Physical Component Of Quality Of Life Research Articles

Depressive disorder and quality of life in patients with cerebral microangiopathy

The association between depressive disorder and quality of life of middle-aged patients with cerebral microangiopathy has not been fully investigated.Aim. Study the association between the depression level and quality of life (QOL) in patients with cerebral microangiopathy.Materials and methods. In outpatients 45–59 years old (n = 262, 42% men, 58% women) with cerebral microangiopathy and depression, the level of anxiety was assessed using the HADS-A scale, QOL — using the SF-36 questionnaire. According to the severity of depression (HADS-D subscale), the following were distinguished: group 1 (n = 116) — 8–10 points (subclinical) and group 2 (n = 146) — ≥11 points (clinical). To analyze the data used: t-test, correlation coefficient, logistic regression model; odds ratio (OR) and 95% confidence interval (CI).Results. In group 2, the average anxiety score on the HADS-A scale was 14.3 ± 4.6 points, and for anhedonia was – 10.4 ± 4.2 points, which is statistically significantly higher than in group 1: 10.1 ± 4.2 and 7.1 ± 2.6 points, respectively (p < 0.05). The overall QOL score was statistically significantly lower in group 2: according to the physical component of health, 52.4 ± 26.5 vs. 88.8 ± 43.5 in group 1 (p < 0.05) and psychological component 38.5 ± 19.4 vs. 70.8 ± 35.8 in group 1 (p < 0.05). Depression, anxiety and anhedonia are associated with a negative effect on the overall QOL: r = −0.84 (p < 0.05), r = −0.81 (p < 0.05), r = −0.87 (p < 0.05), respectively. This association does not depend on age, obesity, type 2 diabetes mellitus: OR for depression was 2.1; 95% CI (1.8–2.4), p < 0.05; anxiety — 1.9; 95% CI (1.2–2.2), p < 0.05; anhedonia — 2.3; 95% CI (2.1–2.7), p < 0.05, respectively.Conclusion. Clinically significant depression reduces noticeably QOL. An increase in the severity of affective symptoms leads to a deterioration in both the psychological and physical components of QOL. Decreased QOL does not depend on age, obesity, type 2 diabetes mellitus.

Assessing upper limb function in multiple sclerosis using an engineered glove.

The importance of upper limb function in multiple sclerosis (MS) is increasingly recognized, especially for the evaluation of patients with progressive MS with reduced mobility. Two sensor-engineered gloves, able to measure quantitatively the timing of finger opposition movements, were previously used to assess upper limb disability in MS. The aims of the present study were: (1) to confirm the association between glove-derived variables and standard measures of MS disability in a larger cohort; (2) to assess the correlation with quantitative magnetic resonance imaging (MRI) and quality of life (QoL) measures; and (3) to determine if the glove-derived variables offer advantages over the standard measure for assessing upper limb function in MS, namely, the Nine-Hole Peg Test (9HPT). Sixty-five patients with MS, stable on disease-modifying treatment, were evaluated at baseline using the glove, and through clinical examination (Expanded Disability Status Scale, Symbol Digit Modalities Test, Timed 25-Foot Walk Test and 9HPT), MRI evaluation and QoL questionnaires. Correlations between the glove-derived variables and clinical, MRI and QoL variables were assessed using Spearman's rank correlation coefficient analysis. Glove-derived variables significantly differed between patients with relapsing-remitting and those with progressive MS, with similar or slightly higher correlations of the 9HPT with clinical variables. We found greater correlations of the QoL physical component with glove-derived variables than with the 9HPT, and a significant correlation of its mental component with the glove-derived variables but not with the 9HPT. The study results, confirming previous findings and showing advantages over the 9HPT, encourage the investigation of sensitivity to change in glove-derived variables in a longitudinal setting.

Randomized controlled trial of medium cut-off versus high-flux dialyzers on quality of life outcomes in maintenance hemodialysis patients

Medium cut-off (MCO) dialyzers help remove larger middle molecules associated with symptoms related to the accumulation of uremic retention solutes. We investigated the effect of an MCO dialyzer on the improvement of quality of life (QOL) in maintenance hemodialysis (HD) patients. Forty-nine HD patients with high-flux dialysis were randomly assigned to either an MCO (Theranova 400, Baxter) or a high-flux (FX CorDiax 80 or 60, Fresenius Medical Care) dialyzer and completed the study. QOL was assessed at baseline and after 12 weeks of treatment using the Kidney Disease Quality of Life Short Form-36, and pruritus was assessed using a questionnaire and visual analog scale. The reduction ratios of middle molecules were also evaluated. Laboratory markers, including serum albumin, did not differ between the two groups after 12 weeks. Removals of kappa and lambda free light chains were greater for MCO dialyzer than high-flux dialyzer. The MCO group had higher scores than the high-flux group in the domains of physical functioning and physical role (75.2 ± 20.8 vs. 59.8 ± 30.1, P = 0.042; 61.5 ± 37.6 vs. 39.0 ± 39.6, P = 0.047, respectively), and the MCO group had lower mean scores for morning pruritus distribution and the frequency of scratching during sleep (1.29 ± 0.46 vs. 1.64 ± 0.64, P = 0.034; 0.25 ± 0.53 vs. 1.00 ± 1.47, P = 0.023, respectively). MCO dialyzers may improve patient-reported outcomes, particularly the physical components of QOL and uremic pruritus, in patients with high-flux dialyzers.

Physical Exercise Training Improves Quality of Life in Healthy Older Adults: A Meta-Analysis.

The current meta-analysis first aimed to quantify the overall effect of physical exercise training on the quality of life (QoL) in healthy older adults. Second, the effects on the social, physical, and psychological QoL were assessed. In total, 16 randomized controlled trials were included. The primary analysis showed a medium effect of physical exercise training on QoL in healthy older adults (standard mean difference [SMD] = 0.38, confidence interval, CI, [0.18, 0.59], p < .05). The secondary analyses showed a positive medium effect of physical exercise training on the physical component of QoL (SMD = 0.39, CI [0.17, 0.60], p < .05), and a positive medium effect of physical exercise training on the psychological component of QoL (SMD = 0.348, CI [0.125, 0.570], p < .05), and no significant effect of physical exercise training on the social component of QoL was observed (SMD = 0.16, CI [-0.07, 0.38], p = .17). These findings warrant implementation efforts pertaining to exercise training for older adults to improve the QoL in our aging societies.

Assessment of quality of life and postural balance in women of older age groups who continue to work in their profession

Introduction. The relevance of the study is determined by the tasks set in the National project “Demography” (Federal project “Older generation”), and is the need to take into account the functional and psycho-physiological characteristics of older age groups in the system of measures to preserve their health and efficiency in connection with the upcoming increase in the age, giving the right to retire for the majority of the working population.The aim of study was to determine the main patterns in the changes in indicators characterizing the quality of life (QL) and postural balance in women of older age groups who continue to work in their profession.Materials and methods. 166 working women aged 55–64 years (mean age 59±2.8 years) were examined. The sample included women who agreed to participate in the study and who, 12 months after the survey, continued to work and did not plan to stop working during the following year. The first age group (AG) consisted of women whose calendar age (CA) was within 55–59 years (n=89), the second — women aged 60–64 years (n=77). The physical (PCS) and psychological (MCS) components of health-related QOL were determined by the SF–36v2 questionnaire. To evaluate the components of postural balance (CPB), a sensory Organization Test (SOT) was conducted using a computer posturographic (stabilometric) complex “Smart Equitest Balance Manager”.Results. It was found that all medians of QL components in the examined women were above 50 points, i.e. exceeded the general population norm. Comparison of PCS values in AG 55–59 years and 60–64 years showed differences at the level of statistical trend (0.05&gt;p≤0.1). When comparing MCS, no statistically significant differences between the groups were found. The study of the SOT PBC revealed that women aged 60–64 had a slight decrease in the quality of the equilibrium function in functional samples 1 (p=0.008) and 2 (p=0.009), but the quality of the equilibrium function in sample 6 (p=0.005) was higher than in women aged 55–59, which makes it possible to consider this indicator as a predictor that has a positive eff ecton the continuation of employment over 59 years.Conclusions. Thus, the physical and psychological components of QL in working women 55–64 years exceed the general population norm. However, after 59 years there is a decrease in the physical component of QL and there is no decrease in the psychological component of QL, which suggests that the psychological health of women 60 years and older becomes crucial in predicting retirement. After 59 years, working women experience a decrease in the quality of the equilibrium function in functional samples 1 and 2, indicating the beginning of age-related changes in the PBC, which justifies the need to develop and implement physical education and health programs aimed at maintaining the postural balance in 60-year-old women.

Effectiveness of a community-based self-care promoting program for community-dwelling older adults: a randomized controlled trial.

The existing health care system tends to be focused on acute diseases or patients with high levels of need and is not ideal for meeting the challenges of an ageing population. This study introduced a community-based self-care promoting program for community-dwelling older adults, and tested its effects on maintaining health. To determine whether the program can increase self-efficacy, quality of life (QoL), basic and instrumental activities of daily living, and medication adherence, while reducing health service utilization for community-dwelling older adults. Researchers randomly assigned 457 older adults to receive the intervention (n = 230) or be controls (n = 227). The intervention included assessment and education of self-care and health-promoting behaviors, co-produced care planning and self-efficacy enhancing components supported by a health-social partnership. The control group received placebo social calls. The outcomes were measured at pre-intervention (T1) and three months post-intervention (T2). Analysis showed that the intervention group had a significantly higher score in self-efficacy (P = 0.049), activities of daily living (ADL) (P = 0.012), instrumental activities of daily living (IADL) (P = 0.021) and the physical components of QoL (P < 0.001) at T2 than at T1. The program also significantly improved the mental component of QoL (P < 0.001) and medication adherence (P < 0.001), as well as reducing the total number of health service attendances compared to the control group (P = 0.016). The program can help enhance the self-efficacy of community-dwelling older adults towards self-care, which may in turn enable them to maintain optimal well-being while remaining in the community.

The quality of life in diabetic hemodialysis patients

The aim: to compare the quality of life (QOL) in hemodialysis (HD) patients with diabetes and without it and to evaluate the impact of diabetes on QOL variables. Patients and methods . 192 prevalent HD patients completed the Kidney Disease Quality of Life Short Form (KDQOL-SF™) questionnaire. Of these, 23 patients had diabetes. Results. Compared with non-diabetic HD patients, HD patients with diabetes scored lower on physical component of QOL: the Physical functioning scale - 30.0 (10.0-45.0) vs 65.0 (40.0-80.0) (Me[IQR]), p&lt;0.0001; Bodily pain - 45.0 (32.5-67.5) vs 57.5 (45.0-90.0), p=0.046; Physical Component Summary (PCS) - 25.4 (20.5-35.3) vs 36.6 (29.8-44.5), p&lt;0.0001. In the presence of diabetes, the Odds Ratio (95% CI) of the Role Physical scale score being below 50 were 6.7 (1.5-29.6) times higher than in the absence of diabetes. The Vitality scale score was also lower in diabetic HD patients: 40.0 (25.0-45.0) vs 45.0 (35.0-60.0), p=0.006. Regarding the dialysis-specific scales, diabetic patients had poorer scores than non-diabetics on Symptoms/problems - 64.6 (58.3-70.8) vs 75.0 (62.5-85.4), p=0.012 and Sleep - 47.5 (35.0-62.5) vs 57.5 (45.0-72.5), p=0.012. In the presence of diabetes, the Odds Ratio (95% CI) of the Work status scale score being below 50 were 7.8 (1.8-34.3) times higher than in the absence of diabetes. Conclusion. Diabetic HD patients scored significantly lower than non-diabetic on the scales of self-reported physical health, Vitality, Symptoms/problems, Sleep and Work status.

Assessment of quality of life among women with polycystic ovary syndrome of different reproductive age

Polycystic ovary syndrome (PCOS) is one of the most problematic neuroendocrine syndromes in gynecology. It affects 6–25 % of reproductive-age women. Aim of research. To assess the quality of life in women with PCOS in early and active reproductive age. Materials and methods. The basic group consisted of 90 women with PCOS and was divided into the I and II subgroups. 60 women aged 18–25 years formed the I subgroup, 30 patients aged 26–35 years – the II one. 30 women without this pathology were controls. Diagnosis of PCOS was based on theRotterdam criteria. Quality of life was assessed with the help of the 36-Item Short Form Health Survey. Results. The parameters of quality of life physical component in women of the basic group were slightly less than in controls. Statistically significant difference was determined only in persons of the II subgroup on the “Physical Functioning” and “General Health” scores by 11.59 % (P = 0.039) and 15.98 % (P = 0.026) lower, respectively, compared to controls. More pronounces and significant decrease in quality of life was found in parameters of the psychological component, especially the “Vitality” and “Social functioning” scores were by 16.51 % (P = 0.021) and 23.12 % (P < 0.001) lower, respectively, compared to healthy women. The overall scores of quality of life were lower in persons of the II subgroup than in I. Conclusions. Decrease in quality of life is typical for women with PCOS. No significant difference was detected in the physical component score of quality of life between persons with PCOS and controls in the early reproductive age. Though, “Physical Functioning” and “General Health” scores were statistically lower in patients of active reproductive age compared to healthy individuals. However, a decrease in the psychological component of quality of life is typical for women with PCOS, especially for persons of the active reproductive age compared to those of the early one.

Quality of life of patients with knee osteoarthritis

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

Effect of low-level laser therapy (LLLT) on post-operative pain, trismus and quality of life (QOL) of patients undergoing extraction of impacted lower third molars

Low-level Laser Therapy (LLLT) is a physical modality used to support rehabilitation therapy. Often, patients undergoing extraction of impacted lower third molars experience a decline in their quality of life (QOL). This single-blinded randomised controlled trial (RCT) included patients aged between 18 to 30 years who were randomly allocated to an intervention group that received LLLT (n = 21) or a control group that did not (n = 21). Subjects in the intervention group was given a dose 54 J, energy density 18J/cm2 at 0, 3rd and 7th day post lower third molar removal. The QOL was assessed in both groups using the Short Form 36 (SF-36) before and after LLLT. A statistically significant reduction in pain was observed on post-operative days 3 and 7 (p < 0.05) between both groups. There is a statistically significant reduction of post-operative trismus at day 3 and 7 (p < 0.05) between both groups. A statistically significant (p < 0.05) improvement in the physical role (RP), bodily pain and general health domains of QOL was seen in both groups. Additionally, a significant improvement (p < 0.05) was observed in the physical component of QOL in both groups. The results of this study showed that LLLT (905 nm 18J/cm2 osis, 100 mW power) therapy can decrease post-operative pain and reduce trismus from day 3 in patients that have undergone surgical treatment of impacted lower third molars.

Clinical efficacy and feasibility of whey protein isolates supplementation in malnourished peritoneal dialysis patients: A multicenter, parallel, open-label randomized controlled trial

Poor dietary intake is commonly associated with malnutrition in the dialysis population and oral nutritional supplementation is strategized to redress dietary inadequacy. Knowledge on clinical efficacy of whey protein supplementation (WPS) as an option to treat malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients is limited. This multicenter, parallel, open-label, randomized controlled trial investigated the clinical efficacy of WPS in 126 malnourished CAPD patients with serum albumin <40g/L and body mass index (BMI) <24kg/m2. Patients randomized to the intervention group (IG, n=65) received protein powder (27.4g) for 6 months plus dietary counseling (DC) while the control group (CG, n=61) received DC only. Anthropometry, biochemistry, malnutrition-inflammation-score (MIS), dietary intake inclusive of dialysate calories, handgrip strength (HGS) and quality of life (QOL) were assessed at baseline and 6 months. Clinical outcomes were assessed by effect size (Cohen's d) comparisons within and between groups. Seventy-four patients (n=37 per group) completed the study. Significantly more IG patients (59.5%) achieved dietary protein intake (DPI) adequacy of 1.2g/kg per ideal body weight (p<0.001) compared to CG (16.2%) although difference in the adequacy of dietary energy intake between groups was non-significant (p>0.05). A higher DPI paralleled significant increases in serum urea (mean Δ: IG=+2.39±4.36mmol/L, p=0.002, d=0.57 vs CG=-0.39±4.59mmol/L, p>0.05, d=0.07) and normalized protein catabolic rate, nPCR (mean Δ: IG=+0.11±0.14g/kg/day, p<0.001, d=0.63 vs CG=+0.001±0.17g/kg/day, p>0.05, d=0.09) for IG compared to CG patients. Although not significant, comparison for changes in post-dialysis weight (mean Δ:+0.64±1.16kg vs+0.02±1.36kg, p=0.076, d=0.58) and mid-arm circumference (mean Δ:+0.29±0.93cm vs-0.12±0.71cm, p=0.079, d=0.24) indicated trends favoring IG vs CG. Other parameters remained unaffected by treatment comparisons. CG patients had a significant decline in QOL physical component (mean Δ=-6.62±16.63, p=0.020, d=0.47). Using changes in nPCR level as a marker of WPS intake within IG, 'positive responders' achieved significant improvement in weight, BMI, skinfold measures and serum urea (all p<0.05), while such changes within 'negative responders' were non-significant (all p>0.05). A single macronutrient approach with WPS in malnourished CAPD patients was shown to achieve DPI adequacy and improvements in weight, BMI, skin fold measures, serum urea and nPCR level. CLINICAL TRIAL REGISTRY: www.clinicaltrials.gov (NCT03367000).

Improvement in cardiac dysfunction with a novel circuit training method combining simultaneous aerobic-resistance exercises. A randomized trial.

IntroductionExercise is considered a valuable nonpharmacological intervention modality in cardiac rehabilitation (CR) programs in patients with ischemic heart disease. The effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac patients' with reduced left ventricular function, post-myocardial infarction (MI) has not been thoroughly investigated.Aim of studyto improve cardiac function with a novel method of combined aerobic-resistance circuit training in a randomized control trial by way of comparing the effectiveness of continuous aerobic training (CAT) to SCT on mechanical cardiac function. Secondary to compare their effect on aerobic fitness, manual strength, and quality of life in men post MI. Finally, to evaluate the safety and feasibility of SCT.Methods29 men post-MI participants were randomly assigned to either 12-weeks of CAT (n = 15) or SCT (n = 14). Both groups, CAT and SCT exercised at 60%-70% and 75–85% of their heart rate reserve, respectively. The SCT group also engaged in intermittently combined resistance training. Primary outcome measure was echocardiography. Secondary outcome measures were aerobic fitness, strength, and quality of life (QoL). The effectiveness of the two training programs was examined via paired t-tests and Cohen's d effect size (ES).ResultsPost-training, only the SCT group presented significant changes in echocardiography (a reduction in E/e' and an increase in ejection fraction, P<0.05). Similarly, only the SCT group presented significant changes in aerobic fitness (an increase in maximal metabolic equivalent, P<0.05). In addition, SCT improvement in the physical component of QoL was greater than this observed in the CAT group. In both training programs, no adverse events were observed.ConclusionMen post-MI stand to benefit from both CAT and SCT. However, in comparison to CAT, as assessed by echocardiography, SCT may yield greater benefits to the left ventricle mechanical function as well as to the patient's aerobic fitness and physical QoL. Moreover, the SCT program was found to be feasible as well as safe.

Association between social capital and quality of life among urban residents in less developed cities of western China: A cross-sectional study.

China has experienced rapid urbanization over the past several decades. Social capital is considered a vital human resource, and quality of life (QoL) is an important measure of human health embedded in a physical, mental, and social context. No studies have reported on the association between social capital and QoL in Chinese urban residents. We performed a cross-sectional study to investigate social capital in urban community residents of West China, and its relationship with QoL.Our study was carried out between June and July of 2015. A total of 1136 households were surveyed. The Chinese-translated version of the Short-Form Health Survey (SF-12) and social capital questionnaire were used to evaluate people's QoL and social capital. Associations between QoL and social capital were evaluated by 3 logistic regression analyses.A total of 1136 adult participants aged 18 years and older completed the questionnaire. Young residents were more likely to have lower second (SC2), third (SC3), and fourth (SC4) dimensions of social capital. Migrants and residents with higher education levels and high incomes showed lower SC1 and SC2 relative to other participants, and employed residents had relatively low SC1. Unmarried residents had lower SC2 and SC3. Without adjustment for potential confounding factors, participants with higher SC2 had higher average scores for mental components (MCS) of QoL [odds ratio (OR) = 1.48, 95% confidence interval (95% CI): 1.09-2.02], and the same was seen for SC3 (OR = 1.70, 95% CI: 1.24-2.34). After adjusting for socioeconomic status (SES) and risk factors, SC2 and SC3 were still significantly associated with MCS. Social capital was not significantly associated with physical components of QoL in any of the 3 logistic regression models.In conclusion, social capital is related to MCS of QoL, and increasing it may be an effective way to promote health.

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

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

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

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

Intérêt clinique du traitement ostéopathique chez les patientes ayant une endométriose colorectale : classification fondée sur les symptômes et la qualité de vie

ObjectivesA prospective study to evaluate the clinical impact of osteopathic manipulative therapy (OMT) on symptoms and quality of life (QOL) of patients with colorectal endometriosis. MethodsForty-six patients with colorectal endometriosis completed the SF-36 QOL and symptoms questionnaire before and after OMT. A comparison and clustering analysis was performed to identify subgroups of patient's profile and symptom classification. ResultsThe mean age of the patients was 32±6.2 years. Prior surgery for endometriosis was recorded in 73.9 % of cases but none for deep infiltrating endometriosis. About three-quarters of the patients were nulliparous. The time between pre- and post-OMT completion of questionnaires was 28 days (15–63), A significant improvement in SF-36 QOL physical component summary (P<0.001) and mental component summary (P<0.001) was observed after OMT. Similarly, a significant improvement in gynecological, digestive and general symptoms values was observed. A clustering analysis allowed to identify four profiles of patients with colorectal endometriosis based on symptoms and a respective OMT gain of 30 %, 60 %, 64 % et 45 %. ConclusionsOur results support that OMT improve QOL and endometriosis symptoms of patients with colorectal endometriosis. Moreover, this symptom classification based on OMT gain can serve to design future randomized trial.

Efficacy and drug compliance for tilorone in preventing acute respiratory infection in patients with chronic obstructive pulmonary disease

The purpose of the study was to analyze drug compliance and efficacy of tilorone in preventing acute exacerbations and improving quality of life (QoL) in patients with moderate to severe COPD and a history of frequent acute respiratory viral infections (ARVI). Materials and methods. The study involved patients with moderate to severe COPD (n = 94; 35 females, 59 males; mean age, 61.8 ± 0.7 years). A comprehensive examination of patients included drug compliance assessment with a specially developed scale, clinical and laboratory parameters measured at inclusion and in 12 months. Twenty three patients with high compliance were treated with tilorone. A control group consisted of low-compliant patients who did not give a consent to take tilorone (n = 20). Results. The significant 1.95-fold reduction in ARVI episodes incidence within 12 months was registered in the tilorone group that resulted in reduction in COPD exacerbation and hospitalizations rates, improvement in physical component of QoL and decrease in a cost of the therapy by 84%. Conclusion. Six-week therapy with tilorone 125 mg once a week, two courses annually, aimed at prevention ARVI in patients with moderate to severe COPD and a previous history of frequent ARVI could significantly reduce a rate of ARVI episodes followed by reduction in the rate of acute exacerbations of COPD, hospitalizations due to COPD and in improvement in physical component of QoL. Tilorone did not change lung function and physical tolerance of COPD patients.

Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS

ObjectiveTo improve the effectiveness of treatment in patients with chronic fatigue syndrome it is worthwhile studying factors influencing outcomes. The aims of this study were (1) to assess the association of expectancy and credibility on treatment outcomes, and (2) to identify baseline variables associated with treatment expectancy and credibility. Methods122 patients were included in a randomized controlled trial of whom 60 received cognitive behavioural therapy (CBT) and 62 multidisciplinary rehabilitation treatment (MRT). Expectancy and credibility were measured with the credibility and expectancy questionnaire. Outcomes of treatment, fatigue, and quality of life (QoL), were measured at baseline and post-treatment. Multiple linear regressions were performed to analyse associations. ResultsIn explaining fatigue and the physical component of the QoL, the effect of expectancy was significant for MRT, whereas in CBT no such associations were found. The main effect of expectancy on the mental component of QoL was not significant. For credibility, the overall effect on fatigue and the physical component of QoL was not significant. In explaining the mental component of QoL, the interaction between treatment and credibility was significant. However, the effects within each group were not significant.In the regression model with expectancy as dependent variable, only treatment centre appeared significantly associated. In explaining credibility, treatment centre, treatment allocation and depression contributed significantly. ConclusionsFor clinical practice it seems important to check the expectations of the patient, since expectations influence the outcome after MRT.

Musculoskeletal problems and quality of life of elementary school teachers

Purpose: To investigate prevalence and anatomical distribution of musculoskeletal pain (MSP) and its impact on quality of life (QoL) in elementary school teachers working in Muğla town center. Methods: Physical, sociodemographic and occupational characteristics of 104 teachers were recorded. Onset, prevalence and consequences of MSP (Extended Nordic Musculoskeletal Questionnaire) and QoL (Short Form-36 Health Survey) of teachers with (n = 37) and without (n = 67) MSP during the last 12 months were compared. Results: The prevalence of MSP was 77% for the lifelong period and 36% for the last 12 months. Physical and sociodemographic characteristics, daily employment period and length of standing and sitting were similar between groups (p > 0.05). The most common painful regions were the neck (39%) and the lower back (38%). MSP of these regions was the common reason for seeking healthcare, prevention from activities and taking sick leave. MSP had negative impact, especially on the physical components of QoL (p < 0.05). Conclusions: The results reveal high prevalence of MSP among teachers, as well as its negative impacts on QoL. Especially neck and lower back seem to be the most frequently affected regions of the body. These findings draw attention toward the need for developing strategies to prevent MSP among teachers.

Long-term mortality and quality of life in intensive care patients treated for pneumonia and/or sepsis: Predictors of mortality and quality of life in patients with sepsis/pneumonia

PurposeThe purpose of this study is to evaluate long-term mortality and quality of life (QoL) of intensive care patients with pneumonia and/or sepsis 1 year after discharge and to identify potential predictors for these outcome measures. MethodsThis retrospective cohort study analyzed all patients admitted to the intensive care unit (ICU) of a German university hospital with diagnosis of pneumonia and/or sepsis between 2008 and 2009. Quality of life was assessed by telephone interview or mail using the standardized EuroQol 5-dimension questionaire. ResultsOf 1406 patients treated in the ICU within the observational period, 217 met the inclusion criteria. Whereas in-hospital mortality differed significantly between pneumonia (17%) and sepsis (46%) (P < .001), 1-year mortality was not statistically significant (51% and 65%, P = .057). A high Simplified Acute Physiology Score (SAPS) II value was associated with high in-hospital mortality but failed to predict 1-year mortality. Quality of life, measured 1 year after discharge by visual analog scale (VAS), was 50% ± 25%, which was significantly lower than in a matched control group (70% ± 20%; P < .001). A high SAPS II score on admission did not correlate with VAS but was an independent predictor of a low EuroQol 5-dimension index. ConclusionsThe high post-ICU mortality of patients with pneumonia and sepsis emphasizes the need to focus on long-term follow-up in ICU studies and demonstrates that even when sepsis signs are missing, critically ill patients due to pneumonia have high 1-year mortality. Simplified Acute Physiology Score II does not predict long-term mortality, but a low SAPS II on admission might be useful to identify patients with good physical status after 1 year. Take home messageHospital mortality of patients treated for pneumonia and/or sepsis is high and increases significantly within the first year after discharge. The SAPS II predicts in-hospital mortality and the physical components of QoL but not long-term mortality. TweetOne-year mortality of ICU pneumonia patients is equally high as in sepsis patients. Simplified Acute Physiology Score II cannot predict long-term mortality but can predict QoL.