Mental Components Of Quality Of Life Research Articles

A systematic review and meta-analysis of the effects of non-pharmacological interventions on quality of life in adults with multiple sclerosis

BackgroundMultiple Sclerosis (MS) is a chronic debilitating disease that targets the central nervous system. Globally it is estimated that 2.8 million people live with MS (2018) and as there is no known cure; therefore, identifying methods to increase a patient’s quality of life (QoL) is of considerable importance. Non-pharmacological interventions are a viable and effective option to increase QoL in patients with MS, however, to date, the literature lacks a complete systematic review of these interventions.MethodsA literature search was conducted for studies published up until March 4th 2022 in Scopus, Web of Science, CINAHL Plus, The Cochrane Library, Medline, and Embase. Studies were included if they were randomized control trials (RCTs) assessing a non-pharmacological intervention in adults with MS and measured QoL using the MSQOL-54, SF-36 or MSQLI tools for at least two time points. Quality assessment of each study was completed as well as a review of publication bias. Where possible, meta-analysis was conducted using a random effects model and for other studies a qualitative synthesis was presented.ResultsThirty studies were included in the meta-analysis and eleven studies were summarized qualitatively. The pooled effects across all non-pharmacological interventions showed a modest improvement in both the physical and mental components of QoL, with a standardized mean difference (SMD) of 0.44 (95% CI 0.26–0.61) and 0.42 (95% CI 0.24–0.60), respectively. Non-pharmacological interventions based around a physical activity were found to be particularly effective in improving both the physical composite score (PCS) and mental composite score (MCS), with an SMD of 0.40 (95% CI 0.14–0.66) and 0.31 (95% CI 0.08–0.55), respectively. Interventions incorporating balance exercises presented a significant advantageous solution for improving QoL, with an SMD of 1.71 (95% CI 1.22, 2.20) and 1.63(95% CI 1.15–2.12) for PCS and MCS respectively.ConclusionsThis systematic review and meta-analysis identified that non-pharmacological interventions can be an effective method of improving QoL in patients with MS, especially modalities with a physical activity component and balance interventions.

Факторы риска и качество жизни женщин в периодах пери- и постменопаузы в городе Ереван, Армения

INTRODUCTION: Menopause is associated with various somatic, vasomotor, sexual and psychological symptoms that adversely affect the quality of life of women in peri- and postmenopausal periods. AIM: To assess the quality of life (QoL) of women in peri- and postmenopausal periods, to identify factors producing a negative effect on him during these periods. MATERIALS AND METHODS: А cross-sectional study was conducted through a survey of 353 women above 40. To assess QoL, the SF 36 questionnaire was used. Sociodemographic factors and peculiarities of health status of the participants were considered risk factors. The data were introduced and analyzed using SPSS 23 statistical package. Statistical significance of the results was evaluated by Kruskal–Wallis test with the subsequent a posteriori analysis, and Mann–Whitney test. RESULTS: Peri- and post menopause had negative impact on the parameters of physical component of QoL and all its domains. Participants with regular menstruation had a reliably higher score of physical component of QoL compared to peri- and postmenopausal women (p < 0.001). The scores of physical component of QoL were higher in women at the age under 50 compared to women of older age groups. The scores were higher in women with higher and secondary special education compared to participants with general secondary education (p < 0.05). Higher scores of physical and psychological components of QoL were recorded in working women compared to the retired group (p < 0.05). The parameters of psychological component of QoL were the highest among married and single women. Parameters of physical and mental components of QoL were higher in groups with the income above and at the level of the living minimum compared to those who reported the income below the minimum wage (p < 0.001). A reliably higher scores of physical and mental components of QoL were recorded in participants with favorable microclimate in families compared to the group with an unfavorable one (p < 0.01). A reliable relationship was found between the evaluation of the health and parameters of both components of QoL by the participants. Higher scores were recorded in women who evaluated their health as excellent and above average compared to all other groups (p < 0.05). The presence of chronic diseases had a negative impact on both components of QoL. CONCLUSION: The factors producing negative effects on QoL of women in peri- and postmenopausal periods were the older age, general health status, low educational level, retirement, unfavorable family status and family microclimate, low family income.

Additional opportunities for antihypertensive therapy improvement in young patients with arterial hypertension and concomitant obesity

Abstract The high prevalence of arterial hypertension (AH) and concomitant obesity in young patients is not only a medical but also a social problem. It is important to develop additional modern approaches to the management of young patients with AH and obesity, which will increase the effectiveness of existing antihypertensive (anti-AH) medical therapy and prevent early damage of target organs and complications. The purpose of the research was to evaluate the antihypertensive efficacy of the proposed complex treatment and its impact on quality of life in young patients with AH and obesity (or overweight). Material and methods 123 patients with AH (ESC 2018), of young age 18–44 (mean age 32.81±0.58) y.o. were examined, among them the overweight was in 40 patients, obesity - in 42 patients. The average BMI was (28.34±0.45) kg/m2. All patients were divided into 2 groups depending on the treatment: Group 1 – standard anti-AH treatment, Group 2 – modified combined therapy, which included on the background of standard anti-AH medications the dosed controlled physical exercises with its obligatory registration, a modified DASH diet with increased intake of Ca-containing products and Metformin in the presence of insulin resistance according to the HOMA index (with correction of dose depending on BMI). In dynamics the patients were performed daily blood pressure monitoring (BPM) was performed and the SF-36 questionnaire was used to assess the quality of life (QOL). Results and discussion According to BPM data in the Group 1 the average 24-hour value of SBP decreased by 12.5% (p=0.01), in Group 2 – by 20.2% (p=0.001), DBP - by 11.2% (p=0.03) and by 18.8% (p=0.01) respectively (the difference between the groups for SBP and DBP was p=0.032 and p=0.041, respectively). Assessing the degree of nocturnal blood pressure decreasing, in the Group 1 the percentage of patients with insufficient nocturnal blood pressure decreasing (non-dipper) and stable increasing (night peaker) decreased non-significantly (p=0.086), unlike the Group 2, where there was a significant (p=0.02) positive dynamics in relation to these unfavorable types of blood pressure profile. Evaluating the indicators of QOL according to SF-36, the physical component of health in the Group 1 increased by 16.7%, in Group 2 – by 33.4% (p=0.001), the mental component of health – by 13.5% and 28.9%, respectively (p=0.001). Thus, the additional use of the proposed treatment complex with the inclusion of dosed registered exercises, increased consumption of Ca-containing products and correction of insulinresistance significantly increases the effectiveness of antihypertensive medical therapy and has a positive effect on physical and mental components of QOL in young patients with AH and obesity or overweight. Funding Acknowledgement Type of funding sources: None.

Impact of Lifestyle Modification on Quality of Life in Patients with Metabolic Syndrome: Findings from the CHANGE Program Intervention Study in Prince Edward Island, Canada.

Purpose: To assess the modification in quality of life (QoL) of patients with metabolic syndrome (MetS) after participating in Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program and identify predictors of this modification in QoL among participants. Methods: A convenience sample of 100 patients with MetS completed the 12-month CHANGE program (diet and exercise regular counseling). 36-Item Short Form Health Survey (SF-36), International Physical Activity Questionnaire (IPAC), Physician Assessment and Clinical Education (PACE), and the Mediterranean Diet Score (MDS) questionnaires were employed to assess participants' QoL, physical activity (PA), sedentary behaviors, and quality of diet, respectively. In addition, physical fitness tests (6-Minute Walk Test, One-Leg Stance Test, and Grip Strength Test) were used. Medical history, blood tests, and anthropometric [height, weight, and waist circumference (WC)] and blood pressure measurements were performed by a nurse. Linear regression analysis was performed to identify predictors of QoL. Results: Participants' mean age was 58.3 ± 11.0, and 75.4% were females. After the CHANGE program, participants demonstrated significant reduction in the number of MetS criteria and significant improvement of physical and mental components of QoL. Moreover, there was significant increase in participants' PA, MDS, and physical fitness mean scores with corresponding significant reduction in sedentary behavior time, blood pressure, and WC measures. Linear regression analysis revealed that age, WC, screen time, PA, and physical fitness were significant predictors of QoL. Conclusion: The 12-month group-based diet and exercise counseling led to clinically significant improvement in MetS criteria and in important measures of health and fitness among participants, which improved their QoL. Age, fitness measures, and daily screen time were associated with QoL.

The Relationship Between Sleep Quality and Quality of Life Among Patients With Asthma

Background and objectiveAsthma is a chronic recurring respiratory disease, and its prevalence is on the rise. A drop in the quality of life (QoL), as well as sleep problems, has been reported in asthmatic patients in the literature. This study was conducted to determine the relationship between QoL and sleep quality in asthmatic patients.MethodsThis cross-sectional study recruited 76 diagnosed asthmatic outpatients from our university clinic. The subjects completed the self-administered 36-Item Short-Form Health Survey QoL questionnaire (SF-36) and the Pittsburgh Sleep Quality Index (PSQI) assessment.ResultsThe study results revealed poor sleep quality in 55 (72.4%) of the subjects. The total sleep quality scores significantly and negatively correlated with the physical and mental components of QoL (moderate, p=0.00). All QoL subscales were significantly higher in patients with good sleep quality (PSQI: <5, p<0.00). Logistic regression analysis showed that good sleep quality (modified) could predict a mental component score (MCS) of more than 64.ConclusionPoor sleep quality can bring down the scores of all QoL components in asthma patients and is the best predictor of their QoL. Therefore, sleep quality and QoL indicators could be applied as part of a better approach to classification, management, and control of asthma.

Mental health and quality of life of patients undergoing hematopoietic stem cell transplantation (HSCT) prior to hospitalization: a cross-sectional complete state health study

ABSTRACT Objective The main goal of this cross-sectional study was to examine the relationships between negative/positive psychological dispositions, mental health, and quality of life (QoL) prior to hospitalization among patients undergoing hematopoietic stem cell transplantation (HSCT). Method A total of 187 patients (Mage = 52.07 years) completed a questionnaire 19.6 days before an allograft. Several positive psychological dispositions (i.e. mindfulness, optimism, and acceptance) and a negative psychological disposition (i.e. experiential avoidance) were assessed. Our dependent variables were mental health (i.e. happiness, depression, and anxiety) and QoL. Results In the sample, 56.8% of patients were characterized by an impaired QoL and 56.9% and 21% had, respectively, anxiety and depression levels above the critical threshold (i.e. a score above seven on the Hospital Anxiety and Depression Scale). Anxiety, depression, and happiness were significantly related to the mental component of QoL, whereas physical QoL was only related to depression and happiness. Providing additional support for a complete state health approach, several positive and negative psychological dispositions (i.e. optimism, acceptance, and experiential avoidance) were robustly related to mental illness/wellness and QoL. Conclusions These results highlight the importance of improving psychological health and QoL among HSCT patients prior to hospitalization by both promoting positive psychological and health factors and alleviating negative ones.

Prospective cohort study of elderly patients with coronary artery disease: impact of frailty on quality of life and outcome.

BackgroundElderly, frail patients are often excluded from clinical trials so there is lack of data regarding optimal management when they present with symptomatic coronary artery disease (CAD).ObjectiveThe aim of this observational study was to evaluate an unselected elderly population with CAD for the occurrence of frailty, and its association with quality of life (QoL) and clinical outcomes.MethodsConsecutive patients aged ≥80 years presenting with CAD were prospectively assessed for frailty (Fried frailty phenotype (FFP), Edmonton frailty scale (EFS)), QoL (Short form survey (SF-12)) and comorbidity (Charlson Comorbidity Index (CCI)). Patients were re-assessed at 4 months to determine any change in frailty and QoL status as well as the clinical outcome.ResultsOne hundred fifty consecutive patients with symptomatic CAD were recruited in the study. The mean age was 83.7±3.2 years, 99 (66.0%) were men. The clinical presentation was stable angina in 68 (45.3%), the remainder admitted with an acute coronary syndrome including 21 (14.0%) with ST-elevation myocardial infarction. Frailty was present in 28% and 26% by FFP and EFS, respectively, and was associated with a significantly higher CCI (7.5±2.4 in frail, 6.2±2.2 in prefrail, 5.9±1.6 in those without frailty, p=0.005). FFP was significantly related to the physical composite score for QoL, while EFS was significantly related to the mental composite score for QoL (p=0.003). Treatment was determined by the cardiologist: percutaneous coronary intervention in 51 (34%), coronary artery bypass graft surgery in 15 (10%) and medical therapy in 84 (56%). At 4 months, 14 (9.3%) had died. Frail participants had the lowest survival. Cardiovascular symptom status and the mental composite score of QoL significantly improved (52.7±11.5 at baseline vs 55.1±10.6 at follow-up, p=0.04). However, overall frailty status did not significantly change, nor the physical health composite score of QoL (37.2±11.0 at baseline vs 38.5±11.3 at follow-up, p=0.27).ConclusionsIn patients referred to hospital with CAD, frailty is associated with impaired QoL and a high coexistence of comorbidities. Following cardiac treatment, patients had improvement in cardiovascular symptoms and mental component of QoL.

Quality of life in nursing home non-demented residents in Tunisia

Admission to nursing homes is often associated with a change in the way the elderly live, possibly impacting quality of life (QOL). We aimed to assess QOL in elderly without dementia living in nursing homes, and to examine the association between QOL and sociodemographic features, comorbidities, level of dependency, and depression. We carried out a cross-sectional survey involving 42 old subjects living in Manouba nursing home. The Mini-mental state examination, the Geriatric depression scale, the Activity of daily living, the Cumulative illness rating scale-geriatric, and the 36-item Medical outcomes study short-form health survey-SF36 were used to assess cognitive functions, depression, level of dependency, comorbidities and QOL, respectively. All dimensions of the physical and mental components of QOL were altered in our population, with an overall mean score of less than 66.7 for all domains. A significant correlation was found between the two physical and mental components of QOL and the level of dependency, depression scores as well as comorbidity scores. In the final model of hierarchical regression, which included demographic (age and gender), clinical (level of dependency and comorbidities), and psychosocial (depression and social support) variables, only social support was significantly associated with both QOL dimensions. Strengthening social support in institutions is strongly recommended, especially activities that promote interaction. When family members remain involved in the lives of their older relatives after institutionalization, policies such as family visits and the involvement of family members in the care provided should be strongly encouraged.

Personality Dimensions Are Associated with Quality of Life in Fluctuating Parkinson's Disease Patients (PSYCHO-STIM).

Parkinson's disease (PD) negatively affects patients' Quality of Life (QoL) which depends on both objective criteria such as physical health and subjective ones such as worries and norms according to personal believes. Therefore, QoL could be also associated to personality dimensions in chronic neurological diseases such as PD. Our objective was thus to study the potential association between personality dimensions and QoL in PD patients with motor fluctuations before Deep Brain Stimulation of the Sub-Thalamic Nucleus (DBS-STN). Data were obtained from the French multicentric cohort study Predi-Stim. All PD patients awaiting DBS-STN and responding to the inclusion criteria at the time of the study were included. All participants answered the "Temperament and Character Inventory" (TCI) and the PDQ-39 before surgery. Analyses were made using adjusted univariate generalized linear regression models to evaluate a potential association between TCI dimensions and PDQ-39 scores. Three hundred thirty-three consecutive patients were included. The temperament Harm Avoidance was negatively associated with QoL (p = 1e-4, R2= 0.33), whereas the character Self-Directedness was positively associated with mental component of QoL (p = 2e-4, R2= 0.33) in PD patients with motor fluctuations awaiting DBS-STN. PD patients with motor fluctuations, with lower Harm Avoidance and higher Self-Directedness scores have the best QoL mainly at an emotional and social level. Therapeutic education of these PD patients focusing on their personal resources may thus be important to improve their well-being.

Factors related to physical and mental components of quality of life in the community-dwelling frail older persons.

[Purpose] The aim of this study was to investigate factors associated with changes in both the physical and mental components of quality of life (QOL) in of community-dwelling frail older persons in long-term care and to clarify which aspects are important to maintaining physical and mental components of QOL. [Participants and Methods] In this 1 year follow-up cohort study, participants were older persons from a single day care rehabilitation center in Japan. The Medical Outcome Study 8-Item Short-Form Health Survey (MOS-SF8), which gives both physical component summary (PCS) and mental component summary (MCS) scores, was used as the main QOL assessment. Participants were divided according to their level of QOL maintenance according to changes in PCS and MCS scores over the study period, and the variables were compared between the groups. [Results] PCS domain was significantly associated with forced vital capacity and the MCS domain was significantly associated with the Geriatric Depression Scale and Dysphagia Risk Assessment for the Community-Dwelling Elderly Test. [Conclusion] Depression, reduced pulmonary function, and reduced deglutition ability were independently related to low QOL. Assessment of these factors could be beneficial for maintaining the physical and mental components of QOL in community-dwelling frail older persons in long-term care.

EFFECTS OF COGNITIVE BEHAVIORAL AND PSYCHO-EDUCATIONAL THERAPY IN PATIENTS WITH IMPLANTABLE CARDIOVERTER DEFIBRILLATORS: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED AND QUASI-EXPERIMENTAL TRIALS

Implantable cardioverter defibrillators (ICD) are used for primary and secondary prevention of sudden cardiac death (SCD). Shocks delivered by ICDs, while life-saving, can affect patients’ quality of life. Psychoeducational and Cognitive behavioral therapy (CBT) have been shown to offer a novel approach to reducing ICD shocks and improving quality of life (QOL) in ICD recipients. This systematic review and meta-analysis of randomized controlled trials (RCT) evaluated the pooled effect of CBT and psycho-education on QOL measures and ICD shocks. Systematic searches of literature were conducted for RCTs on the effectiveness of psycho-education and CBT in management of patients with ICD across Medline, PubMed, EMBASE, CINAHL and Web of Science from 1967 to April 2019. All RCTs on patients >18 years of age with ICDs who underwent CBT or psychoeducational treatment post-ICD implantation were included in the study. The meta-analysis was conducted using R statistical software. The mean difference of QOL (Short-form 12 questionnaire (SF-12)), and anxiety measures (STAI questionnaire) were pooled and analyzed using random-effects model. The I2 statistic was used to assess the heterogeneity between studies. I2 with values of 0, 25, 50, and 75 represented none, low, moderate, and high heterogeneity respectively. Results: Overall, 21 studies met the inclusion criteria for systematic review, however only 14 met inclusion criteria for meta-analysis. The meta-analysis of SF-12 components showed significance only in the physical component score (PCS). The mean difference for PCS across all studies was 2.14 [95% CI(1.2-3), p < 0.001, i2 =0.00%, P=0.95], while the mean difference for Mental Component score (MCS) was 0.49 [95%CI(-1.97-2.95), P=0.6, i2=80.7%, P < 0.001] favoring the intervention group. Analysis of studies using STAI anxiety score did not show a significant change in STAI after CBT and psychoeducational therapy. The number of ICD shocks during 12-months follow-up decreased compared to the baseline across all studies by -0.2 [95% CI (-0.4-0), p=0.04, i2 =0.00%, P=0.8] favoring the intervention group (Figure1). Meta-regression analysis showed that the effect of treatment on the mean change in the number of ICD shocks during follow-up compared to the baseline did not vary significantly with the duration of follow-up (p=0.5). The Meta-analysis revealed that CBT and psychoeducation are associated with significant improvement in the Physical component of QOL measures and significant decrease in the number of ICD shocks during follow-up. However, there was no significant improvement in patients’ Mental component of QOL or anxiety scores post intervention.

Quality of life of patients with knee osteoarthritis

Introductions: Osteoarthritis (OA) is a non-inflammatory degenerative disorder of the joint. It has negative impact on health related quality of life (QOL), both in physical and mental health. This study aimed to assess QOL of patient with knee osteoarthritis.&#x0D; Methods: A descriptive cross-sectional study was conducted in outpatient department of orthopedic in Patan hospital, Patan Academy of Health Sciences. Non-probability purposive sampling technique was used. Data was collected from 21st July to 18th August 2017 among 125 knee osteoarthritis patients by face-to-face interview using structured interview.&#x0D; Results: Overall QOL of patients with knee osteoarthritis was good in mental health component mean score (62.09) and poor in physical health with a mean score of (38.18). The physical component of QOL was significantly associated with age (p&lt;0.04) and occupation (p&lt;0.001). There was no association between independent variable and mental component of QOL.&#x0D; Conclusions: The significant proportion of the patients have poor quality of life in physical health component, but majority of patients have good mental health.

Efficacy of Pennebaker's expressive writing intervention in reducing psychiatric symptoms among patients with first-time cancer diagnosis: a randomized clinical trial.

The aim of this randomized clinical trial was to examine the efficacy of Pennebaker's expressive writing intervention (EWI) in improving the perceived quality of life (QoL) and in reducing psychiatric symptoms among patients who received a cancer diagnosis. Seventy-one consecutively recruited patients who received a cancer diagnosis for the first time in their life were randomized into two groups: an EWI group (EWG: n = 35) and a control group (CG n = 36). At the baseline, anamnestic information was collected for all patients, and the patients completed a series of self-reported measures assessing psychiatric symptoms, alexithymia, and health-related QoL. A modified Pennebaker's EWI adapted to cancer diagnosis was also administered to the EWG. Six months later, 32 patients (EWG: n = 17, CG: n = 15) participated in the follow-up and filled out the same questionnaires. The Pennebaker's EWI was effective in decreasing global psychopathology (d = -.55). Small but significant effects were also observed for alexithymia levels and health-related QoL, with the EWG showing a reduction in alexithymia levels (d = -.31) and an increase in the mental component of QoL (d = .31) compared to the CG. Our findings indicate that the Pennebaker's EWI is effective in reducing the negative impact of cancer diagnosis on patients' mental health.

Effects of minimally Invasive Percutaneous Nephrolithotomy on Health-Related Quality of Life

Objective To evaluate the effects of minimally invasive percutaneous nephrolithotomy(MPCNL)on patients' quality of life (QOL) in the short and long term. Methods We prospectively studied 97 consecutive cases who underwent MPCNL between April 2013 to February 2014. A total of 97 cases were included in this study, of which 53 were males and 44 females.Body mass index was 14.9-28.1 kg/m2 and stone burden was (9.4±2.5) cm2. QOL was measured using the short form-36 (SF-36) questionnaire, 2 weeks before surgery and then in the third postoperative month and a year after. Results MPCNL has rendered 91.8%(89/97) of the cases completely stone free with a 15.5%(15/97) complication rate (14.4% Clavien-Dindo I+ II). Compared with that of preoperation, physical function, role physical, bodily pain were improved significantly after postoperative 3 months(P<0.05). Physical function, role physical, bodily pain, social function, role emotional, mental health, general health and vitality were improved after postoperative 1 year(P<0.05). Conclusions MPCNL not only has the advantage of high stone free rate and low complication rate but improves QOL. The physical aspects of QOL is improved at early gradually improve the mental component of QOL late. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Lithotripsy; Quality of Life

Obstáculos en la comunicación entre el cerebro y el intestino

Irritable bowel syndrome (IBS) is a complex disorder that results from interactions of numerous factors. The biopsychosocial model describes a number of predisposing, precipitating, and perpetuating factors, which contribute to the onset and maintenance of symptoms and consequently to quality of life (QoL) impairment. The aim of this study was to examine the impact of several psychological and biological factors on the physical and mental components of QoL in IBS patients. A total of 46 IBS patients completed a set of questionnaires (Big Five Inventory, State-Trait Anxiety Inventory, Beck Depression Inventory-II, Medical Outcome Study Short-Form 36) and kept a diary of their mood, daily stress, and symptoms over a period of two weeks. Patients' heart rate variability, serum cortisol, and fecal calprotectin levels were also measured. The results of regression analyses showed that depression (β = -.30) and negative mood (β = -.28) predicted physical QoL, while depression (β = -.45) and positive mood (β = .33) significantly predicted mental QoL. The model, which included calprotectin, cortisol, anxiety, depression, and positive and negative mood, explained a total of 47% of variance of physical and 57% of variance of mental QoL. Our results confirm the role of negative affect in IBS QoL impairment. They also indicate that biological factors seem important for physical QoL in IBS patients. The role of positive mood as a protective factor for mental QoL might be significant for psychological interventions with IBS patients.

Auriculotherapy for insomnia in elderly people: a 6 week, double-blinded, randomised pilot study

BackgroundInsomnia is a common disorder among elderly people. Sleep loss in the ageing population is associated with increased frequency of accidents and falls, poor health status, depression, and compromised quality of life (QoL). Auriculotherapy, a Chinese medicine-based approach, is a therapeutic method in which specific points in auricles are stimulated to achieve specific therapeutic purposes. In this randomised controlled pilot study, we aimed to determine preliminary treatments using magneto- auriculotherapy (MAT), laser auriculotherapy (LAT), or a combined auriculotherapy approach (ie, MAT plus LAT) to improve sleep and QoL in elderly people with insomnia. MethodsWe included elderly people with insomnia as defined in the Diagnostic and Statistical Manual of Mental Disorders (5th edn). Participants were randomly allocated to three groups, as decided by a computer-generated randomised table: MAT only (placebo LAT followed by MAT; n=10); LAT only (LAT followed by placebo MAT, n=9); and combined AT (LAT followed by MAT, n=12). To achieve the effect of evaluator blinding, treatment effects were evaluated by a researcher who was not aware of types of treatment modality received by participants. Treatment was performed on one ear at a time on seven auricular points three times per week. Participants were assessed at baseline, after completion of the 6 week treatment course, and at 6 weeks follow-up. Outcome measures included: (1) Pittsburgh Sleep Quality Index (PSQI; score 0–21, with a score greater than 5 indicating poor sleep quality); (2) Insomnia Severity Index (score 0–28, high score indicates increased severity); (3) Patient Health Questionnaire (PHQ) to evaluate depressive condition (score 0–27, high score indicates depressive status); and (4) the Chinese (Hong Kong)-specific SF-12 v2 to determine QoL. This trial is registered at ClinicalTrials.gov (number NCT02970695). Ethical approval was sought from the Human Research Ethics Review Committee, The Hong Kong Polytechnic University (HSEARS20151129001). Findings31 participants aged 65 years or older were recruited from four community centres for elderly people in Hong Kong. Mean age of participants was 72·84 years (SD 5·01). A mixed between-participant and within-participant analysis of variance was conducted to assess the effects of three different interventions on different outcome variables across three time periods (pre-intervention, post-intervention, and 6 weeks follow-up). Substantial effects were observed for time, with all three groups showing a reduction in PSQI scores (F[2,27]=13·53; p<0·0001; partial eta squared=0·501), sleep latency (F[2,27]=13·53; p<0·0001; partial η2=0·751), level of insomnia severity (F[2,27]=21·95; p<0·0001; partial η2=0·619), PHQ depressive score (F[2,27]=10·53; p<0·0001; partial η2=0·438). Participants in all three groups showed an increase in sleep efficiency (F[2,27]]=13·80; p<0·0001; partial η2=0·505), physical components of QoL (F[2,27]=4·76; p=0·017; partial η2=0·261), and mental components of QoL (F[2,27]=4·77; p=0·017; partial η2= 0.261) across three time periods. Comparison of the three types of intervention resulted in non-significant effects (p>0·05), suggesting absence of difference in effectiveness of the three treatment approaches. No adverse events were reported. InterpretationThe three treatment approaches using auriculotherapy improved sleep, depressive conditions, and QoL of participants. No difference was noted in treatment effects of these approaches. Future study with a large sample size should be conducted to establish causal relationship between these treatments and their effects. FundingHealth & Medical Research Fund (HMRF), Food and Health Bureau, Hong Kong Special Administrative Region, Hong Kong, China (13144061).

Role of Personality Functioning in the Quality of Life of Patients with Depression.

Depression is associated with reduced quality of life (QoL), and personality pathology is associated with higher impairment and poorer treatment outcomes in patients with depression. This study aims to analyze the effects of personality functioning on the QoL of patients with depression. Severity of depressive symptoms (Beck Depression Inventory), level of personality functioning (Operationalized Psychodynamic Diagnosis Structure Questionnaire), and QoL (Medical Outcome Study 36-item Short-Form) were assessed in a sample of 84 depressive outpatients. Personality functioning showed main effects on both the mental and physical components of QoL. A moderating effect of personality functioning on the relationship between depressive symptoms and QoL was tested but not confirmed. Severity of depressive symptoms was found to mediate the effect of personality functioning on the mental component of QoL. These results suggest that the effect of personality functioning on the QoL of patients with depression may be related to the higher severity of depressive symptoms found in patients with lower levels of personality functioning.

Influence of depression on the quality of life after stroke

AimApproximately 30–60% of the stroke survivors suffers from depression. This, together with the physical changes after stroke may lead to a decline in their quality of life (QOL). The aim of this paper was to analyse the incidence of post-stroke depression, associated risk factors and its influence on the QOL.Material and methodsWe carried out a prospective study on stroke patients during a period of 6months. We excluded patients with dysphasia and aphasia. For each patient, we collected socio-demographic characteristics as well as clinical and therapeutic data. We used the Hamilton Depression Scale to screen for anxiety and depression, the SF-36 scale to assess the quality of life and modified Rankin scale (mRS) to measure the degree of disability.ResultsWe included 155 men and 143 women with stroke, with mean age of 58.15 years. Out of 298 analysed patients, depression was present in 147 (49.3%). Associated risk factors were hypertension, female gender and severity of stroke (P &lt; 0.05). The mean score of the SF-36 was 52.18. Impaired QOL was found in 221 (74.1%) and mRS &gt; 3 was found in 169 (57.1%) of the patients. Impaired mental component of QOL significantly correlated with the presence of depression (P &lt; 0.05) and anxiety (P &lt; 0.05). The severe degree of disability had a significant negative impact on all areas of QOL.ConclusionImportant effect after stroke is occurrence of depression which affects the QOL and functional outcome. All stroke patients should be evaluated for depression through regular interviews with them and their families or caregivers. Adequate antidepressant treatment should be given, in order to improve the QOL and physical rehabilitation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The impact of periodontal disease on physical and psychological domains in long-term hemodialysis patients: a cross-sectional study.

Periodontal disease is a chronic infectious disease. Individuals with end-stage kidney disease (ESKD) experience impaired quality of life (QoL) and low oral health. This is the first comprehensive study which aimed to explore the link between periodontal disease and quality of life, assessed with the Short Form 36-Item Health Survey in hemodialysis patients. In total, 101 patients (57 females) with ESKD were recruited from two Romanian dialysis centers. Periodontal disease assessment included the measurement of periodontal disease index, with its three components: the gingival and periodontal index (GP), the bacterial plaque index (PI) and the calculus index (CI). For assessing QoL, we used the Short Form 36-Item Health Survey (SF-36), with its two components: physical component (PCS) and mental component (MCS). The mean age was 52.5±14.3years. The dialysis vintage was 6.7±5.6years. According to periodontal status, the mean value of GP was 4.0±1.3, mean PI was 1.8±0.9, and mean CI was 1.3±0.7. Regarding the QoL, the means for PCS and MCS were 38.0±17.3 and 45.0±16.3, respectively. In univariate analysis, the physical and mental components of QoL were significantly associated with the gingival and periodontal index, the bacterial plaque index and the calculus index. In the multivariable linear regression, only the gingival and periodontal index remained significantly associated with physical component (β=-3.26, p=0.04, 95% CI -6.39 to -0.13) and mental component (β=-5.57, p=0.001, 95% CI -8.74 to -2.41) of QoL. Our study shows a high prevalence and severity of periodontal disease. The gingival and periodontal index was associated with low QoL, both on physical and on mental components.

A dance intervention for cancer survivors and their partners (RHYTHM).

The purpose of this study was to assess the feasibility, acceptability, and impact of a ballroom dance intervention on improving quality of life (QOL) and relationship outcomes in cancer survivors and their partners. We conducted a pilot randomized controlled trial with two arms (Restoring Health in You (and Your Partner) through Movement, RHYTHM): (1) immediate dance intervention and (2) delayed intervention (wait-list control). The intervention consisted of 10 private weekly dance lessons and 2 practice parties over 12weeks. Main outcomes were physical activity (Godin Leisure-Time Exercise Questionnaire), functional capacity (6 Minute Walk Test), QOL (SF-36), Couples' trust (Dyadic Trust Scale), and other dyadic outcomes. Exit interviews were completed by all participating couples. Thirty-one women survivors (68% breast cancer) and their partners participated. Survivors were 57.9years old on average and 22.6% African American. Partners had similar characteristics. RHYTHM had significant positive effects on physical activity (p=0.05), on the mental component of QOL (p=0.04), on vitality (p=0.03), and on the dyadic trust scale (p=0.04). Couples expressed satisfaction with the intervention including appreciating the opportunity to spend time and exercise together. Survivors saw this light-intensity physical activity as easing them into becoming more physically active. Light intensity ballroom dancing has the potential to improve cancer survivors' QOL. Larger trials are needed to build strong support for this ubiquitous and acceptable activity. Ballroom dance may be an important tool for cancer survivors to return to a physically active life and improve QOL and other aspects of their intimate life.