Components Of Quality Of Life Research Articles

Physical and cognitive function to explain the quality of life among older adults with cognitive impairment: exploring cognitive function as a mediator

BackgroundPhysical and cognitive function are both indicators of aging, characterized by a loss of adaptive response to life challenges and functional limitations, subsequently affecting their quality of life. This study aimed to identify the direct effect of physical function and the indirect effect of cognitive function on the quality of life in older adults with mild cognitive impairment.MethodsThe study participants were 79 older adults recruited from community centers in four urban districts of Korea. All participants completed a self-reported questionnaire for demographic characteristics and outcome variables. Outcome measures included physical function (grip strength, balance, and mobility), cognitive function, and mental and physical components of quality of life (QOL). Statistical analyses were conducted using hierarchical multiple linear regression and the PROCESS macro for mediation analysis.ResultsThe mean age of participants was 77.46 years old with an elementary or lower education level (53.2%). The mean score of cognitive function was 16.39 (SD = 6.5). Physical function (grip strength, balance, mobility) and cognitive function explained 25% of the variance in physical (p = 0.004) and 29% in mental (p < 0.001) components of QOL after controlling for age, sex, and education level. Mobility was associated with both physical (β=-0.27, p = 0.024) and mental (β=-0.36, p = 0.002) components of QOL. The cognitive function partially mediated the relationship between balance and the physical component of QOL; the proportion of mediation was 55%.ConclusionIn conclusion, physical and cognitive function were significant predictors of QOL in older adults with cognitive impairment. Specifically, balance has significant indirect effects on the physical component of QOL through cognitive function as a mediator. Health-promoting strategies could be more effective when focusing on the direct effect of physical function as well as the mediating effect of cognitive function to promote the quality of life in this population.

Efficacy and Feasibility of Presurgical Exercise in Bladder Cancer Patients Scheduled for Open Radical Cystectomy.

This study aimed to examine the feasibility and potential efficacy of presurgical exercise in patients with bladder cancer scheduled for open radical cystectomy with follow-up postsurgery. Prospective single-group design with assessments at baseline, presurgery, and 3 months postsurgery was used in this study. Multimodal supervised resistance and aerobic exercise was undertaken 2-3 d·wk -1 at moderate intensity for a median of 3.5 wk (interquartile range [IQR] = 1.3-5.6). Feasibility was assessed by recruitment and completion rates, patient safety, program tolerance, adherence, and compliance. Lean and fat mass were assessed by dual-energy x-ray absorptiometry, physical function by a battery of tests (chest press and leg press strength, 6-min walk test [6MWT], timed up-and-go, repeated chair rise), and quality of life (QoL), psychological distress, and body image by questionnaire. Hospital length of stay (LOS) and complications were assessed by medical records. Thirty-seven patients were referred with 20 recruited (67.3 ± 12.2 yr) and a presurgery intervention completion rate of 80% (16 of 20). The individual median program adherence was 100.0% (IQR = 89.4-100.0) with compliance of 100.0% (IQR = 90.5-100.0) for resistance exercise and 81.8% (IQR = 55.0-99.5) for aerobic exercise. There were no exercise-related adverse events. Body composition did not change presurgery; however, there were improvements ( P < 0.05) in leg press strength (16%), 6MWT distance (8%), timed up-and-go (12%), chair rise (10%), and multiple QoL domains including mental health. Median LOS was 8.0 d (IQR = 7.0, 15.0). Postsurgery, there were declines in components of QoL and apparent body image dissatisfaction. A preradical cystectomy exercise program is feasible, safe, and well tolerated with improvements in physical function and QoL. Supervised multimodal exercise in bladder cancer patients before cystectomy can enhance physical and mental health potentially buffering the effects of surgery.

Socio-economic inequalities in health-related quality of life among Iranian young people in the middle stage of adolescence: application of Health Equity Assessment Toolkit

BackgroundOne of the main concerns of public health is the increasing inequality of health status, which has an adverse effect on people’s life.PurposeThe current study aims to analyze the role of socioeconomic inequalities in health-related quality of life (QoL) among Iranian young people in the middle stage of adolescence.MethodsA cross-sectional descriptive study was conducted on 576 young people in the middle stage of adolescence. The samples were selected using the Multi-stage sampling method. Data were collected by a demographic checklist, and KIDSCREEN-52 questionnaire and analyzed by SPSS ver.16. The Health Equity Assessment Toolkit (HEAT) Version 4.0 (beta) was used to assess adolescents’ QoL inequalities in terms of socio-economic subgroups.ResultsThe results show that 27.2 adolescents had low quality of life. The score of physical and autonomy components of QoL was significantly more in male versus school environment in female adolescents. Also, the asset index, father’s, and mother’s education, and family income in female adolescents, and the assets and family income in male adolescents were significantly related to the quality of life (p < 0.05). The risk of lower QOL in the poorest quintile was 1.12 times more than in the richest quintile. The consideration index of Asset in terms of sex was 4.5 and the modified Gini index was more than 0.5 in females and males.ConclusionOur findings highlight the significant effects of socioeconomic inequality on the HRQL of Iranian adolescents. Requires a targeted policy approach to reach the poorest quintile for improving the quality of life of adolescents.

Quality of life in patients with neurofibromatosis type 1: a nationwide database study in Japan from 2015 to 2019.

This study examined the association between dermatological, neurological, and bone manifestations of neurofibromatosis type 1 (NF1) and quality of life (QoL) in patients with NF1 using a nationwide database of all patients who newly claimed for medical expense subsidies in Japan from 2015 to 2019. The Japanese Ministry of Health, Labour and Welfare provided the "National Database of Designated Intractable Diseases of Japan" containing clinical and personal records ("Medical Certificates of Designated Intractable Diseases") of all patients with NF1 following approval of the study protocol. To examine the association between the severity of symptoms and QoL, multinominal logistic regression analyses were performed, adjusted for potential confounders. The final study population consisted of 1,487 patients (775 females and 712 males; mean (standard deviation) age, 45.4 (17.9) years). More than 50% and nearly 45% of participants were recorded as having moderate or severe "pain/discomfort" and "anxiety/depression," respectively. The severity of neurological symptoms was significantly associated with all components of QoL, whereas the severity of dermatological symptoms was significantly associated with only moderate or severe subjective and mental health-related components of QoL, and the severity of bone lesions was associated with only moderate or severe physical health-related components of QoL. Subjective and mental health-related components of QoL tended to be deteriorated more than physical health-related components of QoL in younger and female patients. Severities of neurological and dermatological symptoms were significantly associated with subjective and mental health-related components of QoL, while the severity of bone symptoms was associated with only moderate and severe deterioration of physical health-related components of QoL.

Health-related quality of life and its association with outcomes in adults with congenital heart disease and heart failure: Insight from FRESH-ACHD registry

QoL is an important prognostic factor in Heart Failure (HF) of patients with acquired cardiac disease. The aim of this study was to determine the predictive value of Quality of Life (QoL) on outcomes in adults with congenital heart disease (ACHD) and HF. QoL of 196 ACHD patients with clinical HF (mean age: 44.3 ± 13.8 years; 51% male, 56% with complex CHD; 47% NYHA III/IV) included in the prospective multicentric registry FRESH-ACHD were assessed using SF-36 auto-questionnaire. The primary endpoint was defined by all-cause death, HF-related hospitalisation, heart transplantation or mechanical circulatory support. During a median follow-up of 12 months IQR [11.7–12], 28 (14%) patients reached the combined endpoint. Patients with low QoL experienced more frequently major adverse events (Fig. 1 [ML1], Logrank P = 0.013). On univariate analysis, lower score at physical functioning (HR = 0.98; 95% CI 0.97–0.99, P = 0.008), role limitations related to physical health (HR = 0.98; 95% CI 0.97–0.99, P = 0.008) and general health dimensions of the SF-36 (HR = 0.97 95% CI 0.95–0.99, P = 0.002) were significantly predictive of cardiovascular events (Fig. 1). Physical and general components of QoL were associated with worse outcomes in ACHD patients with HF, making QoL evaluation and rehabilitation programs essential to change this trajectory.

Low Back Pain, Disability and Quality of Life in Nursing Personnel: A Cross-Sectional Study

Background and Purpose:Low back pain (LBP) is a global health problem and one of the leading causes of disability. Also, LBP is a major occupational problem among nursing staff. The study aims to determine LBP, disability, quality of life (QoL), and the relationship between LBP and job-related risk factors and dimensions of QoL in nurses. Materials and Methods: In this cross-sectional study with a descriptive-analytic approach, eligible nurses working in teaching hospitals affiliated with Mazandaran University of Medical Sciences were included in the study by census method. Data were collected based on the demographic questionnaire, Visual Analog Scale (VAS), Quebec Back Pain Disability Scale (QBPDS), and Short-Form 36 (SF-36) health survey questionnaire. Data were analyzed (descriptive, logistic regression, spearman correlation) using SPSS software, version 23. Results: This study included 402 nurses with a mean age of 36.47±7.1 years and employment mean of 11.83±6.4 years of an employment. The prevalence of LBP was 86.3% and the mean of pain intensity and disability were 4.8±2.7 and 30.4±17.4, respectively. The mean QoL components, such as physical and mental were 58.03±19.6 and 57.42±18.3, respectively. The factors that were significantly associated with LBP were body mass index (BMI) (P&lt;0.0001), frequent bending (P=0.004), and workplace communication (P=0.008). LBP affected dimensions of QoL, especially physical function (P=0.008), role physical (P=0.02), general health (P&lt;0.0001), and social function (P=0.03). Conclusion: This study showed the high prevalence of LBP among nurses and the role of individual and workplace factors in the occurrence of LBP. Such cognition facilitates the design of an educational program and undertakes the targeted preventive actions.

The association between sleep problems and general quality of life in cancer patients and in the general population.

It is well-known that patients with cancer frequently experience sleep problems, and that sleep quality is associated with general quality of life (QoL). The aims of this study were to analyze the relationship between sleep problems and other components of QoL in more detail and to investigate sex and age differences in sleep quality in cancer patients in comparison with the general population. This study comprised one general population sample (n = 4,476) and eight samples with cancer patients (n between 323 and 4,020). Sleep Quality was measured using the QoL questionnaire EORTC QLQ-C30. All of the cancer patient groups reported more sleep problems than the general population. Sleep problems were associated with all facets of QoL both in cancer patients and in the general population. The highest associations were found in cancer patients for fatigue (r = 0.52) and emotional functioning (r = -0.47). The association between sleep quality and general QoL was lower in the cancer samples (r = -0.37) than in the general population (r = -0.46). Female cancer patients reported markedly more sleep problems than male patients did (d = 0.45), while this sex difference was lower in the general population (d = 0.15). In contrast to the general population, younger cancer patients had greater trouble sleeping than older patients did (d = -0.17). The results underline the significance of the role mental factors play in sleep problems. Health care providers should pay special attention to female patients and younger patients concerning this issue.

Chronic obstructive pulmonary disease and miocardial revascularisation outcomes: relationship with self-reported quality of life

Aim. To assess the impact of chronic obstructive pulmonary disease (COPD) on the outcomes of myocardial revascularisation and the self-reported quality of life (QoL) during long-term follow-up. Methods. This prospective cohort study included 454 consecutive patients who underwent scheduled myocardial revascularisation. The follow-up continued for 3 years after the surgery. All patients underwent pulmonary functional tests before the surgery. The diagnosis of COPD was verified according to the Global Initiative for Obstructive Lung Disease criteria. QoL assessment was performed before and 3 years after the surgery using the 36-Item Short-Form Health Survey (SF-36). Results. In the study group, the diagnosis of COPD was verified in 14.5% of cases. The mortality rate was 5%, and was significantly higher in patients with COPD. The baseline QoL level was reduced in all patients, regardless of the presence of COPD, with an average of 50 points both in the physical and mental health scores of the SF-36 questionnaire. COPD had a significant negative impact on the QoL physical health score after myocardial revascularisation (odds ratio (OR) 0.95 (0.91 - 0.99), p = 0.043). The forced expiratory volume in the first second (OR 1.02 (1.00 - 1.07), p = 0.048) and new-onset atrial fibrillation in the early postoperative period (OR 0.54 (0.33 - 0.88), p = 0,036) were predictors of lack of QoL improvement. COPD did not correlate with the changes in the psychoemotional component of QoL. Conclusion. COPD has an independent negative impact on the clinical outcomes of myocardial revascularisation, including survival and health-related QoL (physical health score). Thereby, preoperative assessment of the respiratory function is important in these patients.

Емоційна складова якості життя пацієнтів з ювенільним ідіопатичним артритом

For children with juvenile idiopathic arthritis (JIA), the quality of life (QoL) emotional component is influenced by numerous factors: the arthritis subtype, disease duration, and activity, patient’s treatment, patient’s physical condition, and pain level, also his age, and sex. However, it’s important to determine the emotional component in the structure of QoL in children with different JIA subtypes (polyarthritis, oligoarthritis, and uveitis-associated arthritis) and features of psychological adaptation in modern conditions. Purpose - to determine both the emotional component of QoL in patients with JIA and their emotional condition considering the disease subtype, its duration, and the therapy complex. Materials and methods. The study was carried out at the SI «Institute for Children and Adolescents Health Care of the NAMS of Ukraine», Kharkiv, from November 2020 to November 2021. The assessment was provided by JADAS27, functional state by CHAQ, QoL according to PedsQLTM 4.0 Generic Core Scales, and emotional state according to the Montgomery-Asberg scale (MADRS) for depression assessment and clinical indicators. Statistical processing of the material was carried out using parametric and non-parametric methods, the critical level of significance for statistical testing hypotheses comparing groups was set at 0.05. Results. The 118 patients with JIA were examined, of them 47 patients with polyarticular, 43 patients with oligoarticular, and 28 patients with JIA-u subtypes. The study involved 77 girls and 41 boys aged 2 to 18 years (133.3±4.6 months). The majority (112 patients) received methotrexate therapy, 30 of them - methotrexate in combination with immunobiological therapy, 6 - sulfasalazine. The overall QoL in the group of children with JIA was at the level of 70.9±1.4 points for the last month and 72.6±1.4 points for the last week without significant difference, and the emotional component in the group as a whole was significantly higher for the last month - 73.1±1.6 points, while during the hospital stay it decreased to 66.3±1.7 points (p≤0.05). According to the results of the assessment of emotional state by the MADRS questionnaire, children aged 8 years and older did not have a depressive episode - 6.02±0.72 points. No significant differences were observed for HRQoL and emotional component in groups with different variants of arthritis and depending on age. However, certain results with a decrease in QoL and emotional state were observed in children with polyarthritis and uveitis-associated variant of JIA. The duration of the disease and treatment affected the QoL and emotional state, especially in the first year (QoL = 62.5±3.8 points for the last month). Correlations between MADRS and emotional state according to PedsQL were indirect and strong both for the last week and for the last month (r=-0.821; r=-0.784; p≤0.05). MADRS and total PedsQL scores also had indirect, medium strength correlations for the study periods (r=-0.558; r=-0.528; p≤0.05). Conclusions. At the beginning of the disease children with JIA have the reduction of QoL indicators with the emotional component. Such results depend on the course of JIA, which predicts the formation of emotional depressive disorders in some of them. The first year of the disease is the most vulnerable for children with polyarthritis, and for children with JIA-u increased disease duration enhances symptoms of emotional disturbances. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

A Systematic Review on Inter-Relationship of Residential Neighborhood Characteristics on Quality of Life of Elderly

The aspects of spatial planning have been aimed at supporting older people to stay healthy and active in their daily lives, as well as to improve their overall quality of life. Older people require accessible and functional venues and social environments that suit their emotional needs and goals. However, there has been limited study on the most significant characteristics of residential settings that impact the well-being of elderly inhabitants. This study aims to provide a comprehensive review of neighborhood residential environment elements and various Quality of Life (QOL) attributes, as well as their interrelationships, to encourage healthy aging. A framework for analyzing neighborhood features was developed as part of this critical analysis through extensive analysis of chosen articles. According to the review, social life is the most influential component of QOL, followed by neighborhood living settings and housing layouts that promote mobility features to participate in physical activities, generating a feeling of community and belonging and leading to a healthy life. Further research should be conducted to investigate the influence of these characteristics on the overall satisfaction level of the elderly in later life.

A Systematic Review on Inter-Relationship of Residential Neighborhood Characteristics on Quality of Life of Elderly

The aspects of spatial planning have been aimed at supporting older people to stay healthy and active in their daily lives, as well as to improve their overall quality of life. Older people require accessible and functional venues and social environments that suit their emotional needs and goals. However, there has been limited study on the most significant characteristics of residential settings that impact the well-being of elderly inhabitants. This study aims to provide a comprehensive review of neighborhood residential environment elements and various Quality of Life (QOL) attributes, as well as their interrelationships, to encourage healthy aging. A framework for analyzing neighborhood features was developed as part of this critical analysis through extensive analysis of chosen articles. According to the review, social life is the most influential component of QOL, followed by neighborhood living settings and housing layouts that promote mobility features to participate in physical activities, generating a feeling of community and belonging and leading to a healthy life. Further research should be conducted to investigate the influence of these characteristics on the overall satisfaction level of the elderly in later life.

Fertility preservation is an imperative goal in the clinical practice of radiation oncology: a narrative review.

With reduced cancer mortality in recent years, increased efforts must be put into safeguarding cancer survivors' long-term quality of life (QOL). Fertility preservation is recognised as a key component of QOL in survivorship. Concerns about fertility have been seen to significantly impact cancer patients' emotional and mental health as, generally, both malignancy and its treatment may cause a temporary or permanent reduction in infertility. This article reviews the primary effects of radiation therapy on male and female gonads and has further highlighted procedures through which the functioning of these organs can be protected before or during radiation treatment. We have also emphasised the importance of the establishment of multidisciplinary tumour boards and patient education regarding future reproductive function which is an important component of the care of individuals with cancer. This article highlights that infertility is a persistent and major concern that can add to long-term stress in cancer survivors, and education about fertility preservation before the initiation of any treatment is especially important.

Additional opportunities for antihypertensive therapy improvement in young patients with arterial hypertension and concomitant obesity

Abstract The high prevalence of arterial hypertension (AH) and concomitant obesity in young patients is not only a medical but also a social problem. It is important to develop additional modern approaches to the management of young patients with AH and obesity, which will increase the effectiveness of existing antihypertensive (anti-AH) medical therapy and prevent early damage of target organs and complications. The purpose of the research was to evaluate the antihypertensive efficacy of the proposed complex treatment and its impact on quality of life in young patients with AH and obesity (or overweight). Material and methods 123 patients with AH (ESC 2018), of young age 18–44 (mean age 32.81±0.58) y.o. were examined, among them the overweight was in 40 patients, obesity - in 42 patients. The average BMI was (28.34±0.45) kg/m2. All patients were divided into 2 groups depending on the treatment: Group 1 – standard anti-AH treatment, Group 2 – modified combined therapy, which included on the background of standard anti-AH medications the dosed controlled physical exercises with its obligatory registration, a modified DASH diet with increased intake of Ca-containing products and Metformin in the presence of insulin resistance according to the HOMA index (with correction of dose depending on BMI). In dynamics the patients were performed daily blood pressure monitoring (BPM) was performed and the SF-36 questionnaire was used to assess the quality of life (QOL). Results and discussion According to BPM data in the Group 1 the average 24-hour value of SBP decreased by 12.5% (p=0.01), in Group 2 – by 20.2% (p=0.001), DBP - by 11.2% (p=0.03) and by 18.8% (p=0.01) respectively (the difference between the groups for SBP and DBP was p=0.032 and p=0.041, respectively). Assessing the degree of nocturnal blood pressure decreasing, in the Group 1 the percentage of patients with insufficient nocturnal blood pressure decreasing (non-dipper) and stable increasing (night peaker) decreased non-significantly (p=0.086), unlike the Group 2, where there was a significant (p=0.02) positive dynamics in relation to these unfavorable types of blood pressure profile. Evaluating the indicators of QOL according to SF-36, the physical component of health in the Group 1 increased by 16.7%, in Group 2 – by 33.4% (p=0.001), the mental component of health – by 13.5% and 28.9%, respectively (p=0.001). Thus, the additional use of the proposed treatment complex with the inclusion of dosed registered exercises, increased consumption of Ca-containing products and correction of insulinresistance significantly increases the effectiveness of antihypertensive medical therapy and has a positive effect on physical and mental components of QOL in young patients with AH and obesity or overweight. Funding Acknowledgement Type of funding sources: None.

Assessing Mediating Role of Financial Satisfaction in the Relationship of Financial Literacy With Quality of Life in Retired Older Adults

Objectives The world’s population is rapidly aging; hence, paying attention to the quality of life (QoL) of the elderly is of great importance. Financial satisfaction is one of the important components of QoL. The present study aims to determine the association between financial literacy and QoL among retired older adults mediated by their financial satisfaction. Methods &amp; Materials This descriptive and cross-sectional study was conducted in 2020 on 270 retired older adults in Qazvin, Iran. The samples were selected through stratified random sampling method from 8 retirement centers in Qazvin, Iran. The data were collected using demographic checklist, the control, autonomy, self-realization, and pleasure (CASP) scale, financial literacy scale, and financial satisfaction scale. Structural equation modeling was used to determine the mediating role of financial satisfaction in the relationship of financial literacy with the QoL. Results The mean age of older adults was 65.17±4.57 years. The majority of them were male (n=166, 61.85%) and married (n=245, 90.7%). Their Mean score of financial literacy and financial satisfaction were 51.60 and 35.11 out of 100, respectively. Their quality of life was at a moderate level (Mean= 63.89 out of 100). The results of the regression analysis showed the significant association of financial literacy (P=0.006, β=-0.17) and financial satisfaction (β=0.25, P&lt;0.001) with the quality of life. The results also confirmed the mediating role of financial satisfaction (P=0.014). Conclusion Financial literacy of the elderly has a significant and positive association with their quality of life mediated by financial satisfaction. Therefore, policymakers in Iran are recommended to develop pre-retirement financial education programs for improving the financial literacy of the elderly.

The Effects of Mind-Body Exercises on Chronic Spinal Pain Outcomes: A Synthesis Based on 72 Meta-Analyses.

An umbrella review of systematic reviews with a meta-analysis was developed to summarize the evidence on the effectiveness of qigong, tai chi, and yoga in chronic spinal pain outcomes. The CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and SPORTDiscus databases were searched. Pain, psychological factors, and quality of life (QOL) were the outcomes of interest. The methodological quality of the reviews was evaluated using the AMSTAR-2 tool. The overlap was calculated using the corrected covered area. A total of 72 meta-analyses drawn from 20 systematic reviews were included and often were rated at a critically low quality. The effects of qigong on chronic low back and neck pain (CLBP and CNP, respectively) were inconsistent, although it improved the physical component of QOL after 12 weeks for CNP. Tai chi was superior to the controls in reducing CLBP; no reviews of interest were found on CNP. Yoga was superior to multiple controls in reducing CLBP, but no relevant effects on depression or QOL were found. QOL, anxiety, depression, and general mood improved with yoga for CNP. Inconsistencies arose related to yoga and CNP. Our findings mainly supported the potential effects of yoga and tai chi on pain-related outcomes, psychological factors, and QOL in populations with CLBP and NP. Clinical and methodological considerations were discussed.

General Anxiety, Diabetes-Specific Anxiety, and Quality of Life in Adolescents With Type 1 Diabetes.

The purpose of the study was to identify the differential associations between general anxiety, diabetes-specific anxiety, and diabetes-specific quality of life (QOL). A cross-sectional study was conducted of 146 adolescents with type 1 diabetes (T1DM) ages 13 to 17 during the COVID-19 pandemic. Participants completed self-report questionnaires assessing demographic characteristics, general anxiety, diabetes-specific anxiety, depressive symptoms, and diabetes-specific QOL. The final sample of 146 adolescents was mostly male, non-Hispanic White, mean age of 14.5 ± 1.27, having diabetes for more than 1 year, and using insulin pumps. Higher diabetes-specific anxiety was associated with poorer general treatment-related QOL, but general anxiety was not. General anxiety, diabetes-specific anxiety, and depressive symptoms were significantly associated with diabetes-specific treatment-related QOL, worry-specific QOL, and poorer communication-related QOL. There may be a differential impact of general anxiety and diabetes-specific anxiety in adolescents with T1DM. Diabetes-specific anxiety may be a more important factor in adolescents reporting poorer general treatment-related QOL, worry-related QOL, and communication-related QOL, while general anxiety and diabetes-specific anxiety appear to similarly impact poorer diabetes-specific treatment-related QOL. Diabetes-specific anxiety may be a more important component of QOL in adolescents. Targeted interventions may be required to effectively improve QOL.

Health-related quality of life and its association with outcomes in adults with congenital heart disease and heart failure: Insight from FRESH-ACHD registry

QoL is an important prognostic factor in Heart Failure (HF) of patients with acquired cardiac disease. The aim of this study was to determine the predictive value of Quality of Life (QoL) on outcomes in adults with congenital heart disease (ACHD) and HF. QoL of 196 ACHD patients with clinical HF (mean age: 44.3 ± 13.8 years; 51% male, 56% with complex CHD; 47% NYHA III/IV) included in the prospective multicentric registry FRESH-ACHD was assessed using SF-36 auto-questionnaire. The primary endpoint was defined by all-cause death, HF-related hospitalisation, heart transplantation or mechanical circulatory support. During a median follow-up of 12 months IQR [11.7–12], 28 (14%) patients reached the combined endpoint. Patients with low QoL experienced more frequently major adverse events ( Fig. 1 [ML1], Logrank P = 0.013). On univariate analysis, lower score at physical functioning (HR = 0.98; 95% CI 0.97–0.99, P = 0.008), role limitations related to physical health (HR = 0.98; 95% CI 0.97–0.99, P = 0.008) and general health dimensions of the SF-36 (HR = 0.97 95% CI 0.95–0.99, P = 0.002) were significantly predictive of cardiovascular events. Physical and general components of QoL were associated with worse outcomes in ACHD patients with HF, making QoL evaluation and rehabilitation programs essential to change this trajectory.

Impact of Lifestyle Modification on Quality of Life in Patients with Metabolic Syndrome: Findings from the CHANGE Program Intervention Study in Prince Edward Island, Canada.

Purpose: To assess the modification in quality of life (QoL) of patients with metabolic syndrome (MetS) after participating in Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program and identify predictors of this modification in QoL among participants. Methods: A convenience sample of 100 patients with MetS completed the 12-month CHANGE program (diet and exercise regular counseling). 36-Item Short Form Health Survey (SF-36), International Physical Activity Questionnaire (IPAC), Physician Assessment and Clinical Education (PACE), and the Mediterranean Diet Score (MDS) questionnaires were employed to assess participants' QoL, physical activity (PA), sedentary behaviors, and quality of diet, respectively. In addition, physical fitness tests (6-Minute Walk Test, One-Leg Stance Test, and Grip Strength Test) were used. Medical history, blood tests, and anthropometric [height, weight, and waist circumference (WC)] and blood pressure measurements were performed by a nurse. Linear regression analysis was performed to identify predictors of QoL. Results: Participants' mean age was 58.3 ± 11.0, and 75.4% were females. After the CHANGE program, participants demonstrated significant reduction in the number of MetS criteria and significant improvement of physical and mental components of QoL. Moreover, there was significant increase in participants' PA, MDS, and physical fitness mean scores with corresponding significant reduction in sedentary behavior time, blood pressure, and WC measures. Linear regression analysis revealed that age, WC, screen time, PA, and physical fitness were significant predictors of QoL. Conclusion: The 12-month group-based diet and exercise counseling led to clinically significant improvement in MetS criteria and in important measures of health and fitness among participants, which improved their QoL. Age, fitness measures, and daily screen time were associated with QoL.

The effect of antioxidant drugs on the self-assessment of clinical symptoms in women during radiation therapy after surgical treatment of endometrial cancer: Placebo-controlled randomized trial

Aim. Comparative analysis of the effect of methylethylpiridinol (Emoxipine), ethylmethylhydroxypyridine malate (Ethoxidol) and ethylmethylhydroxypyridine succinate (Mexidol) on the self-assessment of nonspecific clinical symptoms in women receiving adjuvant radiation therapy after radical surgical treatment of uterine body cancer.&#x0D; Materials and methods. A short-term, prospective, simple blind, placebo-controlled, randomized study of the effect of 14-day course use of emoxipine (150 mg [0.87 mmol] per day intravenously), ethoxidol (225 mg [0.83 mmol] per day intravenously) and mexidol (225 mg [0.88 mmol] daily intravenously) on the dynamics of self-assessment of nonspecific clinical symptoms in patients during radiotherapy after surgical treatment of endometrial cancer was conducted. Self-assessment of clinical symptoms and quality of life (QOL) was studied using the MDASI questionnaire (M.D. Anderson Symptom Inventory). The emotional complaints were assessed using the Giessen questionnaire.&#x0D; Results. The 14-day use of Emoxipine, Ethoxidol and Mexidol in almost eqimolar single doses prevented the negative impact of radiation therapy on the self-assessment of clinical symptoms and QOL according to MDASI. This was manifested by a significant decrease in weakness, sadness and depression, as well as the prevention of nausea and appetite disorders during radiation therapy. At the same time, the emotional coloring of stomach and heart complaints, exhaustion and pressure of complaints decreased according to the Giessen questionnaire. The positive effect of Emoxipine, Ethoxidol and Mexidol on the self-assessment of the clinical condition and the emotional coloring of the corresponding complaints was accompanied by an improvement in such components of QOL as general activity, mood, ability to work, relationships with other people and ability to enjoy life. The studied drugs did not differ in the intensenty of the identified effects.&#x0D; Conclusion. Emoxipine, Ethoxidol and Mexidol significantly improve the multidimensional self-assessment of the clinical condition of patients receiving radiation therapy after surgical treatment of endometrial cancer. The results obtained allow us to consider Emoxipine, Ethoxidol and Mexidol as equally effective means of maintenance therapy at the stage of postoperative radiation treatment of patients with endometrial cancer.

Cardiovascular risk factors, exercise capacity and health literacy in patients with chronic ischaemic heart disease and type 2 diabetes mellitus in Germany: Baseline characteristics of the Lifestyle Intervention in Chronic Ischaemic Heart Disease and Type 2 Diabetes study

Background:Lifestyle interventions are a cornerstone in the treatment of chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus (T2DM). This study aimed at identifying differences in clinical characteristics between categories of the common lifestyle intervention targets BMI, exercise capacity (peak V̇O2) and health literacy (HL).Methods:Cross-sectional baseline characteristics of patients enrolled in the LeIKD trial (Clinicaltrials.gov NCT03835923) are presented in total, grouped by BMI, %-predicted peak V̇O2 and HL (HLS-EU-Q16), and compared to other clinical trials with similar populations.Results:Among 499 patients (68.3±7.7 years; 16.2% female; HbA1c, 6.9±0.9%), baseline characteristics were similar to other trials and revealed insufficient treatment of several risk factors (LDL-C 92±34 mg/dl; BMI, 30.1±4.8 kg/m2; 69.6% with peak V̇O2<90% predicted). Patients with lower peak V̇O2 showed significantly higher (p < 0.05) CIHD and T2DM disease severity (HbA1c, CIHD symptoms, coronary artery bypass graft). Obese patients had a significantly higher prevalence of hypertension and higher triglyceride levels, whereas in patients with low HL both quality of life components (physical, mental) were significantly reduced.Conclusions:In patients with CIHD and T2DM, peak V̇O2, BMI and HL are important indicators of disease severity, risk factor burden and quality of life, which reinforces the relevance of lifestyle interventions.