Psychological Health-related Quality Of Life Research Articles

The Effect of Yoga Intervention on Psychological Symptoms, Health-Related Quality of Life, and Cardiovascular Risk Factors in People with Coronary Artery Disease: A Systematic Review and Meta-Analysis

Abstract Background: Whether yoga is effective in the cardiac rehabilitation of people with coronary artery disease (CAD) remains controversial. Objective: The aim of this study was to investigate the effects of yoga intervention on psychological symptoms, health-related quality of life (HRQoL), and major cardiovascular risk factors in people with CAD. Methods: We searched MEDLINE/PubMed, Cochrane, EMBASE, and Physiotherapy Evidence Database (from the earliest date available to July 2023). Mean difference (MD), standardized MD (SMD), and 95% confidence interval (CI) were calculated. Results: Seventeen studies, with 5,698 patients, met the study criteria. Compared to control (no exercise), yoga resulted in improved depression MD −0.83 (95% CI: −1.35 to −0.31), stress MD −3.83 (95% CI: −4.8 to 2.86), HRQoL SMD 1.48 (95% CI: 0.55 to 2.4), major cardiovascular risk factors (peak VO2 MD 1.7 mL/kg/min [95% CI: 0.2 to 3.3], systolic blood pressure MD −3.2 mmHg [95% CI: −5.9 to −0.5], and diastolic blood pressure MD −2.42 mmHg [95% CI: −4.08 to −0.76]). Conclusions: Yoga was effective in the improvement of psychological symptoms, HRQoL, and cardiovascular risk factors.

ACUTE AND LONG-TERM EFFECTS OF APP-DELIVERED HEARTFULNESS MEDITATION ON PSYCHOLOGICAL OUTCOMES AND THE ENDOCANNABINOID SIGNALING SYSTEM IN CYCLIC VOMITING SYNDROME.

Cyclic vomiting syndrome (CVS) is a disorder of gut brain interaction (DGBI) often triggered by stress. Interventions like meditation may improve psychological outcomes and Health-Related Quality of Life (HRQoL), but their efficacy and the underlying mechanism are unknown. We conducted a 6-week single-arm pilot study to assess the effects of Heartfulness meditation (HFM) in CVS using a custom-designed meditation app. Primary outcomes included state and trait anxiety and mood state changes pre- vs. post-meditation, and secondary outcomes were psychological distress, coping, sleep quality and HRQoL at baseline and weeks 3 and 6. Serum concentrations of endocannabinoids N-arachidonylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG) and related lipids were measured pre-and-post HFM at baseline and week 6. In 30 treatment completers, there was a significant improvement in state anxiety (p<0.001), total mood disturbance (p<0.001), and other mood states (all p values <0.05) across the three time points. Trait anxiety was also improved at week 6. There was a significant improvement in psychological distress (global severity index), sleep quality (daytime dysfunction), coping (using religion/spirituality) and HRQoL (mental and physical) across the three time points (all p <0.05). Significant increases in AEA and related lipids N-oleoylethanolamine and palmitoylethanolamide post-vs.-pre HFM were observed at week 6 (p<0.001, 0.002, 0.003, respectively). No adverse effects were noted. App-delivered HFM is feasible, safe and effective and improves psychological outcomes and augments endocannabinoids. This provides insight into the mechanism underlying HFM and has potential for widespread use as a digital therapeutic in CVS and other DGBI.Study Highlights.

The effect of coping strategies on health-related quality of life in acromegaly patients.

Patients with acromegaly oftentimes exhibit a reduced physical and psychological health-related quality of life (HRQoL). Maladaptive coping styles are associated with poor HRQoL in a number of diseases and patients with pituitary adenomas in general exhibit less effective coping styles than healthy controls. This study aimed to assess coping strategies in acromegaly patients in order to explore leverage points for the improvement of HRQoL. In this cross-sectional study, we administered self-report surveys for coping strategies and HRQoL (Short Form SF-36, Freiburg questionnaire on coping with illness, FKV-LIS) in patients with acromegaly. These were set into relation with a variety of health variables. About half of the 106 patients (44.3% female) with a mean age of 56.4 ± 1.3 years showed impaired physical and psychological HRQoL on average 11.2 years after the initial diagnosis. Body mass index, age at survey date and concomitant radiotherapy explained 27.8% of the variance of physical HRQoL, while depressive coping added an additional 9.2%. Depressive coping style and trivialization and wishful thinking were pivotal predictors of an impaired psychological HRQoL with a total explained variance of 51.6%, whereas patient health variables did not affect psychological HRQoL. Our results show that maladaptive coping styles have a substantial negative impact on psychological HRQoL in patients with acromegaly, whereas physical HRQoL is influenced to a lesser extent. Specialized training programs aimed at improving coping strategies could reduce long-term disease burden and increase HRQoL in the affected patients.

Status of mental and social activities of young and middle-aged patients after papillary thyroid cancer surgery.

Papillary thyroid cancer (PTC) is prevalent among younger populations and has a favorable survival rate. However, a significant number of patients experience psychosocial stress and a reduced quality of life (QoL) after surgical treatment. Therefore, comprehensive evaluations of the patients are essential to improve their recovery. The present study enrolled 512 young and middle-aged patients diagnosed with PTC who underwent surgery at our institution between September 2020 and August 2021. Each participant completed a series of questionnaires: Generalized Anxiety Disorder 7 (GAD-7), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QoL), and Readiness to Return-to-Work Scale (RRTW). GAD-7 data showed that almost half of the study subjects were experiencing anxiety. Regarding health-related quality of life (HRQoL), participants reported the highest levels of fatigue, insomnia, voice problems, and scarring, with patients in anxious states reporting worse symptoms. Based on RRTW, more than half of the subjects had returned to work and had better HRQoL compared to the others who were evaluating a possible return to work. Age, gender, BMI, education, diet, residence, health insurance, months since surgery, monthly income, and caregiver status were significantly correlated with return to work. Additionally, having a caregiver, higher monthly income, more time since surgery, and living in a city or village were positively associated with return to work. Young and middle-aged patients with PTC commonly experience a range of health-related issues and disease-specific symptoms following surgery, accompanied by inferior psychological well-being, HRQoL, and work readiness. It is crucial to prioritize timely interventions targeting postoperative psychological support, HRQoL improvement, and the restoration of working ability in PTC patients.

Short-Term and Long-Term Impact of COVID-19 on Quality of Life and Psychological Outcomes in Saudi Arabia: A Comparative Cross-Sectional Study.

Prior research has revealed notable declines in health-related quality of life (HRQoL) and substantial psychological impacts among individuals infected with COVID-19. However, there is a noticeable gap in studies addressing the enduring long-term effects of COVID-19 on HRQoL and psychological well-being. The current study investigated and compared short and long-term effects of COVID-19 on HRQoL and psychological outcomes among the Saudi population. The Arabic version of the SF-36 questionnaire was used to assess HRQoL while Anxiety and depression were evaluated by the Hamilton Anxiety (HAM-A) and Depression Scales (HDRS). Participants (n=292) were categorized into three groups: the "never-been-infected" group (n=134), the "one-year infected group" (n=43), and the "more than one year infected" group (n=115). Descriptive statistics were presented using numerical values and frequencies. To compare the groups, a one-way analysis of variance (ANOVA) test was used. Most SF-36 domains exhibited lower values while HAM-A and HDRS values were higher in individuals infected during last year compared to those who never infected. Social functioning subscale of the SF-36 showed a significant difference between the groups (F (2.289) = 6.094, p = 0.01) and the effect size was d = 0.95. Pairwise comparison showed a significant reduction in the social functioning component of SF-36 in "one-year group" compared to both groups "never-been-infected" group (mean difference -13.58 (4.40-22.76) p < 0.01) and "more than one year infected" group (mean difference -10.80 (1.44-20.16) p = 0.02). HAM-A and HDRS scores showed mild levels of anxiety (<17 score) and depression (8 to 16 score) in all groups. The influence of COVID-19 on psychological well-being and HRQoL is significant regardless of whether individuals infected with the virus. Overall, the consistent presence of mild anxiety and depression across all groups highlights the need for a holistic approach to mental health.

Enhanced External Counterpulsation for Management of Postacute Sequelae of SARS-CoV-2 Associated Microvascular Angina and Fatigue: An Interventional Pilot Study.

Postacute sequelae of SARS-CoV-2 infection (PASC) are a novel clinical syndrome characterized in part by endothelial dysfunction. Enhanced external counterpulsation (EECP) produces pulsatile shear stress, which has been associated with improvements in systemic endothelial function. To explore the effects of EECP on symptom burden, physical capacity, mental health, and health-related quality of life (HRQoL) in patients with PASC-associated angina and microvascular dysfunction (MVD). An interventional pilot study was performed, including 10 patients (male = 5, mean age 50.3 years) recruited from a tertiary specialized PASC clinic. Patients with angina and MVD, defined as index of microcirculatory resistance (IMR) ≥25 and/or diagnosed through stress perfusion cardiac magnetic resonance imaging, were included. Patients underwent one modified EECP course (15 one-hour sessions over five weeks). Symptom burden, six-minute walk test, and validated generic self-reported instruments for measuring psychological distress and HRQoL were assessed before and one month after treatment. At baseline, most commonly reported PASC symptoms were angina (100%), fatigue (80%), and dyspnea (80%). Other symptoms included palpitations (50%), concentration impairment (50%), muscle pain (30%), and brain fog (30%). Mean IMR was 63.6. After EECP, 6MWD increased (mean 29.5 m, median 21 m) and angina and fatigue improved. Mean depression scores showed reduced symptoms (-0.8). Mean HRQoL scores improved in seven out of eight subscales (+0.2 to 10.5). Patients with PASC-associated angina and evidence of MVD experienced subjective and objective benefits from EECP. The treatment was well-tolerated. These findings warrant controlled studies in a larger cohort.

EMPOWERING LGBTQ OLDER ADULTS: PROMOTING HEALTH EQUITY AND WELL-BEING ACROSS THE LIFE COURSE

Abstract The population is becoming more diverse in terms of sexual orientation and gender identity across all age groups. Lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults are found to experience health disadvantages over time. However, there is a lack of research on health-related mechanisms, so it is important to understand the unique needs and resources in these underserved communities. This symposium fills this research gap by examining the factors that affect LGBTQ health trajectories and subgroup differences using a life course developmental framework, the Health Equity Promotion Model (HEPM). The HEPM model highlights historical, social, environmental, and cultural influence on health and well-being and varying adaptations of LGBTQ older adults. The symposium draws on data from the first national and longitudinal study, Aging with Pride: National Health, Aging and Sexuality/Gender study, which has been following 2,450 LGBTQ midlife and older adults since 2014. Dr. Nelson will discuss sexual and gender identities and their associations with physical and psychological health-related quality of life. By investigating the interplay between marginalization, health behaviors, and health care access over time, Dr. Fredriksen-Goldsen assesses quality of life over time by gender and generational differences. Dr. Kim will discuss the role of social connectivity and intersectionality in predicting cognitive impairment over time among racially and ethnically diverse LGBTQ older adults. Using a health equity lens, this symposium will shed new light on the ways in which historical and environmental contexts influence human development and how marginalization and resilience shape lives over time. This is a Rainbow Research Group Interest Group Sponsored Symposium.

Psychological symptoms and health-related quality of life in intubated and non-intubated intensive care survivors: A multicentre, prospective observational cohort study

ObjectiveTo compare long-term psychological symptoms and health-related quality of life (HRQOL) in intubated versus non-intubated ICU survivors. DesignProspective, multicentre observational cohort study. SettingFour tertiary medical-surgical ICUs in Australia. ParticipantsIntubated and non-intubated adult ICU survivors. Main outcome measuresPrimary outcomes: clinically significant psychological symptoms at 3- and 12-month follow-up using Post-Traumatic Stress Syndrome-14 for post-traumatic stress disorder; Depression, Anxiety Stress Scales-21 for depression, anxiety, and stress. Secondary outcomes: HRQOL, using EuroQol-5D-5L questionnaire. ResultsOf the 133 ICU survivors, 54/116 (47 %) had at least one clinically significant psychological symptom (i.e., post-traumatic stress disorder, anxiety, depression, stress) at follow-up. Clinically significant scores for psychological symptoms were observed in 26 (39 %) versus 16 (32 %) at 3-months [odds ratio 1.4, 95 % confidence interval (0.66–3.13), p = 0.38]; 23 (37 %) versus 10 (31 %) at 12-months [odds ratio 1.3, 95 % confidence interval (0.53–3.31), p = 0.57] of intubated versus non-intubated survivors, respectively. Usual activities and mobility were the most commonly affected HRQOL dimension, with >30 % at 3 versus months and >20 % at 12-months of overall survivors reporting ≥ moderate problems. There was no difference between the groups in any of the EQ5D dimensions. ConclusionsNearly one-in-two (47 %) of the intubated and non-intubated ICU survivors reported clinically significant psychological symptoms at 3 and 12-month follow-ups. Overall, more than 30 % at 3-months and over 20 % at 12-months of the survivors in both groups had moderate or worse problems with their usual activities and mobility. The presence of psychological symptoms and HRQOL impairments was similar between the groups.

Assessing Aspects of Quality of Life Among Patients with Sickle Cell Disease in Saudi Arabia

Introduction: Sickle cell disease is a genetic disorder that can significantly alter the patient's quality of life. The disease trajectory can lead to acute and chronic complications, mainly resulting from repeated episodes of vascular occlusion. The patients can experience frequent infections and hospitalizations, chronic pain, fatigue, hand-foot syndrome, delayed growth. Therefore, assessing the quality of life among sickle cell patients in Saudi Arabia is pertinent to the devise of a comprehensive plan of patient care. The quality of life can be determined based on numerous markers, including physical health, psychological health, happiness, and physical activity. We aimed to assess the overall quality of life among Saudi sickle cell disease patients living in different regions of the Kingdom. This an ongoing study with open enrollment target of more than 600 patients. Methods: A questionnaire-based survey was conducted among the adult Saudi sickle cell disease population residing in different provinces, who were stable, Saudi nationals and over age of 18 years. The questionnaire assessed the quality of life, including fatigue, general happiness, physical activity, and psychological well-being using standardized questionnaire SF-36 and HADS validated Arabic version. Additional data about blood transfusion and visit to ER were collected The collected data were recorded for each respondent, and the results were statistically analyzed. Results: The included participants' (n=166) mean age 33.6 ± 9.2. years, with respondents belonging to eastern region Qatif (n=48; 28.9%), central region Riyadh (n=75; 45.1%), and southern region Jizan (n=43; 25.9), respectively. The study's cohort had varying educational backgrounds, with the highest number holding a bachelor's degree (n=77; 46.4%); followed by secondary education (n=50; 30.1); master's degree (n=8; 4.8); doctoral degree (n=5; 3.0) and other education (n=18; 10). In total, 17.5% of participants reported excellent reviews about health, and only 9% reported badly. However, the overall quality of life compared to the previous year was much lower, with 10.8% responses as worse. Strenuous activities constrained 40.9% of the participants, 14.5% were constrained by work of medium intensity, and 13.2% felt even a lot of constraint while carrying groceries. Almost 40% of respondents answered negatively when asked about feeling energetic compared to psychological health, where more than 50% of responses were positive. More than 52% of participants felt their ability to do activities at work and otherwise was diminished. More than 80% of participants felt pain over the past four weeks that affected their quality of life. The findings have been graphically summarized in Figure 1. The patients with blood transfusion assessed their health significantly poor than those without transfusion (p-value = 0.0022). Their health conflicted with their daily routine significantly (p-value=0.003), where they were significantly more tired (p-value=0.04), and felt less assured (p-value=0.02). Conclusion: The physical and psychological health-related quality of life is satisfactory among Saudi sickle cell disease patients.. Furthermore, the lack of energy and appropriate physical activity is a serious concern that can negatively impact sickle cell disease patients' overall quality of life. This is a planned cohort to measure quality of life in sickle cell disease in Saudi Arabia at a large scale with link to demographic representation .

Psychological distress and convergence of own and proxy health-related quality of life in carers of adults with an intellectual disability.

In adults with an intellectual disability, health-related quality of life (HRQoL) is often measured by proxy report. This cross-sectional study investigated whether the mental health of proxy raters impacts the way they rate HRQoL. In this study, 110 carers of adults with an intellectual disability completed measures of psychological distress (Kessler-6) and HRQoL (EQ-5D-3L) about their own HRQoL and that of the care recipient. Differences between HRQoL scores as rated by the carer about themselves and the care recipient were calculated (convergence scores) and multiple regression models were fitted to estimate the association between proxy psychological distress and convergence scores for subjective/objective HRQoL controlling for support needs of the care recipient, carer age and gender of care recipient. There was a significant association between psychological distress and subjective HRQoL convergence scores (r=.92; P=0.03; 95%; CI: -1.76 to -0.09). There was no association between psychological distress and objective HRQoL convergence scores (r=.01; CI -0.02 to 0.001; P=0.08). The association between psychological distress and HRQoL scores was no longer present when models did not include convergence scores. Carers experiencing more psychological distress tended to rate their own and the care recipients' subjective HRQoL more similarly. Objective HRQoL measures did not show this convergence in scores with increasing carer psychological distress. Findings differed when the analysis approach was changed, suggesting the results above require replication in future studies.

Feasibility, Acceptability, and Preliminary Efficacy of Acceptance Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress.

The bidirectional relationship between inflammatory bowel disease (IBD) flare-ups and depression/anxiety symptoms has prompted investigations into psychotherapy to improve health-related quality of life (HRQoL) by targeting depression and anxiety. Acceptance commitment therapy (ACT) is effective in improving symptoms of depression and anxiety in people with chronic diseases, yet minimal research has examined ACT's effectiveness for IBD. This study examines the feasibility, acceptability, and preliminary efficacy of the ACTforIBD program, an online program codesigned with consumers to deliver ACT to those with IBD. Adults with IBD and symptoms of mild-moderate distress were randomized to ACTforIBD or an active control (psychoeducation) condition. Participants completed 8 weekly, 1-hour sessions, 4 of which were therapist facilitated. Feasibility was based on recruitment and retention and acceptability was derived from postprogram satisfaction measures. Preliminary efficacy was determined by group differences in rate of change in study outcomes from baseline to postprogram. Of 62 participants (89% women, 11% men; mean age 33 years), 55 completed the program (ACTforIBD: n = 26 [83.9%]; active control: n = 29 [93.5%]). Adherence and acceptability were high in the ACTforIBD group, with 80% of participants completing all self-directed modules and 78% of participants expressing satisfaction with the program. Significant and marginally significant group × time interactions were found for anxiety symptoms (b = -1.89; 95% confidence interval, -3.38 to -0.42) and psychological HRQoL (b = -0.04; 95% confidence interval, -0.07 to 0.01), showing decreased anxiety and increased psychological HRQoL in the intervention group. ACTforIBD is feasible, acceptable, and improved anxiety symptoms, and psychological HRQoL. This highlights the need for a full-scale randomized controlled trial to further examine the program's efficacy.

Pain-related and psychological factors mediate the effect of personality on health-related quality of life. A study in breast cancer survivors with persistent pain.

Personality characteristics affect the long-term well-being and health-related quality of life (HrQoL) of breast cancer (BC) survivors. Persistent pain significantly affects psychosocial well-being and HrQoL in this patient group. We studied the effects of temperament and character via pain-related and psychological factors on dimensions of HrQoL in BC survivors. We studied 273 patients who had been treated for BC and who reported persistent pain at any site of the body in Brief Pain Inventory. The patients were recruited from a longitudinal cohort of patients 4-9 years after surgery for BC. Short-Form-36 inventory was used to assess physical and mental dimensions of HrQoL and Temperament and Character Inventory to assess dimensions of temperament and character. We used parallel mediation modeling for studying effects of temperament and character on physical and mental HrQoL. A significant total effect was found for harm avoidance (HA) temperament (βtotal = -0.665, p < 0.001) and character dimensions self-directedness (SD) (βtotal = 0.609, p = 0.001) and cooperativeness (CO) (βtotal = 0.584, p = 0.028) on physical and mental HrQoL. Additionally, different combinations of pain-related and psychological variables fully mediated the indirect effects of HA, SD, and CO on physical and mental HrQoL. HA temperament is a potential emotional vulnerability factor for psychological burden and impaired HrQoL in BC survivors. Character dimensions SD and CO may protect from the negative effect of mood on HrQoL. The results provide new insights about the risk-and target-factors for clinical interventions and effective pain management to improve psychosocial well-being and HrQoL in BC survivors.

Health-Related Quality of Life Among Patients With Painful Chronic Ankle Instability

More than half of individuals with chronic ankle instability (CAI) experience lingering pain from a previous injury. However, there is little empirical evidence investigating the role pain has on health-related quality of life (HRQL). The purpose of this cross-sectional study was to compare physical and psychological HRQL between CAI individuals with and without pain. Group comparisons demonstrated that CAI individuals with pain displayed a lower physical and mental HRQL than those without pain. In addition, CAI individuals with pain reported greater injury-related fear. These findings suggest that persistent pain compounds the negative effect that ankle joint instability has on physical and mental HRQL outcomes. Therefore, conservative therapies should consider multimodal approaches rather than focusing on joint stability alone.

The prevalence and burden of avoidant/restrictive food intake disorder (ARFID) in a general adolescent population

BackgroundLittle is known about the prevalence and impairment associated with possible Avoidant/restrictive food intake disorder (ARFID) in community adolescent populations. We aimed to investigate the prevalence, health-related quality of life (HRQoL), and psychological distress associated with possible ARFID in a sample of adolescents from the general population in New South Wales, Australia.MethodsA representative sample of 5072 secondary school students aged between 11 and 19 years completed the online EveryBODY survey in 2017. The survey included demographic data, eating behaviours, psychological distress and both physical and psychosocial health-related quality of life.ResultsThe prevalence of possible ARFID was 1.98% (95% CI 1.63–2.41) and did not differ significantly across school years 7–12. The weight status of participants with possible ARFID did not differ significantly from those without possible ARFID. When measuring gender identity, the ratio of males to females with possible ARFID was 1:1.7. This was statistically significant, however, the effect size was very small. Psychological distress and HRQoL did not differ significantly between the possible ARFID and non-ARFID group.ConclusionsThe prevalence of possible ARFID was found to be similar to that of anorexia nervosa and binge eating disorder in the general adolescent population. Adolescents who identify as girls rather than boys may be more likely to develop ARFID, replication with new samples is required to confirm these findings. The impact of ARFID on HRQoL may be minimal in adolescence and become more significant in adulthood, further research using longitudinal design, healthy control groups and/or diagnostic interviews is required.

The impact of cancer prehabilitation on psychological outcomes and quality of life in patients with gastro-oesophageal cancer.

e16096 Background: The impact of cancer on psychological health and health related quality of life (HRQoL) is complex and involves an interaction between pre-existing and cancer related psychological morbidity and symptoms. Factors such as self-efficacy are known predictors of recovery and HRQoL. The aim of this study is to assess the impact of multi-modal personalised prehabilitation on psychological outcomes and HRQoL in patients with curable oesophageal and gastric (OG) cancer. Methods: Data was collected for to all patients treated at a specialist centre between Jan 2016 and June 2018. Patients received multi-modal (physical, nutrition and psychological) prehabilitation from diagnosis into the post-operative period. Data on self-efficacy (SE), anxiety and depression (Hospital Anxiety and Depression Scale, HADS) and HRQoL (European Organization for Research and treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)) were collected at diagnosis (T1), completion of neo-adjuvant chemotherapy (T2) and 3 months after surgery (T3). A previously validated mapping function was used for predicting Euro QoL 5D-3L (EQ-5D-3L) from scale scores of the EORTC QLQ-C30 instrument to derive a EQ health utility (EQ-HU). Results: 137 patients underwent surgery. 86 patients underwent a thoracotomy in addition to a laparotomy. 107 patients received neo-adjuvant treatment. There was a significant improvement in SE [8.2 (6.2-9) to 8.8 (7.8-9.7); p = 0.002] and anxiety [5 (3-8) to 4 (2,7); p = 0.04] but not depression [2 (1-5) to 3 (1-5); p = 0.26] between T1 and T2. There were no differences between T2 and T3. There were no differences in global HRQoL and the individual scales of the EORTC QLQ-C30 between T1 and T2. However, between T2 and T3, there were significant reductions in global HRQoL [69.6 (18.2) to 64.7 (20.9); p = 0.04], physical [83.2 (18.2) to 70.9 (20.5); p = 0.001], role [79 (28.6) to 70.9 (28.3; p = 0.02], cognitive [84.2 (22.3) to 76 (23.3); p = 0.004] and social [79 (24.2) to 65.5 (26.1); p = 0.001] but not emotional functions [80.1 (21.4) to 79.5 (23.3); p = 0.67]. Mapping revealed that there was a significant improvement in EQ-HU from T1 to T2 [0.54 (0.52) to 0.79 (0.34); p = 0.001] and a significant fall from T2 to T3 [ 0.79 (0.34) to 0.58 (0.44); p = 0.001]. The minimum and maximum predicted values matched those of the validated mapping function used. Conclusions: This study shows that prehabilitation can have a significant impact on HU in patients on chemotherapy. Despite the well-recognised limitations of mapping, HU at baseline was comparable to that shown in previous research in OG cancer patients. Reduction in HRQoL seen after surgery was much less than previously published research, suggesting the protective effect of prehabilitation. Physical function deterioration, in particular was much less than anticipated.

Factors associated with recognition at work among nurses and the impact of recognition at work on health-related quality of life, job satisfaction and psychological health: a single-centre, cross-sectional study in Morocco

ObjectivesTo describe the sociodemographic, occupational and health factors that influence nurses’ recognition at work and to examine a recognition pathway model to assess the relationship between recognition at work and...

MP61-13 PREVALENCE AND DETERMINANTS OF DECISION REGRET IN LONG-TERM PROSTATE CANCER SURVIVORS FOLLOWING RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 Apr 2023MP61-13 PREVALENCE AND DETERMINANTS OF DECISION REGRET IN LONG-TERM PROSTATE CANCER SURVIVORS FOLLOWING RADICAL PROSTATECTOMY Kathleen Herkommer, Lukas Lunger, Valentin Meissner, Benedikt Kopp, Andreas Dinkel, Stefan Schiele, Donna Ankerst, and Juergen Gschwend Kathleen HerkommerKathleen Herkommer More articles by this author , Lukas LungerLukas Lunger More articles by this author , Valentin MeissnerValentin Meissner More articles by this author , Benedikt KoppBenedikt Kopp More articles by this author , Andreas DinkelAndreas Dinkel More articles by this author , Stefan SchieleStefan Schiele More articles by this author , Donna AnkerstDonna Ankerst More articles by this author , and Juergen GschwendJuergen Gschwend More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003319.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A variety of therapeutic options are available for localized prostate cancer (PC). Choosing the most suitable treatment option can be difficult and requires weighing up against respective side effect profiles. Following radical prostatectomy (RP), PC survivors may experience regret regarding their initial choice of treatment. While long-term impact of functional outcomes on decision regret has been studied extensively, the role of psychosocial factors on decision regret is less understood. The current study aimed to investigate the prevalence and determinants of decision regret in long-term PC survivors following RP. METHODS: A total of 3,408 PC survivors (mean age 78.8±6.5 years, mean time since RP 16.5±3.8 years) from the multicenter German Familial PC Database returned questionnaires. Current decision regret was assessed with one item from the Decision Regret Scale. Validated measures were used to assess treatment decision making, health-related quality of life (HRQoL), PC anxiety, PSA anxiety, general anxiety, and depressive symptoms. Multivariable logistic regression analyses were used to determine variables independently associated with decision regret. RESULTS: Here, 10.9% (373/3408) of PC survivors reported decision regret. Figure 1 depicts the percentage reporting regret by psychological parameters and HRQoL. On multivariable regression, organ-confined disease at RP (OR 1.39, 95%CI: 1.02-1.91), biochemical recurrence (OR 1.34 95%CI: 1.00-1.80), low HRQoL (OR 1.69, 95%CI: 1.28-2.24), depressive symptoms (OR 2.32, 95%CI: 1.52-3.53), and PSA anxiety (OR 1.88, 95%CI: 1.17-3.01) were significantly associated with decision regret. Shared-decision making was associated with a lower risk of regret than passive-decision making. (OR 0.59, 95%CI: 0.41-0.86). CONCLUSIONS: The findings underline that PC survivors may experience decision regret even after 16 years following RP. Promoting shared-decision making may help mitigate long-term regret. Awareness regarding patients showing signs of clinical depression or PSA anxiety should be encouraged to identify patients at risk of decision regret in need of additional support. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e857 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kathleen Herkommer More articles by this author Lukas Lunger More articles by this author Valentin Meissner More articles by this author Benedikt Kopp More articles by this author Andreas Dinkel More articles by this author Stefan Schiele More articles by this author Donna Ankerst More articles by this author Juergen Gschwend More articles by this author Expand All Advertisement PDF downloadLoading ...

Effectiveness of a behavioral medicine intervention in physical therapy on secondary psychological outcomes and health-related quality of life in exercise-based cardiac rehabilitation: a randomized, controlled trial

BackgroundInterventions promoting adherence to exercise-based cardiac rehabilitation (exCR) are important to achieve positive physical and psychological outcomes, but knowledge of the added value of behavioral medicine interventions for these measures is limited. The aim of the study was to investigate the added value of a behavioral medicine intervention in physical therapy (BMIP) in routine exCR on psychological outcomes and health-related quality of life (HRQoL) versus routine exCR alone (RC).MethodsA total of 170 patients with coronary artery disease (136 men), mean age 62.3 ± 7.9 years, were randomized at a Swedish university hospital to a BMIP plus routine exCR or to RC for four months. The outcome assessments included HRQoL (SF-36, EQ-5D), anxiety and depression (HADS), patient enablement and self-efficacy and was performed at baseline, four and 12 months. Between-group differences were tested with an independent samples t-test and, for comparisons within groups, a paired t-test was used. An intention-to-treat and a per-protocol analysis were performed.ResultsNo significant differences in outcomes between the groups were shown between baseline and four months or between four and 12 months. Both groups improved in most SF-36 domains, EQ-VAS and HADS anxiety at the four-month follow-up and sufficient enablement remained at the 12-months follow-up.ConclusionA BMIP added to routine exCR care had no significant effect on psychological outcomes and HRQoL compared with RC, but significant improvements in several measures were shown in both groups at the four-month follow-up. Since recruited participants showed a better psychological profile than the general coronary artery disease population, further studies on BMIP in exCR, tailored to meet individual needs in broader patient groups, are needed.Trial registration number NCT02895451, 09/09/2016, retrospectively registered.

Quality of life and ability to work of patients with Post-COVID syndrome in relation to the number of existing symptoms and the duration since infection up to 12 months: a cross-sectional study

PurposeFollowing SARS-CoV-2 virus infection, patients may suffer from long-lasting symptoms regardless of disease severity. Preliminary results show limitations in health-related quality of life (HRQoL). The aim of this study is to show a possible change depending on the duration since infection and the accumulation of symptoms. Additionally, other possible influencing factors will be analyzed.MethodsThe study population consisted of patients (18–65 years) presenting to the Post-COVID outpatient clinic of the University Hospital Jena, Germany, between March and October 2021. The HRQoL was assessed by the use of the RehabNeQ and the SF-36. Data analysis was descriptive with frequencies, means, and/or percentages. In addition, a univariate analysis of variance was performed to show the dependence of physical and psychological HRQoL on specific factors. This was finally tested for significance at an alpha level of 5%.ResultsData from 318 patients were analyzed, most of whom had 3–6 months of infection (56%) and 5–10 symptoms persisted (60.4%). Both mental (MCS) and physical sum score (PCS) of HRQoL were significantly lower than those of the German normal population (p < .001). The number of remaining symptoms (MCS p = .0034, PCS p = .000) as well as the perceived ability to work (MCS p = .007, PCS p = .000) influenced the HRQoL.ConclusionThe HRQoL of patients with Post-COVID-syndrome is still reduced months after infection and so is their occupational performance. In particular, the number of symptoms could have an influence on this deficit, which would need to be further investigated. Further research is needed to detect other factors influencing HRQoL and to implement appropriate therapeutic interventions.

Identifying Latent Patterns and Predictors of Health Behaviors and Healthcare Barriers Among LGBT Older Adults.

Heightened risk of adverse health behaviors is of major concern among lesbian, gay, bisexual, and transgender (LGBT) older adults. Yet, no previous research has investigated heterogeneity of LGBT older adults on a set of health behaviors in conjunction with healthcare barriers. We aim to identify latent classes of the behavior and barrier patterns and examine differences in physical and psychological health-related quality of life (HRQOL) by the specified latent classes while exploring predictors of the class membership. Three-step latent class analysis applying survey weights was conducted with 14 indicators of health-risk behavior, health-promoting behavior, preventive care use, and healthcare barriers from baseline data of the Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS, N = 2450). The best empirical and substantive fit was determined with four classes consisting of (1) healthy behaviors and minimal barriers (C1, 39%), (2) less healthy behaviors and high barriers (C2, 31%), (3) healthy behaviors and healthcare system barriers (C3, 19%), and (4) optimal health behaviors with risks of limited healthcare access (C4, 11%). Compared to C1, C2 and C3 had lower physical HRQOL and C2 also had lower psychological HRQOL. C4 did not differ in HRQOL from C1. C2 was associated with more day-to-day discrimination, lower mastery, and lower social support. Efforts to lower healthcare barriers are warranted in addition to interventions to strengthen social support and reduce marginalization. Positive relationships between LGBT older adults and healthcare need to be established via trust-building and cultural competency.