Physical Health-related Quality Of Life Domains Research Articles

Quality of Life in Patients with Excellent 3-Month Clinical Outcome after First-Ever Ischemic Stroke: A Time to Redefine Excellent Outcome?

Introduction: Ischemic stroke (IS) may have impact on long-term health-related quality of life (HRQoL) even in the patients with good clinical outcome, and tools mostly used for the assessment of outcome may underestimate or not reflect all relevant sequels after IS. We aimed to analyze HRQoL in the patients with excellent outcome after IS. Methods: We analyzed consecutive IS patients enrolled in the prospective FRAILTY study (ClinicalTrials.gov: NCT04839887) with excellent 3-month clinical outcome (score 0–1 in modified Rankin Scale [mRS]). Stroke Impact Scale (SIS) version 3.0 and Hospital Anxiety and Depression Scale (HADS) were used for the HRQoL, anxiety, and depression assessments, and subgroup comparisons were performed according to NIHSS score (0, ≥1), age (50<, ≥50 years), and sex. Results: In total, 158 patients (55.7% men, mean age 60.3 ± 13.4 years) were analyzed, and 72.2% of them had score 0 in mRS. The overall lowest median scores were found in the SIS domain “emotion,” “strength,” and “participation.” Patients with NIHSS ≥1 had lower scores in all SIS domains except “emotions” and “mobility.” Patients ≥50 years had lower score in “mobility” (p = 0.004) and females in domain of “social participation” (p = 0.044). No differences were found among all subgroups in HADS anxiety and depression. Age, NIHSS score, and depression were found negative predictors for the physical domains of HRQoL. Discussion/Conclusions: Despite excellent 3-month clinical outcome after IS, patients had affected substantially their HRQoL, especially those with NIHSS ≥1. Patients ≥50 years had more affected “mobility” and females “social participation.”

A153: The Relationships Between Physical Activity and Health-Related Quality of Life in Parent-Child Dyads with ASD

Purpose: Researchers have found that the core and combined symptoms of autism spectrum disorder (ASD) negatively influence the health-related quality of life (HRQoL) of autistic children and their parents. Although it is supported that participation in physical activity (PA) can enhance the HRQoL and well-being in general, few studies have addressed the relationship between HRQoL with PA in the population with ASD. This study examines how much leisure-time physical activity participation is correlated to HRQoL in parent-child dyads with ASD. Method: Participants were recruited from two Rehabilitation Centers for neurodevelopmental disability children. Eighty-five ASD children and their parents participated in this study. HRQoL for ASD children and their parents was measured with the World Health Organization Quality of Life short form (WHOQoL-26) and the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0, parent-report version) respectively, while leisure-time PA participation of both children and parents was assessed using the Godin Leisure-Time Exercise Questionnaire (GLTEQ). We first confirmed the psychometrics of the WHOQoL-26 and PedQL 4.0 and then analyzed the relationships between different levels of PA and HRQoL in dyads. Results: Descriptive statistics showed that 30.6% of ASD children (Mage=5.25±1.48; 85.9% boys) and 42.4% of their parents (75.3% between 31-40 years; 73 mothers and 12 fathers) were insufficiently active. For parents of children with ASD, the physical domain of HRQoL had a small positive correlation with light PA (r=0.27, p=0.013) while the psychology domain had a small to moderate positive correlation with moderate (r= 0.23, p=0.04), light (r=0.3, p=0.006), and total (r=0.23, p=0.032) PA. Also, the environment domain of HRQoL had a small positive correlation with moderate (r=0.28, p=0.011) and light (r=0.32, p=0.003) PA. Concerning ASD children, the physical domain of HRQoL had a small to moderate positive correlation with moderate (r= 0.24, p= 0.027) and total (r= 0.32, p= 0.004) PA. Furthermore, there were several interrelationships between parent-child dyads’ PA and parent-child dyads’ HRQoL. ASD children’s social domain in HRQoL was correlated to their parents’ light PA (r=0.25, p=0.021) whereas parents’ environment domain was correlated to their children’s mild PA (r=0.24, p=0.03). Conclusion: There are significant relationships between PA and HRQoL for both children with ASD and their parents. Particularly, the parent-child dyads’ HRQoL may benefit from each other’s leisure-time PA involvement. Due to ASD children’s restricted daily PA norm and their parent’s challenging caregiving environment, the designation of effective PA enhancement strategies may enhance the quality of life in both children with ASD and their parents.

Health-Related Quality of Life After Percutaneous Coronary Intervention for Stable Ischemic Heart Disease: A Systematic Review and Meta-analysis.

There has been no meta-analysis of whether percutaneous coronary intervention (PCI) with optimal medical therapy (OMT) improves health-related quality of life (HRQL) compared with OMT alone in patients with stable ischemic heart disease (SIHD). We searched MEDLINE, Cochrane Central Registry of Controlled Trials, Embase, ClinicalTrials.gov, and International Clinical Trials Registry Platform in November 2022. We included randomized controlled trials (RCTs) that compared PCI with OMT vs OMT alone with HRQL in patients with SIHD. The primary outcome was the aggregated physical HRQL, including physical functioning using the Short Form (SF)-36 or RAND-36, physical limitation using the Seattle Angina Questionnaire (SAQ) or SAQ-7, McMaster Health Index Questionnaire, and Duke Activity Status Index within 6 months. Data were analyzed using a random effects model when substantial heterogeneity was identified or a fixed effect model otherwise. Among 14 systematically reviewed RCTs, 12 RCTs with 12,238 patients were meta-analyzed. Only 1 trial had a low risk of bias in all domains. PCI with OMT improved aggregated physical HRQL (standardized mean difference, 0.16; 95% confidence interval [CI], 0.1-0.23; P < 0.0001) at 6 months. Also, PCI with OMT improved physical functioning on the SF-36/RAND-36 (mean difference 3.65; 95% CI, 1.88-5.41) and physical limitation on the SAQ/SAQ-7 (mean difference, 3.09; 95% CI, 0.93-5.24) compared with OMT alone at 6 months. However, all of the aggregated physical HRQL domains were classified into small effects, and no HRQL domain exceeded the prespecified minimal clinically important difference. These findings showed that PCI with OMT improved HRQL compared with OMT alone in patients with SIHD, but the benefit was not large.

Long-Term Follow-Up of Health-Related Quality of Life and Short-Term Intervention with CFTR Modulator Therapy in Adults with Cystic Fibrosis: Evaluation of Changes over Several Years with or without 33 Weeks of CFTR Modulator Therapy

Background: Longitudinal data on changes in health-related quality of life (HRQoL) in adult people with cystic fibrosis (pwCF) and the longitudinal effects of Elexacaftor/Tezacaftor/Ivacaftor therapy (ETI) on HRQoL or HRQoL domains are currently scarce. This study aimed to investigate the effects of ETI on HRQoL and compare them with those of pwCF who did not receive highly effective CFTR modulators over a longer period. Methods: Baseline assessment and follow-up data for 5.6 years in pwCF with (n = 21) and 6.5 years in pwCF without (n = 6) ETI (≥18 years) were evaluated. The assessment of HRQoL and clinical parameters was identical at both time points. HRQoL was assessed using the CFQ-R, and clinical outcomes included BMI, ppFEV1, and FEV1 z-score. Results: ETI was found to improve all HRQoL domains at more than four points over time, and their increases were significant except for vitality, digestion, treatment burden, and social functioning (p &lt; 0.05). Without ETI, psychosocial domains remained almost constant, whereas most physical domains decreased over time. Conclusions: The results of the present study show that ETI therapy has a positive effect on HRQoL and clinical outcomes over time but not in pwCF without ETI treatment. Furthermore, our results suggest that disease progression over time affects the physical domains of HRQoL more than the psychosocial domains. Due to the small sample size and the heterogeneity of the study population (CFTR mutation genotype), the results should be interpreted with some caution.

Effects of aerobic, resistance, and combined exercise training on health-related quality of life in multiple sclerosis: Systematic review and meta-analysis.

Multiple sclerosis (MS) is an immune-mediated, neurodegenerative disease of the central nervous system that manifests in symptoms that compromise health-related quality of life (HRQOL). HRQOL focuses on a person's overall, subjective evaluation of health status primarily in the physical and mental domains. Exercise training is a form of rehabilitation for managing MS-related outcomes that might influence HRQOL. Reviews on exercise training are available, but we are unaware of a recent comprehensive review and meta-analysis of exercise effects for improving physical and mental domains of HRQOL. This analysis provides an updated review and meta-analysis of randomized controlled trials (RCTs) examining interventions consisting of aerobic, resistance and combined exercise training for improving HRQOL in persons with MS. This systematic review 1) assessed the overall strength of evidence for exercise interventions on HRQOL, 2) evaluated the relative effect of exercise interventions on physical and mental domains of HRQOL, and 3) determined moderators of exercise intervention effects on HRQOL. Seven databases were searched for RCTs evaluating physical and/or mental domains of HRQOL with adults diagnosed with MS and undergoing an intervention of aerobic, resistance or combined exercise training compared with a non-exercise comparator. Data extraction included participant and intervention characteristics, and pre- and post-intervention HRQOL outcome data. Effect sizes (ESs) were calculated as standardized mean differences (SMDs) and a multilevel random-effects model was used to generate an aggregated SMD that compared exercise with non-exercise control conditions. Twelve RCTs met the inclusion criteria and yielded 23 ESs to be analyzed. Participants (N=593; 308 intervention vs. 285 control conditions) had a mean (±standard deviation) age of 42.4 (6.5) years and 80% (18.3%) were female. Results generated a medium effect of exercise for improving overall HRQOL (ES=0.64, p=0.0001) with high heterogeneity (Q11=58.8, I2=86.7%). Exercise training yielded a large effect on the physical domain (k=12, ES=0.82, p<0.0009) and a medium effect on the mental domain (k=11, ES=0.41, p<0.0001). Moderator analyses identified exercise modality, supervision level, intervention delivery and length, HRQOL tool, and number of participants with relapsing-remitting MS as significant influences of ES for HRQOL. Exercise training is clinically effective for improving overall HRQOL in MS and produces greater improvements in the physical domain of HRQOL than the mental domain. The moderator analysis suggests that supervised, aerobic, and group-delivered exercise training of ≥3 months yields the most influence on HRQOL. Such results may have major implications for MS treatment and care.

Health-related Quality of Life After Liver Transplantation-An Important Goal, but One Definition (or Size) Does Not Fit All.

Health-related Quality of Life After Liver Transplantation-An Important Goal, but One Definition (or Size) Does Not Fit All.

Effects of a 16-week home-based exercise training programme on health-related quality of life, functional capacity, and persistent symptoms in survivors of severe/critical COVID-19: a randomised controlled trial

BackgroundLong-lasting effects of COVID-19 may include cardiovascular, respiratory, skeletal muscle, metabolic, psychological disorders and persistent symptoms that can impair health-related quality of life (HRQoL). We investigated the effects of a...

Impact of physical functional capacity on quality of life in patients with interstitial lung diseases

This study aimed to investigate the physical functioning predictors for health-related quality of life (HRQL) decline in patients with idiopathic interstitial fibrosis (IPF), sarcoidosis and other interstitial lung disease (ILD).The study enrolled 52 patients with ILD and 16 healthy individuals. Participants’ HRQL was assessed using the 36-item Short-Form Health Survey questionnaire. Spirometry, physical performance, and daily physical activity (PA) were monitored.Patients with IPF showed significantly lower PA compared to patients with other ILD (p = 0.002)and sarcoidosis (p = 0.01). The type of disease aetiology had no significant effect on aerobic capacity, HRQL and fatigue. Patients with ILD showed significant greater fatigue, lower physical functioning and greater physical aspects scores compared to the control group (F=6.0; p = 0.018; F=12.64; p = 0.001, respectively). A significant positive correlation was observed between 6-minute walking distance (6MWD) and the physical domain of HRQL (r = 0.35, p = 0.012) and PA and the physical aspects of HRQL (r = 0.37, p = 0.007).This study revealed that the key predictors for HRQL decline were lower lung function, lower PA and physical performance.

MP23-13 ASSESSMENT OF BASELINE FUNCTIONAL STATUS AND RECOVERY FOLLOWING ROBOT-ASSISTED RADICAL CYSTECTOMY WITH INTRACORPOREAL URINARY DIVERSION

You have accessJournal of UrologyCME1 May 2022MP23-13 ASSESSMENT OF BASELINE FUNCTIONAL STATUS AND RECOVERY FOLLOWING ROBOT-ASSISTED RADICAL CYSTECTOMY WITH INTRACORPOREAL URINARY DIVERSION Rand Wilcox Vanden Berg, Ashwin Ramaswamy, Bernard Bochner, and Alvin Goh Rand Wilcox Vanden BergRand Wilcox Vanden Berg More articles by this author , Ashwin RamaswamyAshwin Ramaswamy More articles by this author , Bernard BochnerBernard Bochner More articles by this author , and Alvin GohAlvin Goh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002562.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Open and robot-assisted radical cystectomies (ORC and RARC, respectively) have been shown to have equivalent oncologic outcomes. RARC is associated with longer operative times, but also with shorter length of stay and decreased operative blood loss. Despite the recent increase in use of intracorporeal urinary diversion (ICUD), few studies to date have analyzed health-related quality of life (HRQOL) and related functional recovery in the perioperative period in patients undergoing RARC with ICUD. METHODS: We reviewed patients undergoing RARC with ICUD between 2017 - 2021. Patients were prospectively administered the Short Form Health Survey (SF-12), the Lawton-Brody Instrumental Activities of Daily Living Scale (Lawton-Brody), and the Katz Index of Independence in Activities of Daily Living (Katz). SF-12 responses were used to calculate the physical component summary (PCS) and mental component summary (MCS). Demographic characteristics and survey results were compared using the Mann-Whitney and chi-square tests for continuous and categorical variables, respectively. p <0.05 was considered statistically significant. RESULTS: 85 patients met inclusion criteria; 20.0% were female and median age was 69.7 years (IQR 63.4-74.2). Median operative time, blood loss, and length of stay were 424 min (IQR 373-479), 200 mL (IQR 100-300), and 4 days (IQR 4-6), respectively. Functional scores decreased from baseline at 2 weeks post-surgery on the SF-12(PCS) (-20.7, p <0.01) and Lawton-Brody (-2, p <0.01) questionnaires, and at 4 weeks on the Katz questionnaire (-0.6, p=0.05); they all returned to baseline levels by 12 weeks (figure). While not significant, there was an increase over baseline in the SF-12(PCS) at 1 year. Median follow up was 362 days (IQR 96-640). CONCLUSIONS: The post-operative period had a decrease in functional status (ADLs, IADLs) and the physical domain of HRQOL, which recovered in the 3 post-operative months. This pattern and timeframe of functional recovering can help guide future studies of comparative recovery (eg, between RARC and ORC) and inform future trials of the best window of opportunity for interventions into accelerating functional recovery. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e387 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rand Wilcox Vanden Berg More articles by this author Ashwin Ramaswamy More articles by this author Bernard Bochner More articles by this author Alvin Goh More articles by this author Expand All Advertisement PDF DownloadLoading ...

Anxiety, Depression and Quality of Life in Pulmonary Hypertension: A Comparison of Incident and Prevalent Cases

Introduction: Anxiety and depression are common in pulmonary hypertension (PH) and health-related quality of life (HRQoL) is reduced. Sufficient analyses in incident and prevalent patients are lacking, so we provide a comparative analysis of these groups with focus on anxiety, depression and HRQoL. Methods: Depression, anxiety and HRQoL were retrospectively analyzed by Hospital Anxiety and Depression Scale (HADS) and Short Form 36 questionnaire in 91 prevalent and 21 incident PH outpatients from a German tertiary care center specialized in PH. The acquired data as well as hemodynamic and functional parameters of prevalent and incident cases were compared. Results: HRQoL was reduced in both cohorts of patients. Incident patients had significantly worse HRQoL in physical dominated scales than prevalent patients (physical component summary score: p = 0.02; physical role performance: p < 0.01). Depression and anxiety were more pronounced in prevalent patients (elevated depression scales: 28.6% of incident group, 35.2% of prevalent group, elevated anxiety scores: 28.6% of incident group, 39.6% of prevalent group). The groups did not differ in hemodynamic data, but incident patients had significantly lower cardiac biomarkers such as NT-proBNP (p = 0.016) and hs-troponin (p = 0.017). The time since diagnosis was a predictor of the subscale physical role performance (p < 0.001). Conclusion: Physical domains of HRQoL seem to be more limited in incident patients with PH. Anxiety and depression are frequent in both groups. A screening for anxiety and depression is important from the onset of the diagnosis, and patients should receive appropriate therapy to improve HRQoL, anxiety and depression.

Effect of Exercise Training on Quality of Life after Colorectal and Lung Cancer Surgery: A Meta-Analysis.

Simple SummarySurgery is the treatment modality associated with better long-term survival in patients diagnosed with lung cancer and colorectal cancer. However, as a result of surgery, patients experience a substantial decline in health-related quality of life (HRQoL) and increased fatigue symptoms. The purpose of this systematic review was to investigate the effect of pre- and/or postoperative exercise training on HRQoL and fatigue after surgical resection for lung and colorectal cancer. Our results showed that exercise training interventions improve the physical domain of HRQoL and reduce fatigue levels after lung cancer surgery, supporting its use to optimize patients’ recovery. No benefits were found on HRQoL and fatigue after colorectal cancer surgery.Surgical treatment affects health-related quality of life (HRQoL) and increases fatigue symptoms in patients with lung cancer (LC) and colorectal cancer (CRC). We aimed to systematically review the effect of exercise training on HRQoL and fatigue after LC and CRC surgery. Randomized controlled trials published before 21 March 2021, were searched in PubMed, Scopus, Web of Science, SPORTDiscus and PEDro. Eligible trials compared the effect of exercise interventions initiated preoperatively or in the first 3 months after surgery versus usual care on postoperative HRQoL and fatigue. Standardized mean differences (SMD) were pooled using random-effects models. Twelve studies with a total of 777 patients were included. In LC patients (10 studies, n = 651), exercise training in general led to a moderate improvement in the physical domain of HRQoL (0.68: 95% CI: [0.47; 0.89]) and a small reduction in fatigue levels after surgery (SMD = 0.28: 95% CI: [0.02; 0.53]), while no effects were found in other HRQoL domains. In CRC (two studies, n = 126), exercise training showed no effects on HRQoL and fatigue after surgery. Exercise training is an effective intervention to improve physical function and fatigue after LC surgery. Further studies are necessary to clarify the effects of exercise on HRQoL and fatigue after CRC surgery.

Quality of life of children and adolescents with clinical obesity, perspectives of children and parents

Background/objectivesChildhood obesity can have important psychological impacts. The objective of this study was to evaluate the Health Related Quality of Life (HRQoL) of children and adolescents with overweight and obesity. The participants were referred to an outpatient hospital-based obesity treatment. Additionally, we investigated the differences between parent- and self-reported HRQoL. Subjects/methodsChildren and adolescents aged 3−18 years with overweight or obesity, referred by their general practitioner or youth health care physician to the pediatric outpatient clinic of Hospital Gelderse Vallei (Ede, the Netherlands) for multidisciplinary obesity treatment, were enrolled in this cross-sectional study (n = 119). Interventions/methodsParent-proxy reported HRQoL was assessed using the Child Health Questionnaire Parental Form 50 (CHQ-PF50, n = 119) and the Infant Toddler Quality of Life Questionnaire 97 (ITQOL-97). Adolescents completed CHQ Child Form 87 (CHQ-CF87, n = 45) and Impact of Weight on Quality of Life-Kids (IWQOL-Kids, n = 38) to assess self-reported HRQoL. ResultsThe mean age of the children was 9.6 years (SD 4.3). Both parent-proxy reports and child self-reports showed lower HRQoL in children with a higher degree of obesity, especially in the physical domains of HRQoL (p < 0.05). Child self-reported scores were significantly lower than parent-proxy scores on the subscales ‘bodily pain/discomfort’ and ‘general health perceptions’, and significantly higher on ‘behavior’ and ‘family cohesion’ (p < 0.05). ConclusionsChildhood obesity has a negative effect on HRQoL, especially on the physical aspects. The discordance between parent and child reports underscores the importance of using a combination of parent-proxy and child self-reports to assess HRQoL.

Power walking based outpatient cardiac rehabilitation in patients with post-coronary angioplasty: Randomized control trial.

The purpose of this trial was to compare the effectiveness of standardized outpatient cardiac rehabilitation combined with treadmill power walking versus standardized outpatient cardiac rehabilitation alone on health-related quality of life (HQoL), functional exercise capacity (FEC), left ventricular ejection fraction (LVEF) and metabolic equivalent of tasks (METs) in patients who went post coronary angioplasty (CA). Further this study evaluated the association between average numbers of steps taken with above clinical outcomes. In a pragmatic sequential randomized clinical trial, 24 patients were randomized into two groups (n=12) and participated in a standardized outpatient cardiac rehabilitation program (SOCRP) with treadmill power walking as an intervention group and SOCRP alone in control group. Scores obtained before and after 4 weeks of intervention, that is, after 12 treatment sessions were assessed using a HQoL questionnaire and 6-min walk test (6 MWT). Average number of steps taken throughout the 4 weeks, METs and LVEF values were obtained by pedometer, exercise stress testing and echocardiogram respectively. Significant improvements were found in intergroup and intragroup comparison after 4 weeks of cardiac rehabilitation (p<0.05). Scores of 6 MWT and LVEF significantly improved in the intervention group (p<0.003) compared to the control group (p<0.032). HQoL components that is, global and physical, MET values and average number of steps were significantly higher in the intervention group compared to the control group (p<0.001). SOCRP with power walking was more effective in improving HQoL, FEC, LVEF, METs and average numbers of steps than SOCRP alone although both interventions were significant after 4 weeks in patients underwent CA and completed cardiac rehabilitation program. Positive significant associations were found between the average number of steps taken with scores of METs and scores of global and physical domains of HQoL.

Health-related quality of life in adults with tetralogy of Fallot repair: a systematic review and meta-analysis.

With the advancement in diagnostics and clinical management, patients with Tetralogy of Fallot (ToF) are surviving till adulthood. Hence, assessing the impact of ToF repair on health-related quality of life (HRQOL) of these patients is becoming increasingly important. The objective of this paper is to conduct a systematic review and meta-analysis of the HRQOL in patients who have undergone ToF repair. A systematic search was conducted using PubMed, CINAHL, Medline and Web of Science databases. Studies that compared the HRQOL of adult patients (mean age ≥ 18years) who had previously undergone ToF repair with healthy controls were included. Analysis was done via Revman V5.3 using a random effects model. The 16 studies (15 using SF-36) included in the meta-analysis, comprised 1818 patients and 50,265 healthy controls. There was a higher proportion of males (59%). The mean ages at surgery and at HRQOL assessment were 5.37years and 30.3years, respectively. We found that repaired ToF patients had a statistically significantly lower score in the physical component summary (SMD = -0.92 CI = -1.54, -0.30) and physical functioning (SMD = -0.27 CI = -0.50, -0.03) compared to healthy controls. However, these patients had statistically significantly higher scores in the bodily pain domain (SMD = 0.35 CI = 0.12, 0.58) and social functioning (SMD = 0.23 CI = 0.01, 0.46), while there was no significant difference in other domains. Overall, physical domain of HRQOL was statistically significantly lower in repaired ToF patients compared to healthy controls. However, repaired ToF patients scored significantly higher on bodily pain and Social Functioning. There was additionally no difference in the HRQOL between the two groups in other domains of HRQOL.

Health-related Quality of Life in Adult Patients with Multiple Epiphyseal Dysplasia and Spondyloepiphyseal Dysplasia.

ABSTRACTObjectives:Multiple epiphyseal dysplasia (MED) and spondyloepiphyseal dysplasia (SED) are skeletal dysplasias associated with premature osteoarthritis and short stature. Patients with SED often have spinal and ocular problems. Few reports have focused on the health-related quality of life (HRQoL) of patients with skeletal dysplasias associated with premature osteoarthritis. The purpose of this study was to evaluate the HRQoL of adult patients with MED and SED.Methods:Questionnaires covering demographics, medical history (cataract, retinal detachment, and osteoarthritis), surgical history (osteotomy and arthroplasty), and the Short Form-36 (SF-36) health survey were sent to all patients with MED and SED with medical records at the investigators’ institutions. Among the 27 patients who completed the questionnaire, patients aged 20 years or older were included in this cohort.Results:The subjects were 18 affected individuals. The physical component summary score (PCS) was significantly lower in the MED and SED groups than in the normal population and tended to deteriorate with age. Conversely, there was a positive correlation between the mental component summary score and age. The role/social component summary score was not correlated with age. MED patients with osteoarthritis had a low PCS. PCS was particularly low in two SED patients with a medical history of cataract, whereas there was no association with a history of retinal detachment or osteoarthritis.Conclusions:The physical domain of HRQoL in MED and SED patients significantly deteriorated at a young age. Appropriate medical management of these skeletal dysplasias is required not only for orthopedic functions but also for ocular problems.

Understanding the impact of COVID-19 pandemic on health-related quality of life amongst Iranian patients with beta thalassemia major: a grounded theory.

The coronavirus disease 2019 (COVID-19) pandemic and the resulting measures can impact daily life and healthcare management amongst patients with beta thalassemia major. The Corbin and Strauss method of grounded theory was used to explore the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) amongst Iranian patients with beta thalassemia major. Semi-structured interviews with 16 patients with thalassemia major in the eastern of Iran were performed. Data collection was conducted from 19 September through 18 November 2020. Collected data were recorded, transcribed, and coded to develop themes and subthemes. Paradigm components were sought to find out what happened to these patients and explore the process and events. Insights from these interviews led to five major themes: 'changing physical health', 'emotional and psychological reactions', 'changing the nature of relationships and the scope of social support', 'metamorphosis of ongoing healthcare, and 'functionality and adaptation to new realities.' The emerging core concept was labelled: 'maintaining well-being balance.' The COVID-19 pandemic disturbed the balance of life and health of the patients. Multiple strategies to maintain balance and reduce the negative effects of the COVID-19 pandemic on HRQoL were used by the patients, the healthcare team, and support systems. Due to the fear of COVID-19, the patients with beta thalassemia were less likely to contact healthcare professionals. They considered postponing blood transfusion and abandoned evaluating disease complications. Reduced access to the healthcare system and shifting resources from existing programmes to COVID-19 by the healthcare system were incompatible policies. These policies and strategies had strong and negative effects on the physical domain of HRQoL. The patients experienced a deterioration of emotional functioning. They reported a strong reduction in social functioning and felt lonely. Online interventions supporting mental health and social interactions and telemedicine can help during the times of social distancing and lockdowns.

The influence of depression-PTSD comorbidity on health-related quality of life in treatment-seeking veterans

ABSTRACT Objective Posttraumatic stress disorder (PTSD) and depression substantially impair health-related quality of life (HRQOL) for many Canadian Armed Forces (CAF) veterans. Although PTSD and depression are highly comorbid, little is known about whether the disorders may interact in their association with HRQOL. We sought to investigate whether depressive symptoms modify the relation between PTSD and HRQOL in treatment-seeking veterans. Method We accessed the clinical data of 545 CAF veterans aged 18 to 65 years who were seeking treatment at a specialized clinic in London, Ontario. We used hierarchical linear regression to assess the additive and multiplicative relations between depression and PTSD symptoms on HRQOL, controlling for age and alcohol/substance abuse. Simple slopes were examined to probe significant interactions. Results Probable PTSD and major depression were present in 77.4% and 85.3% of the sample, respectively, and 73.0% of the sample presented with probable PTSD-depression comorbidity. Depression symptoms significantly modified the relation between PTSD symptoms and overall mental HRQOL (β = 0.12, p <0.001, ∆R2 = 0.014), and role impairment due to emotional difficulties (β = 0.20, p <0.001, ∆R2 = 0.035). Simple slope analyses revealed the impact of PTSD was greater among those with lower depression symptoms and became weaker with greater depression symptom severity. In adjusted models, only depression was significantly associated with all mental and physical HRQOL domains; PTSD was not associated with physical HRQOL, role emotional impairment, or vitality. Conclusions For those with severe comorbid depression, PTSD symptoms were no longer associated with mental HRQOL, particularly in areas related to emotional functioning. Findings suggest the importance of targeting depression in patients presenting with PTSD-depression comorbidity.

Effectiveness of a family intervention on health-related quality of life\u2013a healthy generation, a controlled pilot trial

BackgroundPhysical activity is associated with better health, but knowledge about health promoting interventions, including physical activity for families in disadvantaged areas and the impact on health-related quality of life (HRQOL) is sparse. The aim of this study was to assess HRQOL in children and their parents after participation in the programme “A Healthy Generation”.MethodsThe programme is delivered in socioeconomically disadvantaged areas in Sweden and offers physical activity and a healthy meal or fruit twice a week from August to May to families with children in grade 2. Children (n = 67), aged 8–9 years, and their parents (n = 90) participated in this controlled study conducted in four schools, two control and two intervention schools. HRQOL of children and adults was assessed at baseline and follow-up after the intervention with the Pediatric Quality of Life Inventory (PedsQL) 4.0 and the Gothenburg Quality of Life scale, respectively. Analyses of covariance (ANCOVAs), linear regression and Pearson’s correlation were conducted.ResultsThere were no significant differences between intervention and control in HRQOL among children or adults after the intervention. However, in a subgroup of children (n = 20) and adults (n = 29) with initial low HRQOL scores at baseline, there was a significant difference between the intervention group and control group after the intervention (children (total score): p = 0.02; adults (social domain) p = 0.04). Furthermore, within the intervention group, there was a significant relationship between level of participation in “A Healthy Generation” and the physical domain of HRQOL among girls (r = 0.44, p = 0.01), but not boys (r = − 0.07, p = 0.58).ConclusionParticipation in the programme “A Healthy Generation” did not show a significant intervention effect on HRQOL in general. However, the findings suggest that HRQOL may be increased for children and adults with low HRQOL in disadvantaged areas. This knowledge can contribute to the development of health promoting interventions in such areas, and to more equitable health.Trial registrationISRCTN ISRCTN11660938. Retrospectively registered 23 September 2019.

Effectiveness of group exercise intervention on subjective well-being and health-related quality of life of older residents in restoration public housing after the great East Japan earthquake: A cluster randomized controlled trial

AimThis study aimed to examine the effectiveness of an exercise intervention on subjective well-being (SWB) and health-related quality of life (HRQOL) in older residents living in restoration public housing in Fukushima Prefecture after the Great East Japan Earthquake. MethodsTwelve restoration public housing complexes were randomly allocated into an intervention group or a control group. Participants in the intervention group were invited to a series of weekly exercise classes over eight weeks. Participants in the control group received the same materials used in the intervention program by mail once a week for eight weeks. The variation (pre-post intervention) of SWB assessed using the Japanese version of the World Health Organisation-Five Well-being Index and the mental and physical domain of HRQOL via The Medical Outcome Study Short-Form 12 were compared between groups. ResultsData of 18 participants in the intervention group and 29 participants in the control group were analyzed. There were no significant differences between groups in the SWB (p = .41) and mental (p = .16) and physical (p = .42) domains of HRQOL. Odds for decreased SWB in three months from the baseline was lower in the intervention group compared with the control group (Odds ratio (OR) = 0.23, 95% Confidence Interval (CI) = 0.06–0.88) but not in the mental (OR = 0.75, 95% CI = 0.23–2.43) or physical (OR = 2.79, 95% CI = 0.79–9.85) domains of HRQOL. ConclusionThe exercise intervention could mitigate deteriorated SWB in older restoration public housing residents.

Associations between the measures of physical function, risk of falls and the quality of life in haemodialysis patients: a cross-sectional study

BackgroundImpaired physical function due to muscle weakness and exercise intolerance reduces the ability to perform activities of daily living in patients with end-stage kidney disease, and by consequence, Health-Related Quality of Life (HRQoL). Furthermore, the risk of falls is an aggregate of physical function and, therefore, could be associated with HRQoL as well. The present study examined the associations between objective and subjective measures of physical function, risk of falls and HRQoL in haemodialysis patients.MethodsThis cross-sectional multicentre study included patients on maintenance haemodialysis. Physical function (quadriceps force, handgrip force, Sit-to-Stand, and six-minute walking test), the risk of falls (Tinetti, FICSIT-4, and dialysis fall index) and HRQoL (PROMIS-29 and EQ-5D-3 L) were measured and analysed descriptively, by general linear models and logistic regression.ResultsOf the 113 haemodialysis patients (mean age 67.5 ± 16.1, 57.5% male) enrolled, a majority had impaired quadriceps force (86.7%) and six-minute walking test (92%), and an increased risk of falls (73.5%). Whereas muscle strength and exercise capacity were associated with global HRQoL (R2 = 0.32) and the risk of falls, the risk of falls itself was related to psycho-social domains (R2 = 0.11) such as depression and social participation, rather than to the physical domains of HRQoL. Objective measures of physical function were not associated with subjective fatigue, nor with subjective appreciation of health status.ConclusionsMore than muscle strength, lack of coordination and balance as witnessed by the risk of falls contribute to social isolation and HRQoL of haemodialysis patients. Mental fatigue was less common than expected, whereas, subjective and objective physical function were decreased.