Medical Outcomes Study Short Form Research Articles

Determinants of Health-Related Quality of Life among Post-Partum Women Residing in a Resettlement Colony of East Delhi.

Abstract: The postpartum period marks a transition phase in the life of the mother as well as the whole family. Health Related Quality of Life (HRQoL) is an important aspect for not only mother’s physical and psychological health. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a sample size of 330 post-partum women and the data was collected in the 6th week of post-partum period using the MOS SF-36 (Medical Outcomes Study Short Form 36 Health Survey) for health related quality of life. Among the study subjects, 34.2% had the birth order two and they showed the best mean HRQoL score. The mean score was low for the study subjects with complications in the antepartum, intrapartum and postpartum period (52.9 ± 18.4) as well as in foetal complications where the intrapartum period complications had the worst mean HRQoL score. Healthcare workers of the study area visited 91.5% of the subjects during the post-partum period and had better HRQoL mean score. Also, 22.4% subjects had history of mistreatment and abuse with decline in the mean HRQoL scores. Across the study subjects, 54.4% had financial hardships faced by their family members which had poor HRQoL mean scores. This study uncovered various horizons of health related quality of life for assessment of women in the post-partum period which emphasised the modifications and considerations to include quality as one of the determinant and indicator of health.

P-509 Evolution of quality of life, sexual function and marital agreement in long term infertile couples: a 10-year prospective cohort study

Abstract Study question Comparing the sexual function, marital adjustment, and quality of life of long-term infertile and parenting couples after a history of ART Summary answer Long time infertility alters the sexual function in women but does not impact negatively the quality of life and the marital adjustment of the couples What is known already The short-term impact of the diagnosis of infertility and its treatments on heterosexual couples has been investigated. But very little literature exists regarding the evolution of the quality of life, marital agreement, and the sexual function of long-term infertile couples. After ART, parenthood is considered to impact the quality of life and thus the conjugal life of the couples in a short time. But there are very few studies comparing the quality of life of couples who underwent ART in regard to the success or not of their parenthood project in the long term. Study design, size, duration This is a prospective, cohort-type analytical study where each patient is their own control over time. Patients were recruited at the Fertility Treatment Unit of our department, over a 10-year period (2009-2018). An interview was held with each partner at the 1st consultation and 10 years later. The recruitment phase took place from January 1st, 2009, and May 31, 2009. Participants/materials, setting, methods We included all heterosexual married couples with women under 40 and men under 45. The evaluation of the quality of life was standardized by the Medical Outcomes Study Short Form 36 (SF-36) and the Fertility Quality Of Life (FertiQol). The female sexual function was evaluated with the Female Sexual Function Index (FSFI). The male sexual function was evaluated through the International Index of Erectile Function (IIEF). The marital adjustment Test (MAT) evaluated the conjugal life. Main results and the role of chance We included 100 couples (100 women and 100 men) of whom only 44 were still together after 10 years:18 were still childless, 8 had adopted, and 18 had live births. The divorce rate in our study population was 56%. There were no significant differences in the socio-demographic features of the parenting and childless couples. Men's sexual function was not different between fathers and childless men. Childless women's sexual function was impaired compared with mothers either regarding the global function (p = 0.003) or all its components (Desire (p = 0,025), excitation (p = 0,001), lubrification (p = 0,007), orgasm (p = 0,017), pain (p = 0,008), and satisfaction (p = 0,006)). There is no difference in terms of marital adjustment (p = 0.479) and in terms of quality of life when applying the SF36. In the 18 long-term infertile women, the core FertiQol emotional scores and the FertiQol treatment tolerance scores were lower than in men (respectively, p = 0.02 and 0.003). Limitations, reasons for caution The small size of the sample of our study is the main limitation of the study. It is mainly related to the high rate of divorce in this specific population and the long period of the study. Wider implications of the findings Health care professionals need to emphasize the information of the couples of the potential effects of long-term infertility on the couple's marital life, the sexual life, and the quality of life, especially among women. They also need to help the patients seek the help and counseling they need. Trial registration number not applicable

The Effect of a Short-Term Pulmonary Rehabilitation on Exercise Capacity and Quality of Life in Patients Hospitalised with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Recent research shows that pulmonary rehabilitation (PR) programmes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), reduced dyspnoea, improved exercise capacity, and prevented occurrence of further exacerbations. To evaluate the utility of a 3-week PR programme in patients with AECOPD. Patients admitted with AECOPD, following clinical stabilisation in the respiratroy intensive care unit (RICU), were alternately assigned to intervention (n=15); and control groups (n=15), respectively. Baseline assessment included spirometry, six-minute walk test (6MWT), symptom limited cardiopulmonary exercise test (CPET), health-related quality of life (HRQoL) assessment by generic questionnaire medical outcomes study short form (S-F 36) questionnaire and dyspnoea evaluation by Borg score. The intervention group patients were treated with usual care plus PR exercises in the form of 20 minutes each of walking, bicycle ergometry and resistance exercises, thrice-weekly for three weeks. The control group patients were treated with only the usual care. After discharge from hospital the treatment regimens were continued on alternate days on outpatient basis, for a total of three weeks. The assessment was repeated in both the groups after three weeks. Nine sessions of PR exercises produced statistically significant improvement in general well-being, forced expiratory volume in the first second (FEV1), 6MWT parameters, exercise capacity, peak oxygen uptake and volume of oxygen consumption (VO2)/Watts slope on CPET in patients with AECOPD. Short duration PR programmes appear to be helpful in the management of AECOPD.

Cross-lagged models of health-related quality of life and breastfeeding across different body mass index groups: A three-wave prospective longitudinal study

BackgroundBidirectional relationships between health-related quality of life (HRQoL) and breastfeeding outcomes during the perinatal period across different body mass index (BMI) groups have not been investigated. Understanding the nature of such relations can provide strategies the for development of targeted interventions. ObjectivesThis study aims to longitudinally (1) investigate the patterns of HRQoL during the perinatal period across different BMI groups; (2) explore bidirectional associations between HRQoL, breastfeeding attitude, and positive breastfeeding status during the perinatal period, and (3) compare the aforementioned relationships across four BMI groups. MethodsA three-wave prospective longitudinal design was adopted in the second and third trimesters and six weeks postpartum. Cross-lagged panel analysis was used to examine reciprocal relations between two domains of HRQoL, breastfeeding attitudes, and positive breastfeeding status from antenatal to postnatal periods. Multi-group analyses were conducted to determine whether different patterns exist in these relationships according to the four BMI groups. The BMI was self-reported. Breastfeeding attitude and HRQoL were measured by the Iowa Infant Feeding Attitude Scale and the Medical Outcomes Study Short Form Health Survey, respectively. ResultsA total of 781 perinatal multi-ethnic women were recruited in Singapore. Our results showed that the physical HRQoL scores were the lowest at Wave 2 compared with those at Waves 1 and 3, whereas the mental HRQoL scores were the lowest at Wave 3 compared with those at Waves 1 and 2 across different BMI groups. Multigroup cross-lagged path analyses showed that breastfeeding attitudes were an antecedent of physical HRQoL in women with underweight. A cross-lagged relationship was found between breastfeeding attitudes and physical HRQoL scores across Waves 1 and 2 in women with obesity. Chi-square difference tests suggested that two paths (breastfeeding attitudes to Wave 2 physical HRQoL, and Wave 2 mental HRQoL to Wave 3 positive breastfeeding status) were significantly different across the four BMI groups. ConclusionsPhysical and mental HRQoL patterns were different during the perinatal period, pre-conception counselling and perinatal care should be tailored to women's physical and mental health care needs. Reciprocal relations between physical HRQoL and breastfeeding attitudes during pregnancy were found in women with obesity. A flexible and individualised approach should provide for the woman with obesity in a respectful manner.

Comparisons between US norm-based two-component and Japanese norm-based three-component SF-36 summary scores in systemic lupus erythematosus patients.

We compared the US norm-based two-component vs. Japanese norm-based three-component summary scores of the Medical Outcomes Study Short Form-36 (SF-36) in patients with systemic lupus erythematosus (SLE). One hundred fourteen Japanese SLE patients were studied. SF-36 physical component summary (PCS) and mental component summary (MCS) scores were computed by the US norm-based two-component (US2) and Japanese norm-based three-component (JP3) models, respectively, and compared. Their association with demographics and disease characteristics was also analysed. The US2-PCS scores were significantly higher than the JP3-PCS scores (p < .001); however, the US2-MCS and JP3-MCS scores were not significantly different (p = .16). Bland-Altman analyses demonstrated that the US2-PCS scores were generally higher than the JP3-PCS scores, and their difference was larger in the subjects with lower PCS scores. However, the multiple linear regression analyses for the PCS and MCS scores computed by the different models demonstrated mostly equivalent standardized regression coefficients with the variables. Although the agreement between the US norm-based two-component and Japanese norm-based three-component models of the SF-36 was insufficient, their scores demonstrated similar associations with other variables. The application of the US original version could be acceptable in certain studies depending on the research question.

Depression and Anxiety Reduce the Probability of Achieving a State of Sustained Minimal Disease Activity in Patients With Psoriatic Arthritis.

We aimed to determine whether the presence of depression or anxiety is associated with the achievement of sustained minimal disease activity (MDA) in patients with psoriatic arthritis (PsA). Adult patients satisfying classification criteria for PsA prospectively followed from 2008 to 2017 were included. A standard protocol including physician assessment and patient-reported outcomes determined whether patients achieved sustained MDA, which was defined as meeting MDA criteria for ≥2 consecutive visits. The presence of depression/anxiety was determined using 3 definitions: 1) a score of ≤38 on the mental component summary of the Medical Outcomes Study Short Form 36 (SF-36) health survey, 2) a score of ≤56 on the mental health domain of the SF-36 health survey, and 3) a rheumatologist's report of a diagnosis or treatment for depression/anxiety. A discrete time-to-event analysis was conducted based on a proportional odds model to identify factors associated with achieving sustained MDA. A total of 743 patients were included in the study. The number of patients identified as having depression/anxiety at baseline included 331 patients (44.54%) according to definition 1, 364 patients (48.99%) according to definition 2, and 211 patients (28.4%) according to definition 3. A total of 337 patients (45.36%) did not achieve sustained MDA. The presence of depression/anxiety was associated with reduced probability of achieving sustained MDA, with odds ratio (OR) 0.30 (P < 0.0001), OR 0.34 (P < 0.0001), and OR 0.47 (P < 0.0001) for definitions 1, 2, and 3, respectively. Other variables associated with a reduced probability of achieving sustained MDA included the Charlson comorbidity index and fibromyalgia. Symptoms of anxiety/depression reduce the probability of achieving sustained MDA in PsA. Comprehensive management of PsA should include measures for addressing these comorbidities.

The effect-modification of physical activity on the association of pain with impaired physical function in aging adults.

Pain is prevalent among older adults and may result in impairment in physical function. However, little is known about the effect-modification of this relationship by physical activity (PA) participation. This large and representative study sought to estimate the effect of pain on physical function among older adults in Ghana and evaluate whether PA modifies this association. Data came from 1201 adults aged ≥50years participating in the AgeHeaPsyWel-HeaSeeB Study in Ghana. Pain constructs were defined using the Medical Outcomes Study Short Form-36 (MOS SF-36). PA was assessed using the International Physical Activity Questionnaire short form (IPAQ-SF) and physical function impairment was measured by seven-item domains based on the activities of daily living (ADL) and instrumental ADL (IADL). Adjusted hierarchical OLS regressions were fitted to estimate the direct and moderating relationships between pain facets, PA, and impaired physical function. The relationships of pain severity (β=0.348, p<.001), and pain interference (β=0.424, p<.001) with impaired physical function were robust after full adjustment for confounding variables. Persons with pain experiences had significantly increased impaired physical function risks. PA significantly modified the association between pain severity (β = -0.232, p<.001) and pain interference (β = -0.143, p<.001) with impaired physical function. Our data indicate that the relationships of pain with physical function impairment are modified by PA intensity. Future studies are warranted to understand the indirect effect of pain on functional limitations and how PA promotion could manage pain and improve functional ability in aging adults.

Quality of sleep and health-related quality of life among health care professionals treating patients with coronavirus disease-19

IntroductionHealth care professionals exposed to coronavirus disease 2019 (COVID-19) are facing high levels of stress.ObjectivesThe aim was to evaluate the quality of sleep (QoS) and health-related quality of life (HRQoL), among health care professionals treating patients with COVID-19, as well as quantifying the magnitude of symptoms of depression and levels of anxiety.MethodsWe included 201 health care professionals in a cross-sectional, web-based study by applying 7-item Generalized Anxiety Disorder (GAD-7) Scale, Zung Self-rating Depression Scale, 36-item Health Survey of the Medical Outcomes Study Short Form (SF36), Pittsburgh Sleep Quality Index (PSQI) and additional survey constructed for the purpose of the study.ResultsPoor QoS and HRQoL correlated with high health anxiety and severe depressive symptoms and several demographic characteristics. Multiple linear regression analysis showed that higher scores on GAD-7 (beta = .71, p &lt; .01) and lower scores on mental health (MH) subscale on SF36 questionnaire (beta = –.69; p &lt; .01) were independent predictors of the higher PSQI score (adjusted R2 = .61, p &lt; .01 for overall model). Higher scores on GAD-7 (beta = .68, p &lt; .01) and worse self-perceived mental status (beta = .25; p &lt; .05) were independent predictors of the lower SF36 scores (adjusted R2 = .73, p &lt; .01 for overall model).ConclusionsThe major MH burden of health care professionals treating infected patients during the COVID-19 pandemic indicates that they need psychological support.DisclosureNo significant relationships.

Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom

To analyze the efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. A retrospective analysis was performed on 37 patients with osteoporotic vertebral compression fractures treated from January 2015 to January 2021, all of whom had spin-derived abdominal pain as the main symptom, and were divided into surgery group(21 cases) and conservative group (16 cases) according to different treatment methods. Patients in the surgery group were treated with percutaneous vertebroplasty, including 7 males and 14 females, with an average age of (75.95±6.84) years old and an average course of disease of (5.26±3.79) days. The conservative group received non-surgical treatment, including 5 males and 11 females, with an average age of (75.50±8.07) years old and an average course of disease of (4.28±3.42) days. Two groups of patients with preoperative mainly characterized by abdominal pain, abdominal distension and constipation, have no obvious chest waist back pain symptoms, the thoracolumbar MRI diagnosed as fresh osteoporotic vertebral compression fractures, record its postoperative abdominal pain visual analogue scale (VAS), medical outcomes study short form-36 (SF-36) score, defecation interval after treatment, etc. Thirty-seven patients were followed up for (14.90±14.11) months in surgery group and( 21.42±17.53) months in conservative group. Compared with before treatment, the VAS of surgery group at each time period after treatment, VAS of conservative group at 1 month after treatment and SF-36 score between two groups at 3 months after treatment were all improved(P<0.05), while VAS of conservative group at 3 days after treatment showed no statistically significant difference(P>0.05). Compared between two groups, there were no significant differences in VAS and SF-36 scores at 1 day before treatment(P>0.05), but VAS at 3 days after treatment in surgery group, life vitality and social function score at 3 months after treatment, and defecation time after treatment in surgery group were better than those in conservative group(P<0.05). There were no significant differences in other indexes(P>0.05). The incision healing of patients in surgery group was good, and no serious complications occurred in both groups. Percutaneous vertebroplasty is an effective method for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. Compared with conservative treatment, percutaneous vertebroplasty has more advantages in early relief of abdominal pain and constipation, recovery of vitality and social function.

Caregiving and Confidence to Avoid Hospitalization for Children with Medical Complexity

To test associations between parent-reported confidence to avoid hospitalization and caregiving strain, activation, and health-related quality of life (HRQOL). In this prospective cohort study, enrolled parents of children with medical complexity (n=75) from 3 complex care programs received text messages (at random times every 2weeks for 3months) asking them to rate their confidence to avoid hospitalization in the next month. Low confidence, as measured on a 10-point Likert scale (1=not confident; 10=fully confident), was defined as a mean rating <5. Caregiving measures included the Caregiver Strain Questionnaire, Family Caregiver Activation in Transition (FCAT), and caregiver HRQOL (Medical Outcomes Study Short Form 12 [SF12]). Relationships between caregiving and confidence were assessed with a hierarchical logistic regression and classification and regression trees (CART) model. The parents were mostly mothers (77%) and were linguistically diverse (20% spoke Spanish as their primary language), and 18% had low confidence on average. Demographic and clinical variables had weaker associations with confidence. In regression models, low confidence was associated with higher caregiver strain (aOR, 3.52; 95% CI, 1.45-8.54). Better mental HRQOL was associated with lower likelihood of low confidence (aOR, 0.89; 95% CI, 0.80-0.97). In the CART model, higher strain similarly identified parents with lower confidence. In all models, low confidence was not associated with caregiver activation (FCAT) or physical HRQOL (SF12) scores. Parents of children with medical complexity with high strain and low mental HRQOL had low confidence in the range in which intervention to avoid hospitalization would be warranted. Future work could determine how adaptive interventions to improve confidence and prevent hospitalizations should account for strain and low mental HRQOL.

Efficacy and Safety of Acupuncture on Symptomatic Improvement in Primary Sjögren's Syndrome: A Randomized Controlled Trial.

AimWe sought to evaluate the efficacy of acupuncture in treating the main symptoms of primary Sjögren’s syndrome, specifically dryness, pain, and fatigue.MethodsA total of 120 patients with primary Sjögren’s syndrome were randomized in a parallel-group, controlled trial. Participants received acupuncture or sham acupuncture for the first 8 weeks, then were followed for 16 weeks thereafter. The primary outcome was the proportion of participants with a ≥ 30% reduction in ≥ 2 of 3 numeric analog scale scores for dryness, pain, and fatigue. The secondary outcomes included the European League Against Rheumatism (EULAR) Sjögren’s Syndrome Patient-reported Index (ESSPRI); the EULAR Sjögren’s Syndrome Disease Activity Index; the Schirmer test score; unstimulated saliva flow; serum immunoglobulin G, A, and M concentrations; the Medical Outcome Study Short Form 36 score; salivary gland ultrasound imaging; and the Hospital Anxiety and Depression Scale score.ResultsThe proportions of patients meeting the primary endpoint were 28.33% (17/60) in the acupuncture group and 31.66% (19/60) in the sham group, without a statistically significant difference (P = 0.705). The IgG concentration at week 16 and the homogeneity in ultrasonography of the salivary glands at week 8 showed significant differences between the 2 groups (P = 0.0490 and P = 0.0334, respectively). No other differences were observed between the 2 groups. ESSPRI and unstimulated saliva flow were improved in both groups compared to baseline, albeit with a significant difference between them.ConclusionIn patients with primary Sjögren’s syndrome, acupuncture did not satisfactorily improve symptoms compared to placebo. However, interesting discoveries and possible underlying reasons were demonstrated and discussed, which may be useful to studies in the future.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT02691377].

Evaluating Distance Bias in Chronic Rhinosinusitis Outcomes

The distance traveled by patients for medical care is associated with patient outcomes (ie, distance bias) and is a limitation in outcomes research. However, to date, distance bias has not been examined in rhinologic studies. To evaluate the association of distance traveled by a cohort of patients with chronic rhinosinusitis with baseline disease severity and treatment outcomes. A total of 505 patients with chronic rhinosinusitis were prospectively enrolled in a multi-institutional, cross-sectional study in academic tertiary care centers between April 2011 and January 2020. Participants self-selected continued appropriate medical therapy or endoscopic sinus surgery. The 22-item Sinonasal Outcome Test (SNOT-22) and Medical Outcomes Study Short Form 6-D (SF-6D) health utility value scores were recorded at enrollment and follow-up. Data on the distances traveled by patients to the medical centers, based on residence zip codes, and medical comorbid conditions were collected. Distance traveled by patient to obtain rhinologic care. SNOT-22 and SF-6D scores. Scores for SNOT-22 range from 0 to 110; and for SF-6D, from 0.0 to 1.0. Higher SNOT-22 total scores indicate worse overall symptom severity. Higher SF-6D scores indicate better overall health utility; 1.0 represents perfect health and 0.0 represents death. The median age for the 505 participants was 56.0 years (IQR, 41.0-64.0 years), 261 were men (51.7%), 457 were White (90.5%), and 13 were Hispanic or Latino (2.6%). These categories were collected according to criteria described and required by the National Institutes of Health and therefore do not equal the entire cohort. Patients traveled a median distance of 31.6 miles (50.6 km) (IQR, 12.2-114.5 miles [19.5-183.2 km]). Baseline (r = 0.00; 95% CI, 0.00-0.18) and posttreatment (r = 0.01; 95% CI, -0.07 to 0.10) SNOT-22 scores, as well as baseline (r = -0.12; 95% CI, -0.21 to -0.04) and posttreatment (r = 0.07; 95% CI, -0.02 to 0.16) SF-6D scores, were not associated with distance. There was no clinically meaningful correlation between distance traveled and mean comorbidity burden. Nevertheless, patients with a history of endoscopic sinus surgery were more likely to travel longer distances to obtain care (Cliff delta = 0.28; 95% CI, 0.19-0.38). Although this cross-sectional study found that some patients appear more willing to travel longer distances for chronic rhinosinusitis care, results suggest that distance traveled to academic tertiary care centers was not associated with disease severity, outcomes, or comorbidity burden. These findings argue for greater generalizability of study results across various cohorts independent of distance traveled to obtain rhinologic care. ClinicalTrials.gov Identifier: NCT02720653.

MO214: Health-Related Quality of Life Among Patients With Anca Vasculitis

BACKGROUND AND AIMSAnti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a debilitating disease that can have a significant impact on a patient's quality of life. The aim of this study was to assess the longitudinal quality of life amongst those diagnosed with AAV using the EQ-5D instrument, which allows for calculation of quality-adjusted life years (QALYs.)METHODA total of 343 patients with AAV participated in this study, of which 191 (55.7%) were male, resulting in 2746 episodes. The EQ-5D-5L standardised instrument was used to evaluate health-related quality of life in the domains of mobility, self-care, usual activities, pain/discomfort, anxiety/depression and to generate a summary index score. Overall health was also rated using a visual analogue scale (0–100). EQ-5D questionnaires were completed during routine nephrology clinic attendances and through a vasculitis patient support smartphone app. We used a random effects model to control for multiple entries relating to individual patients.RESULTSA lower quality of life was seen amongst those with AAV (median index value 0.80, overall population average 0.856). The mean visual analogue scale score was 75.6 ± 17.3 (overall population average 82.8, Fig. 1). Patients’ pain and discomfort level (mean 1.95) was most affected while self-care (mean 1.33) was least affected (Fig. 1). An increase in BVAS tightly correlated with a reduction in quality of life. Using the random effects model, the index score was seen to decrease with increasing age with a 2.7% reduction in index score per decade. A 7% reduction in index score was seen during periods of disease activity compared with periods of remission. Patients with end-stage kidney disease requiring dialysis had an 8% reduction in index score. A reduced quality of life was seen following COVID-19 lockdown with a 5% reduction in index score seen. Using a median survival rate of 6.16 years for patients with small vessel vasculitis, we calculated the QALYs for this population as 4.9 years.FIGURE 1:(A) Domain-specific EQ5D levels and (B) visual analogue score. Both graphs reflect mean and 95% confidence interval.CONCLUSIONWe have defined for the first time the EQ-5D index value over the full disease course in patients with AAV. Notably, we have identified a reduction in quality of life during periods of disease activity. Other studies have demonstrated a reduction in quality of life during active disease using the AAV–PRO questionnaire and the Medical Outcomes Study Short Form-36. A decrease in work productivity has also been noted. Previously reported mean index values of 0.72 and 0.76 were lower than our observed values, although both are significantly reduced compared with population norms. In conclusion, this research highlights the negative impact of AAV on patients’ lives.

Participation Mediates the Relationship Between Postconcussive Symptoms and Suicidal Ideation Among Veterans.

Veterans with mild traumatic brain injury (mTBI) and associated symptoms are at risk for suicide. Postconcussive symptoms (PCS) may heighten risk for suicidal thoughts by limiting veterans' participation. To investigate whether participation mediates the relationship between PCS and suicidal ideation. Cross-sectional, exploratory design. Structural equation models were used to investigate whether participation mediated the relationship between PCS and suicidal ideation. Community. Veterans with mTBI (N = 145). The Ohio State University TBI Identification Method was used to establish mTBI diagnosis. We identified latent variables for PCS and participation using the Neurobehavioral Symptom Inventory and select domains of the Medical Outcomes Study Short Form-36, respectively. We used the Beck Scale for Suicide Ideation to measure the presence of suicidal ideation. Participation mediated the relationship between PCS and the presence of suicidal ideation (odds ratio [OR] = 1.09, p = .011). More severe PCS were associated with lesser participation (β = -.86, p < .001); greater participation was associated with lower odds of suicidal ideation (OR = 0.92, p = .007). PCS may heighten risk for suicidal thoughts among veterans by limiting successful participation, a primary target of occupational therapy intervention. Thus, the results suggest that occupational therapy practitioners can play a substantial role in suicide prevention services for veterans with mTBI. Preventive services could mitigate suicide risk among veterans with mTBI by enabling sustained engagement in meaningful and health-promoting activity (e.g., reasons for living) and targeting PCS. What This Article Adds: Researchers have proposed that occupational therapy practitioners can help prevent veteran suicide by supporting their engagement in meaningful, health-promoting activity and by targeting suicide risk factors within their scope of practice. To the best of our knowledge, this is the first study to offer empirical support for such proposed suicide prevention efforts. Although additional research is needed, these results are promising and highlight a distinct role for occupational therapy in suicide prevention.

Comparison of health-related quality of life of women undergoing robotic surgery, laparoscopic surgery or laparotomy for gynecologic conditions: A cross-sectional study.

To assess and compare the health-related quality of life of women undergoing robotic gynecologic surgery, laparoscopic gynecologic surgery or laparotomy for benign and cancerous conditions. Cross-sectional study design was used. The present study was carried out with 240 women, who underwent gynecologic surgery (robotic 48, laparoscopic 96, and laparotomy 96) in a tertiary care hospital. Instruments included a participant description questionnaire and Medical Outcomes Study Short Form-36. The data were collected 4 weeks after surgery, at the first postoperative visit of women to the clinic. Pearson χ2 test, one-way analysis of variance, and regression analysis were used to assess the data. Over half of the women in each group had surgery because of gynecologic cancer. All the subscale scores of Medical Outcomes Study Short Form-36 were significantly higher in the robotic group than the other surgical groups (P< 0.05). Women in the robotic group had better quality of life in terms of both the physical component and the mental component after surgery. Knowledge of health-related quality of life in the recovery period after surgery is important for healthcare providers to provide adequate preventive measures, information, and follow up.

Amyotrophic Lateral Sclerosis Symptom Score in Integrative Treatments (ALS-SSIT) for Evaluating Therapeutic Effect of Traditional Chinese Medicine: A Prospective Study.

Objective To evaluate the reliability, validity, sensitivity, and clinical applicability of a new scale—the amyotrophic lateral sclerosis symptom score in integrative treatments (ALS-SSIT)—for measuring the effect of traditional Chinese medicine (TCM) in patients with amyotrophic lateral sclerosis (ALS). Methods A total of 160 patients with ALS were enrolled and followed up for 6 months. All patients received TCM. Patients were evaluated at enrollment and at the end of 6 months with a new scale, the ALS-SSIT, developed after extensive consultations with TCM experts with several years of experience in the treatment of ALS. The 36-item Medical Outcomes Study Short Form (SF-36) scale and the amyotrophic lateral sclerosis functional rating scale (ALSFRS) were used as the reference standards. Results The acceptance rate and completion rate of the ALS-SSIT scale were high, and the content validity was confirmed by experts. Test-retest performed at enrollment and at 6 months showed good reliability of the ALS-SSIT scale (Cronbach α, 0.9172 and 0.9181, respectively). The ALS-SSIT scale score showed significant change at 6 months, indicating the ability to reflect the change in disease severity. Conclusion The ALS-SSIT appears to be a feasible, reliable, and sensitive tool for the evaluation of the effect of TCM in patients with ALS.

Health-related quality of life (HRQoL) from HIV patients\u2019 perspective: comparison of patient-reported outcome (PRO) measures among people living with hiv (PLWH) and other chronic clinical conditions

BackgroundPeople living with HIV (PLWH) are generally known to suffer from a lower quality of life compared to the one of general population, but still very few is known about the self-perception of quality of life when comparing HIV to non-communicable diseases. We performed a comprehensive assessment of patient’s reported outcomes measures (PROMs) among PLWH and patients affected by other chronic conditions (OC) such as diabetes mellitus type 1, rheumatoid arthritis, breast cancer in hormonal therapy, in order to investigate differences in PROMs outcomes between PLWH and other pathologies.MethodsA cross-sectional observational study was performed by using questionnaires investigating health-related quality of life (Medical Outcomes Study Short Form 36-item Health Survey), work productivity (WPI), and global health status (EQ-5D-3L). They were administered to patients affected by chronic diseases consecutively observed at a single University Hospital during a 10 months period, with comparable disease related aspects. Logistic regression analysis was used to analyze the association between disease group (HIV vs OC) and PROMs.Results230 patients were enrolled (89 PLWH, 143 OC). Mean age: 49 years (SD 10), mean time of disease 12 years (10), 96% were Caucasian, 35% assumed polypharmacy, 42% of male were PLWH versus 16% OC (p < 0.001), 19% PLWH versus 6% OC had clinical complications (p < 0.001). HIV infection was independently associated to a better health-related quality of life in several domains compared with the other conditions, except in mental health, whereas a worst health-related quality of life in most domains was reported by older patients and those experiencing polypharmacy.ConclusionsIn this cohort of patients with chronic conditions followed within the same health setting, PLWH showed better self-reported health outcomes compared to other chronic conditions with comparable characteristics of chronicity. The potential detrimental role of older age and polypharmacy in most outcomes suggests the need of longitudinal assessment of PROMs in clinical practice.

The impact of corrective surgery for thoracolumbar kyphotic deformity on health-related quality of life in patients with ankylosing spondylitis

Ankylosing spondylitis is a chronic inflammatory disease. It might affect the facet, sacroiliac joint, and vertebra regions. It leads to thoracolumbar kyphotic deformity in the spine region. Both ankylosing spondylitis and kyphotic deformity impair the patients' quality of life. Our objective was to assess the impact of the correction of kyphotic deformity in ankylosing spondylitis on health-related quality of life. 11 thoracolumbar kyphosis patients diagnosed with ankylosing spondylitis were operated and their deformity was corrected. Medical Outcome Study Short Form-36 (SF-36), visual analog scale (VAS), and Oswestry disability index (ODI) studies were performed on patients before surgery and 1 month after surgery to assess their impact on health-related quality of life. In our study, postoperative changes in the sub-parameters of the SF-36 test, which was used to assess the health-related quality of life of patients, were determined to be statistically significant compared to post-surgery. Likewise, postoperative changes in VAS and ODI tests compared to pre-surgery were also statistically significant. Corrective surgery of thoracolumbar kyphosis in patients with ankylosing spondylitis has a positive impact on both better health-related quality of life and recovery of back and low back pain.

Twelve-year long-term postoperative outcomes in patients with chronic rhinosinusitis with nasal polyps.

Evidence regarding long-term postoperative follow-up of chronic rhinosinusitis with nasal polyps (CRSwNP) patients is scarce in the literature. The objective of the present study was to report long-term 12-year postoperative outcomes for CRSwNP patients. CRSwNP patients were prospectively followed after endoscopic sinus surgery. Sinonasal symptoms, nasal polyp score (NPS), Barcelona Smell Test 24 (BAST-24), Lund-Mackay Score (LMS), and Medical Outcome Study Short Form-36 (SF-36) questionnaire were assessed before and 12 years after surgery. At long-term follow-up (median, 12 years), a strong improvement was noted for all patients (N=76) in nasal symptoms score, NPS, BAST-24, and LMS scores compared with baseline. No long-term improvement in SF-36 was found. Patients with CRSwNP have a long-term 12-year postoperative improvement in nasal symptoms, polyp size, computed tomography, and olfaction.

The mediating effect of self-efficacy in the relationship between mental health and quality of life in patients with hypertensive nephrology.

To examine the factors associated with the quality of life and the mediating effect of self-efficacy in the relationship between mental health and quality of life among patients with hypertensive nephrology. A cross-sectional and correlational study using the Strengthening the Reporting of Observational Studies in Epidemiology checklist guidelines. A total of 202 participants were collected from November 2019 to September 2020 from the outpatient department of nephrology of a regional teaching hospital in Taiwan using a convenience sampling method. The research tools included the World Health Organization-5 Well-Being Index, the Chronic Kidney Disease Self-Efficacy Instrument and the Medical Outcome Study Short Form-12. The mediating effect was statistically analysed by linear regression models and verified by Sobel testing. Mental health and self-efficacy were positively correlated with the overall quality of life. The results showed that the total explanatory variation of mental health and self-efficacy on the overall quality of life was 37.1%. Mental health was the most important explanatory factor, which could explain 27.1% of the variations in the overall quality of life alone. Moreover, self-efficacy was a partial mediator in the relationship between mental health and the quality of life among patients with hypertensive nephrology, with a total effect of 34.8%. The quality of life of this population can be improved by enhancing mental health, leading to an improvement in self-efficacy. Consequently, improved mental health and self-efficacy will improve the overall quality of life. Medical staff should be able to assess patients' mental health in providing referrals and assistance in a timely manner. If intervention programmes can be developed to improve patients' self-efficacy, their quality of life can also be improved.