Physical Domain Scores Research Articles

The efficacy of nurse-led hyperbaric oxygen therapy in improving the quality of life in patients with sudden hearing loss.

The quality of life decreases in patients with sudden hearing loss due to hearing problems. In addition, complications due to hyperbaric oxygen therapy can reduce the quality of life. This study was conducted to examine the efficacy of nurse-led hyperbaric oxygen therapy in improving the quality of life in patients with sudden hearing loss. This one-group pretest-posttest design study was conducted with 34 patients with Sudden Hearing Loss who applied to a university hospital for Hyperbaric Oxygen Therapy between November 2018 and February 2019. The data were collected using the Patient Information Form, World Health Organization Quality of Life Scale (WHOQOL-BREF), and Pure Tone Threshold Audiogram. WHOQOL-BREF's quality of life rating (2.59 ± 0.86-3.68 ± 0.59), satisfaction with health status (2.65 ± 0.69-3.62 ± 0.60), physical domain (11.58 ± 2.08-14.84 ± 2.38), psychological domain (12.80 ± 2.21-15.82 ± 2.26), social domain (14.63 ± 3.09-16.78 ± 2.67) and environmental domain (14.25 ± 2.55-16.34 ± 2.60) mean scores significantly increased compared to the pre-treatment scores (p < 0.001). The presence of an acute illness in the last month, the persistence of sudden hearing loss symptoms, level of hearing loss, presence of chronic illness, and smoking were found to affect the quality of life. At the end of the nurse-led hyperbaric oxygen therapy in patients with sudden hearing loss, the quality of life increased and the hearing loss decreased. The most important factor affecting the quality of life was the persistence of symptoms of sudden hearing loss.

Gender differences in the revised Fibromyalgia Impact Questionnaire: a pilot study.

Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with symptoms such as fatigue, sleep disturbances and cognitive impairment. Prevalence is higher in females but the application of the 2010/2011 and 2016 revision of the American College of Rheumatology (ACR) criteria reduced prevalence differences and the actual female:male ratio is approximately 3:1. Even if lately some studies have been conducted regarding FM gender differences, disease severity is still assessed using questionnaires, such as the Revised Fibromyalgia Impact Questionnaire (FIQR), designed and validated through a predominantly female sample. The aim of this pilot study was to compare the 21 items of the FIQR among male and female patients in order to evaluate the possible existence of a gender bias. In this case-control study, consecutive patients with a diagnosis of FM (2016 ACR criteria) were asked to answer an online survey, including demographic characteristics, disease variables and the Italian version of the FIQR. Among the 544 patients that compiled the questionnaire, 78 patients, 39 males and 39 females, matched for age and disease duration, were consecutively enrolled in order to compare their FIQR scores. The univariate analysis showed that total FIQR scores and physical function domain scores were significantly higher in females and, among the 21 items of the FIQR, the female group obtained significantly higher scores in 6 of them. Our results showed that female patients obtain significantly higher scores in the FIQR total score and physical function domain score, in particular in 5 out of the 9 sub-items of the FIQR physical function domain. These preliminary results indicate that the use of the FIQR as a severity index in male patients probably underestimates the disease impact in this group.

Stress Is Associated with Quality of Life Reduction among Health Professionals in Vietnam: A Multisite Survey

Stress in healthcare workers is increasingly common in recent times. Stress can have negative effects on the mental health and quality of life of healthcare workers. This study is aimed at measuring the quality of life and determining the relationship between quality of life and stress of health professionals in some hospitals in Vietnam. A cross-sectional descriptive study was conducted on 520 health professionals working at Hanoi Medical University Hospital and Thai Binh Medical University Hospital. The World Health Organization Quality-of-Life Scale (WHOQOL-BREF) and the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) scale were used to assess the quality of life and the stress status of healthcare workers. Multivariate regression was performed to measure the relationships between stress and quality of life. Results showed that the level of stress of health workers according to the DASS-21 scale at mild, moderate, severe, and very severe was 10.7%, 8.7%, 5.6%, and 2.9%, respectively. The mean score of overall quality of life was 60.97 ± 11.39 . Health workers under stress had a decrease in quality of life scores in physical, mental, social, and environmental domains. Stressed health workers had a reduced quality of life. Attention should be paid to providing appropriate interventions to reduce stress and improve the quality of life in healthcare workers.

The COVID-19 Pandemic Impact on the Psychophysical Health of Post-Menopausal Women: A Cross-Sectional Study.

Background and Objectives: The aim of this study was to investigate lifestyle, menopausal symptoms, depression, post-traumatic stress disorder (PTSD) and sleep disorders in post-menopausal women throughout the first wave of the COVID-19 pandemic, including the impact of menopause hormonal therapy (HT). Materials and Methods: Post-menopausal women were given the following questionnaires: socio-demographic characteristics; lifestyle; history of COVID-19; menopause-specific quality of life (MENQOL), the first part of which refers to the pre-pandemic period ("pre COVID-19") and the second refers to the current period ("during COVID-19"); Beck's depression inventory (BDI); the impact of event scale-revised (IES-R); and the Pittsburgh sleep quality index (PSQI). Results: One hundred and twenty-six women completed all questionnaires, with a mean age of 55.5 ± 6.0 years. The mean menopause duration was 5.7 ± 5.6 years. Twenty-four women were taking HT. A significant mean weight gain, a reduction in physical activity (respectively p < 0.001) and worsened quality of romantic relationships (p = 0.001) were reported during the pandemic. Menopausal symptoms did not vary significantly throughout the pandemic; however, women taking menopausal HT had lower physical (p = 0.003) and sexual (p = 0.049) MENQOL domain scores, lower depressive symptoms (p = 0.039) and better romantic relationships (p = 0.008). Conclusions: The COVID-19 pandemic caused reduced physical activity, worsened food habits and weight gain in post-menopausal women. They also reported a high rate of severe-moderate PTSD and a negative influence on their romantic relationships. Menopausal HT seems to be a potential protective factor for sexual and physical status and for symptoms of depression.

Randomized Controlled Trial of Isha Kriya versus Observation to Improve Quality of Life in Hematopoietic Cell Transplantation Recipients

Hematopoietic cell transplantation (HCT) impacts its recipients' quality of life (QoL). Few mindfulness-based interventions (MBI) in HCT recipients have shown feasibility, but heterogeneous practices and outcome measures have questioned the real benefit. We hypothesize that a self-guided meditation as a mobile app will improve QoL in the acute HCT setting. This single-center, open-label, randomized controlled trial was conducted in 2021-2022. The study was cleared by Institutional Ethics Committee and registered at the Clinical Trial Registry of India. Recipients were included after obtaining written informed consent. Recipients without access to smartphones or regular practitioners of yoga, meditation, or other mind-body practice were excluded. Autologous + allogeneic HCT recipients of age ≥ 18 years were included in the study. Recipients were randomized to the control arm or Isha kriya arm in a 1:1 ratio stratified by type of transplant. Patients in the Isha kriya arm were recommended to perform the kriya twice daily from pre-HCT to day+30 post-HCT. Isha Kriya is 12-minute guided meditation based on the principles of yoga, focussing on breath, awareness, and thought. The primary endpoint was the QoL summary scores assessed by the Functional Assessment of Cancer Therapy - Bone Marrow Transplantation (FACT-BMT) and the Patient-Reported Outcomes Measurement Information System–Global Health (PROMIS-GH) questionnaires. The secondary endpoints were the difference in QoL domain scores. The validated questionnaires were self-administered before the intervention, day +30, and day +100 after HCT. The analysis of endpoints was done on an intention-to-treat basis. Domain and summary scores were calculated for each instrument as recommended by the developers. A p-value <0.05 was used for statistical significance, and cohen's d effect size determined clinical significance. A total of 72 HCT recipients were randomized to the Isha kriya and the control arm. Patients in both arms were matched for age, gender, diagnosis, and type of HCT. Both arms had no difference in the pre-HCT QoL domain, summary, and global scores. Post-HCT at day+30, there was no difference in the mean FACT-BMT total scores (112.9 ± 16.8 vs.101.2 ± 13.9, p = 0.2) and the mean global health scores (Global mental health 45.1 ± 8.6 vs. 42.5 ± 7.2, p = 0.5, global physical health 44.1 ± 6.3 vs. 44.1 ± 8.3, p = 0.4) in the two groups. There was similarly no difference in the physical, social, emotional, and functional domain scores. However, the mean BMT-subscale scores, which addresses BMT-specific quality-of-life concerns, were statistically and clinically significantly higher in the Isha kriya arm than the control arm (27.9 ± 5.1 vs. 24.4 ± 9.2, p = 0.03, Cohen's d 0.5, medium effect size). This effect was transient as the day+100 scores showed no difference (28.3 ± 5.9 vs. 26.2 ± 9.4, p = 0.3). Isha kriya did not improve the FACT-BMT total and global health scores in the acute HCT setting. However, practicing Isha kriya for a month did show a transient improvement in the FACT-BMT subscale scores on day +30 but not on day +100 post-HCT.

Relationship between self-management of patients with anxiety disorders and their anxiety level and quality of life: A cross-sectional study.

To explore the correlation between self-management and anxiety and quality of life in patients with anxiety disorders and to understand whether self-management can influence the relationship between anxiety and quality of life and provide a basis for improving their anxiety and quality of life. A cross-sectional survey of 245 patients with anxiety disorders in West China Hospital of Sichuan University was conducted using the Self-Management of Anxiety Disorders Scale, Self-rating anxiety scale (SAS), and World Health Organization Quality of Life-BBREF. The data were then analyzed using descriptive tests and Pearson correlation in SPSS 25. Bootstrap mediated effects tests were used to test the effect relationship between anxiety, quality of life and self-management scores in patients with anxiety disorders and Amos was used to establish the structural equation model. The results of the correlation analysis showed that the total self-management score was positively correlated with the total quality of life score (r = 0.695, P <0.001), physical domain score (r = 0.552, P <0.001), psychological domain score (r = 0.661, P <0.001), social relations domain score (r = 0.542, P <0.001), and environmental domain score (r = 0.614, P <0.001). Additionally, it was negatively correlated with SAS score (r = -0.470, P <0.001). Self-management partially mediates the relationship between anxiety and quality of life, and the direct effect value of anxiety on quality of life was -0.44. The indirect effect value of self-management was -0.27, accounting for 38% of the total effect value. Self-management of patients with anxiety disorders was negatively correlated with anxiety and positively correlated with quality of life. It played a partially mediating effect between anxiety and quality of life. We recommend that healthcare providers pay attention to self-management interventions for patients with anxiety disorders to further improve their quality of life.

Establishing minimal clinically important differences for the Quality of Life Instrument of Chronic Gastritis QLICD-CG(V2.0) based on distribution-based methods

BackgroundTo establish the lowest score reflecting meaningful changes from the perspective of patients is very important for explaining the results of patient reports. The measurement scale of quality of life in patients with chronic gastritis has been used in clinical practice, but the minimal clinically important difference (MCID) has not been worked out. In this paper, we use a distribution-based method to calculate the MCID of the scale QLICD-CG (Quality of Life Instruments for Chronic Diseases- Chronic Gastritis) (V2.0).MethodsThe QLICD-CG(V2.0) scale was used to evaluate the quality of life in patients with chronic gastritis. Since the methods for developing MCID were diverse and there was no uniform standard, we took MCID developed by anchor-based method as the gold standard, and compared the MCID of QLICD-CG(V2.0) scale developed by various distribution-based methods for selection. Standard deviation method (SD), effect size method (ES), standardized response mean method (SRM), standard error of measurement method (SEM) and reliable change index method (RCI) are given in the distribution-based methods.ResultsA total of 163 patients, with an average age of (52.37 ± 12.96) years old, were calculated according to the various methods and formulas given by the distribution-based method, and the results were compared with the gold standard. It was suggested that the results of the SEM method at the moderate effect (1.96) should be taken as the preferred MCID of the distribution-based method. And thus the MCID of the physical domain, psychological domain, social domain, general module, specific module and total score of the QLICD-CG(V2.0) scale were 9.29, 13.59, 9.27, 8.29, 13.49 and 7.86, respectively.ConclusionsWith anchor-based method as the gold standard, each method in distribution-based method has its own advantages and disadvantages. In this paper, 1.96SEM was found to have a good effect on the minimum clinically significant difference of the QLICD-CG(V2.0) scale, and it is recommended as the preferred method to establish MCID.

Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial

ObjectiveThe purpose of this study was to collect pilot efficacy data on a novel treatment for refractory chronic cough (RCC), which we call cough desensitization treatment (CDT).Design and methodsIn this parallel cohort, sham-controlled, randomized controlled trial, 21 adults with RCC were randomly assigned to 12 sessions of either CDT (progressive doses of aerosolized capsaicin while behaviorally suppressing cough; n = 11) or a sham treatment (repeated exposure to aerosolized saline; n = 9). The Leicester Cough Questionnaire (LCQ) was the primary outcome measure. Perceived cough severity with a visual analogue scale and cough challenge testing (for measuring cough-reflex sensitivity) were secondary outcome measures. Data were analyzed with mixed effects linear regression and follow-up contrasts.ResultsResults on all measures favored CDT. Excluding one sham participant, whose baseline LCQ scores were deemed unreliable, mean change in LCQ at 3-weeks post treatment was 6.35 and 2.17 in the CDT and sham groups, respectively. There was moderate to strong evidence of a greater improvement in the CDT group in total LCQ score (p = .058) and LCQ Psychological domain (p = .026) and Physical domain (p = .045) scores. Strong evidence was found for a greater reduction in urge-to-cough during CCT in the CDT group (p = .037) and marginal for a reduction in the capsaicin cough-reflex sensitivity (p = .094). There was weak evidence of a greater reduction in cough severity in the CDT group (p = .103).DiscussionAlthough the study is limited due to the small sample size, the data provide additional evidence supporting further research on CDT. CDT resulted in a greater change in the primary efficacy measure (LCQ) than both pharmaceutical and behavioral treatments currently found in the literature.Trial RegistrationThis trial (NCT05226299) was registered on Clinicaltrials.gov on 07/02/2022.

Quality of life of hypertensive men with erectile dysfunction in a tertiary health centre in southern Nigeria.

Erectile dysfunction (ED) is the most common disorder of sexual health seen in men in community studies. A man's sexual health has been found to be a key factor in determining the capacity for maintaining a healthy relationship. This study sought to determine the quality of life of hypertensive men with ED attending the out-patient clinics of Federal Medical Centre (FMC), Asaba, South-South, Nigeria. This study was conducted in the Out Patients Clinics (OPC) of FMC, Asaba, Delta state, Nigeria. After obtaining approval from the ethics and research committees in Asaba, 184 consenting hypertensive men who met the eligibility criteria were selected by systematic random sampling to participate in the study from October 2015 to January 2016. This study was a cross-sectional survey. Data were collected with a semi-structured interviewer-administered questionnaire adopted from the international index of Sexual Health Inventory for Men (SHIM) and the World Health Organization Quality of Life Scale (WHOQOL-BREF). The study complied with the principles of Helsinki and Good Clinical Practice. The results showed the mean score for physical domain (58.78 ± 24.37), the psychological domain (62.68 ± 25.93), the social domain (50.47 ± 29.09), and the environmental domain (62.25 ± 18.52). Over a fifth, 11 (22.0%), of the respondents with severe ED had poor quality of life. This study showed that ED is common in hypertensive men and their quality of life was more impaired than those with normal erectile function.Contribution: This study contributes to holistic approaches to patient care.

Health-related quality of life of men with primary osteoporosis and its changes after bisphosphonates treatment

IntroductionOsteoporosis leads to more serious consequences in men than in women, but less is known about its impacts on health-related quality of life (HRQoL) of men, and whether the anti-osteoporosis treatment can improve HRQoL of men with osteopenia/osteoprosis.MethodsWe enrolled men with primary osteoporosis and age-matched healthy controls. We collected medical history, serum levels of carboxyl-terminal type I collagen telopeptide, procollagen type I propeptides, and bone mineral density of patients. All patients and controls completed the short-form 36 (SF-36) questionnaires. Changes in HRQoL of osteopenia/osteoporosis men were prospectively evaluated after alendronate or zoledronic acid treatment.ResultsA total of 100 men with primary osteoporosis or osteopenia and 100 healthy men were included. The patients were divided into three subgroups: osteopenia (n = 35), osteoporosis (n = 39) and severe osteoporosis (n = 26). Men with osteoporosis or severe osteoporosis had impaired HRQoL in domains of physical health compared to healthy controls. HRQoL scores in physical health related domains of patients with severe osteoporosis were significantly lower compared to healthy controls, and were the poorest among the three subgroups of patients. Fragility fracture history was correlated with lower SF-36 scores about physical health. In 34 men with newly diagnosed osteoporosis receiving bisphosphonates treatment, HRQoL scores were significantly improved in domains of physical health after treatments.ConclusionsThe HRQoL is significantly impaired in men with osteoporosis, and the more severe the osteoporosis, the poorer the HRQoL. Fragility fracture is an important influencing factor of deteriorated HRQoL. Bisphosphonates treatment is beneficial to improve HRQoL of osteopenia/osteoporosis men.

The Impact of Low Back Pain on the Quality of Life of Children between 6 and 12 Years of Age.

This study aimed to evaluate the impact of low back pain on the perceived health-related quality of life of children between 6 and 12 years of age. This is a cross-sectional study of three hundred seventy-seven students from three schools (two private and one public) located in the city of Botucatu, São Paulo. Data were collected using the Pediatric Quality of Life Inventory (PedsQL, version 4.0), a questionnaire comprising questions on personal background, sociodemographic and socioeconomic information, and a questionnaire about quality of life. Comparisons were made between groups with and without low back pain. The chi-squared test was used for analyzing categorical variables, and the non-parametric Mann-Whitney test was used for continuous variables. According to the findings obtained in this study, it was observed that low back pain in the last month was reported by 27.3% of the total participants. The perceived health-related quality of life was lower among individuals who had low back pain, and the scores of physical and emotional functioning domains were also lower in the presence of low back pain. The prevalence of low back pain among children and adolescents is relatively high. Furthermore, the repercussions of low back pain may lead to a lower overall perception of the health-related quality of life in this population and affect aspects of physical and emotional functioning.

Health Related Quality of Life in patients undergoing Lower Limb Amputation secondary to Peripheral Arterial Disease

Aim: To assess domains of health-related quality of life among patients undergoing major lower limb amputation secondary to peripheral arterial disease. Study design: Observational questionnaire-based study. Place and Duration: Data from 1st January to 31 December 2020(collected from September 2022 to November 2022) was assessed out of which ninety-one patients fulfilled the inclusion criteria. Methodology: Twenty-three patients were interviewed after verbal consent over telephone using validated questionnaires: World Health Organization Quality of Life-BREF, Amputee Single Item Mobility Measure, Locomotor Capability Index-5. Independent sample t-tests and ANOVA were performed for demographics and domain scores. Pearson-Correlation tests were performed for relations between domains and mobility scores. Results: 12 (52.20%) of interviewed patients received below knee amputation, comprising mostly of males 16 (69.60%) with diabetes 18 (78.30%). Participants who used prosthesis had statistically significantly greater mobility scores compared to non-prosthesis users t(21)=3.396, p=0.03. Below knee amputees report better quality of life compared to above knee as these amputees had lower physical domain (mean difference -22.75, p=0.027) and environmental domain scores (mean difference -12.44, p=0.009). This study found that male participants had statistically significantly greater physical t(21)=2.698, p=0.013 and environmental t(21)=2.77,1 p =0.011 scores after a major lower limb amputation compared to females. Conclusion: Males and patients with prosthesis report significantly better quality of life compared to females and non-prosthesis users, owing to socioeconomic and cultural barriers. Keywords (MeSH): Amputation, Surgical, peripheral arterial disease, Artificial Limbs, Quality of Life

Assessment of quality of life, school performance, and physical activity in adolescents with Familial Mediterranean fever.

The aim of this study is to evaluate differences in school performance, school attendance, quality of life, and physical activity in adolescents with Familial Mediterranean fever (FMF) compared to healthy controls. One hundred and twenty-nine patients with FMF and 154 healthy controls between 13 and 18 years were included in the study. Demographic, school performance (according to grade point average), school absenteeism, and type and frequency of exercise were recorded. Quality of life was evaluated with the Pediatric Quality of Life Inventory (PedsQL) 4.0. The mean age of FMF patients was 15.1 ± 2.7 years, and 69 patients (53.5%) were female. School performance was significantly higher in the control group compared to FMF patients (P < 0.001). In the control group, there were significantly higher participants who engaged in professional sports (P < 0.001). Patients with FMF had significantly lower self-reported PedsQL scores in school functioning, physical, and psychosocial health domains compared to those in the control group (P = 0.001, P < 0.001, and P = 0.028, respectively). FMF patients demonstrated lower school performance and quality-of-life scores compared to healthy controls. In addition to improving symptoms in chronic diseases, it is important to evaluate and improve the quality of life of patients in routine practice and to ensure psychosocial well-being.

Assessment of Quality of Life Among Patients With Recurrent Clostridioides difficile Infection Treated with Investigational Oral Microbiome Therapeutic SER-109

Recurrent Clostridioides difficile infection (CDI) is a debilitating disease leading to poor health-related quality of life (HRQOL), loss of productivity, anxiety, and depression. The potential association of treatment with HRQOL has not been well evaluated. To explore the association of SER-109 compared with placebo on HRQOL in patients with recurrent CDI up to week 8. This study was a secondary analysis of a randomized, double-blind, placebo-controlled trial that took place at 56 sites in the US and Canada from July 2017 to April 2020 and included 182 patients randomized to SER-109 or placebo groups. SER-109 or placebo (4 capsules once daily for 3 days) following antibiotics for CDI. Exploratory analysis of HRQOL using the disease specific Clostridioides difficile Quality of Life Survey (Cdiff32) assessed at baseline, week 1, and week 8. In this study, 182 patients (109 [59.9%] female; mean age, 65.5 [16.5] years) were randomized to SER-109 (89 [48.9%]) or placebo (93 [51.1%]) groups and were included in the primary and exploratory analyses. Baseline Cdiff32 scores were similar between patients in the SER-109 and placebo groups (52.0 [18.3] vs 52.8 [18.7], respectively). The proportion of patients with overall improvement from baseline in the Cdiff32 total score was higher in the SER-109 arm than placebo at week 1 (49.4% vs 26.9%; P = .012) and week 8 (66.3% vs 48.4%; P = .001).Greater improvements in total and physical domain and subdomain scores were observed in patients in the SER-109 group compared with placebo as early as week 1, with continued improvements observed at week 8. Among patients in the placebo group, improvements in HRQOL were primarily observed in patients with nonrecurrent CDI while patients in the SER-109 group reported improvements in HRQOL, regardless of clinical outcome. In this secondary analysis of a phase 3 clinical trial, SER-109, an investigational microbiome therapeutic was associated with rapid and steady improvement in HRQOL compared with placebo through 8 weeks, an important patient-reported outcome. ClinicalTrials.gov Identifier: NCT03183128.

Preliminary findings from a risk stratification, quality of life and burden of illness in pulmonary arterial hypertension pilot study

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Janssen Australia and New Zealand (Janssen-Cilag Pty Ltd) Pulmonary Arterial Hypertension (PAH) management strategies focus on lowering mortality risk, extending the patient’s life span through the control and alleviation of disease symptoms, improving Quality of Life (QoL) and decreasing the burden of illness. This paper describes preliminary results of an Investigator Initiated pilot study exploring the relationship between PRO measures (PAH-SYMPACT, EQ5D5L); Burden of Illness assessment; and the ESC/ERS Risk Stratification. Findings Measures of PAH risk and QoL were assessed in 42 patients presenting to the IPAH clinic for management; mean age 69.2 [range 39, 84]; females 35 (83.3%), males 7 (16.7%). Tools analysed and compared included: PAH-SYMPACT and EQ-5D-5L as PRO and QoL measures; and ESC-ERS PAH risk stratification criteria to assess mortality risk. Health utility scores were derived from existing value sets: there was a 20% median reduction in QALYs for our patient population, with detrimental effects being more marked in those patients with greater impairment of EQ-5D-5L physical and cognitive-emotional domains (respectively: r = -0.92, p&amp;lt;0.001; and r = -0.85, p&amp;lt;0.001), PAH-SYMPACT physical domain reduction (r = -0.59, p&amp;lt;0.01), and PAH-SYMPACT cardiovascular symptoms (r = 0.64), p&amp;lt;0.01) and cardiorespiratory (r = 0.64, p&amp;lt;0.01) involvement. Physical domain scores were highly correlated for the two PROs studied (r = 0.74, p&amp;lt;0.001), but an unexpected poor correlation was seen in the cognitive/emotional domain (non-significant negative correlation) which requires further exploration. Unsurprisingly, EQ-5D-5L Visual Analogue Score for well-being was inversely correlated with physical domain impairment (r = -0.59, p&amp;lt;0.01), although it was noted that this did not apply for the cognitive/emotional domain. The agreement between tools was variable, with highest concordance seen for assessment of the physical domain (r = 0.74, p&amp;lt;0.001), and this raises the need to further define the merits of disease-specific (PAH-SYMPACT) vs generic (EQ-5D-5L) PRO analytic approaches. Tools examined in this study were well-correlated with symptomatic impairment, but neither PRO tool correlated with established risk markers as characterized in compound prognostic guides such as ESC-ERS criteria. Conclusions The fact that PRO indices showed little correlation with established risk stratification markers implies that the information provided by PROs is not redundant, and it is yet be assessed whether the incorporation of PRO’s may add further to the precision of risk assessment, a little-studied area which this group is further exploring. There should be more widespread and uniform use of PRO measures as part of standard PAH management.

Health Expectations and Quality of Life After Acute Respiratory Failure: A Multicenter Prospective Cohort Study

Patients often have high expectations for recovery after critical illness, but the impact of these expectations on subsequent quality of life (QoL) after serious illnesses has not been evaluated empirically. Among adult survivors of acute respiratory failure (ARF), are met vsunmet expectations for health associated with self-reported QoL 6months after discharge? This was a prospective longitudinal cohort study enrolling consecutive adult patients with ARF managed in ICUs at five academic medical centers. At hospital discharge, we evaluated participants' expected health 6months in the future via a visual analog scale (VAS; range, 0-100), with higher scores representing better expected health. At 6-month follow-up, perceived health was assessed using the EQ-5D VAS, and QoL was assessed using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) instrument. Participants' health expectations were categorized as having been met when perceived health at 6months was no more than eight points lower than their expectation at study enrollment. The primary analysis compared WHOQOL-BREF domain scores (range, 0-100) at 6months after discharge in patients with met vsunmet health expectations using the nonparametric Mann-Whitney U test. Secondary analysis modeled WHOQOL-BREF domain scores using multivariate regression, and sensitivity analyses assessed QoL using EQ-5D-5L index values. In the primary analysis, QoL was significantly better among participants with met vsunmet health expectations across all domains of the WHOQOL-BREF: physical health (estimated difference in scores: median, 19 [interquartile range (IQR), 12-15]; P< .001), psychological health (median, 12 [IQR, 6-18]; P< .001), social relationships (median, 6 [IQR, 0-13]; P= .02), and environmental health (median, 12 [IQR, 6-13]; P< .001). In multivariate regression, the difference between expected and perceived health remained associated significantly with the physical health domain score. Fulfillment of health expectations is associated with better QoL after ARF, suggesting a mechanism underpinning successful ICU recovery programs that incorporate normalization and expectation management.

The Impact of Sleep Disturbances on Health-Related Quality of Life in Children With Acquired Brain Injury After Critical Care

BackgroundOver 60,000 children with acquired brain injury (ABI) in the United States require admission to pediatric intensive care units annually. Over 50% suffer sleep-wake disturbances (SWDs) months after discharge. Given the importance of sleep to brain repair, we hypothesized that SWD would be associated with poorer health-related quality of life (HRQOL). MethodsCross-sectional analysis of prospectively collected data in children with ABI aged 3 to 18 years evaluated 1 to 3 months after critical care hospitalization (N = 151). SWD measured by Sleep Disturbances Scale for Children and defined as T-score ≥60 signifying moderate-severe risk of sleep disorders. HRQOL measured by Pediatric Quality of Life Inventory, which defines minimal clinically important difference as 4.5 points in total score. Secondary outcomes included scores for Physical, Emotional, Social, and School Function domains. SWD groups were compared with Mann-Whitney tests. Multiple linear regression evaluated association between SWD and HRQOL controlling for patient and ABI characteristics. Significance was defined as P < 0.05. ResultsSWDs were present in 66% (n = 100). HRQOL total score was significantly lower in children with SWD (median = 70; interquartile range [IQR] = 54, 80) versus without (median = 85; IQR = 67, 94; P < 0.001). Median scores in emotional, social, and school domains were significantly lower in SWD group (all P < 0.01). When controlling for age, sex, critical care interventions, preadmission comorbidities, and decline from preadmission Functional Status Scale, presence of SWD significantly reduced HRQOL total score nearly three times minimal clinically important difference (β-coefficient = −12.1; 95% confidence Interval = −17.9, −6.2). ConclusionsSWD following ABI significantly decreased HRQOL overall and across multiple health domains. Sleep is potentially modifiable. Our data support future studies targeting sleep to improve outcomes after ABI.

Ambulatory oxygen therapy in lung transplantation candidates with idiopathic pulmonary fibrosis referred for pulmonary rehabilitation.

To determine independent factors related to the use of oxygen and the oxygen flow rate in idiopathic pulmonary fibrosis (IPF) patients placed on a lung transplant waitlist and undergoing pulmonary rehabilitation (PR). This was a retrospective quasi-experimental study presenting functional capacity and health-related quality of life (HRQoL) data from lung transplant candidates with IPF referred for PR and receiving ambulatory oxygen therapy. The patients were divided into three groups on the basis of the oxygen flow rate: 0 L/min (the control group), 1-3 L/min, and 4-5 L/min. Data on functional capacity were collected by means of the six-minute walk test, and data on HRQoL were collected by means of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), being collected before and after 36 sessions of PR including aerobic and strength exercises. The six-minute walk distance improved in all three groups (0 L/min: Δ 61 m, p < 0.001; 1-3 L/min: Δ 58 m, p = 0.014; and 4-5 L/min: Δ 35 m, p = 0.031). Regarding HRQoL, SF-36 physical functioning domain scores improved in all three groups, and the groups of patients receiving ambulatory oxygen therapy had improvements in other SF-36 domains, including role-physical (1-3 L/min: p = 0.016; 4-5 L/min: p = 0.040), general health (4-5 L/min: p = 0.013), social functioning (1-3 L/min: p = 0.044), and mental health (1-3 L/min: p = 0.046). The use of ambulatory oxygen therapy during PR in lung transplant candidates with IPF and significant hypoxemia on exertion appears to improve functional capacity and HRQoL.

Sex Differences in Quality of Life and Clinical Outcomes in Patients with Heart Failure

Background: Heart failure (HF) is generally associated with poor quality of life (QoL). Limited data are available characterizing health-related QoL (HRQL) in Chinese patients with HF. Methods: We used the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to record QoL in 4082 patients with HF from China who were followed up over 12 months in the Heart Failure Registry of Patient Outcomes (HERO) study. Baseline HRQL and differences in QoL between women and men with heart failure were compared. We used multivariable Cox regression with adjustment for variables to assess the association between MLHFQ summary scores and a composite of all-cause mortality and HF hospitalization. Result: At baseline, the mean MLHFQ in the overall population was 42.9 ± 19.57; the scores for physical and emotional domains were 22.0 ± 8.69 and 8.66 ± 6.08, respectively. Women had a higher (poorer) MLHFQ summary score (44.27 ± 19.13) than men (41.63 ± 19.90) (P&lt;0.001). Female patients also had higher MLHFQ physical and emotional scores than male patients (P&lt;0.001). The specific scores of the questionnaire were higher in women than men. NYHA class was the strongest independent predictor of MLHFQ score (β=6.12 unit increment; P&lt;0.001). Sex was not independently associated with higher MLHFQ scores after multivariable adjustments. The 12-month mortality in the overall cohort was 19.6%, the hospitalization rate was 24.4%, and the composite endpoint was 40.15%. A 10-point increase in MLHFQ score was associated with higher risk of mortality (female and male HRs=1.19 [95% CI 1.12–1.26]; P&lt;0.001 and 1.18 [95% CI 1.12–1.24]; P&lt;0.001, respectively) and composite outcomes (HRs=1.08 [95% CI 1.04–1.13]; P&lt;0.001 and 1.11 [95% CI 1.07–1.14]; P&lt;0.001, respectively). Females did not show a significant association between HRQL and hospitalization (HR=1.04 [95% CI 0.99–1.09]; P=0.107). Conclusion: Quality of life was largely poorer in women than men, but was similar between sexes in terms of physical burden and emotional limitation. HRQL is an independent predictor of all-cause death and HF hospitalization in patients with HF.

Value of Heart Rate Variability, Neutrophil-Lymphocyte Ratio and Quality of Life of Patients with Depressive Symptoms in Acute Myocardial Infarction

Introduction. Major depression criteria can be found in more than 20% of coronary heart patients and more than 30% acute coronary syndrome patients have significant depressive symptoms. Several studies have shown that reduction of hearth rate variability (HRV) and enhancement of neutrophil lymphocyte ratio (NLR) can cause enhancement of morbidity and mortality in myocardial infarction patients. On the other hand, depression can cause reduction of HRV, enhancement of NLR and reduction of quality of life. This study aimed to determine differences in HRV, NLR and quality of life between acute myocardial infarction (AMI) patients with depressive symptoms and AMI patients without depressive symptoms. Methods. A cross-sectional study was conducted among AMI patients who were treated during the period of March to July 2021 at the Intensive Cardiac Care Unit (ICCU) Cipto Mangunkusumo Hospital Jakarta. Samples were taken consecutively until the amount of sample is met. Data were analyzed using unp aired T test. Results. There was a total of 46 subjects AMI patients in this study, ten subjects with depressive symptoms and 36 subjects without depressive symptoms. From the analysis, it was found that AMI patients with depressive symptoms had lower standard deviation normal to normal (SDNN) average (p=0.447), lower low frequency/high frequency (LF/HF) (p=0.323), and higher NLR average (p=0.438) than AMI patients without depressive symptom, although it was not statistically significant. Analysis showed that the mean value of SF36 total scores (p<0.001), physical function domain scores (p<0.001), energy domain scores (p<0.001), mental health domain scores (p<0.001), social function domain scores (p=0.028), bodily pain domain scores (p=0.002), and general health domain scores (p=0.002) were lower in AMI patients with depressive symptoms. Conclusion. AMI patients with depressive symptoms had lower SDNN, lower LF/HF, and higher NLR than AMI patients without depressive symptoms, although it was not statistically significant. AMI patients with depressive symptoms significantly have lower quality of life than AMI patients without depressive symptoms.