Quality Of Life Factors Research Articles

Being the other child - A systematic review on the quality of life and mental health of siblings of children with rare diseases.

Siblings of children with rare diseases play a crucial yet often overlooked role in the family dynamic and their sibling's illness experience. This systematic review aims to synthesize and evaluate existing research on the Quality of Life (QoL) and mental health outcomes of siblings in this unique context. We performed a systematic literature search in six databases, including quantitative studies on siblings of children with rare diseases. A total of 37 reports (34 studies) met the inclusion criteria. Siblings' QoL and mental health were compared to normative samples and their siblings with a rare disease. Risk factors for siblings' QoL and mental health were systematically investigated. Moreover, methodological quality and risk of bias were analyzed. The findings revealed that siblings of children with rare diseases experience reduced QoL and mental health compared to norm data, although results have been mixed. Psychosocial risk factors like parental family stress factors, compared to disease-specific risk factors, play a particular role in the QoL and mental health of siblings of children with rare diseases. Healthcare providers should consider and address the potential psychosocial impact on QoL and mental health in siblings of children with rare diseases. Additionally, opportunities to bridge existing research gaps and suggestions for advancing theory-driven research in this area will be discussed.

Role of Oxidative Stress and Inflammation in Postoperative Complications and Quality of Life After Laryngeal Cancer Surgery

(1) Background: Laryngeal surgery due to carcinoma leads to significant tissue disruption, cellular injury, and inflammation. This leads to increased levels of reactive oxygen species (ROS), causing oxidative damage that can influence quality of life (QOL) and recovery and complicate the postoperative course. The aim of this study was to compare how postoperative quality of life and surgical complication occurrence interacted with the biomarker levels of oxidative stress (malondialdehyde, MDA; superoxide dismutase, SOD; glutathione peroxidase 1, GPX1; and catalase, CAT) and inflammation (interleukin 1, IL-1; interleukin 6, IL-6; C-reactive protein, CRP) in patients treated with conservative and radical laryngeal surgery. (2) Methods: The study included 56 patients who underwent surgical treatment for laryngeal cancer. Blood samples were collected to analyze oxidative stress and inflammation parameters before surgery and on the first and seventh days postoperatively. Serum concentrations of MDA, SOD, GPX, CAT, IL-1, IL-6, and CRP were measured using coated enzyme-linked immunosorbent assay (ELISA) kits. EORTC QLQ-H&H43 questionnaire was used to measure the QOL of patients. (3) Results and Conclusions: T stage, pain intensity, and the extent of the surgical procedure were established as significant predictive factors for QOL in multivariate analysis. There was a significant positive correlation between surgical complication occurrence and preoperative values of GPX and MDA, but significant predictors of surgical complication occurrence on the 7th postoperative day were SOD and MDA values (p < 0.05).

Quality of life and associated characteristics in long-term care residents with advanced dementia in Macao: a cross-sectional study

BackgroundThe quality of life (QoL) of long-term care residents with advanced dementia represents a critical concern. However, empirical data on this topic especially within Chinese society remains relatively scarce.AimsThis study aimed to investigate the QoL in this population and identify the key factors affecting it.MethodsA cross-sectional study employing cluster sampling methodology was carried out in three long-term care facilities in Macao, involving a sample of 81 residents. The participants were assessed using the Functional Assessment Staging Test (FAST) and the Quality of Life in Late-Stage Dementia (QUALID) scale. Other variables recorded included Behavioral and Psychological Symptoms of Dementia (BPSD), comorbidities, PAINAD scores, and Waterlow scores.ResultsThe majority of participants were female (65.4%), and 70.1% were classified at Stage 7 on the FAST scale. The mean score on the QUALID was 23.94 ± 7.58, suggesting a relatively lower QoL in Macao, particularly in items of smiling, interaction, and touch. Multiple linear regression analysis indicated that higher PAINAD scores, presence of BPSD, and higher FAST stage were significantly associated with lower quality of life among long-term care residents with advanced dementia, explaining 65.9% of the total variance (F = 36.639, p < 0.001).ConclusionsThe findings indicated that residents with advanced dementia in Macao experience relatively lower quality of life, particularly in aspects such as smiling, interaction, and touch. Pain, BPSD, and advanced dementia stage are the three major associated factors of QoL among long-term care residents with advanced dementia. Comprehensive and individually tailored care strategies focusing on pain management and interventions targeting BPSD are suggested to enhance QoL in this population.

Impact of parenteral nutrition on quality of life, the family and gastrointestinal symptoms in children with intestinal failure.

Intestinal failure (IF) and dependency on parenteral nutrition (PN) are risk factors for lower health-related quality of life (HRQOL) in children. Weaning from PN is a major goal of paediatric IF treatment, however, its impact on HRQOL remains unclear. This study aimed to assess HRQOL, gastrointestinal (GI) symptoms and family impact in children with IF in relation to their need for PN. Data were collected in a cross-sectional study from children with IF and a reference group of healthy children using electronic versions of Paediatric Quality of Life Inventory™ forms. The study included 56 children with IF and 48 healthy children. Parents of children with IF reported significantly lower HRQOL than healthy children (-8.7, p = 0.001). PN dependency did not influence HRQOL scores, but families with children dependent on PN had a lower family impact score than children weaned from PN (49.9 vs. 73.6, p < 0.001). Parents of children in the PN group reported more GI problems than those in the weaned group (-8.1, p = 0.04), and diarrhoea, gas and bloating were common symptoms of IF. GI symptoms varied according to PN dependency and IF aetiology. Multivariate analysis found a significant association between HRQOL and total GI symptom score (parent scores: 0.34, p = 0.02, self-score 0.48, p = 0.02). Children with IF had lower parent-reported HRQOL than healthy children. PN dependency did not affect HRQOL, however, the need for PN had a significant negative impact on family well-being. GI symptoms may negatively impact HRQOL in the IF population.

A post-hoc analysis of risk factors for poor quality of life after surgical treatment of spondylodiscitis

Patient-reported outcome measures for quality of life (QoL) like the Oswestry-Disability-Index (ODI) are useful for a quick, comprehensive and comparable evaluation of spondylodiscitis treatment. While it is known that even after successful surgical treatment, the QoL of spondylodiscitis patients remains below that of the general population, risk factors for a poor outcome have not been described so far. We did a retrospective post-hoc analysis of 130 surgically treated spondylodiscitis patients from 2008 to 2022. Biographical, clinical und QoL data were prospectively collected before (T0) and one year (T1) after surgery. The primary outcome was QoL at T1. Patients were grouped according to their ODI score at T1 (Group 1: ODI < 35, favorable QoL; Group 2: ODI ≥ 35, poor QoL) and analyzed for risk factors present at T0. Poor QoL at T1 occurred in 51 patients (39%). Multivariate analysis identified a higher preoperative leg pain (odds ratio: 1.2) and the presence of a malignant disease (odds ratio: 1.9) as independent preoperative risk factors for a poor QoL at T1. Spondylodiscitis patients with malignancy and/or preoperative leg pain may be at increased risk for poor QoL after surgical treatment. These results can be used to individualize patient information and provide a better assessment of prognosis before surgery.

TREINO COGNITIVO MOTOR NO EQUILÍBRIO FUNCIONAL E COGNIÇÃO DE IDOSOS: UMA REVISÃO BIBLIOGRÁFICA

With the aging population, the preservation of cognitive abilities and functional balance in elderly individuals has emerged as a critical issue for maintaining autonomy and quality of life in this population. The practice of activities that combine cognitive and motor stimuli, known as cognitive-motor training, has been suggested as an effective strategy to mitigate the physical and cognitive declines associated with aging. In light of this, the present study aims to analyze the effects of cognitive-motor training on functional balance and cognition in the elderly, based on a literature review. The methodology adopted was a literature review using scientific databases such as Google Scholar and the CAPES Periodicals Platform to select articles addressing the impact of cognitive activities combined with physical exercises on the balance and cognitive abilities of elderly individuals. The main results suggest that cognitive-motor training has positive effects on functional balance, enhancing postural stability and mobility in the elderly. These benefits directly impact the reduction of fall risks, a determining factor for quality of life in older age. Additionally, cognitive-motor training was found to contribute to improvements in memory, attention, and mental processing, highlighting the potential of this intervention for maintaining cognition in elderly individuals. However, the review identified some important limitations, as many of the studies analyzed were conducted in specific contexts, which may limit the generalization of results to different profiles of elderly individuals and environments. Therefore, future research should explore the diversity of approaches and adapt protocols to different realities, seeking to validate the observed effects across a broader range of conditions. It is concluded that cognitive-motor training represents a valuable strategy for promoting balance and cognition in the elderly, potentially contributing to the maintenance of autonomy and quality of life. From this review, the importance of developing personalized interventions and investigating new methodologies that maximize the benefits of cognitive-motor training is emphasized, consolidating it as an effective and safe practice in elderly health care.

A cross-sectional study on post-stroke depression and the quality of life

BackgroundPost-stroke depression (PSD) is a common mood disorder associated with stroke. By investigating the differences in life quality factors among stroke survivors, the results of this study offer insights into how to better prevent and manage the onset and progression of depression.MethodsThis study is a cross-sectional study that selected patients receiving treatment in the Department of Rehabilitation Medicine at Hebei University Affiliated Hospital from September 1 to November 30, 2023. The inclusion criteria for this study were as follows: 1. Age ≥ 18 years; 2. Diagnosis of hemorrhagic or ischemic stroke confirmed by imaging examination. The exclusion criteria included: 1. A history of psychiatric disorders such as depression or anxiety prior to the onset of the illness; 2. History of psychiatric medication use before the onset; 3. Functional impairments, such as speech, cognitive, or consciousness disorders, that hinder cooperation with the survey questionnaire. Ultimately, a total of 131 patients were included in the study. Based on the results of the Patient Health Questionnaire-9 (PHQ-9), patients were divided into the PSD group and the non-PSD group. The primary evaluation metrics included the General Self-Efficacy Scale (GSES), Visual Analogue Scale (VAS), modified Rankin Scale (mRS), and Fatigue Assessment Scale (FAS), allowing for a comparison of demographic, clinical data, and evaluation metrics between the two groups. Statistical analysis was performed using SPSS version 25.0, and GraphPad Prism version 9.0 was used for graphical representations.ResultsThe morbidity rate of PSD in this study was 48%, which was slightly higher than the global statistical data. The demographic data did not show any statistical differences in terms of age, sex, history of smoking and drinking, or occupation, but they did show a significant difference in terms of education level (p < 0.05), which was primarily related to low education level in the PSD group. In contrast, the clinical data did not show any differences in terms of stroke type, pathogenic site, or medical history (p > 0.05).ConclusionIn this study, statistical results indicated no significant difference in the mRS between the two groups. However, the GSES, VAS, and FAS showed significant differences. This suggests a strong correlation between GSES, VAS, and FAS with the occurrence of PSD, indicating that these factors may serve as predictors for PSD. In medical practice, focusing on patients’ self-efficacy, pain, and fatigue levels could facilitate recovery. When developing rehabilitation plans, it is crucial to minimize patients’ feelings of self-defeat, enhance their self-efficacy, and manage fatigue effectively. Furthermore, reinforcing pain management throughout the rehabilitation process may promote more effective patient recovery.

Assessment of Quality of Life and Determinants Among the Elderly Population in Rural Areas of Puducherry: A Mixed Method Study

Background: Elderly people living in rural areas often faces unique challenges that affect their quality of life (QOL), including limited access to healthcare and social support. Understanding the factors influencing their well-being is essential to improve the quality of life. The study aims to assess the QOL and its determinants among the elderly in rural areas of Puducherry. Methods: A community based sequential explanatory mixed method study was conducted among the elderly residing in the rural field practice area of a medical college in Puducherry district. 200 participants were recruited by simple random sampling from the family health records in the Rural Health Training Centre of a medical college. WHO QOL-BREF questionnaire was used to assess the Quality of Life quantitatively and an interview guide to explore its determinants. Data were entered in MS excel and analyzed using SPSS v16.0. Results: The mean age of the participants was 68.8± 2.5 years with majority being females. The environmental domain scored the highest mean QOL and psychological domain the lowest mean QOL. The overall mean QOL was 234.8 ± 65.4. The main determinants of poor QOL are age ≥ 75 years, lower socio-economic class, those who are widow/separated and presence of comorbid conditions. The binary logistic regression predicts the factor for poor QOL was age ≥ 75 years with OR (95% CI) as 6.23 (2.44-15.91). Conclusion: The overall mean QOL was moderate. The factors identified for poor QOL need to be addressed with key intervention strategies. Quality affordable medical services at door step to improve physical domain and targeted health education for family members and the community, who form the immediate environment around the elderly, can play a crucial role in enhancing the social domain.

Understanding loneliness after widowhood: The role of social isolation, social support, self-efficacy, and health-related factors

BackgroundWidowhood negatively affects trajectories of social isolation and loneliness. Given the inevitability of spousal bereavement for many, further investigation into potential modifiers of bereavement-related loneliness is warranted. AimTo examine the moderating effects of social isolation, social support, sociodemographic, self-efficacy, health, and quality of life factors on changes in loneliness before and after widowhood. MethodsWe analysed 19 waves of data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, comprising 749 widowed and 8,418 married individuals (comparison). Coarsened exact matching weights were applied, controlling for age and time trends. Local polynomial smoothed plots illustrated social health trajectories from three years before to three years after spousal death. All analyses were gender-stratified. ResultsLow social isolation and higher social support did not prevent increased loneliness following widowhood. Men in major cities were less likely to experience reductions in social isolation during bereavement, despite being less socially-isolated at baseline than men in regional/remote areas. The bereavement-loneliness relationship was consistent across all subgroups. For men, this relationship was weakened by older age and being born in a non-English-speaking country, but strengthened by poverty and living in a regional/remote areas. For women, it was weakened by older age, and strengthened by factors such as being born in a non-English-speaking country, poverty, employment or volunteering, and having a long-term mental health condition. ConclusionLoneliness is a common and potentially unavoidable experience during widowhood, highlighting the importance of screening by healthcare workers to improve wellbeing and prevent future mental health issues.

Assessment of Depression, Anxiety, Stress, Quality of Life, and Fatigue in Patients After a Cerebrovascular Accident.

Background A cerebrovascular accident, or stroke, is a neurological disorder. Those who suffer from a stroke not only face physical disabilities but also a range of psychological issues resulting from concerns about their current situation. The purpose of this study was to assess depression, anxiety, stress, and fatigue after a stroke, along with its effects on quality of life (QoL), degree of disability, and prevalence of various risk factors of stroke. Materials and methods Adult male and female patients who had experienced a stroke and came to the psychiatry or neurology outpatient departments were evaluated. A detailed stroke history was taken for them. The Stroke-Specific Quality of Life Scale (SSQOL) Scale, Depression Anxiety Stress Scale 21, Alcohol Use Disorders Identification Test C (AUDIT C) scale, Suicide Behaviors Questionnaire-Revised (SBQ-R) scale, Fatigue Severity Scale (FSS), and Modified Rankin Scale (mRS) were applied to assess the QoL, depression, anxiety, stress, alcohol use, suicidal behavior, fatigue, and the degree of disability, if any, after stroke. Results The study involved 100 stroke patients aged 18-60 years, with 82 males and 18 females. The mean age was 45.76 ± 8.54 years. 88% experienced an ischemic stroke, and 12% a hemorrhagic stroke. 68% had comorbidities, and alcohol use was present in 48% of patients. The QoL was lowest in the domains of social roles, upper extremity, family roles, and productivity. The study revealed that 67% of patients experienced depression, 63% anxiety, and 62% stress, with 40% having a high risk of suicidal behavior, 57% experiencing fatigue, and 67% disability. There was a significant positive correlation between lower QoL scores, higher depression, anxiety, stress, disability, suicidal ideation, fatigue, and factors such as increased age, female gender, recurrent stroke, psychiatric illness history, multiple comorbidities, and substance use. Conclusion Neuropsychiatric problems following a stroke are common and have serious consequences that significantly influence stroke survivors' QoL and ability to recover.

Assessing the Quality of Life of Parents of Children With Thalassemia: A Cross-Sectional Study in Medina City, Saudi Arabia.

Thalassemia is a group of genetic disorders that result in a lack of hemoglobin (Hb) production. Children with thalassemia rely on regular blood transfusions for survival, which places a significant burden on their families and negatively impacts their quality of life (QOL). This study aimed to assess QOL from the perspective of parents of thalassemic children in Medina City, Saudi Arabia. A cross-sectionalstudy was conducted among 52 parents in Medina through September and October 2023 using a socio-demographic and clinical characteristicquestionnaireand an assessment of parents' QOL. The study was conducted among 52 parents in Medina, with a mean (standard deviation (SD)) age of 44.4 (9.5). Most participants (63.5%) were males, 90.4% were married, and 61.5% had one child with thalassemia. The majority (84.6%) had a blood transfusion every three weeks, and 80.8% had Hb before transfusion less than 9 gm/dL. The mean (SD) QOL and health score was 246.4 (51.2) out of 400. The parent's low income (p<0.001) and being non-Saudi parents (p=0.017) were significant factors for low QOL and health. Parents with thalassemic children revealedmoderate QOL and health in Medina City, Saudi Arabia. Low income and expatriation negatively affected the parents' QOL and health. These results emphasize the need for financial support through assistance programs to alleviate the financial burden on these families. Additionally, specialized thalassemia treatment centers should be established to ensure easy access to comprehensive healthcare services.

Effects of Symptom Burden on Quality of Life in Patients with Lung Cancer.

Lung cancer patients suffer from numerous symptoms that impact their quality of life. This study aims to identify the symptom burden on quality of life in lung cancer patients. This survey used a structured questionnaire to collect data from 8 March 2021 to 12 May 2021. Patient demographic information was collected. The data on symptom burden and quality of life (QOL) of patients were obtained from the QLQ-C30 and the QLQ-LC13. The stepwise multiple regression analysis was used to estimate lung cancer-related symptom burden in relation to quality of life. The study included 159 patients with lung cancer who completed the questionnaire. The mean age of the patients was 63.12 ± 11.4 years, and 64.8% of them were female. The Global Quality of Life score of the QLQ-C30 was 67.87 ± 22.24, and the top five lung cancer-related symptoms were insomnia, dyspnea, and fatigue from the QLQ-C30, and coughing and dyspnea from the QLQ-LC13. The multiple regression analysis showed that appetite loss was the most frequently associated factor for global QOL (β = -0.32; adjusted R2: 27%) and cognitive function (β = -0.15; adjusted R2: 11%), while fatigue was associated with role function (β = -0.35; adjusted R2: 43%), emotional function (β = -0.26; adjusted R2: 9%), and social function (β = -0.26; adjusted R2: 27%). Dyspnea was associated with physical function (β = -0.45; adjusted R2: 42%). Appetite loss, fatigue, and dyspnea were the main reasons causing symptom burdens on quality of life for lung cancer patients. Decreasing these symptoms can improve the quality of life and survival for patients with lung cancer.

Quality of Life and Psychological Distress Related to Fertility and Pregnancy in AYAs Treated for Gynecological Cancer: A Systematic Review.

With growing survival rates for Adolescent and Young Adults (AYAs) diagnosed with gynecological cancer, the focus shifted to Quality of Life (QoL). Fertility-sparing surgery offers a viable alternative to standard, usually fertility-impairing treatments. Treatment choice remains difficult and renders perspectives of AYAs on decision-making and psychological outcomes afterwards. This review examines the impact of (in)fertility on psychological well-being both during cancer treatment, and in the long term. A systematic review of the peer-reviewed literature was conducted by searching Pubmed, Web of Science, Cochrane Trial database and PsycINFO on 30 November 2023. The review included studies with a focus on gynecological cancer, fertility and pregnancy related psychological outcomes, QoL, and psychosocial factors influencing decision-making. Case reports and reviews were excluded. Quality was assessed with the Mixed Methods Appraisal Tool (MMAT). 15 studies, published between 2005 and 2023, involving 1328 participants, were included. Key findings highlight the significance of informing all AYAs about cancer treatment effects on fertility and discussing fertility preservation options. Feeling time-pressured and conflicted between choosing the best oncological outcomes and preserving fertility were common. Factors such as younger age at diagnosis, time pressure, and inadequate counseling by healthcare workers increased reproductive concerns which contributed to long term psychological distress. Research on AYAs with gynecological cancer without fertility preservation possibilities is limited and should be prioritized. This review shows that both Shared Decision-Making (SDM) and follow-up processes can be improved by addressing fertility-related questions and concerns, therefore increasing long-term QoL. This review is registered in PROSPERO (ID 448119).

Impact of carer burden, social support, and gratitude on quality of life in families of older adults with dementia

This study explores how carer burden, social support, and gratitude affect the quality of life of family members of older adults with dementia. Participants included 156 family members living with older adults diagnosed with dementia. Data were collected using structured self-report questionnaires and analyzed using hierarchical regression analysis. Significant predictors of quality of life were identified as family support, friend support, and gratitude, and the explanatory power of these factors for quality of life was 48.2 %. To enhance the quality of life of families of older adults with dementia, programs promoting supportive familial interactions, activities enhancing support from friends, and initiatives fostering gratitude should be implemented.

Quality of Life Factors in Adults with Eosinophilic Oesophagitis in New Zealand.

Eosinophilic oesophagitis (EoE) is an immune-mediated oesophageal disorder causing dysphagia. Patients with EoE experience reduced QoL due to symptoms; however, this has not been assessed in the New Zealand population. The aim of this study was to assess QoL in patients with EoE in New Zealand. This observational study recruited participants from two New Zealand hospitals. Records were reviewed to confirm diagnoses, and consenting participants completed an electronic survey, consisting of the Dysphagia Symptom Questionnaire (DSQ) score and the QoL-specific EoE (EoE-QoL-A) questionnaire score. Correlation analysis examined the relationship between the DSQ and EoE-QoL-A scores. Differences in baseline variables were assessed. Univariate logistic regression assessed the association of variables with disease activity and QoL. Fifty-four participants responded, and four were excluded due to incomplete surveys. The majority (76%) were male, and the median age was 47 years (IQR 42-58). The median DSQ was 49 (IQR 0-60), and the median EoE-QoL-A score was 68 (IQR 48-80). A reduced EoE-QoL-A score was associated with active disease (OR = 0.96,95% CI 0.926-0.995). Significant associations were found between disease activity and overall EoE-QoL-A score (r = -0.37, p < 0.01) as well as the sub-categories eating and diet (r = -0.54, p < 0.001), social (r = 0.30, p < 0.05), and emotional impact (r = -0.44, p < 0.01). The EOE-QoL-A score was higher in those on PPI (75 vs. 60, p = 0.02). This study identified a decreased quality of life (QoL) in individuals with EoE in New Zealand, aligning with international literature. The increased DSQ scores suggest a possible gap in current management approaches. The correlation between the DSQ and QoL highlights the need for improved care models of care for EoE.

Lived experiences of working-age polytrauma patients in Germany - A qualitative Analysis

BackgroundSurvivors of a major trauma experience a range of difficulties in relation to the reduction in physical, psychosocial, and cognitive functions, which can result in a reduced health-related quality of life. This study aims to explore lived experiences of major trauma survivors in the German healthcare system. MethodsSemi-structured exploratory interviews were performed with nine major trauma survivors (18–55 years; Injury Severity Score ≥16). For exploratory analyses, an artificial intelligence-based coding software was used. Further, results were clustered by using the International Classification of Functioning, Disability and Health framework (ICF). ResultsCommunication was one of the major topics concerning amongst others diverting opinions between different healthcare disciplines and a general lack of information. The participants showed a high demand for a contact person. Furthermore, social support was essential during recovery for those interviewed. Social network was not only important as emotional and physical support but also for overcoming of gaps in the healthcare system. The support by employers and colleagues seemed to be beneficial for our participants in relation to returning to work. Further, psychological consequences of trauma, and that mobility is a key factor for quality of life, self-efficacy and return to work were discussed. DiscussionThe qualitative analyses highlight several topics such as communication, burden of sickness, support systems that the participants mentioned as important along their journey through the German healthcare system during recovery. Through the ICF model the interplay of certain components that influenced the outcome of the major trauma survivors was visualized. ImplicationsThese results might offer a deepened understanding of modifiable components of a patient pathway in recovery process such as improvements of patient communication, provision of a contact person and others.

Composite Functional and Quality of Life Outcomes in Adults Operated for Cloacal Malformation

IntroductionComposite long-term outcomes of cloacal malformations remain unclear. We aimed to evaluate bowel and bladder control, sexual function, reproductive health, and quality of life in adulthood. MethodsA Nordic multi-center cross-sectional observational study evaluating the outcome of adult patients with cloacal malformations was performed. Patient characteristics were retrieved from case records. Established questionnaires were sent to the patients to evaluate bowel- bladder- and sexual function and quality of life. ResultsThirty-four of 48 (70%) eligible patients with median age 28 years (18–45) responded. Eight (24%) patients had a common channel >3 cm. Imaging-confirmed spinal and sacral abnormalities were present in 4 and 17 patients respectively. 85% (n = 29/34, four patients with permanent urinary diversions after bladder neck closure excluded) reported no urinary leakage without physical activity or urge to urinate. Three patients had a permanent enterostomy. 42 % (n = 11/26) reported acceptable bowel function according to Bowel Function Score (with eventual ongoing bowel management). The median Profile of Female Sexual Function Score was below normative values. Quality of life was comparable to the reference population, but thirty percent scored within the distress domains. Eight patients (24%) had been pregnant (15 pregnancies), resulting in seven live births, but the need of assisted reproduction techniques (40%, n = 6/15) and miscarriage (40%, n = 6/15) was common. ConclusionsAdequate spontaneous bowel control was rare, while most patients were dry for urine without additional procedures. Cloacal malformation also have a negative impact on sexual function health related quality of life and reproductive health. Long-term follow-up is crucial, not only regarding bowel and bladder function, but also for sexual and reproductive function, which may be important negative factors for health-related quality of life. Level of EvidenceLevel IV.

Patient-Reported Quality of Life for Osteoradionecrosis Reconstruction in the Head and Neck: A Longitudinal Framework and Risk Factors.

Osteoradionecrosis (ORN) is an aggressive sequela of head and neck cancer, treatment of which focuses on functional restoration and quality-of-life (QoL). This study aims to identify risks for poor QoL in ORN reconstruction and build a chronologic, longitudinal framework for QoL. A prospective database of reconstructions performed by the senior author was reviewed from 2015-2023. QoL metrics (University of Washington [UWQoL]v4) were prospectively administered prior to surgery, one year post-operatively, and each yearly follow-up. 56 ORN patients were included (average 58.2years, mean 6,412Gy radiation). Reconstruction commonly was achieved with the fibula(55.4%) and anterolateral-thigh flaps(37.5%). The total complication rate was 23.2%, median 10.7mo post-operatively.Both "health-related QoL in comparison with prior to cancer diagnosis" (62.5 vs 43.5;p=0.030) and "Overall QoL during the past 7-days" (50.5 vs 41.7;p=0.029) were higher post-ORN reconstruction than before. Physical-QoL was higher pre-cancer reconstruction (79.0) than prior to ORN reconstruction (50.6;p<0.001) and following reconstruction (52.5;p=0.001). Social-emotional function was higher following ORN reconstruction compared to pre-reconstruction (68.7 vs 59.6;p=0.010).On multi-variate analysis, both post-operative social-emotional and physical function were impacted by betelnut use (p=0.038;p=0.025). Poor improvement in QoL from pre to post-ORN reconstruction were affected by maxilla involvement (p=0.048), fistula (p=0.004), and hardware issues (p=0.001). Our longitudinal experience trended decline in QoL at ORN diagnosis with gradual improvement following reconstruction, with eventual social-emotional, pain, anxiety, chewing, and global-QoL significantly improved following surgery. Betelnut was a risk factor for poor post-operative QoL. Maxillary involvement, post-op fistula and hardware issues were risks for non-improvement in QoL.

Skills on wheels: caregiver perspectives on the design and long-term impact of a pediatric wheelchair Skills training program.

Manual wheelchair skills training programs are novel developments, particularly in the United States. As perceived by the caregivers of participants, this study aimed to examine the long-term impact of the Skills on Wheels program on participants' occupational engagement and quality of life at home, at school, and in the community. Secondly, this study investigated the caregivers' perspectives of the program design of Skills on Wheels. This was a qualitative inquiry based upon thematic analyses of semi-structured interviews after participation in a pediatric wheelchair skills training program. The study participants were 9 caregivers whose children participated in this program over the 2021 and 2022 implementation years. Caregivers were given a 10-question semi-structured interview. The five overarching topics included program impact: (i) occupational engagement, (ii) program impact: quality of life factors, (iii) program resources/design, (iv) novelty/importance of program/wheelchair skills training, and (v) desired continued wheelchair skills practice in the future. Results provided tangible feedback to integrate into program design and supported the Skills on Wheels program's positive value as it relates to impact on quality of life and occupational engagement for participants.

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.