been shown. This study aimed to investigate changes in clinically relevant predictors during initiation of levothyroxine (L-T4) therapy and their ability to predict improvement in QoL. Method Quality of life was measured in patients with newly diagnosed hypothyroidism, during the initial 12 months of L-T4 therapy, by the thyroid-related patient-reported outcome questionnaire, ThyPRO-39. The main outcome measures were the Composite QoL scale and the Tiredness and Emotional Susceptibility subscales (0–100, higher scores worse). Clinical variables (resting energy expenditure (REE), body composition, thyroid function, L-T4 dose, and cognitive function tests) were evaluated as predictors of improvement in QoL by univariate and multiple regression analysis. Results Thirty-seven hypothyroid patients with a baseline median TSH of 30 mU/l and a median QoL score of 29 were included. After twelve months of L-T4 treatment, the ThyPRO-39 QoL score had significantly improved to a median score of 14, while REE per kg fat-free mass (FFM) increased significantly from a mean of 26.5 to 28.7 kcal/day/kg (p < 0.001). Change in ThyPRO-39 was not associated with a change in REE/FFM (unstandardized coefficient (USC): 0.09 with confidence interval (CI): −1.93 to 2.11, p=0.93) but was positively predicted by baseline body mass index (BMI) (USC: 1.54 with CI: 0.59 to 2.49, (p=0.002), without association with weight loss (USC: 0.33 with CI: −1.21 to 1.27, p=0.96). Conclusion Improvement in QoL as measured by ThyPRO-39 after initiation of L-T4 therapy for hypothyroidism was not associated with changes in REE. High baseline BMI, but not weight loss during therapy, was associated with improvement in QoL. This trail is registered with www.Clinicaltrials.gov (registration no. https://clinicaltrials.gov/ct2/show/NCT02891668).

Quality of life and mental health status among the caregivers of genetic disease patients in Southern Karnataka, India

ObjectivesThe burden due to genetic diseases and congenital anomalies are on a rise. These diseases have an impact on several implications of life, ranging from economic burden, lifelong dependency and associated social stigma. The present study was conducted to assess the quality of life and mental health status among caregivers of genetic disease patients in Southern Karnataka, India. MethodsThis cross sectional study was conducted among 101 caregivers of genetic disease patients attending a tertiary care hospital in Southern Karnataka, India for a period of one and half years. After obtaining consent, sociodemographic data was collected. WHO-BREF and DASS-21 tools were used to assess the quality of life and mental health status, respectively. SPSS V.22 was used for statistical analysis. Quantitative data showing non-parametric distribution was expressed as median, interquartile range. Inferential statistical tests like Mann Whitney U test and Kruskal Wallis test were used. ResultsThe median quality of life score was 81 with interquartile range of 75–81 in Domain 1(Physical health), 69 with interquartile range of 56–75 in Domain 2(Psychological domain), 75 with interquartile range of 56–75 in Domain 3(Social relationships) and 69 with interquartile range of 63–75 in Domain 4 (Environment). The median score of depression among the participants was 2 with an interquartile range of 0–7, anxiety was 0 and that of stress was 2 with an interquartile range of 0–8. Females had higher depression, anxiety and stress scores. ConclusionPsychological health, environment and social relationships were affected the most. Awareness, service accessibility along with psychosocial support can help in positive adaptation.