Physical Health-related Quality Of Life Research Articles

Psychological Distress, Resources, and Coping Strategies Among Evacuees and Non-Evacuees From an Armed Conflict Zone: A Network Analysis.

This study focuses on two groups: evacuees from Israel's southern and northern frontline communities following the October 7th Hamas attack, and individuals from regions not directly threatened. Using network analysis, we identified key associations and central nodes related to stress indicators (i.e., exposure to traumatic life events, physical health-related quality of life, anxiety, and depression) as well as personal resources (i.e., self-mastery and meaning in life), and coping strategies. The study included 221 evacuees and 145 non-evacuees (controls), recruited via iPanel, Israel's leading online research panel. Participants completed standardised self-report questionnaires. Evacuees exhibited higher levels of anxiety, depression, and traumatic life events, than did controls. Additionally, evacuees showed higher levels of problem-focused coping and a greater sense of meaning in life, along with lower physical health-related quality of life. Network analysis revealed that both groups had four sub-networks: 'personal state', 'psychological distress', 'resources', and 'coping'. However, the sub-networks' composition varied. Both groups shared similar sub-networks for 'coping' and 'personal state', but differed in 'psychological distress' and 'resources'. For the controls, dysfunctional coping strategies were part of 'psychological distress', whereas for evacuees, they were included in 'resources'. Additionally, meaning in life was more central among the controls, influencing the interaction between coping mechanisms, personal states, and psychological distress. For evacuees, physical health-related quality of life was more closely associated with the absence of negative factors-(i.e., anxiety, depression, traumatic experiences, and lower self-mastery)-rather than the presence of adaptive coping strategies and meaning in life. These differences highlight the vulnerability of evacuees and the central role of personal resources. Targeted interventions that foster resources such as self-mastery and meaning in life are vital for coping with the psychological distress associated with forced displacement.

Physical activity, fatigue severity, and health-related quality of life of community-dwelling stroke survivors: a cross-sectional study

BackgroundPhysical inactivity among stroke survivors (SSV) may result from fatigue, physical disabilities, and psychosocial factors, all of which adversely affect health-related quality of life (HRQL). Studies on combined interactions among physical activity (PA), fatigue severity (FS), and HRQL in SSV are scarce. This study was aimed to determine the relationships among PA, FS, and HRQL in community-dwelling SSV and to predict the association with selected socio-demographic and clinical variables.MethodsThis analytical cross-sectional correlation study involved 102 consented community-dwelling SSV. Respondents were purposively recruited from physiotherapy outpatient clinics of selected secondary and tertiary hospitals in southwest Nigeria. PA, FS, and HRQL of the SSV were assessed using the Stroke Physical Activities Questionnaire (SPAQ), Fatigue Severity Scale (FSS), and Stroke-Specific Quality-of-Life (SS-QoL) scale, respectively. Information on respondents’ socio-demographic and clinical characteristics was also collected. Data were analyzed using descriptive and inferential statistics at p < 0.05 significance level.ResultsRespondents’ mean age was 59.98 ± 11.59 years. The majority were females (52.9%), had ischemic stroke (72%), and with right-side weakness (54%) of over 6 months (80%). Respondents’ mean scores on SPAQ, FSS, and SS-QoL scales are 1867.47 ± 1817.93 MET min/week, 31.94 ± 11.29, and 156.47 ± 26.62, respectively. There were no significant associations between selected socio-demographic/clinical variables and physical activity levels except in gender (χ2 = 6.737; p = 0.034), fatigue severity except in side of affectation (χ2 = 5.839; p = 0.054), and HRQL except in level of education (χ2 = 23.497; p = 0.001) and side of affectation (χ2 = 7.389; p = 0.007). There was a moderate and significant correlation (R = 0.426; p < 0.05) among PA, FS, and HRQL. Regression analysis revealed no significant associations with the socio-demographic/clinical variable except the side of affectation for HRQL, low (R = 0.223) level of prediction of socio-demographic/clinical variables for PA (F 8, 93 = 0.607; p > 0.05), and fair (R = 0.326) level of prediction for FS (F 8, 93 = 1.386; p > 0.05).ConclusionModerate correlations among fatigue severity, physical activity, and health-related quality of life in stroke survivors suggested that enhancing one domain can benefit others, while the limited predictive ability of socio-demographic and clinical variables highlighted the need to consider cultural and psychological factors in post-stroke outcomes.

Social support and recovery in ARDS survivors: a prospective cohort study

BackgroundSocial support (SS) may contribute to the long-term recovery of critical illness survivors. This study focuses on survivors of the acute respiratory distress syndrome (ARDS) to investigate the causal relationship between SS and health related quality of life (HRQoL) and healthcare utilization in critically ill patients.MethodsA cohort study with N=877 ARDS survivors in 61 ICUs was conducted in Germany, between 2014 and 2019. SS (F-SozU K-14) and HRQoL (Physical and Mental Component Scale: PCS, MCS of the SF-12) were assessed at 3, 6, 12, and 24 months after ICU discharge. Healthcare utilization was assessed after 12 and 24 months. To identify confounders and allow for causal inferences, a directed acyclic graph (DAG) was developed.ResultsAdjusted regression models demonstrated significant positive impact of SS on mental HRQoL after three months onward (all ßs &gt;0.15, allps &lt;0.05). This influence increases over time. In contrast, the influence of SS on physical HRQoL and healthcare utilization remained inconclusive (only one significant association for physical HRQoL at 12 months: β=0.128, p&lt;0.05, otherwise allps &gt;0.05).ConclusionResults indicate SS plays an important and unique role in the long-term recovery of survivors of critical illness in the mental area. It appears that the more distal mechanism of SS unfolds progressively over time, perhaps as the immediate sequelae of critical illness after discharge subside. In contrast, SS does not appear to exert a substantial causal impact on physical HRQoL and healthcare utilization.

Systematic review of the needs and health-related quality of life domains relevant to people surviving cancer in Europe.

To systematically review qualitative studies on outcomes, needs, experiences, preferences, concerns and health-related quality of life (HRQoL) of people surviving cancer in Europe in the last decade. Protocol registered ( https://www.crd.york.ac.uk/PROSPERO , ID575065). studies with qualitative methods, constructs related to HRQoL, andadults surviving cancer in Europe. The search was conducted in PubMed and Scopus since 2013. Abstracts and full text were revised, data extracted and study risk of bias assessed independently by two researchers. The primary outcomes were the themes arising from each study. A thematic analysis stratified according to the study objective was undertaken by grouping themes into categories. Of 18,256 articles identified, 43 fulfilled the inclusion criteria: 16 studies with a generic objective and 27 with specific objectives. Seven categories (57 themes) emerged from the studies with a generic focus: Clinical Management (n = 16), Symptoms and Physical Function (n = 5), Psychological Function (n = 21), Social Function (n = 18), HRQoL (n = 3), Life Disruption (n = 6), and Individual Factors (n = 1). The 12 studies focused on treatment and care experiences stand out among those with specific objectives, with most themes fitting into the same seven categories. Results clearly showed the predominance of the social and psychological function domains over physical domains among people surviving cancer, additionally identifying specific needs in clinical management, such as information and communication, and relationship with and support from professionals. Therefore, these aspects should be incorporated into the evaluation of patient-centred initiatives for people surviving cancer. only two databases were searched, and most European countries were not represented.

Multicomponent rehabilitation to improve independence and functioning in elderly patients with common age-associated diseases: a scoping review

ObjectiveMulticomponent rehabilitation (MR) could restore functioning in elderly patients after hospitalisation, even beyond geriatrics, but specific evidence seems lacking. This review mapped the evidence on MR in elderly patients following...

Anxiety Contributes to Physical Health Among Older Adults Who Are Incarcerated in Prison

ABSTRACT This study explores links between anxiety and physical health among older adults (aged 45+) incarcerated in Kentucky state prisons. Using secondary data, independent sample t-tests, and hierarchical multiple linear regression, we identify disparities in anxiety and physical health among those with and without self-reported anxiety and the contribution of symptoms of anxiety to physical health in the sample. Findings show individuals with self-reported anxiety experienced increased impairment in daily activities, multimorbidity, and decreased physical health-related quality of life. Older adults are a large and growing proportion of prison populations, and addressing anxiety may improve physical health and reduce related costs.

Long‑term physical and mental Health-Related Quality of Life in Italian patients post COVID-19 hospitalisation.

Prior evidence suggests that patients' Health Related Quality of Life (HRQoL) worsens after COVID-19. This study aimed to investigate HRQoL in Italian patients post-hospitalization for COVID-19, focusing on changes in physical and mental HRQoL over time since COVID-19 diagnosis. A cohort of patients hospitalized for COVID-19 at Molinette Hospital in Turin, Italy, was contacted post-discharge to assess HRQoL using the SF-36 questionnaire. Patients completed the questionnaire only once at a different time since diagnosis. This design allowed for the analysis of responses up to three years after diagnosis. Measured scores were compared with normative data from the Italian population using z-scores. HRQoL differences by gender, comorbidities, and self-perception of health status before and after COVID-19 were tested. The effect of time since diagnosis on physical (PCS) and mental (MCS) SF-36 scores was analysed using multiple linear models and stratified analyses. A total of 601 patients completed the questionnaire. HRQoL was significantly lower compared to the normative Italian population. Men and individuals without comorbidities had better HRQoL, and self-perceptions of health status before and after COVID-19 influenced HRQoL. Time since diagnosis was associated with improved PCS, but MCS remained unaffected. Mental health declined in patients using anxiolytics post-COVID-19, and increasing age negatively affected physical health. Our findings highlight the impact of time since diagnosis on HRQoL post-COVID-19 in an Italian population and suggest the need for further investigation into the pandemic's effects on HRQoL. Physicians should implement measures to improve mental HRQoL post-COVID-19.

Trajectories of health-related quality of life across age cohorts: A longitudinal analysis of the German population over 16 years.

Understanding the trajectories of health-related quality of life (HRQoL) across different age cohorts and sociodemographic factors is crucial for promoting healthy aging. This study aims to examine the course of physical and mental HRQoL over a 16-year period in a nationwide sample of the German population. Data from the German Socio-Economic Panel spanning from 2002 to 2018 (N=4111; female=52.0%; age range=18-81 years; agemean in 2002=45.65 years) was analyzed using latent growth curve modeling. Measures of mental and physical HRQoL were assessed using the SF-12 questionnaire. Sociodemographic variables including age, gender, region, income, education were examined as predictors of HRQoL trajectories. The analysis revealed distinct trajectories for mental and physical HRQoL. Mental HRQoL showed a non-linear trend, peaking between the ages of 62-72, while physical HRQoL exhibited a linear decline with increasing age. Women consistently reported lower starting values for both mental and physical HRQoL across age cohorts. East Germans reported lower starting values for both dimensions of HRQoL compared to West Germans, although the gap in mental HRQoL narrowed over time. Higher income and education were associated with better HRQoL outcomes, particularly for physical HRQoL. This study highlights the importance of considering age, gender, region, income, and education in understanding the trajectories of HRQoL. Target interventions for individuals with certain risk factors can contribute to enhance overall well-being in the population.

Long-term recovery in critically ill COVID-19 survivors: A prospective cohort study.

Long-term recovery following critical COVID-19 has not been sufficiently studied. The primary objective was to describe changes in functional outcome and Health-Related Quality of Life (HRQoL) between 3 and 12 months in critically ill COVID-19 survivors. The secondary objective was to investigate factors associated with good functional outcome and HRQoL at 12 months. Prospective multicentre cohort study including critically ill COVID-19 patients admitted to six intensive care units in Sweden between May 2020 and May 2021. Surviving patients were invited to face-to-face follow-ups at 3 and 12 months. Functional outcome was assessed using the Glasgow Outcome Scale Extended (GOSE), ranging from 1 to 8. Physical and mental HRQoL was assessed by the physical component summary (PCS) and mental component summary (MCS) scores of the Short form health survey version 2 (SF-36v2®). Multivariable logistic regression models were used to identify factors associated with good functional outcome (GOSE ≥7) and good physical and mental HRQoL (PCS and MCS ≥45) at 12 months. The percentage of participants with a good functional outcome increased from 35% to 64% between 3 and 12 months (p < .001). Mean PCS improved from 40 to 44 between 3 and 12 months (p < .001), while the mean MCS was within the normal range at 3 months, with no change at 12 months (46 vs. 48, p = .05). Increasing age was associated with a good functional outcome. Lower clinical frailty and absence of diabetes mellitus were associated with a good PCS. A shorter duration of mechanical ventilation was associated with a good outcome for all three outcome measures. Survivors of critical COVID-19 showed improved functional outcome and physical HRQoL from 3 to 12 months post-ICU. A shorter duration of mechanical ventilation is associated with good functional outcome and good HRQoL, while older age is associated with good functional outcome. Younger patients and those with comorbidities or higher frailty may require targeted follow-up and rehabilitation. Study registration ClinicalTrials.gov Identifier: NCT04974775, registered April 28, 2020.

Exploring the Impact of School-To-Work Transitions on Health-Related Quality of Life in Emerging Adulthood Using the German Socioeconomic Panel (GSOEP)

Despite the increasing depression diagnoses and the frequent origin of later-life (mental) illnesses during this period, surprisingly scarce research for Germany addresses emerging adulthood, and particularly health implications regarding social milestones like school-to-work transitions. To address this gap, we aim to investigate the relationship between school-to-work transitions and Health-related Quality of Life (HRQOL), using data from the German Socio-Economic Panel 2002–2017. The findings reveal slight associations between school-to-work transitions and HRQOL. Successful completion of out-of-school education is positively associated with both mental (MCS) and physical (PCS) HRQOL, predominantly among women. For labor market entry, a modest increase in MCS is observed primarily among men. These results suggest slightly positive associations between school-to-work transitions and HRQOL of emerging adults in Germany. While short-term health implications seem limited, potential heightening effects from cumulative transitions or long-term consequences remain unobserved and call for continued attention on emerging adulthood in life course research.

Longitudinal relationship between 24-Hour Movement behavior patterns and physical function and quality of life after stroke: a latent transition analysis

Background24-hour movement behavior, including Physical activity (PA), Sedentary behavior (SB), and sleep, is independently associated with health after stroke. Few studies have explored 24-hour movement behavior patterns in stroke survivors and their transitions, as well as the health implications of the transitions. This study aimed to explore the different subgroups and stability of 24-hour movement behavior patterns in people after stroke and the relationship of profile transitions with physical function and health-related quality of life (HRQoL).MethodsIn this study, 131 people with first-ever stroke were investigated at one week (T1), one month (T2), three months (T3), and six months (T4) after discharge. The participants were asked to wear a wristband smartwatch for 7 consecutive days during each pe riod to collect 24-hour exercise data. After each period, their physical function and HRQoL were assessed. Latent profile analysis (LPA) identified typologies of 24-hour movement behaviors, and latent transition analysis (LTA) examined the stability and change in these profiles over time. The relationship of transition types with physical function and HRQoL was analyzed using a generalized linear regression model.Results108 participants were categorized into 3 latent profiles of 24-hour movement behavior: “Active, Non-sedentary, and Short sleep,” “Active and Sedentary,” and “Inactive and Sedentary.” The LTA results indicated that the proportion of participants with the “Active, Non-sedentary, and Short Sleep” profile and “Active and Sedentary” profile staying in the original latent profile was high. However, participants in the “Inactive and Sedentary” profile showed a high probability of transitioning to “Active and Sedentary” profile (T1→T2: 65.2%; T2→T3: 76.3%; T3→T4: 51.7%;T1→T4: 54.2%). Transition types are associated with physical function and HRQoL.ConclusionsThe results demonstrated substantial transitions in 24-hour movement behaviors within 6 months of rehabilitation after discharge, associated with later physical function and HRQoL. Furthermore, the participants’ sedentary behavior was highly stable within 24-hour movement behaviors, necessitating prompt diagnosis and intervention.

Health-Related Quality of Life and the Role of the Big Five Personality Traits in Postlingually Deaf Cochlear Implant Users.

This study aimed to investigate the relationships between generic health-related quality of life (HRQoL), the Big Five personality traits, speech understanding, and sociodemographic factors in a group of postlingually deaf cochlear implant (CI) users. The study group included 81 participants who met the inclusion criteria: profound sensorineural hearing loss, 18 years of age or more, and using at least one CI implanted after 18 years of age. Some 18% were bilateral CI users. The mean age of the participants was 60 ± 11 years. They completed the Assessment of Quality of Life (AQoL-8D) and the Short Form IPIP-BFM-20 (shortened version of the 50-item Big Five Markers Questionnaire from the International Personality Item Pool). The response rate was 57%. The HRQoL was lower in the study group than in the general population. Moreover, all Big Five personality characteristics were significantly lower than the Polish norm. The personality traits of intellect/imagination, emotional stability, and extraversion contributed to higher overall HRQoL scores, particularly for most psychosocial AQoL-8D dimensions. Higher agreeableness predicted higher HRQoL in the Independent Living, Pain, Coping, and Relations dimensions, whereas higher extraversion predicted higher physical HRQoL in the Senses dimension. Better speech understanding in quiet and noisy environments correlated with better physical HRQoL. Additionally, male gender and higher education were linked to higher global HRQoL. Conversely, being female was associated with lower global psychosocial and physical HRQoL, particularly in Pain. Higher education also contributed to improved physical HRQoL. In general, CI users have lower physical and psychosocial HRQoL as well as in measures that depend on personality traits. In terms of physical HRQoL, speech understanding plays an important role. It might prove useful if CI candidates and users were given a Big Five personality evaluation and an HRQoL assessment based on which they might be offered counseling or psychological intervention.

Digital Rehabilitation Program for Breast Cancer Survivors on Adjuvant Hormonal Therapy: A Feasibility Study.

Background: Breast cancer survivors often face physical and psychological challenges, including weight gain, metabolic syndrome, and reduced quality of life. To address these concerns, a mobile app-based rehabilitation program called "THRIVE" was developed to improve physical activity, medication adherence, and health-related quality of life (HRQoL) in this population. Methods: This prospective, single-arm study assessed the feasibility and effectiveness of the "THRIVE" app among breast cancer survivors undergoing hormonal therapy. Participants were recruited from Queen Mary Hospital in Hong Kong between December 2022 and June 2023. Eligible survivors had completed treatment within the last five years or had stable advanced disease on hormonal therapy. Participants monitored their exercise, medication adherence, and self-care via the app and a Fitbit activity tracker for 16 weeks. Primary outcomes included recruitment, dropout, adherence rates, and safety. Secondary outcomes, measured at baseline and week 16, included physical activity intensity, HRQoL, psychological stress, body composition, and app satisfaction. Results: A total of 50 participants, with a median age of 53 years, completed the study. The recruitment rate was 70.4% with no dropouts. The adherence rate, measured by completing exercises recommended in the mobile app at least three times per week, was 74%. No severe adverse events were reported. While physical activity intensity showed no significant changes from baseline to week 16 (p = 0.24), cognitive function (p = 0.021), future perspective (p = 0.044), arm symptoms (p = 0.042), depression (p = 0.01), and anxiety (p = 0.004) improved. All participants reported perfect medication compliance (100%). Satisfaction with the app was high. Conclusions: This mobile app-based rehabilitation program demonstrated good feasibility, with satisfactory recruitment, adherence, and safety, providing valuable insights into future definitive studies.

Physical activity, and improvement in health-related quality of life among Australian middle-aged and older adults living with type 2 diabetes mellitus.

Physical inactivity is a major global public health concern and a recognized risk factor for type 2 diabetes mellitus (T2DM). However, the relationship between physical activity and health-related quality of life (HRQOL) in people with T2DM using longitudinal data remains underexplored. We aim to identify the improvement in HRQOL associated with physical activity in Australian middle-aged and older adults using population-based longitudinal data. Data for this study were drawn from waves 9, 13, 17, and 21 of the Household, Income and Labour Dynamics in Australia (HILDA) Survey. We constructed an unbalanced panel consisting of2,472 person-year observations from 1,270 unique individuals living with T2DM. We used a random effects Generalized Least Squares (GLS) model to examine the relationship between physical activity and HRQOL in people with T2DM. The regression results showed that physical activity is positively associated with physical component summary (PCS), mental components summary (MCS), and health state utility value (SF-6D). People with T2DM engaging in physical activity less than once or 1 or 2 times per week had a higher mean score for PCS (β = 4.28, 95%CI:3.38, 5.17), MCS (β = 2.36, 95%CI:1.38, 3.34), and SF-6D utility value (β = 0.04, 95%CI:0.03, 0.05) than their counterparts engaged in no physical activity. Similarly, engaging in physical activity three times daily per week had a further elevated mean score for PCS (β = 6.65, 95%CI: 5.72,7.60), MCS (β = 3.75, 95%CI:2.71, 4.79), and SF-6D utility value (β = 0.07, 95%CI: 0.06,0.08). Our results showed that physical activity is positively associated with improved HRQOL among people with T2DM. Public health initiatives should prioritize health education and community programs to promote physical activity across all demographics to enhance HRQOL in people living with T2DM.

HUBUNGAN ANTARA SOKONGAN SOSIAL DENGAN KUALITI HIDUP GOLONGAN B40 YANG KEHILANGAN PEKERJAAN

Job loss profoundly impacts the quality of life among low-income groups, triggering economic challenges, mental health issues, and social status disruptions. The presence of social support can mitigate these negative effects; however, the quality and type of support received may have varying impacts on individuals. This study aims to examine the relationship between social support and the quality of life among the B40 group experiencing job loss. Employing a cross-sectional correlational survey design, the study sampled 400 respondents from the B40 group who had lost their jobs. Quality of life was assessed using the Short Form-36 Survey (SF-36), encompassing both mental and physical health components, while social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS), including dimensions of family, friends, and significant others. The findings reveal a significant positive relationship between social support and physical health-related quality of life: family (r = 0.25, p &lt; 0.001), friends (r = 0.15, p &lt; 0.001), and significant others (r = 0.18, p &lt; 0.001). However, only the significant other dimension (r = -0.15, p &lt; 0.001) demonstrated a significant negative relationship with mental health-related quality of life. These findings highlight the positive association of social support with physical health and the complex negative influence of significant other support on mental health-related quality of life. The study suggests that relationships with significant others (e.g., partners or spouses), which involve expectations, responsibilities, or conflicts, can exert a complex impact on mental health quality.

Bereaved Family Quality of Life Varies With Comorbid Psychological Distress and ICU-Care Quality.

Health-related quality of life (HRQOL) is highly endorsed, but HRQOL studies scarcely investigate the following: ICU family members; modifiable end-of-life (EOL) ICU-care factors; conjoint associations with prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), and depression; and long-term bereavement outcomes. Exploratorily investigate associations of PGD-PTSD-depressive-symptom states (resilient, subthreshold-depression dominant, PGD dominant, and PGD-PTSD-depression comorbid) and quality of EOL ICU care with families' HRQOL 6-24 months post loss. This cohort study examined symptoms of PGD (11 items of the PG-13), PTSD (Impact of Event Scale-Revised), and depression (Hospital Anxiety and Depression Scale), and HRQOL (Medical Outcomes Study 36-Item Short-Form Health Survey) among 303 ICU family members. Quality of EOL ICU care was measured by objective process-based care-quality indicators abstracted from medical records and classified by subjective family-assessed quality of patient dying and death (QODD). Associations were simultaneously examined by multivariate hierarchical linear modeling with resilient state and high QODD class as reference. Physical and mental HRQOL were worse in the 3 more distressed symptom states, especially mental HRQOL which showed an incremental dose-response effect: subthreshold depression-dominant (β [95% CI]=-2.419 [-3.374, -1.464]), PGD-dominant (-8.366 [-10.116, -6.616]), and PGD-PTSD-depression comorbid (-14.736 [-17.772, -11.700]) states. Mental HRQOL was significantly worse in the 3 poorer QODD classes: moderate (-1.085 [-2.138, -0.032]), poor to uncertain (-4.362 [-5.616, -3.108]), and worst (-3.239 [-4.433, -2.045]). HRQOL was not associated with objective care-quality indicators. Bereaved family members' HRQOL was significantly associated with PGD-PTSD-depressive-symptom states and QODD classes-both modifiable through high-quality EOL ICU care.

Health-Related Quality of Life in Living Kidney Donors Participating in Kidney Exchange Programs

Abstract Kidney exchange programs (KEP) have revolutionized living donor kidney transplantation (LDKT) by enabling transplants for patients with HLA or ABO incompatible donors. However, the implications for donors participating in KEP, particularly regarding postoperative health-related quality of life (HRQoL), are not well elucidated. This study compares the HRQoL of donors participating in KEP with donors donating directly (non-KEP). The study included 724 donors, with 121 in the KEP group and 603 in the non-KEP group. Outcomes were assessed using the mental component summary (MCS), physical component summary (PCS), EQ-5D-3L, MVI-20 score, and self-rated pain level. We used a mixed-effects regression model to assess differences between KEP and non-KEP over time, accounting for repeated measures within subjects. There was a significant temporary decline in both the MCS and PCS post-donation; however, these outcomes returned to pre-donation levels after an interval of two month. Donors participating in the KEP had higher PCS and MCS 1-year post-donation. Comparable results were observed in the self-assessed HRQoL using the EQ-5D-3L instrument, as well as in the fatigue scores measured by the MVI-20. We found that participation in KEP does not adversely affect donors' short- or long-term mental and physical HRQoL outcomes and that LDKT donors have HRQoL of pre-donation levels soon after donation. These insights are reassuring, indicating that donors participating in KEP can expect HRQoL comparable to those who do not. This reinforces the viability of KEP as a safe option for expanding LDKT and findings can inform patient and donor education.

Health-related quality of life profiles of adults with arthritis and/or fibromyalgia: a cross-sectional study.

Adults with arthritis experience poor health-related quality of life (HRQOL), though research often focuses on single HRQOL outcomes or summary scores. We aimed to identify HRQOL profiles in adults with different arthritis types and determine risk and protective factors. Data including PROMIS-29 Profile v2.1 and PROMIS Short Form v2.0 - Emotional Support 4a were collected through a national foundation's online survey of adults with arthritis in the U.S. We used latent profile analysis (LPA) to characterize the heterogeneity in arthritis patients by clustering them into HRQOL profiles, based on statistical model fit and clinical interpretability. We fit a multinomial logistic regression model with HRQOL profile assignment as the outcome to determine associations with protective and risk factors. We included 25,305 adults with arthritis. The LPA results favored a five-HRQOL profile solution (entropy = 0.83). While some profiles displayed better HRQOL in some domains, 93% of the sample displayed impacted pain and physical functioning. One profile (20%) displayed mean T-scores nearly 2 standard deviations below the population mean. Despite poor physical HRQOL outcomes, one profile (10%) displayed average mental health. All demographic and clinical factors contributed significantly to the model, including risk factors (arthritis types, work status) and protective factors (more emotional support, starting exercise). We identified profiles with consistently impacted HRQOL in arthritis, though one displayed average mental health functioning despite poor physical functioning. These results highlight the value of considering the patient's HRQOL experience alongside treatment options, and the potentially positive impact of non-pharmacological interventions.

Changes in Physical Function After Long Corrective Fusion to the Ilium for Adult Spinal Deformity

Study Design. Prospective cohort study. Objective. To investigate longitudinal changes in physical functional status after long corrective fusion in patients with adult spinal deformity (ASD) during 2 years of follow-up. Summary of Background Data. In ASD surgery, reports assessing physical functional status in long-term observations for more than a year are lacking. Assessing whether patients maintain significant improvements in their physical status with a longer follow-up duration is crucial. Methods. A total of 70 female patients with ASD who underwent long corrective fusion of ≥ 7 segments between June 2016 and June 2022 were included in this study. Preoperative and postoperative assessments (at 6 months, 1 year, and 2 years) included radiographic spinopelvic parameters, health-related quality of life (HRQOL) using the Scoliosis Research Society Outcome Instrument-22 (SRS-22) questionnaire, and physical function tests conducted by a physical therapist. Results. All domains of the SRS-22 improved the most in the first 6 months after surgery (P &lt;0.0001); however, the Pain and Function domains continued to improve gradually until 2 years postoperatively. Regarding trunk dynamic balance, the timed up-and-go test score improved gradually until 2 years postoperatively (P &lt;0.0001). Regarding gait performance, gait speed and the 6-minute walking test improved the most in the first 6 months after surgery (P &lt;0.01) and almost reached a plateau 1 year postoperatively. Conclusions. Long corrective fusion for ASD significantly enhanced physical function and HRQOL within 2 years, with the greatest improvement in the first 6 months after surgery. These findings underscore the importance of increasing activities of daily living through early exercise instruction, as well as preventive measures to avoid early surgery-related complications. Level of Evidence. 3

Impact of sleep quality on health-related quality of life domains and the mediating effects of symptoms in people with multiple sclerosis.

Many people living with multiple sclerosis (PwMS) experience poor sleep, which is associated with diminished overall health-related quality of life (HRQoL). We quantified associations between sleep quality and HRQoL domains and examined the extent to which other MS symptoms could account for these associations. In this cross-sectional survey of 1,717 Australians with MS, we used Assessment of Quality of Life (AQoL) 8D and Pittsburgh Sleep Quality Index (PSQI) to assess HRQoL and sleep quality, respectively. Total, direct, and indirect effects of sleep quality on HRQoL domains were determined using mediation regression analysis. Poor sleep quality was significantly associated with all domains of HRQoL, with strongest associations seen for mental health (β=-0.08) and pain (β=-0.11), and weaker associations for independent living (β=-0.05) and senses (β=-0.03). Poor sleep quality had the largest direct effect on mental health (60.8%), happiness (48.7%), and pain (49.7%). MS symptom clusters mostly contributing to indirect effects were "feelings of anxiety and depression" for psychosocial, and "pain and sensory symptoms" for physical HRQoL super dimensions. Improving sleep could lead to substantial improvements in all HRQoL domains and the improvement in HRQoL could be partially achieved through indirect improvements in sleep on MS symptoms.