Medical Outcomes Study Short Form Research Articles

1033. One year of Bictegravir in Mexico City: Differences in the Neuropsychiatric Adverse Events vs. Efavirenz

BackgroundIn Mexico, Efavirenz (EFV) was considered as first-line regimen for several years. However, the Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) had a history neuropsychiatric effects such as depression, suicidal thoughts, insomnia, hypersomnia, impairment cognition, impairment in quality of life, these adverse events cause poor adherence and abandon EFV regimens. Since June 2019, bictegravir (BIC) in a single tablet regimen was introduced in Mexico as a first-line treatment. Therefore, the objective of the study was to compare the presence of depressive and cognitive symptoms, suicidality, sleep disturbances, quality of life between BIC and EFV regimens.MethodsProspective cross-sectional study, non-probability sample, both groups BIC and EFV were matched according to age. Patients were recruited from June 2019 to May 2020 in Condesa Specialized Clinic in Mexico City. All the patients had 1 to 4 months from starting treatment. The evaluation test used were Medical Outcomes Study Short Form-36 (SF-36), Beck Depression Inventory (IDB-IA), Center for Epidemiologic Studies-Depression Suicidal Ideation subscale (CES-D IS), State Impulsivity Scale (SIS) and Pittsburgh Sleep Quality Index (PSQI).ResultsOne thousand six hundred patients, 800 in BIC group and 800 in EFV group. The mean age 37 years. Non-statistical difference was found in sociodemographic and HIV-related variables. Statistically significant differences were found between BIC and EFV groups (t = 1.91 - 15.28, p < 0.03). The largest differences were seen in cognitive symptoms such as impulsivity, quality of life mental score and suicidal ideation (t > 10.61). No differences were found in physical role and sleep disorders.BIC & EFV groups comparison ConclusionIn this study we found BIC group have fewer neuropsychiatric events than EFV group. The principal differences were in cognitive symptoms, suicidality, functionality associated with central nervous system symptoms. We suggest having a long-term follow-up of the sleep quality variables, to observe patient’s adaptation to treatment for a period over to 12 months.Disclosures All Authors: No reported disclosures

Health-related quality of life in early psoriatic arthritis compared with early rheumatoid arthritis and a general population

ObjectiveBoth psoriatic arthritis (PsA) and rheumatoid arthritis (RA) have a significant impact on quality of life, but few reports have compared the two diseases. The current study assessed health-related quality of life (HRQoL) in PsA at diagnosis and after five years compared with early rheumatoid arthritis (RA) and a matched general population. MethodsPatients with early PsA and early RA included in two Swedish registries with HRQoL data measured by the Medical Outcomes Study Short Form 36 (SF-36) at baseline and at five years follow-up were included. Differences in SF-36 scores compared with the general population were calculated for each patient. Physical function, disease activity, the delay before diagnosis, pain, and general wellbeing were used as explanatory variables. Statistical tests included t-tests and univariate and multivariate linear regression. ResultsPsA (n = 166) and RA (n = 133) patients of both sexes had significantly reduced HRQoL at disease onset. After five years, PsA patients still had impairments in several domains of SF-36, whereas RA patients had an almost normalized HRQoL. The time from symptom onset to diagnosis, disease activity, and disability independently contributed to the reduced improvement in PsA. ConclusionBoth early PsA and RA are characterized by severely reduced HRQoL. Despite more severe disease at inclusion, normalization of HRQoL is seen in patients with RA but not PsA. This may be due to delay in the diagnosis of PsA or more powerful interventions in RA. Earlier detection, lifestyle intervention, and more aggressive management strategies may be needed for PsA.

Quality of life assessment in patients with acute limb ishemia

Background. In conditions of permanent progress in the quality of surgical care in various areas of surgery, it is very important to allow patients themselves to evaluate provided treatment.&#x0D; Aims: this paper analyzes the quality of life in individuals with acute lower limb ischemia who have undergone lower limb revascularization surgery.&#x0D; Materials and methods. An assessment of the quality of life of 122 patients with acute lower limb ischemia (ALI) of II degree who were treated at the Moscow Сity Сlinical Hospital оf S.S. Yudin from 2016 to 2018 (average age 72.1 14.7 years) was performed. The quality of life was assessed using the medical Outcomes Study-Short Form (MOS SF-36) quality of life assessment methodology.&#x0D; Results. When assessing the quality of life of patients, it was found that the psychological and physical components of patients health are significantly affected by the angiotropic effect of the affecting factor associated with the presence of diabetes mellitus. 1 month after surgical restoration of blood flow against the background of the initial embolism, 83.6% of the respondents who did not suffer from diabetes noted a persistent improvement in their General condition and quality of life.&#x0D; Conclusion. This method of assessing the quality of life after surgical restoration of blood flow in patients with acute lower limb ischemia can be used in angiosurgical practice and clearly reflects of patient satisfaction with the treatment.

CL1 The Additional Burden of Caring for Adults with Depression and Suicidal Ideation in Five Large European Countries

Suicidal ideation (SI) affects ∼30-40% of those with major depressive disorder (MDD). While studies show that caring for a person with MDD confers substantial strain, little is known of the additional burden of caring for persons with MDD and suicidal ideation (SI). This study examined the excess burden of caring for people with depression and SI in five major European countries. A retrospective, cross-sectional analysis of the 2020 Europe National Health and Wellness Survey (NHWS; France, Germany, Italy, Spain, UK) was conducted. Caregivers for adults with unipolar depression and SI (CAUD-SI) were compared to caregivers for adults with unipolar depression without SI (CAUD-nSI) and non-caregivers. Outcomes including health status (EuroQol 5-dimension 5-level; EQ-5D-5L), health-related quality of life (HRQoL Medical Outcomes Study Short Form [SF-12v2]), Work Productivity and Activity Impairment (WPAI), and healthcare resource utilization (HRU) were assessed. Generalized linear models adjusted for covariates and presented as marginal means±standard error (SE). 554 CAUD-SI were compared to 837 CAUD-nSI and 49,662 non-caregivers. After adjusting for covariates, CAUD-SI had significantly lower health status, HRQoL and HRU compared to non-caregivers. Compared to CAUD-nSI, CAUD-SI had significantly lower EQ-5D-5L scores (0.58±0.02 vs 0.61±0.02; p<0.019) and physical component score (PCS; SF-12v2; 42.4±0.45 vs 43.7±0.39, p=0.015). A significant increased HRU was observed for CAUD-SI compared to CAUD-nSI: healthcare provider visits (10.8±1.2 vs 9.2±1.0, p=0.022), emergency room visits (1.4±0.3 vs 0.8±0.2, p=0.002), and hospitalizations (0.8±0.1 vs 0.5±0.1, p=0.001). No significant differences were observed for indicators of WPAI for all comparison groups. The present study shows that in these five European countries, caring for persons with depression and SI is associated with an increase in the humanistic (health status and physical functioning) and economic (HRU) burden compared to caring for persons with depression without SI. Management of patients with MDD and SI should consider the additional burden on caregivers.

Higher Fatigue Prospectively Increases the Risk of Falls in Older Men.

Background and ObjectivesFatigue is a common complaint and shares many risk factors with falls, yet the independent contribution of fatigue on fall risk is unclear. This study’s primary aim was to assess the association between fatigue and prospective fall risk in 5642 men aged 64–100 enrolled in the Osteoporotic Fractures in Men Study (MrOS). The secondary aim was to examine the association between fatigue and recurrent fall risk.Research Design and MethodsFatigue was measured at baseline using the Medical Outcomes Study (short form) single-item question “During the past four weeks, how much of the time did you feel energetic?” Responses were then classified: higher fatigue = “none,” “a little,” or “some” of the time and lower fatigue = “a good bit,” “most,” or “all” of the time. We assessed falls using triannual questionnaires. Fall risk was examined prospectively over 3 years; recurrent falling was defined as at least 2 falls within the first year. Generalized estimating equations and multinomial logistic regression modeled prospective and recurrent fall risk as a function of baseline fatigue status, adjusted for demographics, medications, physical activity, and gait speed.ResultsMen with higher (26%) versus lower baseline fatigue were older (75.1 ± 6.2 vs 73.2 ± 5.7 years), 24% less active, and had worse physical function (gait speed = 1.09 ± 0.24 vs 1.24 ± 0.21 m/s), all p < .0001. Within 1 year, 25.4% (n = 1409) had fallen at least once, of which 47.4% (n = 668) were recurrent fallers. Men with higher versus lower fatigue had 25% increased fall risk (relative risk = 1.25, 95% CI: 1.14–1.36) over 3 years follow-up, but had 50% increased odds of recurrent falling (odds ratio = 1.50, 95% CI: 1.22–1.85) within the first year.Discussion and ImplicationsFatigue is an important risk factor of falling independent of established risk factors. Reductions in fatigue (ie, increased energy) may lessen the burden of falls in older men and provide a novel avenue for fall risk intervention.

The impact of coronary stenting on long-term quality of life in patients with stable coronary heart disease

The purpose of the work is to assess the impact of percutaneous coronary intervention (PCI) on quality of life (QOL) parameters in patients with stable coronary heart disease (CHD).Material and methods. 175 people with stable CHD were examined, group I consisted of 77 people who underwent PCI for 1 year, group II - 98 patients who did not undergo myocardial revascularization. During the study, all patients underwent general clinical examination, ECG recording in standard 12 leads, echocardiography (ECHOCG), daily ECG monitoring to determine heart rate variability, determination of QOL parameters according to the Ukrainian version of the international questionnaire Medical Outcomes Study Short Form (MOS SF-36).Results. It was established that for patients with stable CHD is characterized by a decrease in all indicators of QOL. No significant difference was found in the parameters of QOL of persons who underwent PCI and patients who were not revascularized. There was a tendency to greater limitation of vital activity due to physical problems in the group of persons without revascularization - (13.9 ± 3.6) points against (22.3 ± 4.9) points in group I, (p = 0.16). The physical status of patients of group I was (44.8 ± 2.8) points, persons of group II - (41.7 ± 2.6) points, p = 0.42. Mental status was in group I (36.8 ± 1.8) points, in group II - (35.1 ± 2.0) points (p = 0.54). The general status of persons who underwent revascularization was (61.6 ± 3.1) points, persons without revascularization - (62.7 ± 3.2) points (p = 0.8). The negative correlation of physical status with the age of patients (r = -0.36), the presence of chronic respiratory diseases (r = -0.41), the presence of ventricular extrasystoles (VE) when recording the ECG (r = -0.25) , as well as the number of VE during the day according to daily monitoring (r = -0.29), the number of paired VE (r = -0.27), the number of episodes of ventricular bigeminy (r = -0.23) and trigeminy (r = -0.26).Conclusions. In persons with stable CHD there is a decrease in physical, mental and general status of QOL according to the questionnaire MOS SF36. The QOL values of patients with stable CHD who underwent PCI during the year do not differ significantly from the parameters of persons who did not undergo revascularization. The physical and mental status of patients with stable CHD is most associated with age, the presence of concomitant chronic pathology, ventricular arrhythmias.

Damage index for antiphospholipid syndrome during long term follow-up: Correlation between organ damage accrual and quality of life.

Consequences of organ damage in primary antiphospholipid syndrome (PAPS) are diverse, our aim was to determine organ damage over time and the correlation of organ damage accrual with health-related quality of life (HRQoL) in PAPS. First phase: retrospective cohort applying Damage Index for Antiphospholipid Syndrome (DIAPS) at 1, 5, 10, 20 years, or longer since diagnosis. Second phase: cross-sectional study, assessing HRQoL by the Medical Outcomes Study Short Form 36 (SF-36), and organ damage accrual. Descriptive statistics and Spearman correlation coefficient were used. Sixty-seven patients were included, mean follow-up:15 years. Deep vein thrombosis prevailed (71.6%), pulmonary embolism (35.8%) and stroke (32.8%). Organ damage was found in 98.5%, with a cumulative DIAPS value of 3, with greater involvement in the neuropsychiatric and peripheral vascular domains. Regarding HRQoL, deterioration in the physical component summary (PCS) was found in 89.6%. Organ damage accrual correlated inversely and significantly with all the SF-36 domains, mainly with the total score and PCS. Body pain and PCS correlated the most (rho = -0.503, rho = -0.475). Organ damage accrual impaired HRQoL in PAPS. Secondary thromboprophylxis through adequate systemic management and control of cardiovascular risk factors are necessary to prevent further impairment.

19P Musculoskeletal pain and health-related quality of life among breast cancer patients

The musculoskeletal pain is one of the leading health problems among women. This study aims to examine the associations between musculoskeletal pain and health-related quality of life (HR-QOL) among breast cancer patients and women without a history of breast cancer. A cross-sectional study was conducted among 68 breast cancer patients for an average of 3.5 years and 137 postmenopausal women without a history of cancer. Musculoskeletal pain was assessed using a 10-cm visual analog scale; HR-QOL was examined using the Medical Outcomes Study Short Form (SF-36) health survey. Linear regression was used to estimate the associations between pain and HR-QOL in both groups. Approximately 64 % of the breast cancer patients andwomen in the comparison group reported musculoskeletal pain.Among women with breast cancer, those with pain had significantlylower HR-QOL scores in the physical (52.2 vs. 42.6;p<0.001) and mental (52.7 vs. 45.5; p=0.01) component summary scores compared with those without pain. In the comparisongroup, pain was associated with significantly lower scores in the physical (55.4 vs. 46.0; p<0.001), but not the mental, component summary score (52.1 vs. 52.4; p=0.82). The significantassociations between pain and HR-QOL persisted afterconfounder adjustment in both groups. Among women withsimilar severity of pain, breast cancer patients reported significantlylower HR-QOL in the mental summary component compared with the women in the comparison group. Among breast cancer patients, musculoskeletal pain adversely affects both mental and physical components of HR-QOL. Preventing or treating musculoskeletal pain may improve overall HR-QOL among breast cancer patients.

Effect of Kinesiotaping on Quality of Life of Knee Osteoarthritis Patients

Introduction: Knee osteoarthritis (OA) causes pain which limits functional activity and quality of life. Quadriceps femoris muscle strengthening with weight-pulley system is effective in improving functional activity. Kinesiotaping is known in reducing pain thus improving activity and quality of life. This study was to determine the effect of kinesiotaping in addition to weight-pulley system exercise on quality oflife in grade II and III knee OA patients.&#x0D; Methods: Participants were randomly assigned to intervention group (n=13) and control group (n=14). All participants were treated with weight-pulley system exercise for nine sessions meanwhile participants in intervention group received additional kinesiotaping. Pre- and post-intervention quality of life were evaluated using Medical Outcome Study Short Form-36 (SF-36).&#x0D; Results: There were differences in total score of SF-36, bodily pain, general health, vitality, and role emotional between intervention and control group; (90.53±8.23, 76.98±11.88; p=0.002), (83.75±16.86,67.31±17.3; p=0.022), (88.57±10.27, 72.69±12.18; p=&lt;0.001), (93.93±7.64, 80.77±10.18; p=0.002) and (92.86±14.18, 74.37±24.17; p=0.027), respectively.&#x0D; Conclusion: Application of kinesiotaping in addition to weight-pulley system exercise improved quality of, particularly in bodily pain, general health, vitality and role emotional in grade II and III knee OApatients.

Quality of life, body image, and mobility in lower-limb amputees using high-tech prostheses: A pragmatic trial.

High-tech prostheses are supposed to achieve better functional recovery over mechanical-controlled prostheses in lower-limb amputees. However, quantitative data are insufficient. We aimed to evaluate changes in quality of life, life satisfaction, perception of body image, and functional performance of lower-limb amputees when using a mechanical-controlled prosthesis versus a microprocessor-controlled knee (MPK) or transtibial vacuum-assisted suspension system (VASS) prosthesis. In this pragmatic study, 57 lower-limb amputees were assessed with the Satisfaction with the Prosthesis Questionnaire (SATPRO), revised Amputee Body Image Scale (ABIS-R), Trinity Amputation and Prosthesis Experience Scales (TAPES), Medical Outcomes Study Short Form-36 (SF-36) and 6-min walk test (6MWT). All assessments were performed under 2 conditions (i.e., using a mechanical-controlled prosthesis vs. an MPK/VASS prosthesis. Amputees who used an MPK/VASS prosthesis showed significant increases in all SF-36 subscale scores and all subscale scores of TAPES except adjustment to limitation (P=0.156). The amputees showed clinically relevant improvements in 6MWT (P<0.001) and in SATPRO and ABIS-R scores (P<0.001). Lower-limb amputees using an MPK/VASS prosthesis had better life satisfaction, quality of life and functional performance than those using a mechanical-controlled prosthesis.

Adult Measures of General Health and Health-Related Quality of Life.

s was very high (intraclass correlation coefficient 0.996). Any disagreements were resolved through a discussion between all authors. Given the large number of potentially relevant measures identified, only those measures that were used at least 4 times in the screened abstracts were selected for this review. Consequently, this report provides reviews of 4 generic health profiles: the Medical Outcomes Study Short Form 36 and Short Form 12 Health Surveys, the Nottingham Health Profile, and the Sickness Impact Profile, and 4 health utility measures: the Medical Outcomes Study Short Form 6D, the Health Utilities Index Mark 3, Quality of Well-Being Scale (selfadministered), and the Assessment of Quality of Life Scale. Although the EuroQol 5-domain is also frequently used in rheumatology, the review of this measure is included in Measures of Disability article in this issue. MEDICAL OUTCOMES STUDY SHORT FORM 36-ITEM (SF-36) AND SHORT FORM 12-ITEM (SF-12) HEALTH SURVEYS

Three-Spike Insole Can Substitute the Total Contact Insole (TCI) in Refractory Plantar Fasciitis: Randomized Control Trial

Category:HindfootIntroduction/Purpose:Plantar fasciitis is one of the common foot complaints that is chronic and can induce dysfunction. Approximately 80% of patients improve with conservative management such as stretching exercise, ice bag massage, and splint. Refractory plantar fasciitis, unresponsive to conservative care for more than 6months, can be treated with insole, extracorporeal shockwave therapy, injection, and surgery etc. Total contact insole (TCI) is effective in reducing pain with just putting it in the shoes but quite expensive and time consuming for the custom production. Therefore, we produced alternative three-spike insole that can press about half of patient’s plantar fascia using 3-dimensional (D) printing and compared the clinical outcomes with it and TCI.Methods:A pragmatic, participant-blinded randomized trial was carried out from February 2019 to January 2020. Inclusion criteria was refractory plantar fasciitis and the duration of follow-up for each patient was 6 months. Three-dimensional printing used thermoplastic polyurethane (TPU) for the material of insole and the hardness was 58 +- 5 Shore-A. Twenty-eight patients were randomly allocated to use a three-spike insole or a TCI (Figure 1). The following assessment tools were used; visual analog scale for pain, American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), Karlsson- Peterson (KP) score, Medical Outcomes Study Short Form-36 (SF-36) for quality of life, and Foot Function Index (FFI). The groups were evaluated by a blinded assessor at baseline and after 6, 12, and 24 weeks.Results:The groups were homogenous for the majority of variables at baseline. Overall patient reported satisfaction showed improvement from mean 5.2 (range, 1 - 12) weeks of wearing and patient’s wearing time in a day was mean 2.4 (range, 0.5 - 3.0) hours. All the subscales except for sports in FAOS and mental component summary in SF-36 showed significant improvement from 6 weeks in both groups. There was no significant difference in all parameters between both groups at 6 weeks but AOFAS score, some of FAOS subscales, KP score, SF-36, and FFI showed significantly better outcome in three-spike insole group at 12 weeks. Those significant differences in outcome parameters tended to diminish at 24 weeks.Conclusion:We reaffirmed that insole is effective in plantar fasciitis and showed the three-spike insole restores function rapidly comparing to TCI. Three-spike design that supports not the whole longitudinal arch but about half of it was efficient enough. We can manufacture the three-spike insole for the popularization that can lower the price and producing time.

Impact of Health-related Quality of Life and Prediagnosis Risk of Major Depressive Disorder on Treatment Choice in Low- and Intermediate-Risk Prostate Cancer

BackgroundTreatment for low-risk (LR), favorable intermediate-risk (FIR), and unfavorable intermediate-risk (UIR) prostate cancer (PC) is complicated by clinical equipoise between multiple options. It is unknown how prediagnosis health-related quality of life (HRQoL) and major depressive disorder (MDD) risk impact treatment decisions. ObjectiveTo analyze associations of patient-reported HRQoL and MDD risk with treatment for LR, FIR, and UIR PC patients. Design, setting, and participantsUsing the Surveillance, Epidemiology and End Results and Medicare Health Outcomes Survey–linked database, we identified 1678 PC patients (498 with LR, 685 with FIR, and 495 with UIR) aged ≥65 yr and diagnosed between 2004 and 2015, who completed the health outcomes survey ≤24 mo before diagnosis. Outcome measurements and statistical analysisHRQoL was measured by physical (PCS) and mental (MCS) component summaries of the Medical Outcomes Study Short Form 36 (SF-36) and Veterans RAND 12-item (VR-12) health survey instruments. MDD risk was derived from survey items screening for depressive symptoms. Associations with treatment choice were assessed by multivariable multinomial logistic regression. Results and limitationsLR patients with higher PCS scores were more likely to receive radiation than surgery (adjusted odds ratio [AOR] 1.5 [95% confidence interval {CI}: 1.1–2.1; p = 0.02]). FIR patients with MDD risk were more likely to receive neither treatment than surgery or radiation (surgery: AOR 2.6 [95% CI: 1.1–6.2; p = 0.03]; radiation: AOR 2.2 [95% CI: 1.2–4.2; p = 0.01]). UIR patients with MDD risk were more likely to undergo radiation than surgery (AOR 2.3 [95% CI: 1.0–4.9; p =0.04]). Additionally, higher PCS scores were associated with receipt of surgery compared with neither treatment (AOR 1.5 [95% CI: 1.1–2.0; p =0.01]). This study is limited by its retrospective design. ConclusionsOlder PC patients with MDD risk received less invasive treatments in the FIR and UIR groups. Higher PCS scores were associated with treatment modality in LR and UIR patients. HRQoL and MDD risk impact treatment choice, warranting additional study. Patient summaryTreatment of prostate cancer requires thoughtful decision-making processes. This study shows that both pretreatment mental status and pretreatment physical status affect treatment decisions, and should be considered during counseling.

Assessment of quality of life of patients with dermatological pathology, doctors, medical students under quarantine during COVID-19 pandemic

For almost a year now, the society has been living in the severely stressful conditions of the COVID-19 pandemic. Considering that for many months people have been under serious information-driven expectations of the appearance and further development of clinical signs of this pathology in them, it is quite logical to assume that their level of anxiety will increase and their self-assessment of the quality of their lives (QoL) will lower.Objective — to conduct a study of the dependence of quality of life indicators in outpatient dermatological patients and people who work in medical service on the level of their neurotization, anxiety, emotional burnout against the background of the negative influence of the basic chronic stress situation — many months of quarantine caused by the COVID-19 pandemic.Materials and metods. Patients were questioned to assess the QoL using the Medical Outcomes Study Short Form 36 questionnaire (SF-36).Results and discussion. A pilot complex study of the dependence of the QoL indicators of outpatients and medical workers (doctors, students) conducted mainly at the initiative of the recipients themselves at 6 months of quarantine revealed certain correlations (conditioning) not so much with age and sex, but mainly with professional aspects. It turned out that QoL self-esteem against the background of the dominant negative influence of a chronic stressful situation — months of quarantine caused by the COVID-19 pandemic — is quite dependent on the severity of neurotization, anxiety, and emo­tional burnout of the tested person. The problem of interpreting correlations between personality traits and emotional burnout, levels of anxiety, stress resistance, neurotization, subjective control, and self-esteem of QoL needs further in-depth development on big and statistically sufficient material. It is especially important to develop professional recommendations and methods of psychocorrective influence not so much for patients with somatic (dermatological) pathology, but for physicians who, at their workplace, have to personally and directly contact many potentially infected patients on a daily basis.Conclusions. With regard to interpersonal communication, many months of quarantine, as expected, led to a noticeable deterioration in the self-esteem of QoL in all surveyed.

Health-Related Quality of Life Based on Comorbidities Among Patients with End-Stage Renal Disease.

ObjectivesThe aim of this study was to investigate comorbidities in patients with end-stage renal disease, and to compare health-related quality of life (HRQOL) according to the type, and number of comorbidities.MethodsA total of 250 adults undergoing hemodialysis were recruited at local clinics. HRQOL was measured using the 12-item Medical Outcomes Study Short Form questionnaire. Data were analyzed using descriptive statistics, analysis of variance, and t test.ResultsAround 70.8% of patients with end stage renal disease had 1 or more comorbidities, and the most common comorbidities were hypertension, diabetes, and cardiovascular disease. HRQOL was significantly different based on the number of comorbidities (F = 9.83, p < 0.001). The effect of comorbidities on the scores for mental health domains of the HRQOL questionnaire was not conclusive compared with the scores for the physical domain which were conclusive. Among the comorbidities, diabetes was associated with a lower quality of life.ConclusionThe customized management of diabetic and hypertensive patients is necessary for the early detection and prevention of chronic kidney disease, and slowing the progression of renal disease and managing cardiovascular risk factors is essential.

Pain and Fatigue in Patients With Ankylosing Spondylitis Treated With Tumor Necrosis Factor Inhibitors: Multinational Real-World Findings.

Patients with ankylosing spondylitis (AS) experience symptoms and comorbidities that impact their health-related quality of life (HRQoL) and ability to work. This real-world, global survey was conducted among AS patients receiving tumor necrosis factor inhibitors (TNFis) to evaluate both the frequency and severity of persistent symptoms, and the impact of pain and fatigue on HRQoL, employment status, and work activity. Patients with AS and their treating physicians from 13 countries across 5 continents completed questionnaires capturing demographics, patient symptoms, current disease status, HRQoL, current therapy, employment status, and Work Productivity and Activity Impairment. Seven hundred five patients who had been receiving a TNFi for 3 months or more and completed both Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) pain and fatigue domains were included in the analysis; of these, 37.6% reported high BASDAI pain scores and 41.3% high BASDAI fatigue scores. Medical Outcomes Study-Short Form, 36-item version 2 domain, 5-dimensional EuroQoL Questionnaire, and 5-dimensional EuroQoL visual analog scale scores were significantly lower (p < 0.0001), and Work Productivity and Activity Impairment scores significantly higher (p < 0.0001), in patients with high levels of pain or fatigue than low levels. Globally, levels of pain and fatigue remained high in AS patients receiving TNFi treatment, which were significantly associated with reduced HRQoL and work productivity. Such persistent symptoms in usual care suggest a substantial unmet need in AS pharmacologic and nonpharmacologic therapeutic pathways.

Association of cognitive fusion with domains of health

BackgroundMental health issues are reaching epidemic proportions among our youth. Understanding factors associated with emotional and physical functioning are critical to developing effective interventions and preventive strategies. Despite evidence of the association of cognitive fusion and emotional and physical health among adults, little is known about how this is associated with emotional and physical well-being in emerging adulthood. The purpose of this study was to examine how cognitive fusion is associated with different domains of health after controlling for psychosocial variables. MethodsA sample of 353 undergraduate students completed measures on sleep, stress (Perceived Stress Scale- 14), domains of health (Medical Outcomes Study Short Form Survey), the five facets of dispositional mindfulness (Five Facet Mindfulness Scale), social support (Lubben Social Network Scale), and cognitive fusion (Cognitive Fusion Questionnaire). ResultsUsing step-wise hierarchal multiple regression, we examined the variance accounted for by health behaviors and psychosocial variables in various domains of health (emotional, physical, social, general health, fatigue/energy, pain and limitations from physical/emotional functioning). After controlling for psychosocial variables and sleep, cognitive fusion was a significant predictor of six out of eight domains of health. In the domains of physical functioning and general health, facets of mindfulness (nonjudging and awareness, respectively) emerged as significant factors. ConclusionsThis study suggests that cognitive fusion plays an important role in some areas of health for emerging adults, even more so than other established predictors. Among emerging adults, it appears that thoughts play a key role in well-being and cognitive defusion techniques may be useful to enhance health among this population.

Clinical outcomes and quality of life in patients with acute and subacute type B aortic dissection after thoracic endovascular aortic repair.

ObjectiveThoracic endovascular aortic repair (TEVAR) is considered the mini-invasive treatment of choice for patients with Stanford type B aortic dissection (TBAD). This study aimed to investigate the clinical outcomes and quality of life (QoL) in patients with acute and subacute TBAD after TEVAR.MethodsFrom January 2014 until July 2016, 22 acute patients (Group A) and 18 subacute patients received TEVAR (Group B), and 13 patients were managed non-operatively (Group C). The Medical Outcomes Study Short Form-36 was used to assess QoL preoperatively and after TEVAR. Operative techniques and complications were retrospectively analyzed.ResultsThe role emotion, vitality, and mental health domains scored well preoperatively. Except for role emotion, vitality, and mental health, the remaining domains significantly improved after TEVAR. There was no significant difference in QoL metrics between Groups A and B. In Group C, bodily pain and social functioning domains were improved, and role emotion was decreased, with no improvement in the remaining domains. The 3-year survival rates were 95.5%, 100%, and 85.7% for Groups A, B, and C, respectively.ConclusionsTEVAR may be safe and effective in patients with acute and subacute TBAD with similar and favorable clinical and QoL metrics.

Quality of Life in Adults Undergoing Percutaneous Device Closure of Atrial Septal Defect.

To assess changes in the quality of life in adult patients undergoing percutaneous device closure of atrial septal defect (ASD).We used a standard Medical Outcome Study Short Form 36 (SF-36) that includes psychological and physiological aspects to assess and analyze the quality of life of 73 adult patients who underwent percutaneous device closure of ASD.Of the 73 patients who were investigated in this study, 67 completed questionnaires successfully. The following findings were revealed after analyzing the preoperative results and postoperative results. In some dimensions ( "physical functioning," "vitality," "general health" ), the postoperative perception was better than the preoperative status. Some differences were found in the quality of life feedback between the case group and the control group. Among the different subgroups, older patients scored lower than younger patients on most dimensions, and men seemed to perform better on "role-physical" factors than women. Unmarried people performed worse on "role-physical" and "bodily pain" than married people. Among people with different academic degrees, those with higher degrees demonstrated better scores on multiple dimensions ( "role-physical," "mental health," "social functioning," and "general health" ) than those with lower degrees.After percutaneous device closure of ASD, most adult patients feel that the quality of life is improved compared with that during the preoperative status. With the change of patients' own conditions, their quality of life seems to change differently. In order to better help patients integrate into life, psychological and physical support is still needed.

Health-related quality of life and post-traumatic stress disorder in inpatients injured in the Ludian earthquake: a longitudinal study

BackgroundThe aim of this longitudinal study was to identify risk factors for posttraumatic stress disorder (PTSD) in inpatients injured in the Ludian earthquake and examine the relationship between PTSD symptoms and health-related quality of life (HRQoL) following the earthquake.MethodsThree assessments were performed during an 18-month follow-up period. In total, one-hundred forty-seven inpatients of one-hundred seventy-four inpatients (85% of the initial sample) underwent all the assessments. Injured inpatients admitted to the No. 1 People’s Hospital of Zhaotong City after a severe earthquake (6.5 on the Richter scale) were enrolled in the study and assessed using the Posttraumatic Stress Disorder Checklist-Civilian Version, Clinician-Administered Posttraumatic Stress Disorder Scale, and Medical Outcomes Study Short Form-36 Scale.ResultsAt the first, third and eighteenth months after the earthquake, the prevalence rates for PTSD were 23, 14, and 7%, respectively. In a regression model, bereavement, history of major diseases, and severe injury in the earthquake were associated with severe PTSD symptoms. HRQoL was negatively correlated with PTSD symptoms. Compared to that of Chinese norms, participants’ HRQoL was significantly lower in all eight HRQoL domains of the Medical Outcomes Study Short Form-36 Scale.ConclusionsThe findings suggest that a substantial proportion of inpatients injured in the earthquake experienced severe PTSD symptoms and poor HRQoL. Therefore, early preventive programs and interventions should be implemented following disasters, to reduce PTSD and improve HRQoL in injured individuals.