Physical Quality Of Life Measures Research Articles

#1036 Studying the quality of life in patients with CKD during the short physical rehabilitation program

Abstract Background and Aims The purpose of the study was to study the quality of life in patients with stages 2-3 CKD during a short physical rehabilitation program. Method The study included 130 patients with stage 2-3 CKD at the age of 45 - 65 years (average age - 58.7 ± 0.73 years). Patients included in the study were divided into 2 groups – main group and control group, depending on adherence to non-drug treatment: 1st - CG group (control) – patients receiving standard therapy (n = 30); 2nd - MG group (main) - patients who, in addition to medication treatment, received a course of physical training for 12 weeks 2-3 times a week (n = 100). Laboratory data were analyzed in patients urea, creatinine, electrolytes, albumin, total protein, blood hemoglobin. Results During the study of patients with CKD at pre-dialysis stages, patients in the main group rated their quality of life more positively. The total quality of life indicator in the main group during 12 weeks of regular physical training increased by 15.5% (p < 0.05). In the control group, after 12 weeks of physical training quality of life parameters remained at the same level, but there was a tendency to decrease. Patients in the study group reported significant improvements in physical quality of life measures compared with control group measures, including role limitations (physical) (mean change = −8.9 in the control group compared with mean change + 19.0 in study group P < 0.001), physical functioning (mean change = −0.7 in the control group compared with a mean change of +11.1 in the study group; P ˂ 0.005), Patients in the study group also reported a significant improvement in pain scores. Conclusion Thus, when studying the quality of life, a group of patients who received physical training with standard therapy noted an improvement in both physical and mental functioning.

Assessing Quality of Life during COVID-19 Outbreak among a Vulnerable Population with Pulmonary Disease

Background: Individuals monitored for pulmonary disease represent a particularly vulnerable population to the Coronavirus. They present, prior to any COVID 19 exposure, a respiratory condition that could be complicated by a contamination with this virus. Thus, any exposure to this virus might have an impact on their health and their quality of life. Objectives: This study aims to evaluate health-related quality of life in this population during the Covid-19 pandemic; to analyze the associations of mental and physical quality of life measures with sociodemographic, physical, and psychological parameters; and to determine whether the Covid-19 pandemic and the related measures were associated with an immediate change in these scores. Methods: This is a cross-sectional, descriptive, and analytical study, conducted between May and June 2020. Quality of life assessment was carried out using the HRQoL SF 12 Health-Related Quality of Life Scale, and data were analyzed using SPSS software. Results: Of the 78 patients included, 41 (52.6%) were male with a predominance of the age range above 60 years (35.9%). The mean of the physical quality of life score PCS-SF12 was 33.16 (±12.64), and the mean of the mental quality of life score MCS-SF12 was 41.64 (±13.14). Statistical analysis revealed a significant difference in mental quality of life scores according to gender, education level, employment status prior to lockdown, asthma diagnosis, duration of follow-up for lung disease, follow-up for psychiatric pathology, and worsening of symptoms due to Covid-19 pandemic situation. Conclusion: While the quality of life of patients with lung disease is severely impacted by the nature of their illness, the pandemic and containment measures have exacerbated the situation. Psychological support is still needed to improve their mental health and thus their care.

Quality and Sources of Dietary Carbohydrate Intake and Self-perceived Quality of Life in Middle-aged and Older Adults of the Framingham Heart Offspring Study (P18-081-19)

ObjectivesThe objective of the present study was to examine the cross-sectional association between carbohydrate quality and intake of carbohydrate-rich food groups with quality of life. MethodsWe examined the cross-sectional association between carbohydrate intake and self-reported quality of life among 2414 participants of the Framingham Offspring Study (FOS). Self-reported quality of life was assessed using three summary scores from the SF-36 questionnaire: Physical Component Summary (PCS), Mental Component Summary (MCS), and Physical Function Score (PFS). Cumulative dietary intake from the fifth (1991–1995) and sixth (1995–1998) FOS examinations was used to assess overall dietary carbohydrate quality using the Carbohydrate Quality Index (CQI) as well as intake of five carbohydrate-rich food groups: fruits, vegetables, whole grain (WG), refined grains, and sugar-sweetened beverages (SSB). Multivariable-adjusted mean PCS and MCS, and the odds ratio (OR) of reporting good physical function defined as PFS ≥ 80, were estimated across tertiles of carbohydrate exposures. P for trend was calculated to assess linearity of associations. ResultsHigher CQI was significantly associated with a 3% higher mean PCS score after adjustment for demographic and lifestyle factors, and independent of high cholesterol, hypertension, diabetes, and other aspects of diet (P trend = 0.0003). Furthermore, our results showed a higher odds of having good PFS in the highest CQI tertile [OR (95% CI) 1.9 (1.5–2.5); P trend < 0.0001]. No association was observed between CQI and MCS. After adjustment for other aspects of diet, fruit and vegetable intake were positively associated with PCS and with odds of having good PFS, while an inverse association was observed between SSB intake and PCS. A nominal significant positive relationship was observed between WG intake and PCS (P-trend = 0.06) after adjustment for other aspects of diet, fruit and vegetable intake. Refined grain intake was not associated with any quality of life measures. ConclusionsOverall carbohydrate quality, as well as specific carbohydrate-rich food sources including fruits, vegetables, and WG, are associated with higher self-reported physical quality of life measures. Funding SourcesThis work is supported by the General Mills Bell Institute of Health and Nutrition and USDA ARS agreement No. 58-1950-4-003.

Mild traumatic brain injury in older adults: early cognitive outcome.

Severe traumatic brain injury (TBI) in older age is associated with high rates of mortality. However, little is known about outcome following mild TBI (mTBI) in older age. We report on a prospective cohort study investigating 3 month outcome in older age patients admitted to hospital-based trauma services. First, 50 mTBI older age patients and 58 orthopedic controls were compared to 123 community control participants to evaluate predisposition and general trauma effects on cognition. Specific brain injury effects were subsequently evaluated by comparing the orthopedic control and mTBI groups. Both trauma groups had significantly lower performances than the community group on prospective memory (d=0.82 to 1.18), attention set-shifting (d=-0.61 to -0.69), and physical quality of life measures (d=0.67 to 0.84). However, there was only a small to moderate but non-significant difference in the orthopedic control and mTBI group performances on the most demanding task of prospective memory (d=0.37). These findings indicate that, at 3 months following mTBI, older adults are at risk of poor cognitive performance but this is substantially accounted for by predisposition to injury or general multi-system trauma.

Exploring the Effectiveness of a Mindfulness-Based Chronic Pain Management Course Delivered Simultaneously to On-Site and Off-Site Patients Using Telemedicine

The present study investigated the effectiveness of a mindfulness-based pain management program developed to increase accessibility and acceptability for a severe chronic pain population seeking help in two tertiary level hospital pain clinics. Sixty chronic pain patients completed a 12-week Mindfulness-Based Chronic Pain Management program, while 59 individuals on the waiting list served as a control group. Ages ranged from 32 to 79 (mean age 52), and classes contained a mix of on-site and distant-site participants connected via a telemedicine link. Quality of life, pain catastrophizing, usual pain levels, and pain-related suffering were measured at two points during the study period. Program participants showed significant improvements in mental health, pain catastrophizing, and suffering levels, while the controls remained relatively unchanged. Neither group showed significant changes in the physical quality of life measures or usual pain levels. The present study lends support for the effectiveness of mind–body interventions in improving mental health and suffering in chronic pain sufferers seeking help in tertiary pain clinic settings. It also provides evidence for the usefulness of a mindfulness-based program modified specifically for the chronic pain population, and supports its delivery through telemedicine.

A comparison of performance-based measures of function in HIV-associated neurocognitive disorders

The objectives of this study are to compare the results of newer performance-based functional assessments in the study of HIV-associated neurocognitive disorders (HAND) and to correlate these functional assessments with specific levels of severity of HAND. One hundred fourteen HIV+ subjects in an existing cohort were evaluated with a medical history, neurological exam, neuropsychological test battery as well as subjective and novel objective measures of functional abilities. Self-reported measures of functional performance included the Karnofsky Performance Scale, a questionnaire for instrumental activities of daily living, and a questionnaire for physical quality of life measures. The newer objective functional performance assessments included the Columbia Medication Management and the San Diego Finances tests. These newer performance-based measures of function were assessed for their ability to predict level of HAND. The two objective measures of functional performance, The Columbia Medication Management Scale and the San Diego Finances Test, were both associated with levels of severity of HAND. The Karnofsky Performance Scale and the questionnaires for role and physical quality of life were subjective measures that were also associated with specific levels of HAND. Newer measures of functional performance can be used to objectively evaluate functional impairment in HAND and validate different levels of HAND.

A double-blind placebo-controlled pilot study of controlled-release paroxetine on depression and quality of life in chronic heart failure

Depression is frequently observed in patients with heart failure and is associated with poor quality of life and adverse prognosis. However, the prevalence of depression in heart failure could be overestimated because symptoms of depression overlap with those of heart failure. Similarly, the importance of depression may be overestimated if depression merely reflects worse heart failure. Because the response to depression treatment has not been evaluated in this patient population, we evaluated the efficacy of controlled-release paroxetine (paroxetine CR), a selective serotonin reuptake inhibitor, on depression and quality of life in chronic heart failure. A double-blind, randomized, placebo-controlled design was used to evaluate reductions in depression following 12 weeks of treatment with paroxetine CR (n = 14, age 62.1 +/- 12.3 years) or placebo (n = 14, age = 61.9 +/- 9.0 years). Patients with symptomatic congestive heart failure and a score of at least 10 on the Beck Depression Inventory (BDI) were eligible. Beck Depression Inventory was obtained at baseline and 4, 8, and 12 weeks of follow-up. Quality of life was assessed using the Medical Outcomes Study Short Form and the Minnesota Living with Heart Failure Questionnaire. Controlled-release paroxetine resulted in significantly more recovery from depression (BDI <10) than placebo (69% vs 23%, P = .018) and resulted in lower continuous BDI scores throughout the intervention (P = .024). Controlled-release paroxetine was associated with higher general health levels compared with placebo on the Medical Outcomes Study 36-Item Short Form survey (38 +/- 10 vs 30 +/- 6, P = .016) at 12 weeks of follow-up. Reductions in depression were correlated with improvements in psychological aspects of quality of life (P < .05) but not with physical quality of life measures (P > .10). Antidepressant therapy with paroxetine CR results in significant reductions in depression among patients with heart failure. The reductions in depression with paroxetine CR are accompanied by improvements in psychological aspects of quality of life. Larger controlled trials are needed to further document the effectiveness of paroxetine CR and other selective serotonin reuptake inhibitors in patients with heart failure and to determine patient subgroups that are most likely to benefit from antidepressive interventions.

Cruciate-retaining Total Knee Arthroplasty at 5 to 7 Years Followup

Cruciate-retaining total knee implants may improve postoperative function in total knee arthroplasty, but whether patients experience good restoration of kinematics, undue wear, or increased revision rates is debatable. I evaluated clinical results, radiographs, and survival rates of the NexGen posterior cruciate-retaining implant at 5-7 years followup in 251 knees (198 patients) in a prospective, consecutive total knee replacement series done from 1996-1997. A consistent improvement in knee scores and range of motion was observed from preoperative evaluation through 5 years followup. Alignment remained constant and knee stability did not deteriorate. Knee Society scores were good or excellent for 90% of patients. The average range of motion was 123 degrees, and 73% of patients achieved a mean range of motion of 116 degrees -130 degrees. Mean physical quality of life measures improved from preoperative evaluation to the last followup. There were no complete or progressive radiolucencies. Four screw radiolucencies had progressive increases in diameter. Survival of the implant at 7 years was more than 98%. The NexGen posterior cruciate-retaining implant provided satisfactory kinematic and clinical results with no substantive polyethylene wear. Therapeutic study, Level II-2 (poor-quality randomized controlled trial). See the Guidelines for Authors for a complete description of levels of evidence.

Economic Development, Political-Economic System, and the Physical Quality of Life

This study compared capitalist and socialist countries in measures of the physical quality of life (PQL), taking into account the level of economic development. The World Bank was the principal source of statistical data for 123 countries (97 percent of the world's population). PQL variables included: 1) indicators of health, health services, and nutrition (infant mortality rate, child death rate, life expectancy, population per physician, population per nursing person, and daily per capita calorie supply); 2) measures of education (adult literacy rate, enrollment in secondary education, and enrollment in higher education); and 3) a composite PQL index. Capitalist countries fell across the entire range of economic development (measured by gross national product per capita), while the socialist countries appeared at the low-income, lower-middle-income, and upper-middle-income levels. All PQL measures improved as economic development increased. In 28 of 30 comparisons between countries at similar levels of economic development, socialist countries showed more favorable PQL out-comes.