Physical Aspects Of Quality Of Life Research Articles

The effectiveness of art-based interventions for cancer patients: A systematic review and meta-analysis.

This study aimed to examine the effectiveness of art-based interventions on anxiety, depression, fatigue, and overall quality of life (QoL), including its physical, psychological, and social dimensions in cancer patients. The literature search included all studies published up to March 2024. Searches were conducted in the MEDLINE, Web of Science, EBSCO, and PubMed databases considering the updated Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The quality of the studies was assessed using the Revised Cochrane Risk of Bias Tool (RoB 2) and the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) developed by the Cochrane Collaboration. Data were analysed using the MAJOR package in JAMOVI 2.3.28. Fifteen studies conducted with 1113 cancer patients were identified and included in this study. Ten of the studies included women with breast cancer. The remaining studies involved chemotherapy patients with various cancers (n=3), cancer patients in a blood and marrow transplantation unit (n=1), and nasopharyngeal cancer patients (n=1). Meta-analysis indicated that art-based interventions had a significant effect on anxiety, depression and physical aspects of QoL but no significant impact on fatigue, overall QoL, or the psychological and social dimensions of QoL. This study provided clinical support for pursuing art-based research on anxiety, depression, and the physical QoL in cancer patients. However, the effect of art-based interventions on cancer patients' fatigue and their overall QoL, including its social and psychological dimensions, was insignificant. The study protocol was registered in advance in the PROSPERO (CRD42024531397/April 13, 2024).

Who gains the most quality-of-life benefits from metabolic and bariatric surgery: findings from the prospective REBORN cohort study

Prioritizing patients for metabolic and bariatric surgery (MBS) based on their potential postoperative benefits is essential. To examine changes in quality of life (QoL) during the initial postoperative year among patients with diverse eligibility statuses and determine which group experiences greater benefits. Center intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de- Montréal (CIUSSS-NIM), Canada. We categorized patients into 3 groups based on obesity class and the presence of comorbidities: Group 1 (obesity class II without comorbidities, n = 28); Group 2 (obesity class II with comorbidities, n = 36); and Group 3 (obesity class III, n = 460). QoL (Short-Form QoL questionnaire [SF-12]) and anthropometrics were measured at 6 months before, and 6 and 12 months after surgery. Repeated measures mixed models revealed a significant main effect of time (P < .001) and an interaction between time and group for the physical component of QoL (P = .007). These indicated consistent improvements across time in all groups, with the greatest benefits seen in Group 3 relative to Group 1. There were no interactions between time and group for the mental components of QoL (P= .402). There were significant interaction effects for weight and BMI (P's < .001), with Group 3 losing more weight than Groups 1 or2. All groups that underwent MBS had improvements in the physical aspects of QoL and weight over time, even those who have traditionally not be considered eligible for MBS (i.e., Group 1). This provides a starting point to explore the importance of not excluding patients due to their weight and comorbidity status and setting comprehensive eligibility criteria encompassing all patients who might benefit from MBS, beyond just weight loss.

Gender Differences in Psycho-Emotional State and Quality of Life in Patients 3 Months after Pneumonia COVID-19

Background: there is the different susceptibility to viral infections, course of the disease, reaction to stress and quality of life (QoL) in men and women. The aim of this study is to identify the psycho-emotional state and QoL characteristics of women and men in 3 months after COVID-19 pneumonia. Patients and methods: during the cross-sectional study within the framework of the prospective cohort study “Prospective follow-up of patients after COVID-19-associated pneumonia”, 133 patients (54.1% women; mean age 54 ± 9 years) were examined by experimental psychological method (PHQ-9, GAD-7, PSS-10, SF-36). The mental health was assessed by a psychiatrist, the cardiovascular system — by a cardiologist. Results: women were more likely to have psychoemotional disorders (p = 0.011) and symptoms of depression (p = 0.030). All indicators of QoL were higher among men. In women, a decrease in the scores on the vital activity scale increased the frequency of detecting signs of anxiety, depression (p = 0.004) and stress, an increase in the values on the social functioning scale showed an association with severe lung damage in the acute period of the disease (p = 0.024). In men, a decrease in pain intensity indicators is associated with the detection of mental disorders (p = 0.039) and the appointment of psychotropic therapy (p = 0.005). The severity of stress was observed with a decrease in values on all scales of the QoL questionnaire. The older age of the examined was determined with a decrease in the indicators of the physical component of health (p = 0.006) and other physical aspects of QoL. Conclusion: the mental state differs significantly in men and women 3 months after COVID-19 pneumonia. QoL of both sexes is associated with stress. In women, QoL depends on the mental state, in men depends on physical well-being. The results obtained can be applied in the planning of rehabilitation measures taking into account gender characteristics.

Quality of life of individuals with serious mental illness and family caregivers

The well-being and satisfaction of individuals with serious mental illnesses (SMI) and their family caregivers are less than desirable. Research on the quality of life (QoL) of individuals with SMI and their caregivers, including disorders other than schizophrenia, is limited. Thus, this study aimed to investigate the self-perception of QoL in patients with SMI and their family caregivers and the associated factors. This cross-sectional study was conducted in patients with SMI and their caregivers who completed self-assessment instruments to determine their QoL. Social support and burden in caregivers and symptomatology levels in individuals with SMI were assessed. The physical aspect of QoL in individuals with SMI was associated with employment status and symptom severity. The physical component of caregivers’ QoL was associated with kinship relationship, the presence of other family members with disabilities, social support, and age. The mental component was associated with global symptomatology and the diagnosis of major depression in individuals with SMI and caregiver burden in family members. In conclusion, these findings on correlated factors of QoL in individuals with SMI and their caregivers could be used in developing therapeutic interventions for mental health.Plain summaryA significant number of people with serious mental health problems and their families often endure poor quality of life. However, research on how these individuals truly feel about their lives is limited. This study aimed to explore the perceptions of quality of life among individuals with serious mental health issues and their family caregivers in Spain. We sought to understand the personal sentiments of these individuals and their caregivers regarding their quality of life and the factors that influence it. Our findings indicate that job status, symptoms of the illness, and family relationships play crucial roles in how these individuals view their quality of life. Additionally, caregivers' age, support they receive, and the challenges they face in their families can influence their feelings. This implies that, to enhance their lives, it is crucial to consider these factors and provide appropriate support.

Predictors of Changes in Quality of Life of Patients with Major Depressive Disorder-A Prospective Naturalistic 3-Month Follow-Up Study.

Major depressive disorder (MDD) is one of the leading causes of disease burden worldwide and affected patients frequently report impairments in quality of life (QoL). Therefore, the present research aimed to identify predictors of domain-specific QoL changes in MDD patients following the acute phase of pharmacological treatment (3-month). This study is a prospective, naturalistic, and observational analysis on 150 patients. Depressive symptoms, QoL, overall pain intensity, and functionality were assessed using Hamilton Depression Rating Scale, World Health Organization Quality of Life scale-abbreviated version, Visual Analog Scale, and Sheehan Disability Scale, respectively. Reductions in symptom severity and disability were predictors of improvement across all domains of QoL. Pain intensity reduction was a predictor of increases in the physical aspect of QoL. A reduced number of psychiatric hospitalizations and being in a relationship predicted an improvement of QoL in the psychological domain whereas a positive history of suicidal attempts was associated with better social relationships QoL. The predictive models explained 41.2% and 54.7% of the variance in psychological and physical health domains of QoL, respectively. Awareness of sociodemographic and changes in clinical factors that impact the change in domain-specific QoL might help in shaping personalized treatment.

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.

The Impact of the Environment on the Quality of Life and the Mediating Effects of Sleep and Stress

(1) Background: Environment is an independent factor that affects one’s quality of life (QoL), where studies suggest that health behaviours also affect one’s quality of life. The purpose of the present study was to examine the association between environmental conditions and QoL and how individual health behaviours affect this association. (2) Methods: Participants aged 20 or above were recruited from 11 tertiary planning units in the central part of Kowloon. These tertiary planning units were selected as they represented the overall living environment in Hong Kong, with a mix of the poorer urban areas alongside relatively affluent districts. A mediation analysis was implemented using multiple linear regressions to examine the effects of environmental conditions on QoL. (3) Results: Of the 607 eligible participants included for analysis, 390 were female and 217 were male, with a mean age of 47.4 years. Living within 500 m of a green space area had benefits on the physical aspect of QoL and physical activity but no effect on the psychological aspect of QoL. Moderate satisfaction with public spaces affected QoL positively. In contrast, less satisfaction with public spaces affected QoL negatively in both physical and psychological aspects through the mediating effect of stress. Poor environmental quality affected all domains of QoL negatively through the mediating effects of increased stress and poor sleep. (4) Conclusions: Environment is an important factor that affects individuals’ overall well-being. The interaction between environmental conditions and individual variables, especially perceived stress and sleep, is extremely important when assessing its impact on QoL. The findings of this study support the importance of individual stress and sleep in mediating the relationship between the environment and QoL for health. Further studies should be conducted to include objective measurements, such as those of cortisol levels for stress and physical fitness tests.

Results of a three-year follow-up and quality of life dynamics after pulmonary thromboendarterectomy

Aim. To evaluate the results of a three-year follow-up of patients with chronic thromboembolic pulmonary hypertension (CTEPH) and quality of life (QOL) dynamics after pulmonary thromboendarterectomy (PTE).Material and methods. The study included 125 patients with CTEPH aged 49,7± 11,9 years. Three-year follow-up included the recording of adverse cardiovascular events, surgeries, death during the period from the end of hospitalization and up to three years. The SF-36 questionnaire was used to assess physical and mental wellbeing before and three years after PTE. Multivariate linear regression was used to assess the factors affecting QOL in the long-term postoperative period.Results. During a three-year follow-up, adverse cardiovascular events was recorded in 1,9% of patients. One patient underwent coronary artery bypass graft surgery and one patient — cholecystectomy. Reoperative PTE was not carried out. The overall three-year survival rate was 90,4%.At baseline, patients with CTEPH had a low level of physical and mental well-being (&lt;40 points). Three years after the operation, these parameters significantly increased (p&lt;0,05), but did not exceed 50 points. Multivariate linear regression revealed an unfavorable effect of early postoperative residual pulmonary hypertension on the physical health three years after PTE. Other factors (age, sex, body weight, comorbidity, hospital acquired complications) did not affect the physical and emotional aspects of QOL.Conclusion. Three-year survival rate in patients with CTEPH after PTE was 90,4%. During the follow-up period, no recurrent thromboembolic events were recorded. Adverse cardiovascular events were recorded in 1,9% of patients. Three years after surgery, the physical and mental health increased in comparison with preoperative values, but did not exceed 50 points on the SF-36 questionnaire. The physical aspect of QOL after surgery is affected by early postoperative residual pulmonary hypertension.

Replacing sedentary time with physical activity and sleep: associations with quality of life in kidney cancer survivors.

Kidney cancer survivors spend large quantities of time sedentary and little time physically active, which negatively impacts quality of life (QoL). This study examined (1) the association of reallocating sedentary time to sleep, light physical activity (PA), or moderate-to-vigorous PA (MVPA) on QoL in kidney cancer survivors and (2) the threshold at which results are clinically meaningful. Kidney cancer survivors (N = 463) completed a survey including the Godin Leisure-Time Exercise Questionnaire, sitting time, sleep duration, and Functional Assessment of Cancer Therapy (FACT) scales. Isotemporal substitution analyses estimated associations of reallocating sedentary time to PA and sleep on QoL. Reallocating 10min/day of sedentary time to MVPA was significantly associated with higher scores on the Trial Outcome Index-Fatigue (B = 0.60, SE = 0.25, p = 0.02), FACT-Fatigue (B = 0.71, SE = 0.32, p = 0.03), functional well-being (B = 0.18, SE = 0.08, p = 0.02), and fatigue subscales (B = 0.35, SE = 0.15, p = 0.02). Reallocating sedentary time to sleep was significantly associated with higher FACT-General (B = 0.15, SE = 0.08, p = 0.04) and functional well-being subscale (B = 0.06, SE = 0.03, p = 0.049) scores. Reallocating sedentary time to light PA was significantly associated with higher fatigue subscale scores (B = 0.46, SE = 0.23, p = 0.045). Kidney cancer survivors would need to reallocate a minimum of about 83, 200, and 65min/day of MVPA, sleep, and light PA, respectively, for associations to be clinically meaningful. Reallocating sedentary time to MVPA, light PA, or sleep at higher doses is associated with better fatigue and physical aspects of QoL. Interventions should consider replacing sedentary time with MVPA or light PA in a gradual manner, and improve sleep quality for kidney cancer survivors.

Association between dyadic interventions and outcomes in cancer patients: a meta-analysis.

Patient-caregiver dyadic interventions are when "interventions are offered to cancer patients and their family caregivers together as the unit of care." The purpose of the present study was to determine the association of dyadic intervention for cancer patients and their family caregivers with quality of life (QOL), and other outcomes for people with cancer. Literature searches were conducted using the electronic databases to identify all randomized clinical trials on cancer patient-caregiver dyads. Meta-analysis was used to analyze data. Twenty-three RCTs provided data on 2317 patient-caregiver dyads. In the meta-analysis, at the 0- to 3-month follow-up, dyadic intervention was associated with statistically and clinically significant improvements in patient total QOL (standardized mean difference [SMD], 0.25; 95% confidence interval [CI], 0.01-0.50); the total spiritual aspect of QOL (SMD, 0.28; 95% CI, 0.06-0.50); the emotional (SMD, 0.16; 95% CI, 0.02-0.29), social (SMD, 0.21; 95% CI, 0.07-0.36), and mental (SMD, 0.26; 95% CI, 0.07-0.46) aspects of QOL; depression (SMD, - 0.35; 95% CI, - 0.65 to - 0.05); anxiety (SMD, - 0.42; 95% CI, - 0.70 to - 0.13); relatedness (SMD, 0.18; 95% CI, 0.04-0.32); and marital functioning (SMD, 1.01; 95% CI, 0.05-1.97). At the 3.1- to 6-month follow-up, dyadic intervention was associated with significant improvements in patient social aspect (SMD, 0.19; 95% CI, 0.03-0.35) and depression (SMD, - 0.29; 95% CI, - 0.56 to - 0.03). There was no association between dyadic interventions and the patient functional and physical aspects of QOL. Dyadic intervention was associated consistently with no improvements in hopelessness, pain, fatigue, and survival. In this review, dyadic interventions for caregivers and cancer patients were associated with improvements in multiple psychosocial aspects of patient outcomes.

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

4-Year Changes in Sex Hormones, Sexual Functioning, and Psychosocial Status in Women Who Underwent Bariatric Surgery.

Initial weight loss after bariatric surgery has been associated with improvements in reproductive hormones and sexual functioning in women. Few studies have investigated the durability of these changes. The objective of this paper is to investigate changes in sex hormones, sexual functioning, and relevant psychosocial constructs over 4years in women who underwent bariatric surgery. The setting is a prospective cohort of 106 women from the Longitudinal Assessment of Bariatric Surgery consortium. Changes in sex hormones were assessed by blood assay. Sexual functioning, quality of life (QOL), body image, depressive symptoms, and marital adjustment were assessed by psychometric measures. Women lost on average (95% confidence interval) 32.3% (30.4%, 34.3%) at postoperative year 3 and 30.6% (28.5%, 32.8%) at postoperative year 4. Compared to baseline, women experienced significant changes at 4years in all hormones assessed, except estradiol. Women reported significant improvements in sexual functioning (i.e., arousal, desire, and satisfaction) through year 3, but these changes were not maintained through year 4. Changes in relationship quality followed a similar pattern. Improvements in physical aspects of QOL, body image, and depressive symptoms were maintained through 4years. Improvements in reproductive hormones and physical aspects of QOL, body image, and depressive symptoms were maintained 4years after bariatric surgery. Improvements in sexual functioning, relationship satisfaction, and mental components of QOL eroded over time.

Impact of Fatigue Characteristics on Quality of Life in Patients After Heart Transplantation.

Fatigue has been identified as a major symptom in heart transplant (HTx) patients; however, researchers have not examined the role of fatigue characteristics (ie, intensity, interference, and duration) in the quality of life (QOL) of HTx patients. The aim of this study was to explore differences in physical and mental aspects of QOL by patient characteristics, as well as the association between fatigue characteristics and QOL in HTx patients after considering other confounding factors (symptom distress and psychological distress). A cross-sectional study was conducted in which patients completed the Transplant Symptom Frequency and Symptom Distress Scale, the Fatigue Symptom Inventory, the Hospital Anxiety and Depression Scale, and the 12-item Short-Form Health Survey. Multiple regressions were used to identify factors significantly related to QOL. A total of 126 patients reported moderate levels of fatigue intensity, mild fatigue interference, and low QOL scores in the physical and mental domains. Patients with better physical and cardiac function and lower symptom distress and fatigue interference had better scores on the physical aspect of QOL (explaining 30.7% of the variance); patients with lower fatigue interference, anxiety, and depression had better scores on the mental aspect of QOL (explaining 50% of the variance). Fatigue interference had a greater influence on QOL domains than fatigue intensity. The degree to which fatigue interferes with daily life should be assessed, and suitable interventions should be introduced in clinical settings to help patients manage their fatigue and improve their QOL.

The effects of a lifestyle intervention program on physical outcomes, depression, and quality of life in adults with metabolic syndrome: A randomized clinical trial

Lifestyle modification is recommended as the primary intervention for metabolic syndrome (MetS). The study was to examine the effects of a lifestyle intervention program (LIP) on physical outcomes, depression, and quality of life (QoL) in Chinese adults with MetS. A randomized control trial design was used. A three-month LIP guided by the Health Promotion Model was developed, including a lifestyle modification booklet, one session of discharge education, and six telephone follow-ups. Patients with MetS were recruited from the inpatient departments of a hospital and were randomized to receive either the LIP or usual care. The physical outcomes, depression (Depression subscale of Hospital Anxiety and Depression Scale), and QoL (Medical Outcome Study Short Form-12, SF-12) were measured at baseline, one-month (T1) and three-month (T2). The effects of the LIP were examined by the generalized estimating equation (GEE) model. The study recruited 173 participants, with 86 in the intervention group and 87 in the control. Continuous improvements were observed in all the study outcomes in the intervention group. The GEE model revealed significant improvements in body weight (T1: p=0.017, T2: p=0.007), body mass index (T1: p=0.015, T2: p=0.009), depression (T1: p=0.027, T2: p<0.001), and physical aspects of QoL at T2 (p=0.02). The current LIP was effective in losing body weight, improving depression and QoL of MetS populations in three-month observation. Considering its low-cost and convenience, the LIP could be applied in clinical practice to improve patient outcomes.

Obesity, ethnicity, and quality of life among breast cancer survivors and women without breast cancer: the long-term quality of life follow-up study.

The purpose of this study was to examine the relationship between obesity and quality of life (QOL) among Hispanic and non-Hispanic white breast cancer survivors and population-based controls from the 'Long-Term Quality of Life Study'--a 12- to 15-year follow-up study of breast cancer cases/survivors and controls from New Mexico (n = 451). Using multiple linear regressions, obesity measures [body mass index (BMI) ≥ 30 kg/m(2)] at baseline and follow-up interview were modeled with composite scores for physical and mental health from the SF-36 Quality of Life Survey. Interaction between ethnicity and BMI and change in BMI were evaluated. All models were adjusted for age, ethnicity, Charlson Index, depression, fatigue, and physical activity. Baseline obesity (β = -6.58, p = 0.04) was significantly associated with decreased mental health among survivors, but not among controls. Obesity at baseline and follow-up were significantly associated with decreased physical health among survivors (baseline β = -10.51, p = 0.004; follow-up β = -7.16, p = 0.02) and controls (baseline β = -11.07, p < 0.001; follow-up β = -5.18, p = 0.04). No significant interactions between ethnicity and BMI were observed. Our findings provide unique information about a diverse population of breast cancer survivors and controls and the impact of obesity on the mental and physical aspects of QOL.

Analysis of the physical aspects of quality of life of kidney recipients

To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL.

Patient-Centered Outcomes Following Thoracentesis.

BackgroundPleural effusions impact over 1.5 million people annually in the United States and cause significant morbidity. Although therapeutic thoracentesis is associated with improvement in respiratory parameters, unanswered questions remain regarding its impact.ObjectiveThe purpose of this study was to investigate patient-centered outcomes, the need for additional pleural interventions, and mortality in the 30 days following thoracentesis.MethodsThis prospective observational cohort study was performed in a tertiary care academic medical center between December 2010 and December 2011. Adult patients referred for thoracentesis were offered enrollment. The following characteristics were evaluated both before and at 30 days postprocedure: dyspnea using modified BORG (mBORG), physical and mental quality of life (QoL) using the short form 12, and basic activities of daily living (BADLs). The primary outcomes included changes in these parameters 30 days after thoracentesis. Secondary outcomes included the need for additional pleural procedures and mortality within 30 days of the thoracentesis. Multivariable logistic regression was used for analysis.ResultsOf the 284 patients who underwent thoracentesis, 80 (28.2%) died within 30 days of the procedure. Of the 163 patients comprising the analytical cohort, 35 (21.5%) patients required an additional pleural intervention within 30 days of the index procedure. Patients who survived more than 30 days following thoracentesis had a sustained improvement in dyspnea and mental QoL, but a minority had improvement in physical QoL or BADLs. Surviving patients demonstrated no significant associations between bilateral and unilateral thoracentesis, volume of fluid removed, or the etiology of the effusion (malignant vs nonmalignant) and improvement in QoL, dyspnea, and BADLs. Relative to nonmalignant etiology, the presence of a malignant effusion was strongly associated with the need for an additional intervention, yielding an odds ratio (95% confidence interval [95% CI]) of 16.92 (5.47-52.37). Patients with hepatic hydrothorax and infectious etiologies of their effusion were also likely to require additional pleural interventions.ConclusionThe majority of patients in this cohort demonstrated sustained improvement in dyspnea and the mental aspect of QoL 30 days following thoracentesis, independent of the etiology and regardless of the volume of pleural fluid removed. A minority experienced sustained improvements in the physical aspect of QoL and BADLs. Although 28.2% of patients died within 30 days, nearly 1 in 5 survivors required an additional pleural intervention. These results emphasize the significant clinical impact, morbidity, and mortality experienced by patients who undergo thoracentesis for pleural effusions.

Percutaneous Nephrolithotomy: Short- and Long-Term Effects on Health-Related Quality of Life

Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large and complex kidney stones, having increased its safety and effectiveness over the last years. Nonetheless, there is little known about its impact on quality of life (QoL). This study aimed at evaluating the effects of PCNL on patients' QoL in the short and long term. We prospectively studied 40 consecutive cases who underwent PCNL. 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. Changes in QoL were assessed under statistical and clinical relevance criteria. PCNL has rendered 70% of the cases completely stone free with a 35% complication rate (33% Clavien I+II). The baseline scores of all SF-36 domains were worse than the referral population. Three months after PCNL, bodily pain was the only dimension whose change was relevant for patients (effect size [ES]=0.71, minimal clinically important difference [MCID]=0.56). A year after, this favorable effect of PCNL on body pain is still present, being also beneficial on both role physical (ES=0.58, MCID=0.52) and the physical component summary (ES=0.56, MCID=0.43). Social function was also close to reaching clinical relevance a year after the procedure (ES=0.66, MCID=0.72). Kidney stone disease considerably affects the patients' QoL. PCNL not only has good outcomes rendering the kidney stone free without major complications but produces an immediate body pain relief. This is perceived as relevant by the patients even a year after the procedure, when some other physical aspects of QoL also get better, helping patients to restore their social activities.

The Impact of Postoperative Complications on Long-term Quality of Life After Curative Colorectal Cancer Surgery

To investigate the effect that complications have on patients' long-term quality of life (QoL) after curative colorectal cancer surgery. Colorectal cancer surgery is a high risk, with approximately 1 in 3 patients suffering a complication. The long-term consequences of postoperative complications are important but have poorly been documented. The MRC-CLASICC trial (laparoscopic-assisted vs open surgery for colorectal cancer) included prospective evaluation of QoL using validated scoring questionnaires: EORTC QLQ-C30/CR38 and EQ5D. These were used to compare QoL at 3, 6, 18, and 36 months to baseline values for patients categorized into 2 groups: (i) those suffering any complication and (ii) those suffering any of 5 common complications (wound, chest, anastomotic leak, hemorrhage, and cardiac event). A total of 614 of 794 CLASICC patients were suitable for inclusion. Complications occurred in 215 (35.0%) patients, including: wound complications (61, 9.9%), chest infection (50, 8.1%), anastomotic leak (27, 4.4%), hemorrhage (14, 2.3%), and cardiac event (26, 4.2%). Significant long-term differences in QoL between patients with and without complications were found for Physical and Social Function, Role Functioning, and Body Image on EORTC QLQ-C30/QLQ-CR38 analysis and Mobility, Self-care, and Pain/Discomfort on EQ5D analysis. No significant differences were seen for emotional/cognitive functioning, global QoL, financial difficulties, or future perspectives. Risk factors of age, gender, ASA (American Society of Anesthesiologists) grade, and stoma moderated the impact of complications in the short- to medium-term QoL, but had less influence on long-term QoL. Postoperative complications have adverse effects on long-term QoL, particularly for Physical, Role and Social Functioning, and Body Image, as well as for Mobility, Self-care, and Pain/Discomfort. These findings should inform future preoperative counseling and health care planning.

A prospective comparison of the FACT-e and EORTC-QLQC30 and OG25 questionnaires for evaluating changes in health-related quality of life in patients with esophageal cancer.

130 Background: The FACT-E (Functional Assessment of Cancer Therapy– Esophageal) and the EORTC QLQ-C30 (European Organization for Research on Treatment of Cancer Quality of Life Questionnaire) and its cancer-specific module (OG25) are two validated instruments used to assess quality-of-life (QOL) in patients with esophageal cancer. This study investigates the differences between these two instruments. Methods: This is a prospective study of 22 consecutive patients treated with chemoradiation followed by surgery. Questionnaires were self-administered at each of the following: baseline (prior to treatment), 6-8 weeks and 12-14 weeks following start of chemoradiation, and 1, 3, 6, 9, 12, and 18 months following esophagectomy. Mixed model regression was applied to model the repeated measures of the two questionnaires to compare slopes. Results: Of the 22 patients, 20 proceeded to surgery. Overall survival and disease-free survival at 18 months were 59% and 55% respectively. Comparison of the QOL domains over time showed good correlation for physical and functional well-being, with an apparent variation in the magnitude of the changes over time for the latter. The questionnaires were discordant with respect to social and total well-being. Social well-being showed a return to baseline by 1 month post-op using the FACT, but never recovered to baseline for the EORTC. FACT Total well-being recovered to baseline by 9 months, while the EORTC only approached baseline values by 18 months. The disease-specific modules showed post-operative symptom improvement with the FACT and a deterioration with the EORTC. There was also discordance in emotional well being. Conclusions: Domain comparisons of the EORTC and FACT questionnaires showed differing results. Discordance was seen for emotional, social and overall QOL, as well as symptomatology. The EORTC total and physical well-being domains showed a similar pattern of change over time. These findings might result from the overall tendency of the EORTC to emphasize physical aspects of QOL. Thus these two instruments appear to measure different aspects of QOL, which may affect their clinical utility.