Mental Summary Scores Research Articles

A Dual-Modality Home-Based Cardiac Rehabilitation Program for Adults With Cardiovascular Disease: Single-Arm Remote Clinical Trial.

Cardiac rehabilitation (CR) is a safe, effective intervention for individuals with cardiovascular disease (CVD). However, a majority of eligible patients do not complete CR. Growing evidence suggests that home-based cardiac rehabilitation (HBCR) programs are comparable in effectiveness and safety with traditional center-based programs. More research is needed to explore different ways to deliver HBCR programs to patients with CVD. We aimed to assess the feasibility and impact of a digital HBCR program (RecoveryPlus.Health) that integrates both telehealth and mHealth modalities on functional exercise capacity, resting heart rate, and quality of life among adults with CVD. This 12-week prospective, single-arm remote clinical trial used a within-subject design. We recruited adults with CVD (aged ≥40 years) from the community with a CR-eligible diagnosis (stable angina pectoris, myocardial infarction, and heart failure) between May and August 2023. All enrolled patients referred to the RPH clinic in Roanoke, Texas, were included. The care team provided guideline-concordant CR services to study participants via two modalities: (1) a synchronous telehealth exercise training through videoconferencing; and (2) an asynchronous mobile health (mHealth) coaching app (RPH app). Baseline intake survey, electronic health record, and app log data were used to extract individual characteristics, care processes, and platform engagement data. Feasibility was measured by program completion rate and CR service use. Efficacy was measured by changes in the 6-minute walk test, resting heart rate, and quality of life (12-Item Short-Form Health Survey) before and after the 12-week program. Paired t tests were used to examine pre- and postintervention changes in the outcome variables. In total, 162 met the inclusion criteria and 75 (46.3%) consented and were enrolled (mean age 64, SD 10.30 years; male: n=37, 49%; White: n=46, 61%). Heart failure was the most common diagnosis (37/75, 49%). In total, 62/75 (83%) participants completed the 12-week study and used the telehealth modality with 9.63 (SD 3.33) sessions completed, and 59/75 (79%) used the mHealth modality with 10.97 (SD 11.70) sessions completed. Post intervention, 50/62 (81%) participants' performance in the 6-minute walk test had improved, with an average improvement of 40 (SD 63.39) m (95% CI 25.6-57.1). The average 12-Item Short-Form Health Survey's physical and mental summary scores improved by 2.7 (SD 6.47) points (95% CI 1.1-4.3) and 2.2 (SD 9.09) points (95% CI 0.1-4.5), respectively. There were no changes in resting heart rate and no exercise-related adverse events were reported. The RecoveryPlus.Health digital HBCR program showed feasibility and efficacy in a group of nationally recruited patients with CVD. The findings add to the evidence that a telehealth and mHealth dual-modality HBCR program may be a promising approach to overcome some of the main barriers to improving CR access in the United States. ClinicalTrials.gov NCT05804500; https://clinicaltrials.gov/search?cond=NCT05804500.

Health-Related Quality of Life Among Irregular Sub-Saharan Migrants in Northern Morocco.

Due to its geographical proximity to Europe, Morocco experiences a significant influx of migrants from neighboring Sub-Saharan African countries. Attempts to cross the Strait of Gibraltar make Northern Morocco a stopover for Sub-Saharan migrants. However, faced with increasingly restrictive measures from European Union countries, many of these migrants are compelled to turn this transit into a prolonged stay in Morocco, often in irregular status and facing challenging socio-economic conditions that threaten their health and their quality of life-related to health. This study aims to assess the level of health-related quality of life and its determinants among irregular Sub-Saharan migrants in Northern Morocco using the 36-Item Short Form Survey (SF-36) measurement scale. A total of 526 irregular Sub-Saharan migrants residing in the cities of Tangier and Tetouan were recruited using snowball sampling. A socio-demographic information sheet and the SF-36 scale were used to collect data. Subsequently, the data were entered and statistically analyzed using Statistical Product and Service Solutions (SPSS, version 21.0; IBM SPSS Statistics for Windows, Armonk, NY). Numerical variables were summarized as mean ± standard deviation and categorical variables as frequency and percentage. Non-parametric tests, including the Mann-Whitney U test and Kendall's Tau-B, were used to measure the association of physical and mental component scores with sociodemographic variables, for a significance level set at p < 0.05. Multivariate logistic regression was conducted to identify factors determining health-related quality of life, using odds ratios (OR) and a 95% confidence interval (CI) for p < 0.05. Participants were aged between 18 and 50 years, with a mean age of 29.7 ± 7.6 years; 80% were single, and the majority were male (63.7%). In terms of education, 57.2% have a secondary level. The physical (PCS = 46.5 ± 9.03) and mental (MCS = 35.5 ± 9.9) summary scores were low. PCS and MCS were lower among subjects aged ≥ 36 years compared to those aged 18-25 years (p = 0.000). Women had lower PCS than men (p = 0.002). The migrants having more than three years in Morocco had lower MCS compared to those recently settled (p = 0.002). PCS and MCS were lower among participants who were assaulted compared to those who were not (p = 0.000). Multivariate logistic regression results showed that age, type of habitat, and assault significantly affected both PCS and MCS scores. Gender is a significant determinant for PCS and duration of stay in Morocco for MCS. The quality of life of Sub-Saharan irregular migrants appears to be low, particularly concerning the mental health component, highlighting the need for priority interventions in this area to improve their health status.

Relationship between health-related quality of life and swallowing function in community-dwelling independent older adults

The purpose of this study was to examine the relationship between health-related quality of life (QOL) and swallowing function among independent community-dwelling older Japanese adults aged 65 years or older. A total of 500 participants (250 males and 250 females) were surveyed about BMI, dysphagia and eating disorders (Dysphagia Risk Assessment for the Community-dwelling Elderly [DRACE]), quality of life (QOL; SF-8 Physical and Mental Summary Score), sleep (Pittsburgh Sleep Questionnaire Japanese version [PSQI-J]), and depression (Geriatric Depression Scale [GDS]). Participants were divided into two groups based on risk of aspiration and data between the groups were compared. Logistic regression analysis revealed that the SF-8 physical component summary score (PCS) and mental component summary score (MCS) were associated with aspiration risk. In the multiple regression analysis, the SF-8 related to eating and swallowing function and PSQI-J were extracted. The risk of aspiration among the older adults in this study was found to be associated with health-related QOL, sleep quality, revealing a wide-ranging impact on physical, mental, and social functioning. These associated factors may pose a risk for community-dwelling independent older adults, suggesting the need to focus on eating and swallowing function for frailty.

Total hip arthroplasty with porous tantalum trabecular metal pads in patients with Crowe IV developmental dysplasia of the hip: a midterm followup study

PurposeCrowe IV developmental dysplasia of the hip (DDH) is a catastrophic hip disease. Moreover, obtaining ideal clinical efficacy in conventional total hip arthroplasty (THA) is often difficult. In this study, we aimed to assess the mid-term clinical results of THA with porous tantalum trabecular metal (TM) pads for acetabular reconstruction in the treatment of Crowe IV DDH.MethodsA cohort of 28 patients (32 hips) diagnosed with Crowe type IV DDH who underwent acetabular reconstruction during THA using TM pads with scheduled follow-up between 2011 and 2018, were included in this study. Eight cases were men and 24 were women, with a mean age of 48.4 years (range, 36–72 years) and a mean follow-up was 74.3 months (range, 42–132 months). All patients underwent acetabular reconstruction using TM pads and total hip replacement with subtrochanteric osteotomy.ResultsAt the final follow-up, 28 hips (87.5%) demonstrated mild or no postoperative limping. The Harris Hip Score improved from 58.4 ± 10.6 preoperatively to 85.6 ± 8.9. The mean pain, stiffness, and function scores on the Western Ontario and McMaster University Osteoarthritis index were 86.5 ± 10.2, 87.3 ± 12.4 and 85.4 ± 11.6 respectively. The mean score of patient satisfaction was 90.4 ± 7.6. Additionally, the SF-12 physical summary score was 41.8 ± 5.6 and the SF-12 mental summary score was 51.6 ± 5.4. TM construct survivorship due to all-cause failure was 90.6% at 5 years with 3 hips at risk, 87.5% at 10 years with 4 hips at risk. The survivorship due to failure from aseptic loosening was 96.9% at 5 years with 1hips at risk and 93.75% at 10 years with 2 hips at risk.ConclusionThis study demonstrated satisfactory mid-term clinical and radiological results with the application of TM pads for acetabular reconstruction combined with THA in patients with Crowe IV DDH.Trial registration numberChiCTR1800014526, Date: 18/01/2018.

Health-related quality of life and associated factors among primary caregivers of children with cerebral palsy, in Bahir Dar and Gondar cities, Ethiopia, 2022.

Caring for a child with cerebral palsy (CP) could negatively affect the Health-Related Quality of Life (HRQOL) of the mothers who are usually the primary caregivers. To the best of our 'knowledge, there is a dearth of information on the HRQOL of primary caregivers of children with CP in Ethiopia. Therefore, this study aimed to investigate caregivers' HRQOL and factors associated with it in Gondar and Bahir Dar Cities, Northwest Ethiopia, 2022. A community-based cross-sectional study was conducted among primary caregivers of Children with CP from April 20 to June 20, 2022, in Gondar and Bahir Dar cities. Convenience sampling was used to get study participants. Data were collected by trained health extension and community-based rehabilitation workers. The collected data were coded, cleaned, entered into EPI data, and exported to Stata-16 for analysis. A generalized linear model was employed to show the relationship between dependent and independent variables. A P-value≤0.05 was considered statistically significant at a 95% confidence interval. In this study, HRQOL among primary caregivers of children with CP was 28.72(±13.38) and 23.26(±12.37) in the physical summary score (PSC) and mental summary score (MSC) respectively. Age 17-30yeas (p-value = 0.03), unable to read and write (p = 0.01), privately employed (p = 0.01) and government employed (p = 0.02), monthly income<1000 Ethiopian Birr (ETB) (p = 0.01), insufficient sleeping (p = 0.001), others relationship(p = 0.001), have three and above children (p = 0.001), others house composition (p = 0.003), have no helpers (p = 0.001) and third birth order of child (p = 0.03) were all factors associated with HRQOL in PSC. On the other hand, income<1000ETB (p = 0.05), insufficient sleeping (p = 0.001), others in relation to the child (p = 0.001), others in house composition (p = 0.03), dyskinetic CP (p = 0.01) and ataxic CP (p = 0.001) were all factors associated with HRQOL of caregivers in MSC components. The HRQOL among primary caregivers of children with CP in Bahir Dar and Gondar cities was low. Age, monthly income, educational status, sleeping status, relationship and house composition, number of living children, birth order of child, helpers, and type of CP were all significantly associated with HRQOL of primary caregivers of children with CP.

Abstract TMP58: Neuroimaging Markers of Patient-Reported Outcomes in Acute Ischemic Stroke

Objectives: To determine the relationship between patient-reported outcome measures (PROMs) and volumetric biomarkers assessed on clinical imaging in acute ischemic stroke (AIS). Background: AIS is a leading cause of long-term disability. White matter hyperintensity (V_WMH), brain (V_Brain) and stroke lesion volume (V_Lesion) have been linked as potential determinants of functional outcomes after stroke. Recently, there has been surging attention to PROMs, which allow for direct, patient-centered health assessments of stroke victims. However, the link between neuroimaging biomarkers and PROMs is not well studied. Methods: Patients presenting to the Emergency Department at Massachusetts General Hospital between February 2017 and February 2020 with a confirmed AIS on MRI were eligible and underwent a follow-up telephone interview, including PROM-10 questionnaires. V_WMH and V_Brain were automatically determined from clinical MRI. V_Lesion was manually segmented. Regression analyses were performed to identify associations of brain volumetrics and clinical variables with PROM-10 subscores and global mental and physical summary scores. Results: Utilizing data from 150 patients (mean age: 64.7; 41.9% female), higher V_WMH was associated with worse global mental (β = -0.65), global physical (β = -0.60), social activities (OR = 0.59), physical health (OR = 0.68), fatigue (OR = 0.69) and social satisfaction (OR = 0.66) scores. V_Lesions were associated with poorer global mental (β = -0.79), social (OR = 0.55) and physical (OR = 0.66) activities, mental health (OR = 0.68) and emotional distress (OR = 0.68) scores. Higher V_Brain was linked to better global mental (β = 0.93), global physical (β = 0.79), physical activities (OR = 1.72) and mental health (OR = 1.54) scores. Conclusions: Imaging biomarkers were significantly associated with PROMs. The inclusion of these markers with PROMs in routine post-stroke assessment can enhance our understanding of recovery.

Phenomenology and psychiatric correlates of pseudocataplexy.

Pseudocataplexy is a rare functional neurological disorder that mimics cataplexy, pathognomonic for narcolepsy type 1 (NT1). We describe the psychiatric comorbidity and personality traits of patients with pseudocataplexy versus NT1 cases. The case-control observational study enrolled consecutive patients with pseudocataplexy and a control group of age-matched consecutive NT1 patients. The diagnostic work-up included a structured interview, 48-hour polysomnography, multiple sleep latency test, cataplexy provoking test, and hypocretin-1 measurement in cerebrospinal fluid.All participants were administered Beck Depression Inventory, State-Trait Anxiety Inventory, Patient Health Questionnaire-15 (PHQ-15), Personality Inventory for DSM-5 brief form, and quality of life (QoL) measurement by 36-item Short Form health survey (SF-36). Fifteen patients with pseudocataplexy and 30 with NT1 were included. Despite the suspicion of possible cataplexy, none of the pseudocataplexy participants fulfilled international diagnostic criteria for NT1. Pseudocataplexy patients presented higher rates of moderate state anxiety (40% vs. 10%, p=0.018), medium level of somatic symptoms, defined by PHQ-15 score >10 (66.7% vs. 16.7%, p=0.003), and a trend towards moderate-to-severe depressive symptoms (33.3% vs. 10%, p=0.054) compared to NT1. No significant differences in personality traits emerged. Pseudocataplexy patients had worse QoL profile in almost all SF-36 domains including physical (mean±SD: 37.7±9.88 vs. 51.13±7.81, p<0.001) and mental (mean±SD: 33.36±12.69 vs.42.76±11.34, p=0.02) summary scores. Patients with pseudocataplexy present more severe psychiatric symptoms and a lower QoL profile in comparison with patients with NT1. The severe somatoform and affection impairment in pseudocataplexy may explain the poorer QoL and should require a tailored therapeutic approach.

Variations in 1-year Trajectories of Levels of Pain and Capability After Shoulder Arthroplasty Are Associated With Baseline Mental Health.

There is variability in the trajectories of pain intensity and magnitude of incapability after shoulder arthroplasty. A better understanding of the degree to which variation in recovery trajectories relates to aspects of mental health can inform the development of comprehensive biopsychosocial care strategies. (1) Do pain intensities at baseline and the trajectories during recovery differ between groups when stratified by mental health composite summary score, arthroplasty type, and revision surgery? (2) Do magnitudes of capability at baseline and the trajectories during recovery differ between these groups? We used a registry of 755 patients who underwent shoulder arthroplasty by a single surgeon at a specialized urban orthopaedic hospital that recorded the mental component summary (MCS) score of the Veterans RAND 12, a measure of shoulder-specific comfort and capability (American Shoulder and Elbow Surgeons [ASES] score, which ranges from 0 to 100 points, with a score of 0 indicating worse capability and pain and 100 indicating better capability and pain and a minimum clinically important difference of 6.4), and the VAS for pain intensity (range 0 [representing no pain] to 10 [representing the worst pain possible], with a minimum clinically important difference of 1.4) preoperatively, 2 weeks postoperatively, and 6 weeks, 3 months, 6 months, and 1 year after surgery. Forty-nine percent (368 of 755) of the patients were men, with a mean age of 68 ± 8 years, and 77% (585) were treated with reverse total shoulder arthroplasty (rTSA). Unconditional linear and quadratic growth models were generated to identify the general shape of recovery for both outcomes (linear versus quadratic). We then constructed conditional growth models and curves for pain intensity and the magnitude of capability showing mean baseline scores and the rates of recovery that determine the trajectory, accounting for mental health (MCS) quartiles, primary or revision arthroplasty, and TSA or reverse TSA in separate models. Because pain intensity and capability showed quadratic trends, we created trajectories using the square of time. Patients in the worst two MCS quartiles had greater pain intensity at baseline than patients in the best quartile (difference in baseline for bottom quartile: 0.93 [95% CI 0.72 to 1.1]; p < 0.01; difference in baseline for next-worst quartile: 0.36 [95% CI 0.16 to 0.57]; p < 0.01). The rates of change in recovery from pain intensity were not different among groups (p > 0.10). Patients with revision surgery had greater baseline pain (difference: 1.1 [95% CI 0.7 to 1.5]; p < 0.01) but no difference in rates of recovery (difference: 0.031 [95% CI 0.035 to 0.097]; p = 0.36). There were no differences in baseline pain intensity and rates of recovery between patients with reverse TSA and those with TSA (baseline pain difference: -0.20 [95% CI -0.38 to -0.03]; p = 0.18; difference in rate of recovery: -0.005 [95% CI -0.035 to 0.025]; p = 0.74). Patients in the worst two MCS quartiles had worse baseline capability than patients in the best quartile (difference in baseline for bottom quartile: -8.9 [95% CI -10 to -7.4]; p < 0.001; difference in baseline for the next-worst quartile: -4.9 [95% CI -6.4 to -3.4]; p < 0.01), with no differences in rates of recovery (p > 0.10). Patients with revision surgery had lower baseline capability (difference in baseline: -13 [95% CI -15 to -9.7]; p < 0.01), with a slower rate of recovery (difference in rate of recovery: -0.56 [95% CI -1.0 to -0.079]; p = 0.021). There were no differences in baseline capability or rates of recovery between TSA and reverse TSA. The observation that preoperative and 1-year comfort and capability are associated with mental health factors and with similar recovery trajectories reminds us that assessment and treatment of mental health is best considered an integral aspect of musculoskeletal care. Future studies can address how prioritization of mental health in musculoskeletal care strategies might reduce variation in the 1-year outcomes of discretionary surgeries such as shoulder arthroplasty. Level III, therapeutic study.

Health-related quality of life after first venous thromboembolism in individuals aged 70 years and older

BackgroundThere is limited information on short- and long-term effects of venous thromboembolism (VTE) on health-related quality of life (HRQoL) in the elderly. ObjectivesTo assess change in generic HRQoL and disease-specific HRQoL in patients 1 year after the VTE. MethodsThe Age and Thrombosis, Acquired and Genetic risk factors in the elderly (AT-AGE) study is a 2-center case-control study performed in Leiden, the Netherlands, and Vermont, United States, among individuals aged ≥70 years. We measured generic HRQoL using the 36-item Short Form Health Survey (SF-36) and disease-specific HRQoL using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms Questionnaire (VEINES-QoL/Sym) and the Pulmonary Embolism–Specific Quality of Life Questionnaire (PEmb-QoL). All patients completed these questionnaires shortly after their VTE and 1 year later, while controls completed the 36-item Short Form Health Survey questionnaire once. Linear regression for change in quality of life scores was performed and adjusted for potential confounders. ResultsFor the current analysis, we included patients who were visited twice (n = 316) and controls (n = 427) with HRQoL information. Mean age of patients and controls was similar (78.8 vs 75.5 years). In patients who survived at least 1 year after the VTE, generic HRQoL improved for both summary scores, but it did not reach the level of the age-matched controls: physical and mental summary scores increased by 5.6 and 5.5 points, respectively, but compared with controls, remained 8.2 and 6.4 points lower. For disease-specific HRQoL, the Pulmonary Embolism–Specific Quality of Life Questionnaire overall score decreased from 21.7% to 15.2%, indicating improved HRQoL. Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms Questionnaire scores did not change over time. ConclusionOverall, the quality of life of patients with VTE was worse than that of controls after 1 year, indicating a long-term impact of VTE diagnosis in the elderly.

Prospective cohort study investigating quality of life outcomes following multi-speciality robotic-assisted surgery.

Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities. A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes. Mixed-effects linear regressions were used to determine changes in QoL trajectories. Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks' post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS. RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.

PHQ-9, CES-D, health insurance data—who is identified with depression? A Population-based study in persons with diabetes

AimsSeveral instruments are used to identify depression among patients with diabetes and have been compared for their test criteria, but, not for the overlaps and differences, for example, in the sociodemographic and clinical characteristics of the individuals identified with different instruments.MethodsWe conducted a cross-sectional survey among a random sample of a statutory health insurance (SHI) (n = 1,579) with diabetes and linked it with longitudinal SHI data. Depression symptoms were identified using either the Centre for Epidemiological Studies Depression (CES-D) scale or the Patient Health Questionnaire-9 (PHQ-9), and a depressive disorder was identified with a diagnosis in SHI data, resulting in 8 possible groups. Groups were compared using a multinomial logistic model.ResultsIn total 33·0% of our analysis sample were identified with depression by at least one method. 5·0% were identified with depression by all methods. Multinomial logistic analysis showed that identification through SHI data only compared to the group with no depression was associated with gender (women). Identification through at least SHI data was associated with taking antidepressants and previous depression. Health related quality of life, especially the mental summary score was associated with depression but not when identified through SHI data only.ConclusionThe methods overlapped less than expected. We did not find a clear pattern between methods used and characteristics of individuals identified. However, we found first indications that the choice of method is related to specific underlying characteristics in the identified population. These findings need to be confirmed by further studies with larger study samples.

Physical function, nutritional status, and quality of life before and after chemotherapy in patients with malignant lymphoma.

This study investigates the efficacy of and gender differences in exercise therapy in patients with malignant lymphoma undergoing chemotherapy. Twenty-six patients (13 men, 13 women) received physical therapy (based on the Borg Scale 13) during hospitalization. Physical function was measured using grip and knee extension strength, 6-minute walking distance, and body composition; nutritional status assessed via Mini Nutritional Assessment (MNA®); and serum albumin levels analyzed. Fatigue was evaluated using the Brief Fatigue Inventory, and health-related quality of life was assessed with the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36v2). The analysis of all patients indicated that the right grip strength, skeletal muscle mass, skeletal muscle index, and leg muscle mass significantly decreased, whereas the serum albumin level, MNA® score, and scores of many items of the SF-36v2 significantly increased after chemotherapy. In a gender-specific analysis, only men showed significant declines in the skeletal muscle mass and skeletal muscle index, and improvement in the MNA® score after chemotherapy. In the SF-36v2, there were significant improvements in general health and physical component summary scores among men, and general health and mental component summary scores among women. Exercise therapy at a Borg Scale intensity of 13 may not prevent muscle mass decline in patients with malignant lymphoma, especially male patients. In addition, this study revealed that there is a gender difference in the effect of exercise therapy on quality of life. Thus, gender should be considered in exercise therapy for patients with malignant lymphoma.

Quality of Life in Patients After Stroke

Abstract The goal of all medical treatments is a better quality of life for patients. Post-stroke rehabilitation is a long process with uncertain result. The aim of this study was to explore the factors which affect the quality of life of patients recovering from a cerebrovascular disease. This is a prospective study evaluating the quality of life of one hundred patients one month and six months after a stroke, and patients also answered questions retrospectively, of how they felt before the stroke. As assessment tools we used a questionnaire on general and clinical data and Medical Outcomes Study Short Form (SF-36) questionnaire. Physical functioning and Physical role domains of SF-36 show significant differences in both measured periods (p&lt;0.001). Emotional role, Social functioning, Mental health, Vitality and General health domains show a statistically significant change during first six months, while Bodily pain domain did not change (p&gt;0.05). Physical summary score has changed significantly during 6 months (p &lt;0.001). Mental summary score showed no significant difference in both periods (p &lt;0.687; p &lt;0.958). The brain localization is important factor (p&lt;0.0002). Gender, age, education, employment status and previous strokes did not have a statistically significant influence (p&gt; 0.05). Post-stroke physical impairment is not always accompanied by emotional impairment. Emotional functioning impairments generally return to the premorbid level during the period of six months, while physical impairments continue to occur. Further research is needed for better understanding of these relationships.

Longitudinal changes in mental health outcomes after COVID-19 hospitalization: A prospective study

BackgroundThe long-term trends of COVID-19 mental sequelae remain unknown. Thus, this study aimed to survey the one-year temporal trends of PTSD and health-related quality of life of COVID-19 survivors. MethodsPatients hospitalized with COVID-19 were followed up at three, six, and 12 months after discharge. Patients with COVID-19 who were able to communicate and complete the questionnaires were included in the study. All participants were asked to complete the Medical Outcomes Study 36-Item Short-Form Health (SF-36) survey and the Impact of Event Scale-Revised (IES-R). The cutoff point of 24/25 of IES-R was defined as preliminary PTSD. Patients exhibiting PTSD symptoms at six months or later were regarded as “delayed patients,” while those exhibiting PTSD symptoms at all the time points were “persistent patients.” ResultsOf the 98 patients screened between June and November 2020, 72 participated in the study. A total of 11 (15.3%) had preliminary PTSD at three months, 10 (13.9%) at six months, and 10 (13.9%) at 12 months; delayed and persistent patients were four patients (7.54%) each. Patients with preliminary PTSD had lower mental summary scores in SF-36; 47 (IQR 45, 53) for patients with preliminary PTSD and 60 (49, 64) without preliminary PTSD at three months, 50 (45, 51) and 58 (52, 64) at six months, and 46 (38, 52) and 59 (52, 64) at 12 months. ConclusionHealthcare providers should care about the courses of PTSD in COVID-19 survivors and be aware that patients with PTSD symptoms may have a lower health-related quality of life.

The Spanish Version of the International Index of Erectile Function: Adaptation and Validation.

The International Index of Erectile Function (IIEF) is a widely employed questionnaire in urology to assess erectile dysfunction (ED) in both clinical research and practice. To translate and culturally adapt the Spanish version of the International Index of Erectile Function (IIEF) and to analyze its psychometric properties in Spanish men with erectile dysfunction (ED). Firstly, direct and reverse translations were performed. Secondly, a pilot study was carried out on 23 patients with the lowest possible education level without being illiterate. Finally, 170 participants completed the IIEF. Test-retest reliability, internal consistency and construct validity (exploratory factor analysis) were assessed. Concurrent and divergent validity were evaluated with the Hospital Anxiety and Depression Scale (HADS) and the 12-item Short-Form Health Survey (SF-12), respectively. Discriminant validity (with and without anxiety or depression) was calculated using a receiver-operating characteristic curve analysis. High internal consistency (Cronbach's alpha = 0.968, total score) and moderate-to-excellent test-retest reliability were found. The factor analysis showed a two-factor structure (explained variance of 77.34%). Significant correlations of the IIEF total score (p < 0.01) and domains (p < 0.05) with HADS anxiety and depression scores were observed (concurrent validity), while non-significant correlations with SF-12 physical and mental summary scores were found (divergent validity). The IIEF total score could discriminate between participants with and without anxiety (p < 0.05) and depression (p < 0.01), with an optimal cut-off point of <39.50 for both anxiety (48.30% sensitivity and 78.75% specificity) and depression (50.00% sensitivity and 81.01% specificity). The psychometric properties of the IIEF have not been analyzed in Spanish people to date. Strengths and Limitations: The Spanish version of the IIEF was shown to be capable of discriminating between men with erectile dysfunction with and without depression or anxiety. There are some limitations to this study that should be noted. It was conducted on Spanish participants, and, thus, it should be employed with caution in other Spanish-speaking countries. This study was carried out on a selected population, and, therefore, the generalizability of its results to other populations might be limited. Moreover, a large majority of the participants (89.41%) had secondary or higher education. Future studies should be performed on a more general population with a varied geographical and educational background. The Spanish IIEF is a valid and reliable instrument for assessing erectile function among Spanish men with ED.

Sleep quality and predictors of optimal sleep in patients with rheumatoid arthritis: data from a recent-onset cohort.

Sleep disorders are part of the symptomatology of rheumatoid arthritis (RA) patients and are related to disease characteristics and comorbidities. The study describes sleep quality among RA patients and identifies predictors of optimal sleep. Patients whose data were analysed were identified from the recent-onset RA cohort initiated in 2004. In 2010, the Medical Outcome Study Sleep Scale (MOS-SS) was incorporated into the patients' assessments. Up to December 2019, the cohort comprised 187 patients with at least one MOS-SS application (in 78 patients at cohort entry) and six months of outcomes behaviour (cumulative) previous to the MOS-SS application: DAS28-ESR, pain-VAS, fatigue, HAQ-DI, SF-36, treatment (corticosteroids, DMARDs/patient and adherence), Charlson score, and major depressive episodes. A trained data abstractor retrospectively reviewed their charts. Multiple logistic regression analysis estimated odds ratios (95% confidence interval) to define baseline and cumulative variables predictive of optimal sleep (dichotomised variable derived from the quantity of sleep dimension of the MOS-SS). At the first MOS-SS application, patients were primarily middle-aged women with short disease duration and low disease activity. They scored higher on the "snoring" and "sleep non-adequacy" MOS-SS dimensions. There were 96 patients (51.3%) with optimal sleep. Lower baseline BMI, better baseline fatigue score, longer follow-up at the clinic, and better SF-36 physical summary score were predictors of optimal sleep (mental summary score also remained in the model when switched to the physical summary score). Optimal sleep is achieved by half of the RA patients and predicted by BMI, patient-reported outcomes, and follow-up.

Validation of the Japanese version of the Body Image Scale for bladder cancer patients

The Body Image Scale (BIS) is a 10-item tool that measures the body images of cancer patients. This study aims to validate the Japanese version of the BIS for bladder cancer patients. A multicenter cross-sectional survey was used to identify the participants, which included Japanese bladder cancer patients. The percentage of missing responses, internal consistency, and known-group validity were evaluated. The correlations between the BIS and two HRQOL instruments (the Bladder Cancer Index and the SF-12) were assessed to determine convergent validity. Among 397 patients, 221 patients were treated by transurethral resection of bladder tumor (TURBT) endoscopically, 49 patients underwent cystectomy with neobladder, and 127 patients underwent cystectomy involving stoma. The percentage of missing responses in the BIS ranged from 8.1 to 15.6%. Cronbach's α coefficient was 0.924. Higher BIS scores indicate negative body image, and the median BIS score for patients with native bladders after TURBT (0.5) was significantly lower than those of the patients with neobladder (4.0) and stoma formation (7.0), which indicated the discriminatory ability of the BIS. Each domain of the Bladder Cancer Index and the role summary score of the SF-12 correlated to the BIS scores, which confirmed the convergent validity. A range of BIS scores were identified among patients who reported similar physical summary scores and mental summary scores of the SF-12. This study confirmed the reliability and validity of the Japanese version of the BIS for bladder cancer patients.

Changes in health status and health related quality of life from six months to five years in out-of-hospital cardiac arrest survivors – A NORCAST sub study

BackgroundBrain injury in out-of-hospital cardiac arrest (OHCA) survivors affects health status and health-related quality of life (HRQoL). It is unknown how HRQoL evolves over time, and assessments at different time points may lead to different results. MethodsIn a NORCAST sub study, OHCA survivors eligible for health status (EQ-5D-3L) and HRQoL (SF-36) assessments were examinated six months and five years after OHCA. At five-year follow-up, survivors also retrospectively assessed their health status for each consecutive year following OHCA. The next of kin independently assessed health status and HRQoL of their respective OHCA survivors. ResultsAmong 138 survivors alive after six months and 117 after five years, 80 (88% male) completed both follow-ups. Health status and HRQoL remained stable over time, except for increasing SF-36 mental summary score and decreasing physical functioning and physical component score. Anxiety and depression levels were generally low, although younger survivors stated more anxiety than older survivors. Retrospective assessment showed reduced health status for the first two years, which increased only from the third year. Explorative analyses revealed that younger age, longer time to return of spontaneous circulation (tROSC) and late awakening affected health status, particularly in the first two years post-arrest. ConclusionsOHCA survivors showed stable health status and HRQoL with only minor differences between six months and five years. Younger survivors with long tROSC, late awakening, and more anxiety and depression symptoms at six months, had reduced health status the first two years with significant improvements towards the fourth year.

Effects of total diet replacement programs on mental well-being: A systematic review with meta-analyses.

This systematic review with meta-analyses assessed the effects of total diet replacement (TDR) programs on mental well-being in clinical trial participants with a body mass index greater than or equal to 25 kg/m2 . TDR programs involve replacing all dietary requirements with nutritionally replete formula foods and are generally administered to induce rapid weight loss. To date, it is largely unclear what effects TDR programs may have on mental well-being, particularly in the long-term. To address this, we screened 25,976 references across six databases and extracted 35 publications. These 35 publications provided sufficient data to evaluate the effects of TDR programs on depression, anxiety, stress, positive affect, negative affect, vitality, role-emotional, social functioning, mental health, mental composite summary score, self-esteem, and general psychological health in 24 meta-analyses. Due to the lack of research comparing TDR programs to comparator groups, 22 of our 24 meta-analyses explored change in these mental well-being sub-domains over time in TDR programs without comparators. Specifically, we assessed the change from pre-diet (before the TDR program) to either post-diet (up to and including two months after the TDR program); and/or follow-up (more than two months after the TDR program). For depression and anxiety, we were also able to assess the change from pre-diet to mid-diet (which fell within two weeks of the diet half-way point). The remaining two meta-analyses assessed the difference in depression scores between a TDR group and a food-based comparator group from pre-diet to post-diet and from pre-diet to follow-up. Across all meta-analyses, our results found no marked adverse effects of TDR programs on any mental well-being sub-domain. In fact, clear improvements were observed for depression, anxiety, stress, vitality, role-emotional, and social functioning at post-diet. Interestingly, the improvements for depression, vitality and role-emotional were maintained at follow-up. All improvements were observed in meta-analyses without comparators. While the two comparator-based meta-analyses showed no difference between TDR programs and food-based diets in depression symptoms, there was low statistical power. For all meta-analyses containing three or more independent samples, we constructed prediction intervals to determine the range within which the mean of the true effects may fall for future populations. While these prediction intervals varied between sub-domains, we found that mean depression scores are only likely to increase (i.e., depression will worsen) in less than 3% of future TDR interventions which meet our inclusion/exclusion criteria. Taken together, we concluded that for adults with a body mass index greater than or equal to 25 kg/m2 , TDR programs are unlikely to lead to marked adverse effects on mental well-being. These findings do not support the exclusion of participants from trials or interventions involving TDR programs based on concerns that these programs may adversely affect mental well-being. In fact, by excluding these participants, they may be prevented from improving their metabolic health and mental well-being.

Abstract 1997: Health-related quality of life at diagnosis in survivors of adolescent and young adult cancer

Abstract Purpose: Data are lacking on the distribution, factors associated with, and long-term impact of diminished health-related quality of life (HRQoL) at diagnosis in adolescent and young adult (AYA) cancer survivors (≥2 years post cancer diagnosis). Our goal was to fill this gap in knowledge. Methods: A cohort of AYA (15y - 39y) cancer patients treated at MD Anderson between 2000-2016 who had survived at least 2 y was identified from our Institutional Tumor Registry. HRQoL was assessed at diagnosis with the SF12v1 questionnaire. Demographic and behavioral risk factors, tumor type, and vital status were ascertained. Physical composite summary (PCS) and mental composite summary (MCS) scores were generated from SF12 responses following mean-based normalization; PCS or MCS &amp;lt; 50 indicated “poor” HRQoL. Statistical tests included ANOVA, quantile regression, and multivariable Cox proportional hazards. Results: 2,609 AYA cancer survivors (75% diagnosed between age of 26-39 y; 67% White, 18% Hispanic and 9% Black) were included. Breast cancer was the most frequent diagnosis (25%), followed by sarcoma (12%) and Hodgkin lymphoma (10%). Median follow-up for participants was 10.5 y. Overall mean PCS and MCS scores at diagnosis were 45.3 (SD: 11.4) and 47.0 (SD: 10.5), respectively. Female AYA cancer patients had significantly higher PCS, yet lower MCS compared to their male counterparts (both P&amp;lt;0.001). A positive association between age at diagnosis and PCS was observed (P&amp;lt;0.001), in contrast to the inverse association with MCS (P&amp;lt;0.001). Differences in PCS (P&amp;lt;0.001) and MCS (P=0.001) were also evident by tumor type. For example, women with breast cancer reported the most favorable PCS (51.5) at diagnosis, yet among the lowest MCS (46.1) of the nine tumor types analyzed. The Black AYA population had a larger burden of poor PCS at diagnosis with 61% of patients reporting scores &amp;lt;50 compared to 55% of Hispanic and 51% of non-Hispanic whites. Significant predictors of diminished PCS in AYA cancer survivors in the bottom 25% of PCS scores were younger age at diagnosis (P=0.003), male gender (P&amp;lt;0.001), diagnosis of a hematologic malignancy versus solid tumor (P&amp;lt;0.001), smoking (P=0.003) and not consuming any alcohol currently (P&amp;lt;0.001). Overall, low PCS (&amp;lt;50) at diagnosis (HR=1.57, P&amp;lt;0.001), and diagnosis of a solid tumor compared to a hematologic malignancy (HR=2.33, P&amp;lt;0.001) were associated with lower survival. Conclusions: In this large, diverse AYA cancer survivor cohort, physical and mental HRQoL at diagnosis were impacted by AYA’s age at diagnosis, gender, tumor type, and smoking status. Low PCS at diagnosis was an independent predictor of diminished survival among AYA cancer survivors ≥2y post diagnosis. Our findings suggest that patient-reported poor physical well-being at diagnosis is a biomarker of poor prognosis for AYA cancers. Further studies are needed to identify interventions to improve outcomes for this population. Citation Format: Goldy C. George, Clark R. Andersen, Xiaohui Tang, John A. Livingston, Michael E. Roth, Michelle A. Hildebrandt. Health-related quality of life at diagnosis in survivors of adolescent and young adult cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1997.