Psychosocial Impact Research Articles

Patient-reported outcome measurements in facial skin surgery and a comparison between Mohs micrographic surgery and conventional excisions.

Knowledge of the psychosocial impact of facial skin surgery on patients can help improve counselling strategies. The objective was to measure the psychological impact of facial skin cancer surgery on patients over a 1-year period. Secondary objective was to measure the difference between Mohs micrographic surgery (MMS) and conventional excision (CE) on these parameters. This observational survey study was conducted between March 2019 and July 2020. Patients who had facial skin surgery using MMS or CE were selected. Five surveys were conducted on four timepoints (preoperative, 1 week, 3 months and 1 year post-operative) measuring the quality of life, perceived stigmatization, body image, satisfaction with facial appearance and psychosocial distress. A total of 228 patients (MMS 154 patients, CE 74 patients) were included for the analysis. Scores for quality of life did not significantly change, in the year after surgery (PCS-12 mean 50.5, SD 9.3 and MCS-12 50.6, SD 9.4); however, stigmatization (F (3, 235,39) 7,26, p < 0.01, d = -0.07), body image concerns (F (3, 198,28) = 3.75, p < 0.01, d = -0.14), satisfaction with facial appearance (F (3, 205,18) = 10.74, p < 0.01, d = 0.43) and psychosocial distress (F (3, 208,69) = 9.26, p < 0.01, d = -0.15) did change over time. The use of MMS or CE did not significantly affect outcome scores after 1 year. Patients receiving facial skin cancer surgery exhibited low scores for perceived stigmatization and body image concerns. Their quality of life was not statistically influenced by facial surgery, and their satisfaction with their facial appearance and psychosocial distress even improved after 1 year. The results suggest that the surgical treatment type (MMS or CE) does not influence the outcome. The overall results can help in counselling strategies to improve expectations for patients receiving facial surgery.

A Longitudinal Mixed Methods Case Study Investigation of the Academic, Athletic, Psychosocial and Psychological Impacts of Being a Sport School Student Athlete

BackgroundSport schools are popular environments for simultaneously delivering education and sport to young people. Previous research suggests sport school involvement to have impact (i.e. the positive/negative, intended/unintended and long/short-term outcomes, results and effects) on student athlete’s holistic (i.e. academic, athletic, psychosocial and psychological) development. However, previous research is limited by (1) cross-sectional methods, (2) limited multidimensional assessments, (3) lack of consideration for athlete characteristics (e.g. sex) and (4) failure to evaluate how sport school features affect student-athlete impacts.ObjectivesThe study, using a mixed methods case study approach, aims to (1) longitudinally evaluate the impact of sport school involvement on the holistic development of student athletes, (2) evaluate the impact on holistic development by student-athlete characteristics and (3) explore the features and processes of the sport–school programme that drive/facilitate holistic impacts.MethodsA longitudinal mixed methods design was employed across one full academic school year (33 weeks). Six data-collection methods (i.e. online questionnaire, physical fitness testing battery, academic assessment grades, log diaries, field notes/observation and timeline diagram/illustration) were used to assess the academic, athletic, psychosocial and psychological impacts for 72 student athletes from one sport school in the United Kingdom (UK).ResultsStudent athletes developed positive long-term holistic overall impacts (i.e. academically, athletically and personally), including maintaining stable and relatively high levels of sport confidence, academic motivation, general recovery, life skills, resilience and friends, family and free time scores. Despite positive impacts, juggling academic and sport workload posed challenges for student athletes, having the potential to lead to negative holistic impacts (e.g. fatigue, stress and injury). Positive and negative impacts were linked to many potential features and processes of the sport school (e.g. academic and athletic support services versus insufficient training load build-up, communication, coordination, flexibility and planning). Furthermore, when considering student-athlete characteristics, females had lower sport confidence, higher general stress and body image concerns and less general recovery than males and student athletes who played sport outside the school had lower general recovery.ConclusionsThis mixed method, longitudinal study demonstrated sport school involvement resulted in many positive academic (e.g. good grades), athletic (e.g. fitness development), psychosocial (e.g. enhanced confidence) and psychological (e.g. improved resilience) impacts attributed to the academic and athletic support services provided. However, juggling heavy academic and athletic workloads posed challenges leading to negative impacts including fatigue, pressure, stress and injury. Furthermore, holistic impacts may be sex dependent and further support may be required for female student athletes in sport school environments. Overall, these findings demonstrate the complex nature of combining education and sport commitments and how sport schools should manage, monitor and evaluate the features of their programme to maximise the holistic impacts of sport–school student athletes.

Predictors of psychosocial adaptation in children with CHD.

Survival of CHD has significantly improved, but children with CHD remain susceptible to neurodevelopmental and psychosocial impairments. Our goal was to investigate the association between socio-demographic factors and psychosocial adaptation for future intervention. A retrospective cross-sectional study of an independent children's hospital's records was conducted. Psychosocial adaptation was measured by the Pediatric Cardiac Quality of Life Inventory Psychosocial Impact score (range 0-50, higher score indicates greater psychosocial adaptation). Bivariate and regression analyses were performed to estimate relationships between Psychosocial Impact score and socio-demographic variables including Child Opportunity Index, family support, financial support, academic support, and extracurricular activities. A total of 159 patients were included. Compared to patients in high opportunity neighbourhoods, patients in low opportunity neighbourhoods had a 9.27 (95% confidence interval [-17.15, -1.40], p = 0.021) point lower Psychosocial Impact score, whereas patients in moderate opportunity neighbourhoods had a 15.30 (95% confidence interval [-25.38, -5.22], p = 0.003) point lower Psychosocial Impact score. Compared to patients with adequate family support, those with limited support had a 6.23 point (95% confidence interval [-11.82, -0.643], p = 0.029) lower Psychosocial Impact score. Patients in moderate opportunity neighbourhoods had a higher Psychosocial Impact score by 11.80 (95% confidence interval [1.68, 21.91], p = 0.022) when they also had adequate family support compared to those with limited family support. Our findings indicate that among children with CHD, psychosocial adaptation is significantly impacted by neighbourhood resources and family support structures. These findings identify possible modifiable and protective factors to improve psychosocial adaptation in this vulnerable population.

Hidden Port Site Incisions for Robotic Foregut and Hepatopancreatobiliary Operations: A Cosmetically Superior Approach.

While the widespread adoption of minimally invasive surgery has led to improved cosmesis for abdominal operations, visible scars on the abdomen may still have a negative psychosocial impact on patients, especially for those with poor healing. We have developed a cosmetically favorable, safe, and easily adaptable robotic technique for common foregut and hepatopancreatobiliary procedures with hidden incisions at the level of the pubic hairline to minimize visibility. This technique monopolizes on the unique advantages of the robotic platform to maximize cosmetic outcome while maintaining clinical outcomes and technical ease. Herein we describe how to accomplish this technique for three different procedures: anti-reflux operation, distal pancreatectomy, and small bowel resection. In our experience, this technique of hiding port site incisions at the level of the pubic hairline can be easily adopted for improved patient quality of life and cosmesis. We especially recommend this technique in patients with a history of hypertrophic or keloid scars.

Psychosocial Impact of Patching in Unilateral Congenital Cataract

Psychosocial Impact of Patching in Unilateral Congenital Cataract

Factors associated with behavioral euthanasia in pet dogs.

When pet dogs demonstrate certain serious problem behaviors, this may lead owners to choose behavioral euthanasia. However, research on behavioral euthanasia of pet dogs is sparse and previously published papers have not specifically sampled owners who made the decision to euthanize for behavior. The Behavioral Euthanasia in Pet Dogs Questionnaire was created to collect a wide range of information from dog owners who made behavioral euthanasia decisions. Using this survey, we explored the types of behaviors associated with behavioral euthanasia. Human-directed aggression, especially toward adults living in the household, was the most frequently reported reason for choosing behavioral euthanasia; followed by aggression toward other animals, especially other dogs living in the same household. The majority of dogs displaying human-directed or other animal-directed aggression were reported to have bitten and broken skin, and many of these had bitten in multiple or severe incidents. Most dogs had lived in their homes and displayed problem behaviors for over a year prior to behavioral euthanasia, and the euthanasia occurred at a variety of ages, from less than 1 year old to 18 years old. Additional research is required to understand environmental or nonbehavioral factors contributing to the behavioral euthanasia of companion animals, as well as the psychosocial and emotional impact of behavioral euthanasia on the human experience. Understanding the behavioral factors associated with behavioral euthanasia can direct resources toward problem behavior interventions, improve public education about animal behavior, and strengthen the human-animal bond.

Impact of the SARS-CoV-2 Pandemic on the Management and Prognosis of Infective Endocarditis.

Infective endocarditis (IE) is a serious condition which is difficult to diagnose and to treat, both medically and surgically. The objective of this study was to evaluate the impact of the SARS-CoV-2 pandemic on the management of patients with IE. We conducted a single-centre retrospective study including patients hospitalized for IE during the pandemic (Group 2) compared with the same period the year before (Group 1). We compared clinical, laboratory, imagery, therapeutic, and patient outcomes between the two groups. A total of 283 patients were managed for possible or definite IE (164 in Group 1 and 119 in Group 2). There were more intravenous drug-related IE patients in Group 2 (p = 0.009). There was no significant difference in surgery including intra-cardiac device extraction (p = 0.412) or time to surgery (p = 0.894). The one-year mortality was similar in both groups (16% versus 17.7%, p = 0.704). The recurrence rate was not significantly different between the two groups (5.9% in Group 2 versus 9.1% in Group 1, p = 0.311). The SARS-CoV-2 pandemic did not appear to have had a negative impact on the management of patients with IE. Maintenance of the activities of the endocarditis team within the referral centre probably contributed to this result. Nevertheless, the high proportion of intravenous drug-addicted patients in the pandemic cohort suggests that the SARS-CoV-2 pandemic had a major psychosocial impact.

Living with epilepsy: patient knowledge and psychosocial impact

Background. People living with epilepsy (PLWE) often face psychological comorbidities and social challenges due to low levels of knowledge and awareness about epilepsy, as well as personal experiences with the condition. This can result in a low quality of life for PLWE.Objective: to investigate the psychosocial impact of epilepsy on patients residing in rural regions of South Africa (Limpopo and Mpumalanga Provinces).Material and methods. A non-experimental quantitative research was conducted, which involved 162 respondents living with epilepsy. Most were males, and the majority were between 18 and 35 years old in both provinces combined. The participants were offered a questionnaire divided into three sections comprising sociodemographic aspects, questions that assessed knowledge, and questions on the psychosocial impact of epilepsy.Results. I t was shown that while PLWE have a solid understanding of epilepsy as a medical condition, they may not fully comprehend its effects on daily life. For example, many respondents felt shameful after having a seizure and difficulties in forming relationships, and a significant proportion stated that they were never married because of epilepsy. The study highlights the significant psychosocial impact of epilepsy on PLWE, including depression, difficulties in forming and maintaining social connections, and a lack of marital experience.Conclusion. To improve PLWE’s quality of life, the psychological help is recommended through healthcare facilities or local support groups.

Lived experiences of adolescents with major depressive disorder during the COVID pandemic: A qualitative study from a tertiary care center.

Depression is a leading cause of global disease burden and morbidity among adolescents. Studies have reported higher rates of depression and anxiety secondary to the COVID pandemic and the psychosocial impact of social distancing measures. There is a paucity of literature on the subjective experiences of depressed adolescents in such pandemic circumstances. The objective of this study was to explore the lived experiences of adolescents with major depressive disorder (MDD) during the COVID pandemic, and the impact of the pandemic, and pandemic-related circumstances on adolescents' mental health and coping. In-depth interviews with eight adolescents diagnosed with MDD were analyzed using interpretative phenomenological analysis. The analysis revealed three major themes; "The pandemic was arduous," "Negativity in family interactions," and "Effects on depression." Most adolescents coped using excessive screen time as a distraction, and their families perceived them as indolent. The study found that adolescents' experience of depression during the pandemic was extremely overwhelming because, on the one hand, they had to deal with immediate COVID infection-related worries and were not able to adjust to the new routine, not able to concentrate during online classes while also dealing with greater interpersonal discord with their parents and limited social resources for coping. The findings expand the clinical understanding of adolescents' experience of depression during pandemic circumstances and would aid in better management planning.

Age and Sex Differences in Pediatric Neuropathic Pain and Complex Regional Pain Syndrome: A Scoping Review.

Age and sex differences may exist in the frequency (incidence, prevalence) or symptoms of neuropathic pain (NP) and complex regional pain syndrome (CRPS) due to biopsychosocial factors (eg, neurodevelopment, physiological and hormonal changes, psychosocial differences) that evolve through childhood and adolescence. Age and sex differences may have implications for evaluating screening and diagnostic tools and treatment interventions. To map the existing literature on pediatric NP and CRPS with respect to age and sex distributions, and age and sex differences in symptomology and frequency. A scoping literature review was conducted. Databases were searched from inception to January 2023. Data were collected on study design, setting, demographics, and age and sex differences in frequency and symptoms. Eighty-seven studies were included. Distribution of participants with CRPS (n=37 studies) was predominantly early adolescence (10 to 14y) and female sex, while NP (n=42 studies) was most commonly reported throughout adolescence (10 to 19y) in both sexes. Forty-one studies examined age and sex differences in frequency; 6 studies reported higher frequency in adolescence. Very few studies (n=11) examined differences in symptomology. Large epidemiological studies are required to further understand age and sex differences in frequency of pediatric NP and CRPS. Age and sex differences must be considered when evaluating screening and diagnostic tools and treatment interventions to ensure relevance and validity to both sexes and across ages. Validated tools will improve understanding of age-dependent and sex-dependent differences in symptoms, pathophysiology, and psychosocial impact of pediatric NP and CRPS.

Outcome measures applied to robotic assistive technology for people with cerebral palsy: a pilot study

The application of robotic devices is being used as Assistive Technology (AT) for improving rehabilitation interventions. The purposes of this research were to (1) test a novel low-cost robotic AT to support interventions for people with Cerebral Palsy (CP); (2) determine its usability; and (3) analyze its impact. It was a pilot study with prospective, longitudinal and analytical cohorts was done. Intervention was developed in one association (NGO) of people with CP. Participants were 6 women and 3 men with CP, with a mean age of 51.67. Intervention with LOLA2 (a robotic platform, not wearable, equipped with artificial intelligence) was implemented for training some activities of daily life (ADL) of participants. Functional Independence Measure (FIM), Psychosocial Impact of Assistive Technology Scale (PIADS), and Assistive Technology Device Predisposition Assessment (ATPA) were used for outcome measures. Level of participants’ independence was high (FIM = 98). Psychosocial impact of the robotic platform in terms of competence (M = 0.25), adaptability (M = 0.33), and self-esteem (M = 0.25), was positive, but low. The mean in ATDPA (M = 3) reflects a moderate match. No significant variations concerning the changes in functional independence were detected. The robotic platform is applicable and complementary AT for rehabilitation. This study leads to implementing some improvements in its design, proposed activities, human-robot interaction, and system for registering information.

Pregnant and postpartum women’s experiences of the indirect impacts of the COVID-19 pandemic in high-income countries: a qualitative evidence synthesis

BackgroundPregnant and postpartum women’s experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic.MethodsA qualitative evidence synthesis of studies relating to women’s experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings.ResultsSixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment.ConclusionsThe findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.

Psychosocial impact of acne vulgaris on the quality of life among adolescents versus adults

Psychosocial impact of acne vulgaris on the quality of life among adolescents versus adults

"COVID-19 - A Perfect Storm": A Qualitative Exploration of Residential Care Facility Managers Perspectives on the Psychosocial Impacts of COVID-19.

Growing evidence highlights the negative impact of managing the COVID-19 pandemic on the wellbeing of the healthcare workforce, including in the aged care sector. We undertook a qualitative study during the pandemic's third year to explore the psychosocial impacts on nine managers of residential care facilities (RCFs) across metropolitan and rural New South Wales, the largest state in Australia. Four themes were identified: (1) Increased pressure on maintaining aged care services, (2) Increased responsibility on RCF managers, (3) Psychosocial impacts due to accumulating pressures, and (4) Experience of beneficial supports. COVID-19 compounded pre-pandemic sector challenges and added new stressors. While resilient and resourceful, RCF managers experienced workplace stress and burnout, which may affect quality of resident care and impact on staff retention. There is a need for more investment to effectively support staff, and research to identify optimal psychosocial and management supports.

Gender equity in hemophilia: need for healthcare, familial, and societal advocacy.

Hemophilia is a rare bleeding disorder caused by a genetic defect on chromosome X. It is inherited as an X-linked trait, and hence, it is more frequently diagnosed in males, whereas women have been traditionally considered only as carriers of the disease. However, the role of women in families of patients with hemophilia is pivotal. As mothers, sisters, daughters, and female partners of patients with hemophilia, they play a central role in the management of the patient, considering healthcare, social, and familial aspects, but they might be affected by the disease as well, particularly in regions where consanguinity is frequent. This paper aims to explore the involvement of women in hemophilia, including their carrier status, bleeding symptoms, treatment challenges, and psychosocial impact not only related to male patients, but also as patients affected with hemophilia themselves. We advocate health equity, equal access to healthcare for men and women with hemophilia and dedicated resources to improve the unique needs of the women dealing with hemophilia, ultimately leading to improved care and quality of life.

Modifiable Prosthetic Socket Using Air Pump Method

A prosthesis backup for a part of the body that may have been missing at birth or lost in an accident or through amputation. Prostheses are used to restore the normal functions of the missing body part. Traumatic injuries and different conditions have been set up as common causes of amputation. The need for prostheses in being patterns requires individual measuring and manufacturing of prostheses inclusively for every case. Also, Amputees find it delicate to fit and carry out their routine with a prosthetic duly heavy for them making it considered a burden. Quality of life, phantom branch pain, and the psycho-social impact of prosthetics are duly taken into account for the development of malleable prosthetic sockets. thus, preventing the individual manufacturing of prosthetic legs and the treatment is done and fixing of prosthesis becomes easier. A collaborative observation demands the design of a bio-compatible, feathery, and provident prosthesis to track normal mortal gait by barring phantom limb pain. This will improve the amputee's confidence to live a quality life in society.

Interpretation of Mayer-Rokitansky-Küster-Hauser syndrome by systematic literature review

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also known as Müllerian aplasia, is a rare congenital anomaly affecting the female genital tract, characterized by the absence of the uterus, cervix and upper vagina in women with normal appearance, karyotype 46 XX and normal endocrine function. The aim of the study was to interpret the main risk factors, clinical criteria and diagnosis of MRKH syndrome and its psychosocial impact through a literature review. A descriptive documentary literature review was conducted, analyzing articles published between 2019 and 2023 in high-impact journals. Sixteen articles were identified, including case studies and theoretical sources of information. The syndrome was found to affect approximately 1 in 4 000 to 5 000 women, with possible genetic basis. Two types are distinguished: type I, with absence of the uterus and vagina, and type II, with additional kidney and skeletal malformations. Diagnosis is made by ultrasound and MRI, and treatment includes the creation of a neovagina through surgical or non-surgical procedures. The syndrome carries a significant emotional and psychological burden due to infertility and sexual difficulties. It was concluded that MRKH involves risk factors such as family history, primary amenorrhea and normal development, requiring a multidisciplinary approach and including treatment options. In Ecuador, the lack of protocols and awareness presents challenges for those affected. It is vital to raise awareness of this condition and support research to improve the quality of life of those affected

Exploring adolescent mental health during the COVID-19 crisis - strengths and difficulties.

The SARS-CoV-2 pandemic has significantly impacted children and adolescents, leading to mental health challenges. Knowledge on their resources and difficulties is crucial and there is a need for valid instruments to assess their psychosocial condition especially in this exceptional situation. We assessed psychopathological symptoms using the SDQ during the pandemic, comparing to pre-pandemic data. Our study aims to understand adolescents' strengths and difficulties amidst COVID-19, evaluating the SDQ's utility in crisis settings. Within the German school-based surveillance study ("B-Fast"), we assessed behavioral strengths and difficulties in 664 adolescents aged 11-17 years during the peak of the German COVID-19 pandemic using the validated Strengths and Difficulties Questionnaire (SDQ) for both external and self-assessed data collection. Data were collected between November 2020 and April 2021. We compared self-assessed SDQ-scores to pre-pandemic data from a comparable sample and examined adolescent classification as "normal" or "borderline/abnormal" based on both external and self-assessed SDQ subscale scores using established cut-off values. Additionally, we conducted sex and rater-based score comparisons. In our study, we observed a significant worsening of "Emotional Symptoms" compared to pre-pandemic levels, while "Conduct Problems" and "Prosocial Behavior" showed improvement. Variations in classification to "normal" and "abnormal" emerged when applying German versus British cut-off values. Females scored higher on "Emotional Symptoms" while males scored higher on "Hyperactivity Symptoms." Correlations between external and self-assessed SDQ ratings ranged from 0.43 (p < 0.001) for "Prosocial Behavior" among girls to 0.62 (p < 0.001) for "Peer Problems" among boys, indicating moderate to high consistency. Our study contributes to understanding the psychosocial impact of the COVID-19 pandemic on German adolescents. Compared to other symptoms, we observed a particular worsening in "Emotional Symptoms" based on our data. Despite the moderate correlation between parental and self-reported evaluations, there appears to be a certain discrepancy in the perception of adolescent quality of life. Therefore, it seems prudent to assess both the external and self-reported evaluations and amalgamate the results from both parties to obtain a comprehensive problem profile of the individual. These findings underscore the importance of using country-specific cutoff values and reaffirm the utility of the SDQ as a valuable assessment tool, even within the unique circumstances posed by a pandemic.

Wigs and Alopecia Areata: Psychosocial Impact and Economic Considerations

Alopecia areata (AA) presents a challenging and unpredictable condition associated with substantial psychosocial and financial burdens. A chronic, relapsing form of non-scarring hair loss, it affects approximately 0.1–0.2% of the population worldwide with a lifetime risk of 1.0% to 2.1%. The psychosocial implications of AA, including its association with depression, anxiety, social phobia, employment disruption, and relationship challenges are well described. Significant economic costs of AA include those of healthcare, lost income, transportation, psychotherapy, and cosmetic accessories (wigs and hairpieces). However, wigs and hairpieces can contribute to enhanced self-esteem, confidence, and overall quality of life (QOL) in AA patients; these positive outcomes correlating with satisfaction in appearance. This article explores the role of wigs in addressing the aesthetic and emotional impact of AA, emphasizing their importance as potential coping mechanisms for individuals facing hair loss whilst also acknowledging possible barriers to their use. Different types of wigs and hairpieces, their respective advantages and disadvantages, and methods of attachment are thoroughly discussed, providing a comprehensive overview for both patients and healthcare professionals. Considering the economic impact of AA, this article explores the cost of wigs in Australia and available financial assistance programs. Wigs can play a pivotal role in rapidly addressing the multifaceted challenges posed by AA, offering time for psychosocial adaptation and delayed response to medical therapies. This review aims to provide valuable insights to inform evidence-based, practical, and personalized counselling of patients with AA and enable shared decision making about the utility of wigs and other cosmetic interventions for hair loss. Further research is warranted to explore differences in the optimal utilization of wigs between diverse sub-populations with AA.

Development and Validation of the Facial Line Distress Scale for Lateral Canthal Lines: FINE-LCL.

Background: Currently available patient-reported outcome measures (PROM) have limited ability to assess unique issues related to lateral canthal lines (LCL). This study aimed to develop a PROM to assess the severity and psychosocial impact of LCL in afflicted patients. Methods: We conducted a cross-sectional survey at a tertiary hospital and two local clinics in Korea. Exploratory factor analysis was conducted to identify the underlying factor structure of the Facial Line Distress Scale for LCL (FINE-LCL), and the internal consistency and test-retest reliability were also examined. Results: We developed a questionnaire comprising 20 items in four domains. Coefficient alphas ranged from 0.94 to 0.97 for subdomains and 0.97 for the total questionnaire. The test-retest intraclass correlation coefficient ranged from 0.77 to 0.90. The FINE-LCL was moderately correlated with the appearance appraisal score and body image. Analysis of the accuracy of the FINE-LCL score in predicting severe LCL was characterized by an area under the curve of 0.79. Conclusions: FINE-LCL is a reliable, valid, and comprehensive PROM for the assessment of the severity of LCL and their associated distress.