Mental Quality Of Life Scores Research Articles

Impact of the coronavirus disease pandemic on robot-assisted radical prostatectomy and urologists' treatment behaviors: A single tertiary center retrospective study.

To assess whether the coronavirus disease (COVID-19) pandemic affected the outcomes of robot-assisted radical prostatectomy (RARP) and urologists' treatment behaviors. We retrospectively examined the medical records of 208 patients who had undergone RARP between August 2017 and December 2022. We compared the rate of preoperative androgen deprivation therapy (ADT), waiting period for RARP, patients' baseline characteristics and quality of life (QOL), proportion of adverse pathology on the RARP specimen, rate of Gleason grade group upgrading from biopsy to the RARP specimen, and prostate-specific antigen (PSA) recurrence-free survival between the pre-pandemic and pandemic groups. The rate of preoperative ADT was significantly higher during than before the COVID-19 pandemic (13.7% vs. 1.9%; p = 0.002). The baseline physical and mental QOL scores did not differ significantly between the groups. The proportion of D'Amico low-risk patients was significantly lower (13.6% vs. 1.2%, p = 0.005) and waiting period for RARP was significantly shorter (median 3.5 months vs. 4.0 months, p = 0.016) in the pandemic group than in the pre-pandemic group. There was no significant difference in the proportion of adverse pathology between the groups (p = 0.104); however, the upgrading rate was significantly higher in the pre-pandemic group (p = 0.002). There was no significant difference in PSA recurrence-free survival between the groups (log-rank, p = 0.752). The COVID-19 pandemic did not adversely affect the oncologic outcomes of RARP and QOL before RARP. However, it caused urologists to increase the use of preoperative ADT and to reserve RARP for higher-risk cases.

État de santé et qualité de vie des patients β-thalassémiques adultes à Marseille, France

IntroductionThe life expectancy of β-thalassemia patients has increased over the last 20 years. In this study, we evaluated the current health status and quality of life of these patients managed in a reference center in Marseille. MethodsThis is a single-center, descriptive study conducted between June and August 2019 in patients over 18 years of age with β-thalassemia major or intermedia. Clinical and paraclinical data were collected retrospectively and the SF-36 health survey questionnaire was proposed to each patient. Results43 of 64 selected patients were included and divided into 2 groups: 35 patients with transfusion-dependent β-thalassemia and 8 patients with non-transfusion-dependent β-thalassemia. Liver iron overload is the most frequent complication, present in 80% of transfusion-dependent and 62.5% of non-transfusion-dependent patients. Cardiac iron overload is present only in the transfusion dependent β-thalassemia group (20%). Hypogonadotropic hypogonadism remains the most common endocrine disorder (41.9%) followed by osteoporosis (37.2%). Among the 31 patients who completed the SF-36 questionnaire, physical and mental quality of life scores were lowered in transfusion dependent (respectively 42.7 and 46.8) as in non-transfusion-dependent patients (respectively 43.8 and 28.9). ConclusionDespite an improvement in medical care, our patients with β-thalassemia show an alteration in their quality of life that will need to be characterized in the entire French cohort.

Comparing depression, anxiety, and quality of life in individuals with cardiac and non-cardiac chest pain.

Psychological factors are often overlooked as potential contributors to cardiovascular disease. This study aimed to investigate the relationship between depression, anxiety, and quality of life with chest pain origin. This cross-sectional study was performed from 2019 to 2020 and included participants from multiple medical centers across Shahrekord, Iran. Participants were recruited through advertisements in medical centers. Participants were divided into three groups: healthy control (n = 67), chest pain with cardiac origin (CCP) (n = 70), and chest pain with non-cardiac origin (NCCP) (n = 73). Data were collected using the Beck's Anxiety scale, Beck's Depression scale, and Short-Form Health Survey questionnaires. The chi-square, exact test, t-test, Kruskal-Wallis, and logistic regression models were used for statistical analysis. All analysis was performed using SPSS 26. The mean scores of depression and anxiety in the NCCP group (depression = 17.03 ± 11.93, anxiety = 17.18 ± 11.37) were significantly higher than those in the CCP (depression = 9.73 ± 5.76, anxiety = 8.77 ± 5.96) and healthy (depression = 7.00 ± 7.61, anxiety = 6.18 ± 7.63) groups (p < 0.05). The mean score of quality of life in the NCCP group (54.87 ± 12.66) was significantly lower than that in the CCP (76.31 ± 12.49) and healthy (80.94 ± 15.78) groups (p < 0.05). Patients with NCCP had higher odds of having depression (adjusted OR = 4.39, 95% CI: 1.25, 15.35) and lower odds for having mental quality of life scores than the CCP and health groups, respectively (adjusted OR = 0.90, 95% CI: 0.87, 0.94). Our findings suggest that collaboration between psychiatrists and other specialists may be necessary to improve patients' health conditions and quality of life.

Socioeconomic Factors Predict Long-Term Quality of Life of Cancer Survivors: An International Survey

IntroductionDespite advances in cancer treatment, the quality of life (QOL) of survivors varies significantly. We assessed the correlation between socioeconomic factors and long-term QOL in a global cohort of cancer survivors. Materials and methodsPatients were offered surveys via online support groups. Using the Short Form-12 validated questionnaire, physical QOL (PQOL) and mental QOL (MQOL) well-being were compared to the general population. Socioeconomic factors were assessed with regression analysis for impact on QOL. ResultsSeven hundred eighty two survivors from six continents responded. They were 57 ± 13 y and 68% female, 90.8% White, with 43 distinct cancer diagnoses. All survivors had PQOL and MQOL scores lower than the general population. Lower education level, household income, and non-White race all correlated with reduced PQOL and/or MQOL. Age was negatively correlated with PQOL (r = −0.08, P = 0.03) and positively correlated with MQOL (r = 0.142, P < 0.001). Care at large regional/academic centers was associated with higher MQOL (42 ± 14 versus 38 ± 11, P = 0.005). Age (β = −0.1, P = 0.04), education (β = 1.1, P = 0.005), and income (β = 2.0, P < 0.001) were predictors of PQOL, while age (β = 0.2, P < 0.001), income (β = 1.7, P = 0.002), and community hospital care (β = −3.6, P = 0.013) were predictors of MQOL. ConclusionsIn a large international survey of cancer survivors, we identified socioeconomic factors and their associations with QOL. Further work should be directed to provide durable support across all socioeconomic classes.

Chronic kidney disease-associated pruritus (CKD-aP) is associated with worse quality of life and increased healthcare utilization among dialysis patients.

Chronic pruritus significantly impairs hemodialysis patients' health status and quality of life (QOL) and it is associated with higher mortality rate, more frequent hospitalizations, poorer dialysis and medication adherence, and deteriorated mental status. However, pruritus is still underestimated, underdiagnosed, and undertreated in the real-life clinical scenario. We investigated prevalence, clinical characteristics, clinical correlates, severity as well as physical and psychological burden of chronic pruritus among adult hemodialysis patients in a large international real-world cohort. We conducted a retrospective cross-sectional study of patients registered in 152 Fresenius Medical Care (FMC) NephroCare clinics located in Italy, France, Ireland, United Kingdom, and Spain. Demographic and medical data were retrieved from the EuCliD® (European Clinical) database, while information on pruritus and QoL were abstracted from KDQOL™-36 and 5-D Itch questionnaire scores. A total of 6221 patients were included, of which 1238 were from France, 163 Ireland, 1469 Italy, 2633 Spain, and 718 UK. The prevalence of mild-to-severe pruritus was 47.9% (n = 2977 patients). Increased pruritus severity was associated with increased use of antidepressants, antihistamines, and gabapentin. Patients with severe pruritus more likely suffered from diabetes, more frequently missed dialysis sessions, and underwent more hospitalizations due to infections. Both mental and physical QOL scores were progressively lower as the severity of pruritus increased; this association was robust to adjustment for potential confounders. This international real-world analysis confirms that chronic pruritus is a highly prevalent condition among dialysis patients and highlights its considerable burden on several dimensions of patients' life.

Sex comparisons in the association of prediabetes and type 2 diabetes with cognitive function, depression, and quality of life: The Maastricht study.

There are sex differences in the excess risk of diabetes-associated cardiovascular disease. However, it is not clear whether these sex differences exist with regard to other complications like mental health aspects. Therefore, we investigated sex differences in the association of prediabetes and type 2 diabetes (T2D) with cognitive function, depression, and quality of life (QoL). In a population-based cross-sectional cohort study (n = 7639; age 40-75 years, 50% women, 25% T2D), we estimated sex-specific associations, and differences therein, of prediabetes and T2D (reference: normal glucose metabolism) with measures of cognitive function, depression, and physical and mental QoL. Sex differences were analysed using multiple regression models with interaction terms. In general, T2D, but not prediabetes, was associated with higher odds of cognitive impairment, major depressive disorder, and poorer QoL. The odds ratio (OR) of cognitive impairment associated with T2D was 1.29 (95% CI: 0.96-1.72) for women and 1.39 (1.10-1.75) for men. The OR of major depressive disorder associated with T2D was 1.19 (0.69-2.04) for women and 1.68 (1.02-2.75) for men. The mean difference of the physical QoL score (ranging from 0 to 100, with 100 indicating the best possible QoL) associated with T2D was -2.09 (-2.92 to -1.25) for women and -1.81 (-2.48 to -1.13) for men. The mean difference of the mental QoL score associated with T2D was -0.90 (-1.79 to -0.02) for women and -0.52 (-1.23 to 0.20) for men. There was no clear pattern of sex differences in the associations of either prediabetes or T2D with measures of cognitive function, depression, or QoL. In general, T2D was associated with worse cognitive function, depression, and poorer QoL. The strength of these associations was similar among women and men.

Cyberchondria Severity and Quality of Life Among Lebanese Adults: The Moderating Effect of Emotions.

Objective: To examine the correlation between cyberchondria and quality of life (QOL) among Lebanese adults during the COVID-19 pandemic, taking into consideration the moderating role of emotions (emotion regulation and positive and negative affect). The following questions were examined: (1) Do greater cyberchondria severity and fear of COVID-19 lead to poorer quality of physical and mental health? (2) How is positive and negative affect related to physical and mental QOL? and (3) How do emotion suppression and cognitive reappraisal correlate with physical and mental QOL, particularly in those with higher cyberchondria?Methods: This cross-sectional study was performed between December 2020 and January 2021 during the COVID-19 pandemic. The study enrolled 449 participants who completed an online questionnaire. The questionnaire included sociodemographic questions and the following scales: Cyberchondria Severity Scale, Quality of Life Short Form-12 Health Survey, Fear of COVID-19 Scale, Emotion Regulation Questionnaire, and Positive and Negative Affect Schedule.Results: The results showed that more positive affect (B = 0.17) and negative affect (B = 0.19) were positively correlated with higher physical QOL scores. More positive affect (B = 0.33) and cognitive reappraisal (B = 0.09) were significantly associated with higher mental QOL scores. The interactions between cyberchondria severity by cognitive reappraisal and cyberchondria severity by emotion suppression were significantly associated with mental QOL (P < .001 for both). In people with high cyberchondria severity, having high cognitive reappraisal was strongly correlated with better mental QOL. In people with high cyberchondria severity, having low emotion suppression was significantly correlated with better mental QOL (P < .001).Conclusions: Exposure to copious amounts of information, whether from verifiable sources or not, can instigate anxious symptoms in individuals who lack adaptive emotion regulation ability. Further studies are needed to identify factors related to health crisis response and their moderators, which can be useful to better understand the incidence and development of anxiety and allow health professionals to develop and implement preventive and therapeutic interventions.

Characteristics and outcomes of patients with gastroparesis using enteral and/or exclusive parenteral nutrition.

Patients with gastroparesis (Gp) may need enteral nutrition (EN) or exclusive parenteral nutrition (PN). Among patients with Gp, we aimed to (1) identify the frequency of EN and exclusive PN use and (2) explore characteristics of patients using EN and/or exclusive PN compared with those using oral nutrition (ON), including changes over 48 weeks. Patients with Gp underwent history and physical examination, gastric emptying scintigraphy, water load satiety testing (WLST), and questionnaires assessing gastrointestinal symptoms and quality of life (QOL). Patients were observed 48 weeks. Of 971 patients with Gp (idiopathic, 579; diabetic, 336; post-Nissen fundoplication, 51), 939 (96.7%) were using ON only, 14 (1.4%) using exclusive PN, and 18 (1.9%) using EN. Compared with patients receiving ON, patients receiving exclusive PN and/or EN were younger, had lower body mass index, and had greater symptom severity. Patients receiving exclusive PN and/or EN had lower physical QOL but not mental QOL or Gp-related QOL scores. Patients receiving exclusive PN and/or EN ingested less water during WLST but did not have worse gastric emptying. Of those who had been receiving exclusive PN and/or EN, 50% and 25%, respectively, resumed ON at 48-week follow-up. This study describes patients with Gp requiring exclusive PN and/or EN for nutrition support, who represent a small (3.3%) but important subset of patients with Gp. Unique clinical and physiological parameters are associated with this subset and provide insight into the use of nutrition support in Gp.

P834 Physical activity in people with Inflammatory Bowel Disease – towards precision prevention

Abstract Background Existing evidence suggests that physical activity, in addition to medical treatment, can counteract physical symptoms and improve the quality of life in patients with inflammatory bowel disease (IBD). We aimed to understand patients' patterns of physical activity to guide the development of an evidence-based personalised intervention for the promotion of physical activity and reduction of sedentary behaviour in patients with IBD. Methods We included a population of 207,959 participants who responded to The Danish Capital Region Health Surveys during the period 2007 to 2021. The population included 1777 individuals with prevalent IBD [705 with Crohn’s disease and 1072 with ulcerative colitis]. Information on sedentary behaviour and physical activity was obtained from self-reported questionnaires, the Physical Activity Scale version 2.1., and sociodemographic information from central nationwide registers. Self-rated physical and mental health was measured with SF-12. Data were weighted for survey design and were analysed by multiple regression analyses. Results The proportion that adopted the recommended physical activity level of at least 4 hours of low, moderate, or high intensity was lower among patients with IBD compared to the background population, also when adjusting for sociodemographic variables and population weights (OR=0.86; 95% CI 0.84-0.88). Among patients with IBD, more women than men were physically active. Crohn’s disease, living alone, having non-western ethnicity, having a BMI&amp;lt; 18.5 or BMI &amp;gt;30, having an unhealthy diet, being outside the labour market, and having small children were all associated with lower levels of physical activity. Moderate to high level of physical activity among patients with IBD was associated with higher self-rated physical health than low levels of physical activity (p&amp;lt;0.001). The highest mental quality of life score was among IBD patients with moderate physical activity compared to high or low physical activity (p&amp;lt;0.001). Conclusion Patients with IBD, especially those with Crohn’s disease, have lower levels of physical activity and more sedentary behaviour compared to non-IBD individuals. Moderate physical activity is associated with a higher physical and mental quality of life score in individuals with IBD compared to high or low levels of physical activity. These results can guide clinicians when IBD patients ask for advice on physical activity. Furthermore, we will use the results to guide the development of an evidence-based personalised intervention for the promotion of physical activity and reduction of sedentary behaviour in patients with IBD.

Association between Experiences in Life and Quality of Life among Lebanese University Students in a Collapsing Country: The Moderating Role of Religious Coping and Positivity.

(1) Background: No goal can be more important than optimal individual quality of life (QOL); life experiences, religious coping, and positivity play pivotal roles in achieving this goal. The aim is to assess the correlation between positive/negative experiences in life and QOL, taking into consideration the moderating role of positivity and positive/negative religious coping among a sample of Lebanese university students. (2) Methods: This cross-sectional study was carried out between November and December 2021, and enrolled 333 university students, aged between 18 and 30 years, from various areas in Lebanon's governorates. The 12-item Short Form Health Survey, the brief religious coping methods scale, and the Scale of Positive and Negative Experience were included in the questionnaire. Forward linear regressions were conducted to check for correlates associated with physical and mental QOL scores. All variables that showed a correlation or effect size &gt; |0.24| were entered in the multivariable and moderation models as independent ones. Significance was set at a p &lt; 0.05. (3) Results: A linear regression, taking the physical QOL score as the dependent variable, showed that living in rural areas compared to urban and more positivity were significantly associated with a better physical QOL, whereas more negative religious coping was significantly associated with a lower physical QOL. More positivity and more positive religious coping were significantly associated with a better mental QOL. The moderation analysis showed that in people with high positive experiences, those with higher negative religious coping had lower mental QOL. (4) Conclusions: In a society as deeply religious as Lebanon, it is crucial to organize awareness programs to help in discriminating between religious coping mechanisms. Across order to stop further detrimental effects on QOL, our findings may serve as a solid foundation for future studies of QOL with additional variables, in other groups and nations.

Multifaceted support for quality of life in childhood cancer survivors: Questionnaire survey

AbstractBackgroundAlong with improvements in curative treatment for childhood cancer, childhood cancer survivors (CCSs) often face numerous problems such as late complications of cancer treatment, social issues at school, struggles in employment, and financial difficulties. These children have received a wide range of support from the medical, educational, and administrative sectors. However, it was unclear how this multifaceted support contributed to quality of life (QOL) of CCSs in Japan.MethodsThe subjects were 46 CCSs of 16 years of age or older at the time of the survey, who had been diagnosed and treated for pediatric cancer. A self‐administered questionnaire survey was conducted to investigate the in‐hospital status during treatment, adjustment when returning to school, and administrative social support. The QOL of CCSs was also evaluated by the Medical Outcome Study 36‐Item Short‐Form Health Survey.ResultsTwenty‐four CCSs answered the questions. The respondents who had experienced school‐life problems tended to have lower role/social QOL scores (p = 0.046), whereas the CCSs who had experienced administrative counseling tended to have lower physical QOL scores (p = 0.036). The mental QOL scores tended to be higher in respondents who were informed of the exact diagnosis of cancer during hospitalization. The role/social QOL scores tended to be lower in respondents who advanced to their preferred career path.ConclusionsIt is essential for three stakeholders—health‐care providers, education offices, and public administrative agencies—to collaborate to share long‐term psychosocial issues or concerns related to employment or daily living that CCSs may encounter, and to establish a coordinated approach to support CCSs.

Patient-Reported Quality of Life in Adolescents and Young Adults with Cancer before, during, and after Radiation Therapy

<h3>Purpose/Objective(s)</h3> Adolescents and young adults (AYAs, 15-39 yo) with cancer have unique vulnerabilities that affect quality-of-life (QOL) during treatment and in survivorship. Yet, few studies have assessed QOL in AYAs with cancer who received radiation therapy (RT). Therefore, we performed a cross-sectional study in AYAs with cancer who completed patient-reported outcomes (PROs) assessing QOL before, during, or after RT. <h3>Materials/Methods</h3> We identified 265 AYAs with cancer who were treated with RT and completed an AYA PRO survey from 2019-2022. The survey containing ten validated PRO instruments from the PROMIS inventory: Global Physical and Mental Health, Anxiety, Depression, Fatigue, Sleep Disturbance, Social Roles, Pain Interference, and Cognitive Function (score of 50 represents the mean from the reference U.S. general population; higher score represents more of the concept being measured). Patients were stratified into 3 cohorts based on the date of PRO completion: before RT, peri-RT (during RT or within 6 months of RT completion), or after RT (6+ months following RT completion). Mean (standard deviation [SD]) PRO scores were calculated. Patient characteristics were extracted from the medical record. Kruskal-Wallis analysis was used to compare scores between cohorts. ANOVA and t-test analyses were used to compare scores between co-variates. <h3>Results</h3> 87 (33%) patients completed PROs before RT, 84 (32%) peri-RT, and 94 (35%) after RT; median [IQR] age was 28 [21-33], 26 [20-32], and 22 [17-27], respectively. Cancer types varied; most had sarcoma (26%) or CNS cancer (23%). Compared to the before RT cohort, the peri-RT cohort had worse Global Physical and Mental Health PRO scores [SD] (48.7 [8.9] vs. 44.9 [9.8] (p=0.03) and 50.9 [8.6] vs. 46.2 [10.3] (p<0.01), respectively). These PRO scores were similar between the peri- and after RT cohorts (44.9 [9.8] vs. 45.5 [9.8] (p=0.68) and 46.2 [10.3] vs. 47.9 [9.6] (p=0.26), respectively). Compared to the before RT cohort, the peri- and after RT cohorts had better Anxiety PRO scores [SD] (55.2 [9] vs. 52.6 [10.4] and 51 [10], respectively, p=0.02). Remaining PRO scores were similar between cohorts (p>0.05). In the peri-RT cohort, patients with any acute RT toxicity had worse Pain Interference PRO scores [SD] vs. patients with none (50.8 [8.9] vs. 44.7 [5.7], p=0.03). In the after RT cohort, adolescents (15-18 yo) and young adults (26-39 yo) had worse Global Mental Health PRO scores [SD] vs. emerging adults (19-25 yo) (46.9 [9.1] and 47.9 [11.2], respectively, vs. 53.8 [9.2], p=0.04); patients with any late RT toxicity had worse Sleep Disturbance PRO scores [SD] vs. patients with none (58.4 [8] vs. 52.4 [9.2], p<0.001). <h3>Conclusion</h3> AYAs with cancer reported lower general physical and mental health QOL scores during RT, which persisted into survivorship. Developmental age, stage, and presence of RT toxicities may contribute to differing scores. Future longitudinal analyses are needed to improve QOL for AYAs receiving RT.

The relative impact of injury and deployment on mental and physical quality of life among military service members.

US service members injured in the recent conflicts in Iraq and Afghanistan were more likely to survive than those in previous conflicts because of advances in medicine and protective gear. However, there is limited research examining the long-term impact of injuries while deployed on physical and mental quality of life (QOL) among service members. We used data from two time-points with an average follow-up period of 4.27 years (SD = 2.13; n = 118,054) to prospectively examine the association between deployment and injury status with QOL. Data were derived from the Millennium Cohort Study surveys (2001 to 2016) and linked with the Department of Defense Trauma Registry (DoD-TR) among a cohort of US service members from all branches and components. The primary predictor (a combination of deployment and injury status) was comprised of the following four categories: 1) not deployed, 2) deployed and not injured, 3) deployed and non-battle injured, and 4) deployed and battle injured. Demographic, military, psychological and behavioral health, and life stress factors were adjusted for in multivariable models. Outcomes of interest were physical and mental QOL from the Short-Form Health Survey for Veterans (VR-36) measured at ~4 year follow-up. Between group comparisons indicated that those deployed and battle-injured had the greatest decline in both mental (-3.82) and physical (-10.13) QOL scores over time (p < .05). While deployment and injury status were associated with poorer mental and physical QOL in adjusted models; only the association between deployment and injury status with physical QOL was clinically meaningful (more than 2.5). In adjusted models, Time 1 mental and physical QOL explained most of the variance (23-25%) in Time 2 mental and physical health QOL as compared to other covariates (e.g., injury and deployment, and other sociodemographic factors increased variance by ~5%). Time 1 QOL was the most significant predictor of later QOL, but those injured while deployed experienced significant and meaningful decrements to long-term physical QOL. This suggests that prevention and rehabilitation interventions should focus on improving physical health among injured service members to avoid long-term adverse effects.

Impact of peptic ulcer disease on the quality of life: A Cross Sectional Study

Background: Peptic ulcer disease (PUD) is a serious chronic medical condition. It is considered one of the most common illnesses worldwide. PUD has its own impact on the patients’ quality of life (QOL). Objectives: This study aimed to assess the QOL in patients with peptic ulcer disease in Mosul city, Iraq. Methods: A cross sectional study was carried out among 385 patients in a public general hospital and 5 local pharmacies in Mosul city during the period from 10th May to 5th August 2021. Data collection was performed using a face-validated SF-12v2 questionnaire assessing the patients’ physical, mental, and overall health. All the data were subjected to descriptive and inferential analyses. Results: Overall, only 8.6% of the participants reported that their general health is poor. The majority (40.8% and 38.4%) stated that peptic ulcer disease has no or little impact on their moderate daily physical activity. Significant differences were found in the physical, mental and overall QOL scores with socio-demographic characteristics. Conclusion: Quality of life assessment indicated that there are some negative impacts in the patients’ daily life caused either by the patients’ environmental aspects or peptic ulcer related symptoms.

Quality of life of patients with multiple sclerosis receiving medical care at Palestinian Ministry of Health Directorates in the West Bank, occupied Palestinian territory, and associated factors: a cross-sectional survey

BackgroundMultiple sclerosis is a neurological disease in which the immune system attacks the myelin sheath of axons, leading to symptoms that include loss of function, fatigue, blindness, and loss of balance. It is more common in women than in men. The disease has detrimental effects on patients’ health-related quality of life (QOL), physically, socially, and emotionally. This study assessed the QOL of patients with multiple sclerosis receiving medical care at Palestinian Ministry of Health directorates. MethodsIn this cross-sectional study, we approached all patients with multiple sclerosis receiving medical care in Ministry of Health clinics in all districts of the West Bank. In total, 150 patients were willing to participate. Participants were aged between 20 and 65 years and receiving treatment in ten directorates in the West Bank. We collected data from patients when they visited the clinics to collect medicines. The multiple sclerosis quality of life-54 (MSQOL-54) instrument is a self-administered questionnaire that is divided into two sections, the first comprising questions on basic demographic and socioeconomic characteristics, and the second focusing on the patient's QOL by assessing physical, mental, and emotional health factors. The MSQOL-54 scale scores were created using the Likert method by averaging items within the scales, then row scores were linearly transformed into 0–100 scales. The physical health composite score encompassed physical function health perceptions, energy and fatigue, and role limitations (relating to physical pain, sexual function, social function, and health distress). The mental health composite score encompassed health distress, overall QOL, emotional wellbeing, and role limitations (relating to emotional and cognitive function). These constructed variables were multiplied by the weight given to each variable to give the subtotal for each composite. Univariate analyses were initially performed using frequencies for categorical variables. Mean and SD were calculated for continuous variables. FindingsPatients had a mean age of 35 years (SD 10·90), and 103 (69%) were women. 43 (29%) lived in the north of the West Bank, 68 (45%) lived in the middle, and 39 (26%) in the south. 78 (52%) had a university degree, and 101 (67%) were married. 114 (76%) had a monthly income equal to the average wage in the occupied Palestinian territory. 77 (51%) were unemployed and 82 (55%) lived in cities. 109 (73%) were diagnosed with multiple sclerosis in the first year of the appearance of symptoms, and 127 (85%) took medication regularly. 76 (51%) benefitted from medication. 149 (99%) were diagnosed as having relapsing remitting multiple sclerosis. The overall mean QOL score was 58·71 (SD 22·06). For role limitation, the mean QOL scores relating to physical and emotional problems were 32 (SD 39·51) and 32 (40·11), to physical function was 35·8 (20·82), to emotional wellbeing was 45·94 (17·88), to fatigue was 40·74 (17·91), to health perception was 42·86 (21·80), and to health distress was 3·19 (1·38). The mean physical and mental health composite scores were 40·94 (38·97) and 39·91 (36·67), respectively. Similar physical and mental components of the QOL scores were found in patients with multiple sclerosis in studies from Bosnia and Herzegovina, Slovenia, and Italy. InterpretationThis study highlights the importance of assessing the QOL of patients with multiple sclerosis in the occupied Palestinian territory. All patients had low physical and mental health-related QOL scores. For the participants in this study, the most affected components of QOL were those related to role limitations due to physical and emotional problems, physical function, emotional wellbeing, fatigue, and health perception. Health distress was found to be the most powerful predictor of QOL of patients with multiple sclerosis. The results could potentially assist the Palestinian Ministry of Health in developing plans to improve the QOL of patients with multiple sclerosis. FundingNone.

Longitudinal mediation analysis of the factors associated with trajectories of posttraumatic stress disorder symptoms among postpartum women in Northwest Ethiopia: Application of the Karlson-Holm-Breen (KHB) method.

In recent years, literatures identified childbirth as a potentially traumatic experience resulting in posttraumatic stress disorder (PTSD), with 19.7 to 45.5% of women perceiving their childbirth as traumatic. A substantial variation in PTSD symptoms has been also indicated among women who experience a traumatic childbirth. However, there has been no research that has systematically investigated these patterns and their underlying determinants in postpartum women in Ethiopia. The aim of this study was to investigate the trajectories of PTSD symptoms and mediating relationships of variables associated with it among postpartum women in Northwest Ethiopia. A total of 775 women were recruited after childbirth and were followed at the 6th, 12th and 18th week of postpartum period during October, 2020 -March, 2021. A group-based trajectory modeling and mediation analysis using KHB method were carried out using Stata version 16 software in order to determine the trajectories of PTSD symptoms and mediation percentage of each mediator on the trajectories of PTSD symptoms. Four distinct trajectories of postpartum posttraumatic stress disorder symptoms were identified. Perceived traumatic childbirth, fear of childbirth, depression, anxiety, psychological violence, higher WHODAS 2.0 total score, multigravidity, stressful life events of health risk, relational problems and income instability were found to be predictors of PTSD with recovery and chronic PTSD trajectory group membership. Depression and anxiety not only were strongly related to trajectories of PTSD symptoms directly but also mediated much of the effect of the other factors on trajectories of PTSD symptoms. In contrast, multiparity and higher mental quality of life scores were protective of belonging to the PTSD with recovery and chronic PTSD trajectory group membership. Women with symptoms of depression, anxiety, fear of childbirth and perceived traumatic childbirth were at increased risk of belonging to recovered and chronic PTSD trajectories. Postnatal screening and treatment of depression and anxiety may contribute to decrease PTSD symptoms of women in the postpartum period. Providing adequate information about birth procedures and response to mothers' needs during childbirth and training of health care providers to be mindful of factors that contribute to negative appraisals of childbirth are essential to reduce fear of childbirth and traumatic childbirth so as to prevent PTSD symptoms in the postpartum period.

Mental Health and Quality of Life among Patients with Cancer during the SARS-CoV-2 Pandemic: Results from the Longitudinal ONCOVID Survey Study.

Simple SummaryAlthough the SARS-CoV-2 pandemic is likely to have created or aggravated mental health symptoms in cancer patients, high-quality longitudinal data on this topic are scarce. The aim of our prospective survey study was to assess cancer patient-reported mental health and quality of life (QOL) at four time points during the first two waves of the pandemic. We found that an important proportion of the 355 participants reported symptoms of COVID-19 peritraumatic distress (34.2% to 39.6%), depression (27.6% to 33.5%), anxiety (24.9% to 32.7%), and stress (11.4% to 15.7%) at any time point during the study period. However, we did not find clinically meaningful mental health and QOL changes during the study period. Additionally, we found no factors associated with better or worse mental health or QOL. In conclusion, the cancer patients who participated in this study showed considerable resilience against mental health and QOL deterioration during the pandemic.Purpose: This longitudinal survey study aimed to investigate the self-reported outcome measures of COVID-19 peritraumatic distress, depression, anxiety, stress, quality of life (QOL), and their associated factors in a cohort of cancer patients treated at a tertiary care hospital during the SARS-CoV-2 pandemic. Methods: Surveys were administered at four time points between 1 April 2020 and 18 September 2020. The surveys included the CPDI, DASS-21, and WHOQOL-BREF questionnaires. Results: Survey response rates were high (61.0% to 79.1%). Among the 355 participants, 71.3% were female, and the median age was 62.2 years (IQR, 53.9 to 69.1). The majority (78.6%) were treated with palliative intention. An important proportion of the participants reported symptoms of COVID-19 peritraumatic distress (34.2% to 39.6%), depression (27.6% to 33.5%), anxiety (24.9% to 32.7%), and stress (11.4% to 15.7%) at any time point during the study period. We did not find clinically meaningful mental health and QOL differences during the study period, with remarkably little change in between the pandemic’s first and second wave. We found no consistent correlates of mental health or QOL scores, including cancer type, therapy intention, and sociodemographic information. Conclusion: This cohort of cancer patients showed considerable resilience against mental health and QOL deterioration during the SARS-CoV-2 pandemic.

Residual symptoms and the quality of life in individuals recovered from COVID-19 infection: A survey from Pakistan

BackgroundThere remains scarcity of literature regarding the patient's health status post-COVID-19 infection. This study analyzes the prevalence of residual symptoms and quality of life (QoL) after COVID-19. MethodsAn anonymous online survey was administrated in Pakistan from November 2020 to April 2021 in COVID-19 survivors. The questionnaire used the 12-Item Short Form Health Survey (SF-12) to assess mental and physical QoL. Multivariate linear regression was used to explore factors associated with mental and physical QoL scores. ResultsA total of 331 COVID-19 survivors participated in our survey. Around 42.0% of the cohort reported within 1–3 months of diagnosis of COVID-19. The common residual symptoms were body aches (39.9%), low mood (32.6%), and cough (30.2%). Better physical QoL was associated with being male (adjusted beta: 3.328) and having no residual symptoms (6.955). However, suffering from nausea/vomiting during initial COVID-19 infection (−4.026), being admitted to the ICU during COVID-19 infection (−9.164), and suffering from residual body aches (−5.209) and low mood (−2.959) was associated with poorer QoL. Better mental QoL was associated with being asymptomatic during initial COVID-19 infection (6.149) and post-COVID (6.685), while experiencing low mood post-COVID was associated with poorer mental QoL (−8.253 [-10.914, −5.592]). ConclusionDespite presumed “recovery” from COVID-19, patients still face a wide range of residual symptoms months after initial infection, which contributes towards poorer QoL. Healthcare professionals must remain alert to the long-lasting effects of COVID-19 infection and aim to address them appropriately to improve patients’ QoL.

The prevalence of frailty and its associated factors in an Italian institutionalized older population: findings from the cross-sectional Alvise Cornaro Center Study.

While it is well established that frail older people have a higher risk of negative health outcomes, the prevalence of frailty and its associated factors in Italian older institutionalized population has never been investigated. The aims of this study were to assess the prevalence of frailty and to identify its associated factors in an Italian residential care home population. An observational cross-sectional study was designed to evaluate older people aged 70 or over of an Italian residential care home. A multidimensional assessment examining functional, geriatric, ophthalmic, and audiological domains was carried out to identify factors associated with frailty. Physical frailty was evaluated using Fried's criteria. Data analysis uncovered a 51.1% prevalence of pre-frailty and a 40.4% prevalence of frailty in the 94 eligible participants (64 females) whose data were complete. The multivariable analysis showed that a low education level (OR = 5.12, 95% CI 1.22-21.49), a low physical quality of life score (OR = 13.25, 95% CI 3.51-50.08), a low mental quality of life score (OR = 9.22, 95% CI 2.38-35.69), visual impairment (OR = 7.65, 95% CI 1.77-33.14), and hearing impairment (OR = 4.62, 95% CI 1.03-20.66) were independently associated with frailty. Frailty was found to be highly prevalent in the residential care home studied. Since frailty is a reversible condition, identifying the modifiable factors associated to it should be viewed as an important step in planning and implementing targeted, early prevention strategies.

Cyberchondria severity and quality of life among Lebanese adults: the mediating role of fear of COVID-19, depression, anxiety, stress and obsessive\u2013compulsive behavior\u2014a structural equation model approach

BackgroundThis study highlights the significant association between cyberchondria and quality of life among the Lebanese population in the time of COVID-19. The aim was to assess the association between cyberchondria and quality of life (QOL) of Lebanese community during the COVID-19 pandemic and assess the mediating effect of fear of COVID-19, depression, anxiety, stress and Yale-Brown Obsessive–Compulsive Scale in this association.MethodsThis cross-sectional study was carried out between December 2020 and January 2021, during the COVID-19 pandemic. A total of 449 persons participated in this study by filling the online questionnaire. Structural equation modeling (SEM) was performed to examine the structural relationship between cyberchondria severity, the mediator (anxiety, stress, depression, obsessive–compulsive disorder (OCD) and fear of COVID-19) and physical/mental QOL.ResultsHaving a university level of education and older age were significantly associated with higher physical QOL scores, whereas higher obsession-compulsion disorder, higher stress and higher anxiety were significantly associated with lower physical QOL scores. Higher anxiety was significantly associated with lower mental QOL scores. The results of the SEM showed that stress, fear of COVID-19 and to a lesser limit OCD, mediated the association between cyberchondria severity and physical QOL, whereas anxiety, stress and fear of COVID-19 mediated the association between cyberchondria severity and mental QOL.ConclusionThis research reported interesting results encouraging more exploration of cyberchondria and its association with quality of life during this unique period of the pandemic. However, this virus has altered the lives of individuals all across the world, and the consequences will last for a long time. Along with all of the steps done to stop the development of COVID-19 and improve physical outcomes, mental health requires immediate care. More research is needed to determine the coping techniques people are employing to deal with the pandemic.