Mental Component Scale Scores Research Articles

Predictors of six-month change in health-related quality of life in people with multiple sclerosis: A secondary data analysis of a randomized controlled trial

BackgroundSymptomatic treatment in people with multiple sclerosis (pwMS) requires multidisciplinary rehabilitation to alleviate disease progression and increasing health-related quality of life (HRQoL). However, the participant- and disease-specific factors that predict sustained improvement in HRQoL in pwMS undergoing inpatient rehabilitation remain unclear. Identifying these factors can help individually tailor inpatient rehabilitation programmes. Therefore, the aim of this study was to identify factors of pwMS at clinic entry for a three-week multidisciplinary inpatient rehabilitation that predict the change in physical and mental HRQoL over six months. MethodsThis is a secondary data analysis of a randomized controlled trial (NCT04356248) conducted at the Valens Rehabilitation Centre, Switzerland. HRQoL was assessed with the Medical Outcome Study 36-item Short Form Health Survey (SF-36) at clinic entry (T0; baseline) and six months after (T3; six-month follow-up). Data for 99 pwMS (mean age in years: 49.60 ± 10.17 SD, mean Expanded Disability Status Scale (EDSS) score: 4.62 ± 1.33 SD, 68.7 % female) were analysed using multiple linear regression. Outcome variables were six-month change in SF-36 Physical (ΔPCS) and Mental Component Scale (ΔMCS) scores. Predictor variables included baseline scores of PCS or MCS, fatigue, anxiety, depressive mood, cardiorespiratory fitness (V̇O2peak/kg), self-efficacy, smoking status, education level, age, EDSS, sex, time since diagnosis and MS phenotype. ResultsThe regression model with ΔPCS as outcome variable explained 18.6 % of the variance of the ΔPCS score (p = .003). Lower PCS score (p < .001) and lower depressive mood (p = .032) at baseline predicted higher ΔPCS score. The regression model with ΔMCS as outcome variable explained 26.8 % of the variance of the ΔMCS score (p < .001). Lower MCS score (p < .001) and longer time since diagnosis (p = .048) at baseline predicted higher ΔMCS score. ConclusionPwMS with lower physical HRQoL and better mood at clinic entry improved most in physical HRQoL over six months. PwMS with lower mental HRQoL and longer time since diagnosis at clinic entry improved most in mental HRQoL over six months. The results of this study contribute to the development of individualized rehabilitation programmes with the aim of maintaining and/or improving HRQoL of pwMS beyond the inpatient rehabilitation stay.

The Effect of Visual Impairment and Its Severity on Vision-Related and Health-Related Quality of Life in Jordan: A Comparative Cross-Sectional Study.

To assess the effect of visual impairment (VI), its severity, and ocular diseases on vision-related and health-related quality of life (QoL) in Jordan. A comparative, cross-sectional, hospital-based study was conducted among a group of 278 patients with VI aged ≥ 18 years, and age and sex-matched control group of 278 individuals with no VI. An interviewer administered the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12) to all participants. All the mean VFQ-25 subscales scores, physical component scale (PCS) and the mental component scale (MCS) of the SF-12 were significantly lower in patients with VI compared to controls with no VI. The VFQ-25 subscales (except general health and ocular pain), PCS, and MCS scores significantly decreased with more severity of VI. In the adjusted multivariate analysis, lower level of education (p=0.013), male sex (p=0.016), and the presence of cerebrovascular disease (p=0.019) were significantly associated with lower VFQ-25 composite scores in visually impaired patients compared to controls. Ocular disease duration of >5 years and progressive VI were significantly associated with lower VFQ-25 composite scores (p= 0.026 and p<0.001) respectively, in patients with VI. Glaucoma had a significantly larger reduction in mean scores of all the VFQ-25 subscales, and the PCS of the SF-12 compared to all other ocular diseases. Both VI and increasing severity of impairment were associated with reduced vision-related and health-related quality of life in adult Jordanians. Glaucoma patients and less educated people were particularly affected. Routine assessment of QoL in visually impaired patients and improving referral protocols to vision rehabilitation services is recommended to improve the QoL in those patients.

The Clinical Characteristics and Related Factors of Centrally Mediated Abdominal Pain Syndrome.

The aim of this study was to explore the clinical characteristics and related factors of centrally mediated abdominal pain syndrome (CAPS). Our study included 73 patients with CAPS and 132 age-matched and gender-matched healthy controls. The general information of the participants was collected, and the questionnaires were completed including the 7-item Generalized Anxiety Disorder Scale, 9-item Patient Health Questionnaire, Hamilton Anxiety Scale, Hamilton Depression Scale Pittsburgh Sleep Quality Index, Visual Analog Scale, and Short-Form 36. Univariate and forward stepwise regression analyses were performed to explore the influencing factors of CAPS. Nonexercise (adjusted odds ration [AOR] 4.53; confidence interval [CI] 1.602-12.809), mild-to-moderate depression (AOR 7.931; CI 3.236-19.438), married status (AOR 3.656; CI 1.317-10.418), and drinking coffee (AOR 0.199; CI 0.051-0.775) were found to be related with centrally mediated abdominal syndrome. The Hamilton Anxiety Scale score (7-13) was significantly related to moderate-to-severe abdominal pain (AOR 7.043; CI 1.319-37.593). Higher Hamilton Depression Scale score was related to lower mental component scale score (β = -0.726, P < 0.01) and physical component scale score (β = -0.706, P < 0.01). Depression, married status, and nonexercise were the independent risk factors of CAPS. Conversely, coffee intake was an independent protective factor of CAPS. Anxiety was related to the severity of abdominal pain, while depression was related to low health-related quality of life.

Factors associated with gait speed: results from the RolE of AST120 (Renamezin) in sarCOpenia preVEntion in pRe-dialYsis chronic kidney disease patients (RECOVERY) study.

Gait speed is an important measure of functional ability. This study aimed to investigate the factors associated with gait speed in patients with chronic kidney disease. The study focused on sarcopenic components, plasma uremic or inflammatory marker levels, and quality of life effects. The RolE of AST120 (Renamezin) in sarCOpenia preVEntion in pRe-dialYsis chronic kidney disease patients is a 48-week, randomized controlled, parallel-group, open-label, multicenter trial to determine the role of Renamezin (Daewon Pharmaceutical Co., Ltd.) in patients with chronic kidney disease. The participants were classified into four groups according to gait speed: ≤0.8, 0.8-1.0, ≤1.0-1.3, and ≥1.3 m/sec. Linear regression analysis was performed to identify the factors associated with gait speed. The group with a gait speed of ≤0.8 m/sec was the oldest and had the highest proportion of participants with low education level and medical aid. Participants with a gait speed of ≤0.8 m/sec showed the lowest physical and mental component scale scores. The interleukin-6 (IL-6) level tended to be the higher trend in the lowest gait speed group. In the multivariate linear regression analysis adjusted for age, sex, diabetes mellitus, and estimated glomerular filtration rate, insurance status, handgrip strength, IL-6 level, hemoglobin level, mental component scale score, and physical component scale score were significantly associated with gait speed. In conclusion, gait speed is associated with handgrip strength, IL-6 level, and various components of quality of life in predialysis chronic kidney disease patients.

#4367 THE IMPACT OF QUALITY OF LIFE ON THE SURVIVAL IN THE ELDERLY END-STAGE RENAL DISEASE PATIENTS : A PROSPECTIVE MULTICENTER COHORT STUDY IN KOREA

Abstract Background and Aims Quality of life (QOL) are associated with mortality in dialysis patients. However, the impact of QOL index or score on elderly patients with end-stage renal disease (ESRD) is controversial. We analyzed the relationship between QOL items and survival in elderly ESRD patients. Method A total of 492 patients with ESKD aged &amp;gt; 65 who assessed for QOL items were included from a Korean nationwide prospective cohort study. QOL was evaluated using the Kidney Disease Quality of Life (KDQOL) instrument, and the effect of each QOL item on mortality was analyzed. Multivariable Cox regression analysis was performed to identify independent risk factors for death after adjusting for compounding factors. Results The low physical component scale (PCS) and short form-36 score were significantly associated with low survival rate (PCS: p&amp;lt;0.001 and short form-36: p = 0.017, respectively), while the mental component scale (MCS) and ESRD-targeted item score had no correlation with survival rate. Multivariable Cox regression analysis confirmed that only a high PCS score is associated with better survival (hazard ratio 0.71, 95% confidence intervals 0.52-0.97, P = 0.031). Linear regression analysis identified that age, sex, modified Charlson Comorbidity Index, albumin, and intact parathyroid hormone were factors to PCS. Among the four PCS components, only physical function score was significantly associated with mortality (p&amp;lt;0.001). Conclusion Among the KDQOL items, PCS was an independent risk factor for death in elderly ESRD patients. The higher physical function score of PCS components was associated with a better outcome, suggesting the importance of physical conditions in elderly dialysis patients.

The direct and mediating effect of social support on health-related quality of life during pregnancy among Australian women

BackgroundPrenatal stress can have a negative effect on the quality of life (QoL) of pregnant women. Social support plays a vital role in improving the psychological well-being of pregnant women by enhancing their stress-coping ability. The current study assessed the association between social support and health-related quality of life (HRQoL) as well as the mediating role of social support in the linkage between perceived stress and HRQoL among pregnant Australian women.MethodsSecondary data was obtained from 493 women who reported being pregnant in survey six of the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH). Social support and perceived stress were assessed using the Medical Outcomes Study Social Support Index (MOS-SSS-19) and the Perceived Stress Scale, respectively. The Mental Component Scale (MCS) and Physical Component Scale (PCS) of the SF-36 were used to examine the mental and physical HRQoL. A mediation model was used to examine the mediating effect of social support in the relationship between perceived stress and HRQoL. A multivariate quantile regression (QR) model was used to assess the association between social support and HRQoL after adjusting for potential confounders.ResultThe mean age of the pregnant women was 35.8 years. The mediational analysis revealed that emotional/informational support (β= -1.53; 95% CI: -2.36, -0.78), tangible support (β= -0.64; 95% CI: -1.29, -0.09), and affectionate support/positive social interaction (β= -1.33; 95% CI: -2.25, -0.48), played a significant mediating role in the relationship between perceived stress and mental health-related QoL. In addition, perceived stress had a significant indirect effect on mental health-related QoL through overall social support (β = -1.38; 95% CI: -2.28, -0.56), and the mediator accounted for approximately 14.3% of the total effect. The multivariate QR analysis indicated that all the domains of social support and overall social support scores were positively associated with higher MCS scores (p < 0.05). However, social support was found to have no significant association with PCS (p > 0.05).ConclusionSocial support plays a direct and mediating role in improving the HRQoL of pregnant Australian women. Maternal health professionals need to consider social support as an essential tool to improve the HRQoL of pregnant women. Further, as part of routine antenatal care activity, assessing pregnant women’s level of social support is beneficial.

Relationship between WIfI stage and quality of life at revascularization in the BEST-CLI trial

ObjectiveThe WIfI (Wound, Ischemia, foot Infection) stage measures the extent of wounds, ischemia, and foot infection in patients with chronic limb threatening ischemia (CLTI) and has been associated with the risk of major amputation. Patients with CLTI have impaired health-related quality of life (HRQoL), which can be multifactorial. We hypothesized that the severity of the limb threat (WIfI stage) would be associated with poor HRQoL among patients with CLTI presenting for revascularization. MethodsThe dataset of the BEST-CLI (best endovascular versus best surgical therapy in patients with CLTI) trial, a prospective, randomized trial comparing open and endovascular revascularization strategies, was queried for HRQoL assessments at patient enrollment. The HRQoL assessments included (1) Vascular Quality of Life; (2) 12-item short form survey (SF-12), containing the utility index score (short-form six-dimension R2 utility index, incorporating physical, emotional, and mental well-being) and mental and physical components; and (3) the EQ-5D. Multivariable regression analysis was used to identify the independent associations with the baseline HRQoL assessments. ResultsA total of 1568 patients with complete WIfI data were analyzed, of whom 71.5% were men. The WIfI distribution was 35.5% with stage 4, 29.6% with stage 3, 28.6% with stage 2, and 6.3% with stage 1. Patients presenting with WIfI stage 4, compared with stage 1 to 3, were more often men (74.9% vs 69.6%) and current smokers (25.4% vs. 17.6%), had had end-stage renal disease (13.3% vs 8.5%) and diabetes (83.6% vs 60.2%), were not independently ambulatory (56.8% vs 38.5%), and had had higher median morbidity scores (4 vs 3; P < .05 for all). On multivariable analysis, WIfI stage 4, compared with stage 1 to 3, was associated with lower SF-12 mental component scale scores (estimate, −2.43; 95% confidence interval, −3.73 to −1.13; P < .001) and short-form six-dimension R2 utility index scores (estimate, −0.02; 95% confidence interval, −0.03 to 0.001; P = .04). The WIfI stage was not independently associated with the baseline Vascular Quality of Life, SF-12 physical component scale, or EQ-5D assessments. ConclusionsWIfI stage was independently associated with poorer quality of life because of mental, rather than physical, health for patients with CLTI. Clinicians should be aware of the burden of mental stress borne by those with the greatest limb impairment.

Investigation the Relation between Sleep and Quality of Life for College Students in Taiwan by Association Rule Mining

Background and objectives: Quality of life and sleep quality of college students were extensively studied. The present study evaluated sleep quality and quality of life of college students in Taiwan by using the Pittsburgh Sleep Quality Index (PSQI) and Short-Form Health Survey (SF-36), respectively. Materials and Methods: Data of 1756 college students aged 20–24 years were collected in this study. Association rule analysis was also used to provide a graphics-based visualization of the relationships between data, enabling the rapid identification of data correlations. Results: The results showed that the average physical component scale (PCS) and average mental component scale (MCS) scores were 52.9 and 44.1, respectively. Based on their body mass index (BMI), participants were divided into underweight, normal, overweight, and obese groups. The results of one-way analysis of variance showed that the p values for the PSQI, PCS, and MCS scores were 3.5 × 10−5, 1.7 × 10−5, and 0.671, respectively. The normal and overweight groups had the lowest PSQI scores. The PCS score of the obese group was lower than that of normal and overweight groups. The p values of the t-test result among PSQI, BMI, PCS, and MCS groups were 0.002, &lt;2 × 10−16, and &lt;2 × 10−16, respectively. The good sleep quality group had higher PCS and MCS scores. Conclusions: In this study, the results of association rule analysis indicated two distinct groups: Group 1, with the characteristics of good sleep quality as revealed by the high MCS and PCS scores, and Group 2, with the characteristics of poor sleep quality as revealed by low MCS and PCS scores and underweight BMI.

Survivors of avalanche accidents: posttraumatic stress disorder symptoms and quality of life: a multicentre study

BackgroundAs any traumatic event, avalanches could trigger psychological disorders on survivors. Our objectives were to determine the prevalence of post-traumatic stress disorder among avalanche survivors and to evaluate post-traumatic stress disorder risks factors as well as the impact on quality of life.MethodsA multicentre study was conducted in victims included in the North Alpine Avalanche Registry from 2014 to 2018. Data were collected through a standard questionnaire during semi-directed phone interviews. The primary outcome was the total score on the Impact of Event Scale Revised. Secondary outcomes were the Mental Component Scale and the Physical Component Scale scores of the Short Form 12 questionnaire.ResultsDuring the study period, 132 of 211 victims survived. Among the 107 victims included, 55 (51.4%) phone interviews were obtained. Six patients (10.9, 95% CI 1.76–20.05) had an Impact of Event Scale Revised score ≥ 33 indicating a strong probability for post-traumatic stress disorder. Median Mental Component Scale score was 39.0 (IQR 30.5–46.3) for post-traumatic stress disorder patients and 40.1 (IQR 36.5–43.4) for non post-traumatic stress disorder (p = 0.76). Median Physical Component Scale score was 39.4 (37.2–44.3) for post-traumatic stress disorder patients and 44.2 (39.1–46.8) for non post-traumatic stress disorder (p = 0.39). No significant difference in the quality of life in both populations was observed, and no independent risk factors of post-traumatic stress disorder was identified.ConclusionAvalanche accidents may induce post-traumatic stress disorders among survivors in a comparable prevalence to the most traumatic event already studied. Early recognition and preventive measures should be set up in order to reduce the psychological burden in these victims.Trial registrationNCT03936738.

Nutritional Risk at intensive care unit admission and outcomes in survivors of critical illness

Risk factors for poor outcomes after critical illness are incompletely understood. While nutritional risk is associated with mortality in critically ill patients, its association with disability, cognitive, and health-related quality of life is unclear in survivors of critical illness. This study's objective was to determine whether greater nutritional risk at ICU admission is associated with greater disability, worse cognition, and worse HRQOL at 3 and 12-month follow-up. We enrolled adults (≥18 years of age) with respiratory failure or shock treated in medical and surgical intensive care units from two U.S. centers. We measured nutritional risk using the modified Nutrition Risk in Critically Ill (mNUTRIC) score (range 0-9 [highest risk]) at intensive care unit admission. We measured associations between mNUTRIC scores and discharge destination, disability in basic activities of daily living (ADLs) using the Katz ADL, instrumental ADLs using the Functional Activities Questionnaire (FAQ), global cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), executive function using the Trail Making Test Part B (Trails B), and health-related quality of life using the SF-36, adjusting for sex, education, BMI, baseline frailty, disability, and cognition, severity of illness, days of delirium, coma, and mechanical ventilation. Of the 821 patients enrolled in the ICU, 636 patients survived to hospital discharge. We assessed outcomes in 448 of 535 survivors (84%) at 3 months and 382 of 476 survivors (80%) at 12 months. Higher mNUTRIC scores predicted greater odds of discharge to an institution (OR 2.0, 95% CI: 1.6 to 2.6; P<0.01). Higher mNUTRIC scores were associated with a trend towards greater disability in basic activities of daily living (IRR 1.3, 95% CI 1.0 to 1.7) at 3 months that did not reach significance (p=0.09) with no association demonstrated at 12 months. There were no associations between mNUTRIC scores and FAQ, RBANS, orTrails B scores. mNUTRIC scores were inconsistently associated with SF-36 physical and mental component scale scores. Greater nutritional risk at ICU admission is associated with disability in survivors of critical illness. Future studies should evaluate interventions in those at high nutritional risk as a means to speed recovery.

The impact of marital and socioeconomic status on quality of life and physical activity in patients with chronic kidney disease.

Quality of life (QOL) and physical activity (PA) is reduced in patients with chronic kidney disease (CKD). The aim was to investigate the impact of marital status and educational level on QOL and PA in patients with CKD including dialysis treatment. This cross-sectional study included ambulatory adult patients undergoing dialysis or CKD stage 4-5. Data for marital status, educational level and PA were obtained using the Danish health and Morbidity Survey. QOL was assessed using the Physical Component Scale and the Mental Component Scale scores from the Kidney Disease Quality of Life Instrument. Five hundred twelve participants were included: 316 (62%) were married/had a permanent partner, 119 (23%) had a low level of education, 327 (67%) were physically active. After confounder adjustments (age, sex, treatment), having a permanent partner was associated with greater scores in Mental Component Scale, β 2.88 [CI 95% 0.99; 4.77], p = 0.003, and being physically active in women OR 2.237 [1.231; 4.066], p = 0.008. A high vs low educational level was associated with greater scores in Physical Component Scale (3.79 [1.01; 6.58], p = 0.008) and in Mental Component Scale (3.55 [0.82; 6.28], p = 0.011). In ambulatory patients with CKD stage 4-5, being married or having a permanent partner and a high educational level had positive impacts on mental QOL. Higher educational level was also associated with better physical QOL. The presented inequality in QOL should be considered in communications, care and treatments in clinical practice.

The relationship between disability and clinical outcomes in maintenance dialysis patients.

BackgroundDialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients.MethodsThis study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization.ResultsThe numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend).ConclusionDisability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

SAT-310 BECK DEPRESSION INVENTORY AND SF-36 AS SCREENING TOOLS FOR DEPRESSION AND ASSESSMENT OF HEALTH-RELATED QUALITY OF LIFE AMONG CHRONIC KIDNEY DISEASE PATIENTS ON HEMODIALYSIS

Depression and Health-Related Quality of Life (HRQoL) are of concern among hemodialysis patients. The aim of the study was to assess the HRQoL, identify the presence of depression among hemodialysis patients in a tertiary government hospital and identify the risk factors that lead to it. A descriptive-analytical study was conducted from June to August 2018. A written and informed consent was secured from dialysis patients of the unit. Beck Depression Inventory (BDI) and SF-36 questionnaires were used to identify the presence of depression and assess the HRQoL, respectively. The correlation between the BDI, Physical Component Scale (PCS) and Mental Component Scale (MCS) of SF-36 and the variables analyzed were determined using the Chi-square Analysis. The association among the BDI, PCS and MCS was determined using the Pearson Correlation. A p-value of < 0.05 is considered statistically significant. The likelihood ratios for the significant associations identified were also analyzed. The prevalence of depression in our study population was 47.7%. This percentage is lower compared to the studies done by Nelson et al. (2009) in India, Jofre et al. (2000) in Spain, Mollaoglu (2004) in Turkey whose studies revealed the presence of depression in 83.5%, 70% and 66% on their study populations respectively. Cultural variation and societal factors may play a role in the development of depression and overall HRQoL among dialysis patients. About 60% had poor HRQoL based on PCS scores but only 33% had poor HRQoL based on MCS scores. This stresses the greater impact on the physical limitations compared to the psychological effect experienced by our dialysis patients due to their disease condition. Fourteen patients (13%) were identified to have depression with poor HRQoL. No significant association was noted between the variables and the presence of depression. Normal BMI, age of less than 60 years, pre-HD SBP of less than 130 mmHg, the presence of three or more co-morbidities and a creatinine level of 300-1000mmol/L were associated with poor HRQoL. Patients on hemodialysis for less than one year were shown to have better quality of life. Similar to previous studies, there is a high prevalence of depression and poor HRQoL among hemodialysis patients in our institution. Normal BMI, age of less than 60 years, pre-HD SBP of less than 130 mmHg, the presence of three or more co-morbidities, creatinine levels of 300-1000 mmol/L and dialysis for more than one year predispose to a poor HRQoL. This warrants regular screening for depression and assessment of HRQoL and subsequent intervention to improve treatment outcome.

Quality of Life Following Peroral Endoscopic Myotomy for Esophageal Achalasia: A Systematic Review and Meta-Analysis.

Background: Peroral endoscopic myotomy (POEM) is a novel minimally invasive intervention for treating esophageal achalasia. Previous publications have proved its excellent efficacy and safety, and even shown it could improve patients’ quality of life (QoL). So, we conducted this study to explore the changes of QoL following POEM.Methods: A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 2009 to April 2019. The statistical analysis was carried out using Review Manager 5.3.Results: A total of 12 studies including 549 patients were identified, which assessed the QoL using validated questionnaires administered. After POEM, the SF-36 questionnaire score of each domain (physical function, role physical function, body pain, general health (GH), social function, vitality, emotional role function, mental health) was significantly increased (p < 0.05). Meanwhile, mental component scale (MCS) and physical component scale (PCS) scores were all improved in patients after POEM procedure (MCS: 12.11, 95% confidence interval [CI], 4.67–19.55, p = 0.001, I2 = 88%, PCS: 17.01, 95% CI, 2.91–31.11, p = 0.02, I2 = 97%). The gastroesophageal reflux disease health-related quality of life questionnaires (GERD-HRQL) also decreased significantly after POEM (13.01, 95% CI, 9.98–16.03, p < 0.00001, I2 = 30%).Conclusions: Our current evidence suggests there is significant improvement in QoL after POEM procedure.

Simultaneous Improvement of Habitual Physical Activity and Life Quality in Kidney Transplant Recipients Involved in Structured Physical Activity Program

ObjectivesThe aim of the study was to compare the effects of a physical activity program on daily physical activity and quality of life in kidney transplant (KTx) recipients and in patients with chronic kidney disease (CKD). Materials and MethodsThe study group consisted of 24 KTx recipients and 15 patients with stage 3 to 4 CKD. Habitual physical activity was monitored for 72 hours. Individualized structured programs of increased physical activity were prepared based on baseline physical performance. The measurements were repeated after 1 and 3 months. Participants completed the 36-item Short Form Health Survey questionnaire and an International Physical Activity Questionnaire at baseline and after 1, 2, and 3 months. ResultsPhysical activity duration and total energy expenditure significantly increased after 3 months in both KTx recipients (from 126 ± 87 to 200 ± 132 min/d, P = .001, and from 1.73 ± 0.37 to 2.24 ± 0.59 cal/min, P < .001, respectively) and CKD patients (from 79 ± 78 to 129 ± 114 min/d, P < .001, and from 1.5 ± 0.5 to 1.92 ± 0.47 cal/min, P < .001, respectively). Short Form Health Survey total score and physical component scale score improved significantly in both groups. Mental component scale score increased significantly only in KTx patients. ConclusionIncreased physical activity induces similar beneficial effects on total and physical activity component of quality of life and habitual daily activity in CKD and KTx patients.

The impact of systemic sclerosis on health‐related quality of life assessed by SF‐36: A systematic review and meta‐analysis

The purpose of this meta-analysis was to systematically review the literature to evaluate the impact of systemic sclerosis (SSc) on the health-related quality of life (HRQoL) assessed by the Medical Outcomes Short-Form-36 questionnaire (SF-36). A systematic literature search was performed on PubMed, Web of Science and Embase until April 2017 to obtain eligible studies. Random effect model was performed to summarize the scores of each domain. Scores from the SF-36 questionnaire were used as the outcome measurements, and mean differences with 95% confidence intervals were calculated. In total, seven studies were eligible for inclusion criteria, comprising 795 SSc patients and 1154 healthy controls. The SF-36 questionnaire score of each domain (physical function, role physical function, emotional role function, vitality, mental health, social function, body pain, general health) was lower in SSc patients than in healthy controls, meanwhile, physical component scale (PCS) and mental component scale (MCS) scores were all lower in patients with SSc than in healthy controls. Likewise, pooled mean scores of PCS and MCS ranged from 31.20 to 52.80, 37.40 to 68.30, respectively. Additionally, the score of PCS was lower than that of MCS in SSc patients. This meta-analysis showed that SSc patients had lower HRQoL than healthy controls, and SSc had negative influence on the HRQoL of patients. This indicates that clinical workers should pay more attention to SSc patients' HRQoL, so as to improve global health of patients with SSc.

Health-related quality of life in patients with psoriatic and rheumatoid arthritis: data from the prospective multicentre NOR-DMARD study compared with Norwegian general population controls

ObjectivesTo compare (1) Short Form-36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS), scale scores and Short Form-6 dimensions (SF-6D) between patients with rheumatoid arthritis (RA) and patients...

Late breast cancer treatment-related symptoms and functioning: associations with physical activity adoption and maintenance during a lifestyle intervention for rural survivors.

Physical activity may be difficult for survivors with poorer functioning following primary treatment. The study examined whether late symptoms of breast cancer treatment impact PA adoption (0-6months) and maintenance (6-18months) during a weight management intervention, and whether late symptoms influence PA when accounting for overall functioning. Secondary analyses were conducted using a sample of survivors participating in a weight management intervention and who provided valid weight and accelerometer data at baseline and 6months (N=176). The Breast Cancer Prevention Trial Symptom Checklist (BCPT) assessed late treatment-related symptoms. SF-12 Physical Component Scale (PCS) and Mental Component Scale (MCS) scores assessed functioning. Change in bouted moderate to vigorous physical activity (MVPA) min/week from baseline to 6months was not associated with BCPT scales (all p values>0.05). When adding SF-12 scores to the model, change in bouted MVPA min/week was significantly associated with the PCS (p=0.045). Change in MVPA min/week from 6 to 18months was significantly associated with cognitive symptoms (p=0.004), but not musculoskeletal or vasomotor symptoms (p values>0.05). When adding 6-month SF-12 scores to the model, MVPA min/week was significantly associated with PCS (p=0.001) and MCS (p=0.028); however, BCPT cognitive problems score became non-significant (p>0.05). Poorer physical functioning was associated with lower PA adoption, and poorer mental and physical functioning was associated with lower maintenance of PA, while late symptoms generally were not. Interventionists should consider level of functioning when identifying individual PA goals during weight management interventions.

Living Arrangements and Health-Related Quality of Life in Chinese Adolescents Who Migrate from Rural to Urban Schools: Mediating Effect of Social Support.

Changes in living arrangements (from living with, or not living with family) may affect the health-related quality of life (HRQoL). This study aimed to investigate the impact of living arrangement on HRQoL among adolescents migrating from rural to urban schools, and whether social support, in addition to living with a family, had an impact. A cross-sectional survey of 459 school adolescents was carried out in two public schools in Guyuan County, Ningxia Hui Autonomous Region, China in 2015. The survey contained the following questionnaires: a self-designed questionnaire, the 12-item Short Form Health Survey (SF-12), and the Social Support Rating Scale (SSRS). Of the 459 adolescents sampled (aged 15.41 ± 1.07 years with range of 13 to 18), 61.7% were living with family, and 38.3% were not living with family. Those students not living with families had lower Mental Component Scale (MCS) scores as well as less social support overall. Those students, who were not living with families, also reported more chronic health problems and more alcohol consumption compared to those students living with families. Social support was a statistically significant mediating factor on the effect of living arrangements on MCS. Our findings demonstrated that those students, who were not living with families, tended to have more health-related quality of life issues, but social support partially mediated the relationship between living arrangements and health.

Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients.

BackgroundHealth-related quality of life (HRQoL) surveys are needed to evaluate regional and ethnic specificies. The aim of the present study was to evaluate the differences in HRQoL, frailty, and disability according to dialysis modality in the Korean population.Patients and methodsWe enrolled relatively stable maintenance dialysis patients. A total of 1,616 patients were recruited into our study. The demographic and laboratory data collected at enrollment included age, sex, comorbidities, frailty, disability, and HRQoL scales.ResultsA total of 1,250 and 366 participants underwent hemodialysis (HD) and peritoneal dialysis (PD), respectively. The numbers of participants with pre-frailty and frailty were 578 (46.2%) and 422 (33.8%) in HD patients, and 165 (45.1%) and 137 (37.4%) in PD patients, respectively (P = 0.349). Participants with a disability included 195 (15.6%) HD patients and 109 (29.8%) PD patients (P < 0.001). On multivariate analysis, the mean physical component scale (PCS) and mental component scale (MCS), symptom/problems, and sleep scores were higher in HD patients than in PD patients. Cox regression analyses showed that an increased PCS in both HD and PD patients was positively associated with patient survival and first hospitalization–free survival. An increased MCS in both HD and PD patients was positively associated with first hospitalization–free survival only.ConclusionThere was no significant difference in frailty between patients treated with the two dialysis modalities; however, disability was more common in PD patients than in HD patients. The MCS and PCS were more favorable in HD patients than in PD patients. Symptom/problems, sleep, quality of social interaction, and social support were more favorable in HD patients than in PD patients; however, patient satisfaction and dialysis staff encouragement were more favorable in PD patients than in HD patients.