Aspects Of Quality Of Life Research Articles

Health-related quality of life disparity in cardiac sarcoidosis versus other myocardial diseases

Abstract Background Sarcoidosis, a systemic inflammatory disorder, can manifest as progressive inflammatory heart disease, termed cardiac sarcoidosis (CS). Despite advances in treatment, the impact of CS on health-related quality of life (HRQoL) remains incompletely understood. This study aimed to compare HRQoL between patients with CS and those with non-inflammatory cardiomyopathies, namely dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM). Purpose To assess and compare HRQoL across patients with cardiac sarcoidosis and non-inflammatory cardiomyopathies. Methods A total of 240 CS patients (86% response rate), 96 DCM patients (55% response rate), and 81 HCM patients (65% response rate) completed the RAND-36 general health-related questionnaire, comprising eight dimensions. Patients listed for transplantation were excluded. Clinical data were obtained from the Finnish myocardial inflammatory diseases registry for CS patients and from medical records in hospitals for HCM and DCM patients. Results Median age ranged from 56 to 59 years across the groups. Unlike DCM, which typically presents with heart failure symptoms, a substantial proportion (82%) of CS patients presented with advanced atrioventricular block or ventricular arrhythmias, while HCM cases were often incidentally detected or identified through family screening. Most CS patients (94%) had implanted pacemakers or ICDs, compared to a lower proportion in HCM (26%) and DCM (63%). DCM patients exhibited a higher prevalence of impaired LVEF (<50%) compared to CS and HCM patients. Functional impairment, as measured by NYHA class, was most pronounced in DCM patients. CS patients experienced more adverse events between diagnosis and the study entry, particularly sustained ventricular tachycardia/ventricular fibrillation. However, heart failure hospitalizations did not significantly differ between groups. Table 1 presents a comparative analysis of patient-reported outcomes across four functional and mental dimensions to assess the relative burden of disease among patients with CS, HCM, and DCM. While the functional dimensions in CS exhibited disparities from both HCM and DCM, no significant differences were observed in the mental dimensions between CS and HCM. CS patients reported lower scores in the domains of role physical, and general health compared to either HCM or DCM counterparts. Conclusion Patients with CS demonstrated significantly poorer HRQoL compared to those with non-inflammatory cardiomyopathies. This underscores the substantial burden of disease associated with CS and highlights the importance of comprehensive management strategies to address both clinical and quality of life aspects in affected individuals.

Functional Outcomes and Self-Reported Quality of Life in Patients with Facial Nerve Impairment Following Vestibular Schwannoma Surgery

Objective: The aim of this observational retrospective study was to report quality of life (QoL) in patients with postoperative facial nerve (FN) palsy after vestibular schwannoma (VS) surgery, investigating clinical factors related to functional outcomes. Methods: Forty-eight consecutive patients (M:F 25:23; median age: 52.5 years) with facial palsy following surgery for sporadic VS were considered retrospectively. FN palsy was graded by using the Sunnybrook facial grading system (SBFGS), while postoperative QoL and subjective functional aspects were assessed by using the Penn Acoustic Neuroma Quality of Life (PANQOL) Scale, the Synkinesis Assessment Questionnaire, and questions on eating and drinking. Results: A significant correlation emerged between all Sunnybrook scores and median PANQOL domain regarding facial function. Increasing overall SBFGS scores were associated with reduced risk of slow chewing on the affected side (p = 0.004), lack of masticatory strength (p = 0.025), masticatory fatigue (p < 0.001), accumulation of food in the oral vestibule (p < 0.001), difficulty in drinking from a glass (p = 0.019), and fluid spillage while drinking (p = 0.016). Conclusions: This study suggests that the clinical evaluation of patients with FN palsy after VS surgery should be integrated with patient reports about functional outcomes and perceived QoL to help clinicians guide rehabilitation choices.

Community attitudes toward tourism and quality of life: a case study of Palangan village, Iran

Community perception is essential for influencing the physical, social, and environmental growth of a region and is key to achieving a high Quality of Life (QOL). Tourism serves as a common means of introducing outsiders to the area where the community lives. Embracing tourism in remote locations like small towns or rural areas can be difficult, and the success of tourism hinges on community attitudes towards it. The community's engagement and approval of tourism are dependent on the benefits such as how tourism improves their QOL in both the short. Therefore, this study aims to explore the local community's perceptions on how tourism influences various aspects of QOL. A survey of 160 households in Palangan Village was conducted to collect primary data, using a conceptual model with 16 indices to evaluate QOL. The findings indicate that the local community generally has a positive perception of the effects of tourism, especially on key QOL components. Civic and generative well-being are considered more significant than other aspects of QOL. Analysis of the data reveals differences in perception across the 16 QOL indices. The highest average ratings were for institutional participation (3.476), quality of employment (3.456), and individual capability (3.203), while the lowest ratings were for standard of living (1.883), social solidarity (2.289), and environmental resource quality (2.725). For instance, the institutional participation index received an average response rating of 3.476. Additionally, the dispersion coefficient index highlighted notable variations in perception, particularly for satisfaction with living conditions (0.488) and standard of living (0.488). Conversely, employment quality (0.360), institutional cooperation (0.385), and freedom of choice had the lowest dispersion coefficients (0.386). Other indices showed moderate levels of dispersion and distribution of perception. In conclusion, these results underscore the significance of community perception in tourism development and its affect on QOL. They also underscore the importance of strategic planning and balanced development to ensure that all aspects of QOL benefit from the expanding tourism sector, leading to a more sustainable and harmonious community.

Premenstrual syndrome and its impact on the quality of life among female medical students at King Faisal University, Al Ahsa, Saudi Arabia

Background: Premenstrual Syndrome (PMS) affects many women, impacting daily activities and potentially hindering academic performance. Female students, in particular, may experience exacerbated effects due to neglecting symptoms. This study investigated the prevalence of PMS and its association with factors influencing female medical students' quality of life (QoL) at King Faisal University, Saudi Arabia. Materials and Methods: A cross-sectional survey distributed to 264 students assessed demographics, family background, menstrual characteristics, PMS symptoms, and study-related QoL. Data were analyzed using SPSS software. Results: PMS prevalence was 34.8% (92/264). Students in clinical years (40% vs. 29% in pre-clinical) and with introverted personalities (43.5%) were more likely to experience PMS. The most commonly reported symptoms were depressive effect, anxiety, fatigue, and irritability (all 100%). Students with PMS reported a higher impact on study-career satisfaction (28.3% vs. 20.3% without) and stress levels (57.6% vs. 37.8% without). Conclusion: This study suggests a significant prevalence of PMS (34.8%) among female medical students. An association was found between PMS, year of study, personality type, and specific aspects of study-related QoL, particularly impacting study-career satisfaction and stress.

Effectiveness of the active communication education program in improving the general quality of life of older adults who use hearing aids: a randomized clinical trial

BackgroundHearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL.MethodsA randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made.ResultsCompared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up.ConclusionsThe ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health.Trial registrationISRCTN54021189 (retrospectively registered on 18/07/2023).

Assessment of the quality of life of cats affected by paraparesis/paraplegia and urinary retention, and their impact on caregivers.

In cats affected by severe thoracolumbar spinal cord pathologies, paraplegia and paraparesis, often accompanied by urinary retention, pose significant challenges, impacting both the cats' welfare and owners' lives. This study aimed to assess the quality of life (QoL) of cats affected by these conditions, and to evaluate the social and familial implications for caregivers. The study was structured into two parts. The first part comprised direct observations of aspects of QoL in cats both in household and shelter settings, while the second part involved the distribution of questionnaires to cat owners and shelter operators. Cats with paraplegia/paraparesis and urinary retention can maintain a good QoL, with hindlimb mobility significantly influencing QoL scores. Shelter cats showed a comparable QoL to household cats, challenging the anecdotal beliefs that shelter cats with severe neurological impairments are destined to lead substandard lives. Operator surveys highlighted the feasibility of managing these cats in shelter environments, emphasising the importance of collaboration between caregivers and veterinary professionals. Likewise, owner surveys revealed a manageable time commitment for care, with most owners achieving proficiency in manual bladder expression within 1 month. Despite challenges, most of the owners reported positive experiences and did not contemplate euthanasia for their cats. Regular veterinary visits and occasional physiotherapy were common practices among caregivers. Owners who respond to the questionnaire and shelter operators have a high commitment to cats with paraplegia/paraparesis. Although the study acknowledges this potential bias, it suggests that dedicated care can ensure a good QoL for cats with severe spinal injuries, both in shelter and household settings. Effective communication between caregivers and veterinary professionals is essential for accurate information dissemination and optimal care provision. This research contributes to raising awareness of managing these conditions and emphasises the importance of collaborative care approaches in veterinary medicine.

Subthalamic Stimulation Improves Short-Term Satisfaction with Life and Treatment in Parkinson's Disease.

The effect of subthalamic stimulation (STN-DBS) on patients' personal satisfaction with life and their Parkinson's disease (PD) treatment is understudied, as is its correlation with quality of life (QoL). Therefore, we tested the hypothesis that STN-DBS for PD enhances satisfaction with life and treatment. In a prospective, multicenter study with a 6-month follow-up involving 121 patients, we measured the main outcomes using the Satisfaction with Life and Treatment Scale (SLTS-7). Secondary outcomes included the eight-item PD Questionnaire (PDQ-8), European QoL Questionnaire (EQ-5D-3L), EQ-Visual Analogue Scale (VAS), Non-Motor Symptom Scale (NMSS), Hospital Anxiety and Depression Scale (HADS), and Unified PD Rating Scale (UPDRS). Longitudinal outcome changes, effect sizes (Cohen's d), and correlations between outcome changes were analyzed. SLTS-7 scores improved at the 6-month follow-up, particularly in the domains of 'satisfaction with physical health' and 'satisfaction with treatment'. Change scores correlated strongly (EQ-VAS), moderately (PDQ-8 SI and HADS), and weakly (UPDRS-activities of daily living and EQ-5D-3L) with other scales. Satisfaction with physical health, psychosocial well-being, or treatment was not related to UPDRS-motor examination. This study provides evidence that STN-DBS enhances patients' personal satisfaction with life and treatment. This satisfaction is associated with improvements in the QoL, daily activities, and neuropsychiatric aspects of PD rather than its motor aspects.

Is there any association between type of dietary fat and quality of life in hemodialysis patients? A cross-sectional study.

Hemodialysis (HD) patients have a low quality of life (QOL), and dietary intakes may impact both somatic and psychosocial aspects of QOL. Nevertheless, the relationship between QOL and different dietary fats has not yet been evaluated. The purpose of this study was to assess the association between QOL and the types/quantities of dietary fats intake in HD patients. In this multi-center cross-sectional study, 251 adult patients under dialysis for at least 3 months were included. Participants' dietary intakes were collected using a validated 168-item semi-quantitative FFQ during the past year. Moreover, to assess QOL, Kidney Disease Quality of Life Short Form (KDQOL-SF 1/3) was used. The linear regression between QOL and different types of dietary fats was conducted. p < 0.05 was statistically significant. Overall, 66 women and 185 men participated in our study. Regression analysis adjusted for total calorie intake showed that there was a negative association between QOL and total fat (95% CI: -0.187, -0.043), SFA (95% CI: -0.688, -0.143), MUFA (95% CI: -0.389, -0.065) and PUFA (95% CI: -0.401, -0.056) when types of dietary fats were individually included to the regression analysis. When all types of dietary fats were simultaneously entered into the analysis, the association between QOL and MUFA (95% CI: -0.243, 1.031) and PUFA (95% CI: -1.159, 0.084) were attenuated. The regression coefficient for SFA remained significant (95% CI: -0.968, -0.138). Also, there was a marginally significant association between SFA and the risk of low QOL was observed when all types of dietary fats were simultaneously entered into the analysis (OR = 1.051, 95% CI: 0.998-1.104). Our investigation found a negative association between SFA consumption and QOL among different types of dietary fats. Furthermore, SFA mediated the relationship between QOL, MUFA, PUFA, and total fat. So, modification of dietary fat intake could enhance QOL in HD patients.

Relationship between Physical Activity Levels, Quality of Life, and Sociodemographic Attributes among Adults in Tabuk, Saudi Arabia: A Direction toward Sustainable Health

Physical activity (PA) improves quality of life (QOL), yet the relationship between PA, QOL, and sociodemographic factors in Saudi Arabia remains underexplored. This study examined this relationship among 369 adults from Tabuk City, Saudi Arabia. The questionnaire measured PA levels and QOL using the Arabic versions of the International Physical Activity Questionnaire and the 36-item Short-Form Health Survey (SF-36), respectively. Data analyses included chi-square, Mann–Whitney U, and Kruskal–Wallis H tests alongside a multivariate regression analysis. Among the SF-36 scores, marital status (p = 0.005), history of chronic diseases (p = 0.004), and medication use (p = 0.001) showed significant differences; pain (80.6 ± 21.5) and energy/fatigue (63.0 ± 18.5) scored highest and lowest, respectively; and sex was significantly associated with PA levels (p = 0.001). The average total SF-36 score was 69.5 ± 15.7, and 42.5% of participants reported low PA. Participants with moderate PA had significantly higher SF-36 scores (p = 0.003), energy/fatigue (p &lt; 0.0001), emotional wellbeing (p = 0.009), and general health (p = 0.004) scores compared with those with low PA. The significant association between PA and QOL underscores the need for sustainable health programs to enhance and maintain PA in alignment with the Saudi Vision 2030 QOL program. It can also inform the development of targeted interventions to enhance PA levels and improve QOL aspects within communities, considering specific sociodemographic attributes to ensure effectiveness and inclusivity.

The impact of multidisciplinary geriatric follow-up on quality of life in older, non-surgical prefrail and frail patients with cancer [sbnd] A randomized controlled trial

IntroductionCancer management in older frail patients can be complex, given the high decline in functional status, comorbidity, and limited life expectancy affecting this group of patients. Therefore, this study aimed to investigate whether oncological treatment combined with comprehensive geriatric assessment (CGA) and tailored follow-up interventions improved or maintained quality of life (QoL) in older prefrail and frail patients with cancer. Materials and MethodsA single-center randomized controlled trial included participants aged 70 or older with head, neck, lung, upper gastrointestinal tract, colon, or rectum cancer referred to non-surgical treatment. All participants underwent CGA conducted by a multidisciplinary geriatric team in an outpatient oncological clinic. The team consisted of a geriatrician and a specialized nurse who provided tailored follow-up visits and phone calls within 90 days after randomization. Exclusion criteria were fit patients, referral for specialized palliative care, or participating in another geriatric research program. In patients with well-functioning cognition, QoL was assessed using the EORTC QLQ-C30 and QlQ-ELD-14 questionnaires before and after the intervention. In patients with cognitive impairment, the Overall QoL-Depression List was used. Changes in QoL were dichotomized into improved/unchanged or worsened and analyzed in a logistic regression model. ResultsIn total, 363 participants were included with a mean age of 76 years (SD 4.6) and 45 % were female. Sixty percent in the intervention group had improved or unchanged QoL compared to 66 % in the control group (odds ratio: 0.75 [95 % confidence interval(CI): 0.45–1.23]). Overall, clinically important changes were found in fatigue and reduced worries about the future. The intervention showed improvements in insomnia symptoms and reported decreased role functioning. Discrepancies were found in the burden of illness without a clinically important difference, where the intervention group experienced an increased burden while the control group had a decreased burden (coefficient: 9.02 [95 % CI, 0.49–17.5]). DiscussionMultidisciplinary geriatric follow-up did not universally improve QoL in older frail patients with cancer. However, positive changes in specific aspects of QoL revealed nuanced impacts, warranting further exploration and larger studies to validate these observations. Tailored interventions targeting fatigue, insomnia, and emotional well-being are crucial for improving QoL in this population. Trial RegistrationRegistered in January 2016 at ClinicalTrials.gov (ID: NCT02837679).

The Effects of Glibenclamide on Cognitive Performance, Quality of Life, and Emotional Aspects Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Controlled Trial

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high incidence of long-term cognitive impairment, decreased quality of life (QoL), and psychiatric disorders. The effects of glibenclamide on such outcomes in the setting of aSAH are unknown. To assess the impact of glibenclamide in patients with aSAH on cognitive performance, QoL, and emotional aspects. Patients identified with aSAH were randomly allocated to receive 5mg of glibenclamide for 21days or placebo, starting within 96hours of the ictus. After 6 months, patients were evaluated with Montreal Cognitive Assessment test (cognitive performance), Medical Outcomes Short-form Health Survey (QoL), and Hospital Anxiety and Depression Scale and Screen for Post-traumatic Stress Symptoms (emotional aspects). The mean Montreal Cognitive Assessment score was 22.5 ± 6.2. No statistically significant difference was found between groups, with a mean score of 21.7 ± 6.4 in the Glibenclamide group and 23.4 ± 6.2 in the placebo group (P= 0.392). A score <23 was observed in 16 patients (35.6%) and its frequency was similar between groups (P= 0.900). The most frequently impaired domains were Attention (N= 21/45; 46.7%) and Visuospatial (18/45; 40.0%). Impairment of each domain was similar between groups (P > 0.05). In each domain, the mean score was similar between groups (P > 0.05). The Hospital Anxiety and Depression Scale scores did not differ between groups (P>0.05). The mean Screen for Post-traumatic Stress Symptoms score as well as the mean scores of its domains were similar between groups (P > 0.05). Glibenclamide did not improve cognitive performance, QoL, and emotional aspects after 6 months of follow-up of aSAH survivors.

Quality of Life in Children with Neurofibromatosis Type 1: Agreement between Parents and Patients, and the Role of Disease Severity and Visibility.

Neurofibromatosis type 1 (NF1) is a genetic disorder that affects multiple systems in the body, often leading to physical disfigurements and a wide range of clinical symptoms. This study aims to investigate the relationship between NF1 severity and visibility and the quality of life (QoL) in children. The Pediatric Quality of Life Inventory (PedsQL) and a modified version of the Ablon scale were used to assess QoL and NF1 severity and visibility, respectively. Self-reported and parent-reported QoL scores were compared, and the associations between NF1 severity/visibility and QoL were explored. Thirty-eight pediatric NF1 patients and their parents were enrolled. QoL scores did not differ significantly between patient self-reports and parent reports. However, correlational analyses revealed that higher NF1 severity was associated with lower physical QoL in patients, and greater NF1 visibility was linked to lower physical and social QoL. For parents, higher NF1 severity correlated with lower school functioning, whereas NF1 visibility did not show a significant correlation with QoL. The severity and visibility of NF1 have distinct impacts on various aspects of QoL in children, highlighting the need for tailored interventions that address both physical and psychological challenges. These findings underscore the importance of comprehensive care approaches in managing NF1 in pediatric populations.

Quality of Life and Symptomatology in Neuropathic Corneal Pain in Comparison With Dry Eye Syndrome.

To investigate and compare the quality of life (QoL) and symptomatology between neuropathic corneal pain (NCP) and dry eye disease (DED). We recruited 150 patients, comprising 50 patients with NCP and 100 patients with DED. Patients' symptoms and QoL were evaluated using the Ocular Pain Assessment Survey and Ocular Surface Disease Index questionnaires. Ocular surface assessments were also performed. Patients with NCP demonstrated significantly lower Oxford and National Eye Institute scores for ocular surface and corneal staining, respectively, and a better tear break-up time than patients with DED. However, patients with NCP reported significantly worse scores on most of the Ocular Pain Assessment Survey questions and significantly more severe overall pain (P = 0.019), maximal and average ocular pain and nonocular pain (all P < 0.05). The NCP group reported significantly worse QoL in all aspects of daily living (all P < 0.001). Patients with NCP spent more time thinking about their eye pain and reported significantly higher pain intensities than patients with DED when exposed to chemical and mechanical stimuli (all P ≤ 0.008). Burning sensation and photophobia were significantly more frequent in patients with NCP (P = 0.032 and P = 0.012, respectively). Similarly, the NCP group reported significantly worse total Ocular Surface Disease Index scores, significantly more frequent vision-related function impairment and painful or sore eyes than the DED group (P = 0.029, P = 0.031, and P = 0.014, respectively). Compared with DED, NCP is more debilitating, leading to more severe and frequent symptoms, and greater negative impact on all aspects of QoL.

Patients’ preferences, experiences and expectations with wait time until surgery in gynaecological oncology: a mixed-methods study in two gynaecological oncological centres in the Netherlands

ObjectivesPatient-centredness of care during wait time before surgery can be improved. In this study we aimed to assess (1) patients’ experiences with and preferences regarding wait time before surgery; (2)...

Assessment of Quality of Life in Patients with Chronic Oral Mucosal Diseases Using the Indonesian Version of the Chronic Oral Mucosal Disease Questionnaire-15 (COMDQ-15).

Chronic oral mucosal diseases (COMDs) can significantly impair the quality of life (QoL) of affected individuals. Monitoring the overall disease's impact and the efficacy of treatments requires the use of the Chronic Oral Mucosal Diseases Questionnaire-15 (COMDQ-15) as a standardized instrument for measuring QoL in these patients. This study aimed to assess QoL in patients with COMDs using an Indonesian version of the COMDQ-15. Seventy patients diagnosed with recurrent aphthous stomatitis (RAS), oral lichen planus, autoimmune blistering diseases (ABD), and cheilitis were included. Levels of QoL among different groups of disease were compared. Various potential factors influencing QoL were evaluated. Bivariate analysis was performed to identify factors associated with overall and specific aspects of QoL. The mean total COMDQ-15 score was 20.83 ± 10.07. The highest scores were in the physical discomfort domain (8.76 ± 4.65), while the lowest was in the medication and treatment domain (2.13 ± 1.99). Physical discomfort was significantly associated with gender, major RAS, and cheilitis. Social and emotional aspects were significantly associated with age and ABD, while patient support was linked to employment status, RAS types, and cheilitis. The Indonesian version of the COMDQ-15 is a valid and reliable tool for assessing QoL in patients with COMDs.

Evaluation of the quality of life among transgender men before and after gender reassignment surgery: a survey from Iran

BackgroundGender dysphoria, characterized by a misalignment between one’s gender identity and assigned sex, propels individuals towards medical interventions like gender reassignment surgery (GRS) to harmonize their bodies with their gender. This process aims to enhance overall quality of life (QoL), functioning, and body image. Recognizing the importance of cultivating a positive body image for transgender individuals navigating societal norms, this narrative highlights the ongoing debate surrounding QoL post-GRS. In response, our study is outlined, aiming to scrutinize QoL and self-image among transgender men post-GRS, offering valuable insights into societal perceptions and psychological well-being in this context.MethodThis cross-sectional survey focused on transgender men aged 15 to 35 who underwent gender reassignment surgery (GRS) in 2018–2022 in Shiraz, Iran. Participants, after passing psychiatric evaluations, completed World Health Organization Quality of Life (WHOQOL-100) questionnaires pre- and at least one-year post-surgery. The scores of the Brief-WHOQOL questionnaire were evaluated in four domains of physical health, psychological health, social relationships, and environmental health.ResultsA total of 60 individual who underwent GRS completed our questionnaire. The average age of the patients was 24.1 ± 3.8 years. Following GRS, the most increase was observed in the psychological factor (by 25.6%). The increase in score was statistically significant in all subgroups (P < 0.001) after operation. Urban living location had a significant association with higher increase in physical health (P < 0.010), psychological health (P = 0.005), and environmental health (P = 0.012) after GRS. In regards to physical health, the low socioeconomic group had a significantly less physical score improvement in QoL compared to the moderate group (P = 0.024) following GRS. In regards to environmental health, the high socioeconomic groups had significantly higher improvement in QoL compared to the low (P = 0.006) and moderate (P < 0.001) group after operation.ConclusionThe results demonstrate that GRS brings about improvements across all aspects of QoL. However, this enhancement is less pronounced among patients hailing from low socioeconomic backgrounds and rural areas.

Quality of Life and Clinical Outcomes of Endosonography-Guided Biliary Drainage in Patients with Malignant Biliary Obstruction: A Single-Center, Prospective Analysis.

Introduction: Endosonography-guided biliary drainage (EUS-BD) serves as a rescue treatment modality for patients with malignant biliary obstruction when endoscopic retrograde cholangiopancreatography (ERCP) fails. Objectives: This study explores the effects of EUS-BD on liver function and quality of life (QoL). Patients and Methods: Patients with malignant biliary obstruction and failed ERCP were enrolled to undergo EUS-BD. QoL, including pruritus severity, was evaluated using EQ-5D-5L and PSS-10 questionnaires before and after EUS-BD. Serum bilirubin and liver function tests were measured on the procedure day, two days, and at least 14 days post-procedure. Results: During a 20-month study period, 1755 ERCPs were performed, with 595 for malignant cases. Of these, 49 underwent EUS-BD following failed ERCP, and 37 (54% women, age range 34-87 years) completed the 14-day follow-up. Pancreatic cancer was the most common (49%) condition, and the median hospital stay was 4 days. Serum bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase significantly decreased 2 and 14 days after EUS-BD (all p < 0.001). Pruritus significantly improved, with an average reduction of 5.19 points on the PSS-10 scale two weeks post-procedure (p < 0.001). EUS-BD led to improvements in anxiety and depression according to the EQ-5D-5L (p = 0.013). Conversely, deteriorations were observed in the Mobility, Self-Care, and Usual Activities domains over time (all p < 0.05). Successful EUS-BD enabled the resumption of chemotherapy in 11 (30%) patients. The median post-procedure survival was 112 (range 27-1030) days. Conclusions: EUS-BD improves liver parameters and some aspects of life quality in patients with malignant biliary obstruction, thereby increasing their eligibility for optimal palliative care.

Who gains the most quality-of-life benefits from metabolic and bariatric surgery: findings from the prospective REBORN cohort study

BackgroundPrioritizing patients for metabolic and bariatric surgery (MBS) based on their potential postoperative benefits is essential. ObjectivesTo examine changes in quality of life (QoL) during the initial postoperative year among patients with diverse eligibility statuses and determine which group experiences greater benefits. SettingCenter intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de- Montréal (CIUSSS-NIM), Canada. MethodsWe categorized patients into 3 groups based on obesity class and the presence of comorbidities: Group 1 (obesity class II without comorbidities, n = 28); Group 2 (obesity class II with comorbidities, n = 36); and Group 3 (obesity class III, n = 460). QoL (Short-Form QoL questionnaire [SF-12]) and anthropometrics were measured at 6 months before, and 6 and 12 months after surgery. ResultsRepeated measures mixed models revealed a significant main effect of time (P < .001) and an interaction between time and group for the physical component of QoL (P = .007). These indicated consistent improvements across time in all groups, with the greatest benefits seen in Group 3 relative to Group 1. There were no interactions between time and group for the mental components of QoL (P = .402). There were significant interaction effects for weight and BMI (P’s < .001), with Group 3 losing more weight than Groups 1 or 2. ConclusionsAll groups that underwent MBS had improvements in the physical aspects of QoL and weight over time, even those who have traditionally not be considered eligible for MBS (i.e., Group 1). This provides a starting point to explore the importance of not excluding patients due to their weight and comorbidity status and setting comprehensive eligibility criteria encompassing all patients who might benefit from MBS, beyond just weight loss.

Vision-Specific Tools for the Assessment of Health-Related Quality of Life (HR-QoL) in Children and Adolescents with Visual Impairment: A Scoping Review.

Vision-related quality-of-life (QoL) measures offer a comprehensive evaluation of the impact of eye conditions and the effectiveness of treatment on important aspects of QoL. A substantial number of tools for assessing health-related quality of life (HR-QoL) in adults have been reviewed. However, despite the high prevalence of uncorrected refractive errors causing visual impairment (VI) in children, there is a notable lack of similar tools for this vulnerable population. This review aimed to systemically map evidence on the availability and use of vision-specific instruments for assessing HR-QoL in children and adolescents with VI. This review follows the Joanna Briggs Institute (JBI) guidelines (2020) and the framework by Arksey and O'Malley and Levac et al. (2010). We conducted systematic searches through databases PubMed, Science Direct, and Scopus and search platforms Web of Science and EBSCOhost to source reviews published in English from the date of their inception to December 2023. The findings are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). We reviewed twenty tools, nine of which were developed for children in the United States and three of which were developed for children in developing countries; no tools specifically developed for children in Africa were found. In the reviewed papers, the tools were presented to children, parents, or proxies in an interview or questionnaire format. For most of the tools, reliability was assessed using internal consistency (n = 12) and test-retest reliability (n = 12). The most dominant measures of validity were construct (n = 16), content (n = 8), internal (n = 4), and criterion (n = 4). There appears to be a need for more tools developed for children in middle-low-income countries, especially for African children.

Associations of cognitive appraisal and patient activation on disability and mental health outcomes: a prospective cohort study of patients undergoing spine surgery

BackgroundWith the increased use of patient-reported outcomes measures (PROMs) to assess spine surgery outcomes, it is important to understand how patients interpret their health changes over time. The measurement of cognitive-appraisal processes enables the quantification of how individuals think about quality of life (QOL). This study examined how appraisal processes were associated with patients’ views of their role in managing their health—patient activation.MethodsThis longitudinal cohort study from August 2019 to January 2022 included 222 adults undergoing spine surgery for cervical (n = 107) and/or lumbar (n = 148) pathology at an academic medical center. PROMs assessed disability (Neck Disability Index for cervical or Oswestry Disability Index for lumbar) and mental health (PROMIS-29 v2.0), cognitive-appraisal processes (QOLAPv2-SF), and patient activation (Patient Activation Measure). ANOVA models were used to examine the relationships between QOL and cognitive appraisal processes before and after surgery, overall and stratified by patient-activation stage. Effect sizes facilitated interpretation.ResultsThere were significant improvements in pain-related disability and mental health following surgery. Cognitive appraisal processes explained substantial amounts of variance, particularly with changes in mental health (45% before surgery, 75% at three months, and 63%, at 12-months after surgery). With respect to physical disability, less disability was associated with a lesser focus on negative aspects of QOL. Appraisal explained the most variance before surgery for high-activation patients. At 12-months post-surgery, however, appraisal explained the most variance for the low-activation patients. Appraisal explained similar amounts of variance in mental health at baseline and three-months post-surgery for all activation groups, but substantially more variance in the low-activation group at 12-months post-surgery. There were differences in the direction of appraisal-outcome associations by activation group in selected appraisal items/domains.ConclusionsCognitive-appraisal processes demonstrate a significant relationship with QOL among spine surgery patients. These processes explain substantial variance in pain-related disability and mental health, especially among those high in activation before surgery and those low in activation at 12-months post-surgery. Our findings suggest that patients’ ways of thinking about their health may be effective targets of motivational coaching, to help them become more engaged over the recovery trajectory.