Quality Of Life Scores In Domains Research Articles

Examining the Quality of Life and Discrimination Impact on Parents of Children With Autism Spectrum Disorder in Aseer Region, Saudi Arabia: A WHO-QOL Survey.

Background Autism spectrum disorder (ASD) is a neurodevelopmental disease marked by social and repetitive or restricted behaviors, as well as communication difficulty. Objectives This survey aimed to assess the quality of life (QoL) of parents with ASDs in the Aseer region of Saudi Arabia using the brief form of the World Health Organization (WHO-QOL) questionnaire. Furthermore, we sought to measure the severity of discrimination experienced by parents of children with ASDs and their impact on QoL. Methodology Using a Google form, a cross-sectional study was carried out online between March and April 2023. The patient records from four different regions of Saudi Arabia were used to recruit study participants. The survey was distributed through well-known social media channels (Instagram, Telegram, Facebook). Results A total of 99 parents were included in this study. The Southern region accounted for the bulk of participants (81.8%, n=81), nearly three-fourths of the children were boys (70.7%), mothers were more common among respondents (65.7%, n=65) than fathers, 66.7% of respondents reported being married, and 78.8% fall into the middle economic class category. The main source of information among the studied population was the Internet (39.4%, n=39), followed by relatives (23.0%, n=23), physicians (8.1%, n=9), and finally books (4%, n=4). The mean scores for the various domains are as follows: physical (58.48 ± 13.84), psychological (62.04 ± 18.08), social relations (61.20 ± 23.24), environment (24.12 ± 14.62), general QoL (72.93 ± 4.30), and general health (73.94 ± 4.63). Nearly half (46.5%) of parents have encountered stigma or discrimination toward their child or family. Individuals who reported experiencing discrimination exhibited significantly lower mean scores in multiple QoL domains than those who did not report discrimination for physical (54.11, ± 14.36vs, 62.26±12.28, p=0.003), psychological (55.80 ± 20.33 vs 67.45 ± 13.94, p=0.002), and social relations (55.43± 24.17 vs 66.20 ± 21.40, p=0.022). Multivariate analysis revealed that discrimination was the only significant predictor of QoL (p < 0.001). Conclusions The QoL of parents having a child with autism is low, moreover, the coincidence of discrimination and stigma significantly lowered QoL.

A comparison of swallowing related quality of life in patients undergoing transoral endoscopic versus open thyroid surgery.

It is important for the endoscopic thyroid surgeon to understand the pros and cons of trans-oral endoscopic thyroidectomy-vestibular approach (TOETVA) vis-à-vis, open conventional thyroidectomy (OTx) so he/she can help patients in making informed choices regarding the type of procedure to opt for. Swallowing related quality of life (SWAL-QoL) has not been compared between the two approaches. Using a rigorous qualitative methodology and validated reliable tool, this study set out to compare the swallowing related quality of life in patients undergoing TOETVA versus OTx. Prospective study at 3 time points in patients planned for hemithyroidectomy (Preoperative, 1week and 12weeks). Data were collected on patients at a tertiary teaching institute in India. Participants ranged from age 18-60years with a diagnosis of benign euthyroid nodule undergoing hemithyroidectomy. Exclusion criteria were-(1) pre-existing vocal cord abnormalities, (2) undergoing surgery for recurrent nodules, and (3) any neuro-muscular disease affecting swallowing ability. Main outcome measure was comparison of swallowing related quality of life domain scores between patients undergoing hemithyroidectomy via either endoscopic trans-oral or open approach. Of the 82 included patients, 40 underwent TOETVA and 42 OTx. Both the groups were comparable in terms of demographic and clinicopathological profile. The mean preoperative SWAL-QOL scores were comparable in all domains. Mean SWAL-QoL scores for all domains on postoperative day 7 were significantly better in TOETVA group with domains burden, eating desire, mental health and communication having medium effect sizes. Physical symptom domain was better in the OTx group but had a small effect size. The difference in SWAL-QoL domains between the two groups persisted for 3months also. Swallowing related quality of life after trans-oral endoscopic thyroidectomy compared to conventional open surgery has not been reported in the literature. Our findings suggest that trans-oral endoscopic thyroidectomy results in significant superior swallowing related quality of life in the majority of domains.

The long-term effects of COVID-19 on pulmonary status and quality of life.

Few studies have looked at how SARS-CoV-2 affects pulmonary function, exercise capacity, and health-related quality of life over time. The purpose of this study was to evaluate these characteristics in post COVID-19 subjects 1 year after recovery. The study included two groups. The case group included post COVID-19 subjects who had recovered after a year, and the control group included healthy participants who had never tested positive for COVID-19. The study screened 90 participants, 42 of whom met the eligibility criteria. The findings revealed that the majority of post COVID-19 subjects had relatively normal lung function 1-year post-recovery. A significant reduction in DLCO (B/P%) was observed in the case group vs. control. The exercise capacity test revealed a clinically significant difference in distance walked and a significant difference in the dyspnea post-walk test in the case group compared to the control group. The case group's health-related quality of life domain scores were significantly affected in terms of energy/fatigue, general health, and physical function. The post COVID-19 subjects were shown to have well-preserved lung function after 1 year. However, some degree of impairment in diffusion capacity, exercise capacity, and health-related quality of life remained.

Gender differences in the predictors of quality of life in patients with cancer: A cross sectional study

PurposeThe aim of the present study was to explore potential differences in the sociodemographic (with a special focus on gender differences) and psychological predictors of quality of life in individuals diagnosed with cancer. MethodsA cross-sectional, observational study was carried out involving individuals struggling with different forms of cancer (N = 430). Linear regression was used to investigate the concurrent predictive role of the independent variables, stratified by gender, for each of the five cancer-specific quality of life domains and overall quality of life. ResultsSociodemographic characteristics had only a negligible to small role in predicting quality of life in both men and women. In contrast, the psychological variables explained a significantly larger portion of the variance in both genders. There were no statistically significant gender differences regarding the raw quality of life domain scores; however, their predictors were markedly different in the two groups. ConclusionThe results of the present study indicate that it is imperative to take gender differences into consideration when planning psychosocial interventions also focusing on strengths, resources, and coping strategies. Considering the consistently emerging importance of family support in patients’ quality of life, offering psychological interventions to caregivers/family members seems warranted to empower them to provide support to patients throughout the illness trajectory.

Implications of the composite free flap harvest site on quality of life after head and neck surgery: a prospective series

Quality of life (QOL) has become a primary determinant of the treatment outcome. There is a poor evidence base regarding the QOL implications of free flap harvest from the various different osseous composite donor sites. This prospective study assessed the impact of free flap harvest on QOL and compared QOL morbidity between fibula, scapula, and iliac crest (deep circumflex iliac artery; DCIA) donor sites in head and neck reconstructive surgery. This was a single-site prospective cohort clinical research study. Fifty-nine patients were recruited between 2017 and 2021; 30 underwent fibula flap reconstructive surgery, 17 scapula flap, and 12 DCIA flap. The patients were assessed using the University of Washington Quality of Life Questionnaire version 4 (UW-QOL v4) preoperatively and again at >12 months postoperatively. The results showed no significant change in the mean global QOL score postoperatively when compared to the preoperative baseline in any of the donor site groups. However, the mean postoperative scores for the appearance domain were significantly lower than the preoperative scores in all of the donor site groups. In addition, fibula flap patients had significantly reduced physical activity and recreation QOL domain scores postoperatively when compared to the preoperative scores.

Factors associated with poorer quality of life in people living with HIV in southwestern France in 2018–2020 (ANRS CO3 AQUIVIH-NA cohort: QuAliV study)

We evaluated people living with Human Immunodeficiency Virus’ (PLWH) quality of life (QoL) and assessed whether their demographic, disease-related, socioeconomic, or behavioral characteristics were associated with poorer QoL. ANRS CO3 AQUIVIH-NA cohort participants (Nouvelle Aquitaine, France) were recruited to a cross-sectional study (2018–2020) and their QoL assessed (WHOQOL-BREF). We calculated median (Q1, Q3) QoL domain scores and assessed factors associated with poorer median QoL using bivariable and multivariable quartile regression. Of the 965 PLWH included, 98.4% were on antiretroviral therapy, 94.7% were virally-suppressed, 63.5% reported good/very good QoL. Median scores (0–100) were highest for physical (69;Q1, Q3: 56, 81) and environmental (69; 56, 75) QoL and lowest for social (56; 44, 69) and psychological (56; 44, 69) QoL. PLWH with ≥ 3 comorbidities, HIV-related stigma, or income of < 1500€/month had poorer median adjusted physical, psychological, social, and environmental QoL scores compared to reference groups. While more than half of PLWH reported good/very good QoL, we have not achieved good QoL in 90% of PLWH. Multi-morbidity, HIV-related stigma, and social determinants were consistently and independently associated with poorer QoL. Addressing structural factors in addition to those indirectly related to HIV is required to attain good QoL in all PLWH.

Impact of a specialized oral nutritional supplement on quality of life in older adults following hospitalization: Post-hoc analysis of the NOURISH trial

Both during and after hospitalization, nutritional care with daily intake of oral nutritional supplements (ONS) improves health outcomes and decreases risk of mortality in malnourished older adults. In a post-hoc analysis of data from hospitalized older adults with malnutrition risk, we sought to determine whether consuming a specialized ONS (S-ONS) containing high protein and beta-hydroxy-beta-methylbutyrate (HMB) can also improve Quality of Life (QoL). We analyzed data from the NOURISH trial-a randomized, placebo-controlled, multi-center, double-blind study conducted in patients with congestive heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Patients received standard care+S-ONS or placebo beverage (target 2 servings/day) during hospitalization and for 90 days post-discharge. SF-36 and EQ-5D QoL outcomes were assessed at 0-, 30-, 60-, and 90-days post-discharge. To account for the missing QoL observations (27.7%) due to patient dropout, we used multiple imputation. Data represent differences between least squares mean (LSM) values with 95% Confidence Intervals for groups receiving S-ONS or placebo treatments. The study population consisted of 622 patients of mean age ±standard deviation: 77.9±8.4 years and of whom 52.1% were females. Patients consuming placebo had lower (worse) QoL domain scores than did those consuming S-ONS. Specifically for the SF-36 health domain scores, group differences (placebo vs S-ONS) in LSM were significant for the mental component summary at day 90 (-4.23 [-7.75,-0.71]; p=0.019), the domains of mental health at days 60 (-3.76 [-7.40,-0.12]; p=0.043) and 90 (-4.88 [-8.41,-1.34]; p=0.007), vitality at day 90 (-3.33 [-6.65,-0.01]; p=0.049) and social functioning at day 90 (-4.02 [-7.48,-0.55]; p=0.023). Compared to placebo, differences in LSM values for the SF-36 general health domain were significant with improvement in the S-ONS group at hospital discharge and beyond: day 0 (-2.72 [-5.33,-0.11]; p=0.041), day 30 (-3.08 [-6.09,-0.08]; p=0.044), day 60 (-3.95 [-7.13,-0.76]; p=0.015), and day 90 (-4.56 [-7.74,-1.38]; p=0.005). In hospitalized older adults with cardiopulmonary diseases and evidence of poor nutritional status, daily intake of S-ONS compared to placebo improved post-discharge QoL scores for mental health/cognition, vitality, social functioning, and general health. These QoL benefits complement survival benefits found in the original NOURISH trial analysis. NCT01626742.

Vasomotor and other menopause symptoms and the prevalence of ideal cardiovascular health metrics among premenopausal stage women.

We examined the association between menopause symptoms and the prevalence of ideal cardiovascular health (CVH) metrics among premenopausal women. This cross-sectional study comprised 4,611 premenopausal women aged 42 to 52 years. Data for CVH metrics were collected during health screening examinations. Menopause symptoms were measured using the Korean version of the Menopause-Specific Quality of Life questionnaire. For vasomotor, psychosocial, physical, and sexual symptoms, participants were divided into absent or symptomatic groups, further divided into tertiles (range, 0-7; 7 being the most bothersome). Ideal CVH metrics were defined according to the American Heart Association Life Simple 7 metrics, except dietary component. Cardiovascular health metrics were scored from 0 (unhealthy) to 6 (healthy) and classified as poor (0-2), intermediate (3-4), and ideal (5-6). Multinomial logistic regression models were used to estimate the prevalence ratios for intermediate and poor CVH metrics using ideal CVH as the reference. The overall and 4 menopause-specific quality of life domain scores were significantly associated with poorer CVH metrics scores in a dose-response manner (P < 0.05). After adjusting for age, parity, education level, anti-Mullerian hormone levels, and alcohol intake, women with the most bothersome degree for vasomotor, psychosocial, physical, and sexual symptoms had significantly higher prevalence of poor CVH metrics, with corresponding prevalence ratios (95% confidence interval) of 2.90 (1.95-4.31), 2.07 (1.36-3.15), 3.01 (1.19-7.65), and 1.66 (1.15-2.39), respectively, compared with those without each vasomotor, psychosocial, physical, and sexual symptom. Premenopausal stage women with either vasomotor or nonvasomotor menopausal symptoms have significantly higher prevalence of poor CVH metrics, compared with those without any menopausal symptoms.

Fatigue in fluctuating Parkinson’s disease patients: possible impact of safinamide

Fatigue is a common non-motor symptom in Parkinson’s disease (PD). Among other pathophysiological mechanisms, neuroinflammation, a pathological PD hallmark associated with changes in glutamatergic transmission in basal ganglia, has been proposed as a crucial factor closely related to fatigue. To test the hypothesis that safinamide could represent an effective treatment of fatigue in PD patients, given its dual mechanism of action (it selectively and reversibly inhibits MAOB and modulates glutamate release), we administered the validated versions of fatigue severity scale (FSS) and Parkinson fatigue scale-16 (PFS-16) to 39 fluctuating PD patients with fatigue before and after a 24-week treatment period with safinamide as add-on therapy. An assessment of secondary variables such as depression, quality of life (QoL), and motor and non-motor symptoms (NMS) was conducted. After 24 weeks of treatment with safinamide, both FSS (p < 0.001) and PF-S16 (p = 0.02) scores were significantly lower than at baseline. Moreover, 46.2% and 41% of patients scored below the cut-off for the presence of fatigue according to FSS and PFS-16, respectively (responders). At follow-up, a significant difference emerged between responders and non-responders in mood, QoL, and NMS. Fatigue improved in fluctuating PD, and more than 40% of patients were “fatigue-free” after a 6 month treatment with safinamide. Patients without fatigue at follow-up displayed significantly better scores in QoL domains, such as mobility or activities of daily living, although disease severity remained stable, supporting the hypothesis that fatigue could considerably affect QoL. Drugs that interact with multiple neurotransmission systems, such as safinamide, could be useful in reducing this symptom.

Randomized Controlled Trial of Isha Kriya versus Observation to Improve Quality of Life in Hematopoietic Cell Transplantation Recipients

Hematopoietic cell transplantation (HCT) impacts its recipients' quality of life (QoL). Few mindfulness-based interventions (MBI) in HCT recipients have shown feasibility, but heterogeneous practices and outcome measures have questioned the real benefit. We hypothesize that a self-guided meditation as a mobile app will improve QoL in the acute HCT setting. This single-center, open-label, randomized controlled trial was conducted in 2021-2022. The study was cleared by Institutional Ethics Committee and registered at the Clinical Trial Registry of India. Recipients were included after obtaining written informed consent. Recipients without access to smartphones or regular practitioners of yoga, meditation, or other mind-body practice were excluded. Autologous + allogeneic HCT recipients of age ≥ 18 years were included in the study. Recipients were randomized to the control arm or Isha kriya arm in a 1:1 ratio stratified by type of transplant. Patients in the Isha kriya arm were recommended to perform the kriya twice daily from pre-HCT to day+30 post-HCT. Isha Kriya is 12-minute guided meditation based on the principles of yoga, focussing on breath, awareness, and thought. The primary endpoint was the QoL summary scores assessed by the Functional Assessment of Cancer Therapy - Bone Marrow Transplantation (FACT-BMT) and the Patient-Reported Outcomes Measurement Information System–Global Health (PROMIS-GH) questionnaires. The secondary endpoints were the difference in QoL domain scores. The validated questionnaires were self-administered before the intervention, day +30, and day +100 after HCT. The analysis of endpoints was done on an intention-to-treat basis. Domain and summary scores were calculated for each instrument as recommended by the developers. A p-value <0.05 was used for statistical significance, and cohen's d effect size determined clinical significance. A total of 72 HCT recipients were randomized to the Isha kriya and the control arm. Patients in both arms were matched for age, gender, diagnosis, and type of HCT. Both arms had no difference in the pre-HCT QoL domain, summary, and global scores. Post-HCT at day+30, there was no difference in the mean FACT-BMT total scores (112.9 ± 16.8 vs.101.2 ± 13.9, p = 0.2) and the mean global health scores (Global mental health 45.1 ± 8.6 vs. 42.5 ± 7.2, p = 0.5, global physical health 44.1 ± 6.3 vs. 44.1 ± 8.3, p = 0.4) in the two groups. There was similarly no difference in the physical, social, emotional, and functional domain scores. However, the mean BMT-subscale scores, which addresses BMT-specific quality-of-life concerns, were statistically and clinically significantly higher in the Isha kriya arm than the control arm (27.9 ± 5.1 vs. 24.4 ± 9.2, p = 0.03, Cohen's d 0.5, medium effect size). This effect was transient as the day+100 scores showed no difference (28.3 ± 5.9 vs. 26.2 ± 9.4, p = 0.3). Isha kriya did not improve the FACT-BMT total and global health scores in the acute HCT setting. However, practicing Isha kriya for a month did show a transient improvement in the FACT-BMT subscale scores on day +30 but not on day +100 post-HCT.

Study of quality of life and depression in people living with HIV/AIDS in India.

The aim of this study was to assess the quality of life (QOL) and the severity of depression in people living with HIV/AIDS (PLWHA) and investigate its correlates. This was a cross-sectional study on 700 PLWHA in India. World Health Organization QOL HIV (WHOQOL HIV-BREF) and Patient Health Questionnaire-9 (PHQ-9) were used to assess QOL and depression in PLWHA, respectively. The study population was divided into five groups on the basis of Cluster of Differentiation 4 (CD4) count as follows: Group A [< 50 cells/μL], Group B [50-199 cells/μL], Group C [200-349 cells/μL], Group D [350-499 cells/μL], and Group E [>500 cells/μL]. The lowest mean scores were noted under Group A [< 50 cells/μL] in physical and psychological domains and the highest mean scores were noted under Group E [> 500 cells/μL] in physical and environment domains. PHQ9 scores negatively correlated with QOL domains and the correlation was statistically significant (p < 0.001) with the highest negative correlation was found in relation to the psychological domain (r = -0.739). The PHQ9 score in those who do not have opportunistic illnesses (7.23 ± 6.14) was lower in comparison to those who had opportunistic illnesses (9.81 ± 6.40) and the difference was statistically significant (p < 0.001). We observed that there was almost a chronological increase in the individual QOL domain score and a decrease in the PHQ9 score with an increase in CD4 count. Our result supports the implementation of routine screening for depression in antiretroviral therapy centers and multidisciplinary interventions to improve outcomes among depressed PLWHA.

Quality of life 1 month after acute pulmonary embolism in emergency department patients.

The Pulmonary Embolism Quality-of-Life (PEmb-QoL) questionnaire assesses quality of life (QoL) after pulmonary embolism (PE). We aimed to determine whether any clinical or pathophysiologic features of PE were associated with worse PEmb-QoL scores 1 month after PE. In this prospective multicenter registry, we conducted PEmb-QoL questionnaires. We determined differences in QoL domain scores for four primary variables: clinical deterioration (death, cardiac arrest, respiratory failure, hypotension requiring fluid bolus, catecholamine support, or new dysrhythmia), right ventricular dysfunction (RVD), PE risk stratification, and subsequent rehospitalization. For overall QoL score, we fit a multivariable regression model that included these four primary variables as independent variables. Of 788 PE patients participating in QoL assessments, 156 (19.8%) had a clinical deterioration event, 236 (30.7%) had RVD of which 38 (16.1%) had escalated interventions. For those without and with clinical deterioration, social limitations had mean (±SD) scores of 2.07 (±1.27) and 2.36 (±1.47), respectively (p= 0.027). For intensity of complaints, mean (±SD) scores for patients without RVD (4.32 ± 2.69) were significantly higher than for those with RVD with or without reperfusion interventions (3.82 ± 1.81 and 3.83 ± 2.11, respectively; p= 0.043). There were no domain score differences between PE risk stratification groups. All domain scores were worse for patients with rehospitalization versus without. By multivariable analysis, worse total PEmb-QoL scores with effect sizes were subsequent rehospitalization 11.29 (6.68-15.89), chronic obstructive pulmonary disease (COPD) 8.17 (3.91-12.43), and longer index hospital length of stay 0.06 (0.03-0.08). Acute clinical deterioration, RVD, and PE severity were not predictors of QoL at 1 month post-PE. Independent predictors of worsened QoL were rehospitalization, COPD, and index hospital length of stay.

P222 Chronic pain is common in Paediatric Inflammatory Bowel Disease and impacts quality of life

Abstract Background Prevalence of chronic pain (CP) is reported as 38% in adult inflammatory bowel disease (IBD), with a significant impact on quality of life, functional and social outcomes 1,2,3. Prevalence and attributes of chronic pain are unknown in paediatric IBD. Aim evaluate the prevalence, disease related factors, and impact on quality of life (QOL) of CP. Methods Prospective, cross-sectional single centre study included 41 children, (8 -18 years), of a predominantly CD cohort 29/41, (70%). Patients and their parents completed validated age-appropriate pain questionnaires4 and IMPACT III QOL questionnaire for IBD5. CP was defined mild and moderate to severe, as per von Korff scale6. Disease specific parameters were recorded. CP and NP medians were compared using Mann-Whitney tests and proportions using Chi squared test (p&amp;lt;0.05). Results CP was prevalent in 33/41 (80%) patients. Abdominal CP was common in 30/33 (90%), joint pain was present in 2/33, (6%) and headache in 1/33, (3%). CP subjects were adolescents with extensive and established disease, predominantly on biologics 26/33 (79%). Analgesia use was low 15/33 (45%), and there was no opiate use. There was no difference in Disease activity CP vs NP, defined by PCDAI, PUCAI, CRP and Faecal calprotectin. QOL life score was significantly lower in CP, there was no difference in body image QOL domain score in CP vs NP. Comorbidity was common 16/33 (48%) in the CP cohort, 5/16 (31%) had diagnoses that maybe associated with comorbid pain. We have shown that anaemia and sleep disturbance may be a signal associated with CP (Fig 1). Conclusion CP is common in paediatric IBD, more common than previous adult studies. Unlike historic adult IBD cohorts, it is not associated with disease activity or related biomarkers. It is unknown whether functional pain co-exists in our cohort. CP significantly impacts emotional, wellbeing and social functioning in children with IBD. This is the first study to report on CP in children with IBD, strategies should target psychosocial intervention. Further studies are needed to evaluate potential effects of socioeconomic status, physical activity, anaemia and prevalence of functional pain in children with IBD. We recommend screening for CP in children with IBD as it is common.

A study of quality of life among the elderly in urban areas of Tirupati

Abstract Background: The objectives of the study are to evaluate quality of life (QoL) among the elderly and to determine the association between socio-demographic factors and QoL. Methods: A community-based cross-sectional study was conducted in elderly subjects (aged 60 years and above) (n = 120) in the urban field practice areas of our tertiary care teaching institute in southern India. QoL was assessed using World Health Organization-QoL BREF Questionnaire. Results: Most of the study population were aged 60–69 years (65.8%), males (51.7%), from nuclear families (78.3%), Hindus (67.5%) and were literates (78.3%). Majority of families belong to the upper lower socio-economic group (45%). Most of them belonged to the backward caste communities (30%). The mean total QoL score was high among ≥80 years, males, illiterates and upper class. All these differences were statistically non-significant. However, the mean total QoL score showed significant relation with socio-economic class. The domain correlation ranged between 0.238 and 0.690 and was statistically significant. Conclusions: Most of the study population were leading moderate QoL, followed by good QoL. Based on total domain QoL scores, it is concluded from this study that overall QoL is good among elderly ≥80 years, males, illiterates and the population in the upper socio-economic class. The mean total QoL score showed a significant relation with socio-economic class.

Determinants of Quality of Life in Women living with Breast Cancer in Southwest Nigeria

Background: The quality of life (QOL) among women with breast cancer is hampered in areas of social, emotional, and sexual functioning and this could persist even years after treatment. It is an important parameter for monitoring disease progression at the early stage. Hence, this study aimed to determine the factors associated with the overall quality of life among subjects living with breast cancer.&#x0D; Methods: The study was a comparative cross-sectional design conducted among women with breast cancer attending the General Surgical Outpatient clinic of LAUTECH Teaching Hospital Ogbomoso and a comparison group of age-matched control. The instrument used include the World Health Organization Quality of Life-BREF and socio-demographic and clinical variable questionnaire in 240 interviewer-administered questionnaires. Data were analyzed using SPSS version 21. A P-value of less than 0.05 was taken as statistically significant. The predictors of overall QOL were analyzed using a binary logistic regression.&#x0D; Results: All QOL domain scores were significantly higher among controls than in subjects with breast cancer. ρ-value = 0.001. Level of education and duration of diagnosis had a statistically significant association with the overall quality of life, P-value&lt; 0.05. Respondents who attained a tertiary level of education were 0.040 times less likely to have a poor quality of life compared to respondents that were not educated (P-value= 0.038) and the odds of having a poor overall quality of life decreased with duration since diagnosis P-value= 0.049.&#x0D; Conclusion: Our study shows that women with breast cancer experience a lower QOL, especially in the physical, psychological and social domains than women without the disease. Also, the level of education, employment and marital status, and duration since diagnosis were major factors influencing QOL. Assessment of QOL is an important metric that should be incorporated into the breast cancer treatment program.

Quality of life, social support, coping strategies, and their association with psychological morbidity among people living with HIV.

Enhancement of quality of life and social support havebecome important therapeutic goals among people living with HIV. However, research from developing countries is sparse in this area. Index study was aimed to assess association of social support, coping, and quality of life with psychological morbidity among people living with HIV. In this cross-sectional study, 100 people with HIV were recruited through purposive sampling who were not receiving antiretroviral therapy. To assess social support, coping, and quality of life social support questionnaire, coping strategy check list and World Health Organization quality of life-HIV BREF were administered, respectively. Quality of life domain scores fell in the moderate category and spirituality, religion, and personal belief domain had maximum score. Educated, married, employed, and male subjects reported better quality of life. Females reported greater use of internalization and emotional outlet coping strategies. Low social support, lower quality of life (in all domains and total score), and greater use of internalization coping strategy were significantly associated with psychiatric morbidity. Internalization coping, low social support, and lower quality of life were associated with greater psychiatric morbidity. Therefore, to improve their mental health and overall course of HIV, multipronged interventions should be implemented for promoting the adaptive coping, social support and quality of life.

Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A GRADE-assessed Systematic Review and Meta-analysis

ContextAcupuncture is a promising therapy for relieving symptoms in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which affects 9–16% of adult men worldwide. ObjectiveThis study aims to explore the efficacy and safety of acupuncture for CP/CPPS. Evidence acquisitionNine electronic databases were searched. Only randomized controlled trials were included. Two reviewers extracted data and assessed the risk of bias of trials using the revised Cochrane risk-of-bias (RoB 2.0) tool. Stata 17.0 was used to analyze the data. Evidence synthesisTwelve trials were included. The results of a meta-analysis showed that acupuncture had larger effect sizes (standardized mean difference [SMD] = –1.20, confidence interval or CI [–1.69, –0.71], acupuncture compared with sham acupuncture; SMD = –1.01, CI [–1.63, –0.38], acupuncture compared with medication; SMD = –0.91, CI [–1.29, –0.54], acupuncture plus medication compared with medication) in reducing the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score. In decreasing NIH-CPSI pain domain score, acupuncture also led to larger effect sizes (SMD = –0.94, CI [–1.18, –0.70], acupuncture compared with sham acupuncture; SMD = –1.04, CI [–1.29, –0.79], acupuncture compared with medication; SMD = –0.85, CI [–1.23, –0.48], acupuncture plus medication compared with medication), whereas the effect sizes in the reduction of NIH-CPSI urinary domain and quality of life domain scores were medium. Compared with sham acupuncture and medication, acupuncture appears to be more effective in improving the global response rate. Results from four trials indicated that acupuncture was better than sham acupuncture in decreasing the International Prostate Symptom Score. No serious adverse effects were found in the acupuncture treatment. ConclusionsCurrent evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Comprehensive acupuncture treatment according to individual symptoms should be considered in future clinical practice and trials for CP/CPPS. Patient summaryIn this study, we further verified the efficacy of acupuncture in patients with chronic prostatitis/chronic pelvic pain syndrome, especially in reducing pain.

Toxicity and Patient Reported Quality of Life Outcomes Following Prostate SBRT with Focal Boost to MRI Identified Prostate Cancer Lesions: Results of a Phase II Trial

<h3>Purpose/Objective(s)</h3> A focused boost to MRI identified prostate cancer lesions treated with radiotherapy has been shown to improve biochemical disease control without increased toxicity in standard fractionated radiation treatment. Prostate cancer is known to be sensitive to higher radiation doses per fraction and thus stereotactic body radiotherapy (SBRT) has become an increasingly popular treatment method. In this prospective phase II trial, we investigated the toxicity and patient reported quality of life outcomes in patients treated with SBRT to the prostate gland and a simultaneous focal boost to MRI identified intraprostatic lesions while also de-escalating dose to the adjacent organs at risk. <h3>Materials/Methods</h3> Eligible patients included low- or intermediate- risk prostate cancer (Gleason score ≤ 7, PSA ≤20, T stage ≤2b). SBRT was prescribed to 40 Gy in 5 fractions delivered every other day to the prostate, with areas of high disease burden (MRI-identified PI-RADS 4 or 5 lesions) escalated to 42.5-45 Gy and areas overlapping organs at risk (within 2 mm of urethra, anterior rectal wall, and bladder base) constrained to 36.25 Gy (n=98). Patients without a pre-treatment MRI were treated to dose of 37.5 Gy with no focal boost (n=14). Acute and late toxicity were graded using RTOG modified toxicity scales. Patient-reported outcome and quality of life was assessed using the AUA-IPSS lower urinary tract symptom score, IIEF-5 erectile function, and EPIC-26 surveys. Statistical testing was performed in statistical software. <h3>Results</h3> From 2015 to 2022, a total of 112 patients were enrolled with a median follow-up of 36 months. No acute or late grade 3+ GI or GU toxicity was observed. Within the focal boost arm, acute grade 2 GU toxicity during treatment or at 6-week follow-up was seen in 26% of patients. Acute grade 2 GI toxicity was seen in 1 patient. Cumulative late grade 2 GU toxicity was 8%. Rate of alpha blocker medication use following treatment was 26%. Cumulative late grade 2 GI toxicity was 2.3%. Patient reported outcomes showed no significant changes from baseline IPSS lower urinary tract, IIEF erectile function, or EPIC-26 urinary incontinence, urinary irritative, gastrointestinal, or sexual domain quality of life scores following treatment (p >0.05 for all tests via RANOVA). Two patients have had a biochemical recurrence to date, at 42 months and 60 months post treatment. <h3>Conclusion</h3> SBRT to a dose of 40 Gy to the prostate gland with a focal boost up to 45 Gy is well tolerated with no observed grade 3 toxicity and similar rates of acute and late grade 2 GI and GU toxicity as seen in other SBRT regimens without intraprostatic dose boost. Moreover, no significant changes were seen in patient reported urinary, bowel, or sexual outcomes from pre-treatment baseline at any follow-up date. Biochemical control data continue to mature but few treatment failures have been observed to date.

Functional outcome after Hartmann's reversal surgery using LARS, COREFO & QoL scores

BackgroundFunctional complaints after colorectal surgery have a profound effect on quality of life (QoL). Our goal was to investigate the prevalence of functional complaints and quality of life after Hartmann's reversal surgery. MethodA cross-sectional study was performed where one hundred nineteen patients were included. All patients underwent Hartmann's reversal procedure between 2007 and 2019. All patients were asked to complete 3 validated questionnaires related to bowel function in benign and colorectal cancer surgery as well as general QoL. ResultsThe response rate was 67%. Among responders, 32.8% reported LARS-like symptoms whereas 25% had significant COREFO Scores (>15). Higher LARS and COREFO scores were significantly associated with worse global QoL and several QoL domain scores (p < 0.05). ConclusionThis study highlights the prevalence of bowel dysfunction after Hartmann's reversal surgery. Patients undergoing this procedure show similar functional complaints compared to those in literature who had a resection without colostomy.

Brain, cognitive, and physical disability correlates of decreased quality of life in patients with Huntington’s disease

PurposeFollowing a case–control design, as a primary objective, this study aimed to explore the relationship between quality of life (QoL) scores and gray matter (GM) volumes in patients with Huntington’s disease (HD). As a secondary objective, we assessed the relationship between QoL scores and other important behavioral, clinical and demographical variables in patients with HD and HD patients’ caregivers.MethodsWe recruited 75 participants (25 HD patients, 25 caregivers, and 25 controls) and assessed their QoL using the World Health Organization Quality of Life scale-Brief Version (WHOQOL-BREF). Participants were also assessed with general cognitive functioning tests and clinical scales. In addition, we acquired MRI scans from all participants.ResultsOur results showed that patients exhibited significantly lower scores in all four QoL domains (physical health, psychological wellbeing, social relationships, and relationship with the environment) compared to caregivers and controls. Caregivers showed lower scores than controls in the physical health and the environmental domains. In HD patients, lower scores in QoL domains were associated with lower GM volumes, mainly in the precuneus and the cerebellum. Moreover, in HD patients, physical disability and GM volume reduction were significant predictors of QoL decrease in all domains. For caregivers, years of formal education was the most important predictor of QoL.ConclusionsHD patients exhibit greater GM volume loss as well as lower QoL scores compared to caregivers and controls. However, caregivers displayed lower scores in QoL scores than controls, with years of education being a significant predictor. Our results reflect a first attempt to investigate the relationships among QoL, GM volumes, and other important factors in an HD and HD caregiver sample.