Quality Of Life In Chinese Patients Research Articles

Psychometric Properties of the Chinese Version of the Functional Assessment of Chronic Illness Therapy - Palliative Care (FACIT-Pal) in Patients With Advanced Cancer

ContextThe Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-Pal) has been widely used in assessing the quality of life (QOL) of patients with life-limiting illness. However, the Chinese version of the FACIT-Pal has not been psychometrically validated yet. ObjectivesThe purpose of this study was to psychometrically validate the FACIT-Pal in Chinese patients with advanced cancer. Methods160 patients with advanced cancer in mainland China participated in this cross-sectional study. The scalability of the instrument was determined by the item-total correlations and the reliability was tested by examining the Cronbach's alpha coefficients. The construct and concurrent validity of the FACIT-Pal were also examined. ResultsThe item-total correlation coefficients ranged from 0.25 to 0.72 (P < .01). Cronbach's alpha coefficient of the Chinese version of the FACIT-Pal was 0.94, ranging from 0.78 to 0.89 for subscales. Confirmatory factor analysis (CFA) results provided support for the measurement structure of the 26-item Functional Assessment of Cancer Therapy-General (FACT-G). Exploratory factor analysis (EFA) of the 19-item palliative care subscale identified five factors accounting for 62.21% of the total variance. Total/subscale scores of the FACIT-Pal were positively correlated with that of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale (FACIT-Sp-12) (r = 0.338–0.811, P < .01), as well as with the Karnofsky Performance Scale (KPS) scores (r = 0.163–0.273, P < .05), except for the correlation between social/family well-being subscale score and KPS score. ConclusionThe Chinese version of the FACIT-Pal demonstrates desirable psychometric properties for evaluating QOL in Chinese patients with advanced cancer.

Fatigue in Chinese Patients With Amyotrophic Lateral Sclerosis: Associated Factors and Impact on Quality of Life.

ObjectivesFatigue was considered as a common symptom in amyotrophic lateral sclerosis (ALS). Previous studies about the impact of fatigue on Quality of Life (QoL) in patients with ALS were limited and inconsistent. Besides, a systematic investigation of fatigue in Chinese patients with ALS was lacking. Therefore, this study aimed to comprehensively evaluate the frequency and associated factors of fatigue and impact on QoL in Chinese patients with ALS.Participants and MethodsProbable and definitive patients with ALS and age- and gender-matched healthy controls (HCs) were consecutively recruited. The frequency of fatigue between both the groups was determined by the Fatigue Severity Scale (FSS). Disease severity, sleep quality, sleepiness, anxiety, depression, and QoL were evaluated in patients with ALS by the ALS Functional Rating Scale-revised (ALSFRS-R) and the ALS Severity Scale (ALSSS), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the McGill Quality of Life Questionnaire (MQOL). Then, clinical characteristics of patients with ALS with fatigue were compared with those without fatigue. Lastly, associated factors of fatigue and impact on QoL in Chinese patients with ALS were assessed.ResultsA total of 175 patients with ALS and 175 HCs were included. Fatigue was significantly more frequent in patients with ALS than in controls (32.6 vs. 17.7%, p = 0.001). Patients with ALS with fatigue scored lower on the ALSFRS-R, the ALSSS [lower extremity (LE) + upper extremity (UE)], the total ALSSS, higher in the HARS, HDRS, PSQI, ESS scores, and a poorer QoL. Daytime dysfunction and the ALSSS (LE + UE) score were associated with a higher risk of fatigue. The ALSSS (LE + UE), the FSS, age, the HARS, and the HDRS score were significantly associated with various aspects of QoL.ConclusionThis study has described fatigue in Chinese patients with ALS and finding daytime dysfunction and the lower ALSSS (LE + UE) were associated with a higher risk of fatigue. Also, we identified an inverse relationship of fatigue intensity with the psychological domain of QoL.

Typology of Family Relationships, Psychological Distress, and Quality of Life in Chinese Patients With Advanced Lung Cancer: A Latent Profile Analysis.

Family relationships affect psychological adjustment and quality of life (QoL) in patients with advanced cancer. The typology of family relationships has not been examined in Chinese patients with advanced cancer. The aims of this study were to identify profiles of family relationships and examine their relationships with psychological distress and QoL in Chinese patients with advanced lung cancer. A total of 252 Chinese patients with advanced lung cancer at 2 hospitals in Shanghai participated in the study. They completed self-reported questionnaires. Latent profile analysis was used to identify the optimal classification of perceived family relationships based on 3 indicators (cohesiveness, expressiveness, and conflict resolution). Three profiles of family relationships were identified. The supportive profile (70.6%) showed high cohesiveness, expressiveness, and conflict resolution. The low-expressive profile (15.9%) showed low expressiveness but high cohesiveness and conflict resolution (15.9%). The conflictive profile (13.5%) showed low conflict resolution but high cohesiveness and expressiveness. Compared with supportive families, low-expressive and conflictive families were associated with worse depressive symptoms and anxiety symptoms, which could result in poorer QoL. Cohesiveness, expressiveness, and conflict resolution could be used to identify family relationship typology in Chinese patients with advanced lung cancer. Family relationship typology was associated with psychological distress and QoL. The findings indicate a need for screening families and provide culturally sensitive family interventions to effectively support families at risk of poor outcomes.

Real-World Effectiveness of Ivabradine in Chinese Patients with Chronic Heart Failure: Interim Analysis of the POSITIVE Study.

BackgroundIvabradine improves cardiac function and clinical outcomes in chronic heart failure (HF) by reducing heart rate (HR), but there is a lack of real-world data on its effectiveness and safety in Chinese patients.MethodsWe designed a prospective, multicenter, observational study of Chinese adults with HF and left ventricular systolic dysfunction, resting HR ≥ 75 beats per minute (bpm), and an indication for ivabradine treatment. An interim analysis was performed using a cut-off date of 31 October 2019. The primary outcome was change in HR at 6 months after the initiation of ivabradine. Secondary endpoints included change in New York Heart Association (NYHA) functional class; quality of life (QoL), measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ); and adverse events (AEs).ResultsOverall, 655 subjects were included in the interim analysis. Mean reduction in HR from baseline was 13.2 (95% confidence interval [CI] 11.2–15.2) bpm at Month 1, and 14.5 (95% CI 11.8–17.2) bpm at Month 6 (p < 0.001 for both changes). NYHA functional class and KCCQ scores improved significantly over time (p < 0.001 for all comparisons with baseline), indicating amelioration of symptoms and better QoL, respectively. Forty-four subjects (6.7%) reported a total of 60 ivabradine-related AEs, most frequently phosphenes and bradycardia (both n = 6, 0.9%).ConclusionTreatment with ivabradine for 6 months effectively reduced HR and improved functional class and QoL in Chinese patients with chronic HF. Treatment was well tolerated.Clinical Trial RegistrationISRCTN11703380; registered on 8 November 2016.

The effects of WeChat-based educational intervention in patients with ankylosing spondylitis: a randomized controlled trial

BackgroundAnkylosing spondylitis (AS), as a common inflammatory rheumatic disease, often causes depression and impaired health-related quality of life (QoL). Although positive effects of patient education have been demonstrated, limited studies explored the benefits of education via mobile applications for AS patients. This study aimed to evaluate the effects of the WeChat-based educational intervention on depression, health-related QoL, and other clinical outcomes in AS patients.MethodsWe conducted a single-blind randomized controlled trial from March to December 2017. Patients were recruited and randomized into the intervention group which received a 12-week WeChat-based educational intervention (consisting of four individual online educational sessions, online educational materials) or the control group receiving standard care. Data was collected at baseline and 12 weeks. Outcomes were measured by Beck Depression Inventory-II, the Medical Outcomes Study Short Form 36-item Health Survey (SF-36), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and visual analog scales.ResultsA total of 118 patients with AS were included and analyzed. Measures at baseline were comparable between groups. After the intervention, the intervention group reported significant higher scores of all domains of SF-36 except for physical functioning and validity, compared with the control group. Additionally, patients in the intervention group had lower depressive symptoms than the control group. No significant difference in other outcomes was observed at 12 weeks.ConclusionsThis study found that the 12-week educational intervention via WeChat had positive effects on reducing depressive symptoms and improving health-related QoL in Chinese patients with AS. We suggest that this intervention can be integrated into current routine care of AS patients.Trial registrationThis study has been approved by the hospital’s ethics committee (ID: 20160364) in 2016 and registered at the Chinese Clinical Trial Registry (registry number: ChiCTR-IPR-16009293).

Symptom clusters and quality of life in Chinese patients with heart failure

BackgroundEffective symptom assessment and management can improve quality of life in patients with heart failure. However, how psychological symptom cluster, physical symptom cluster and heart failure symptom cluster influence the quality of life of patients with heart failure remains unknown. Aims(a) To describe the symptom clusters among Chinese patients with heart failure (HF), (b) explore the relationship between symptom clusters and quality of life (QOL), and (c) detect if physical and psychological symptoms are mediators of the association between heart failure symptom and QOL. MethodsThree hundred and one patients with heart failure completed measures of symptom (MSAS), QOL and demographic and clinical characteristics. Multiple regression analysis was used to analyse the data. FindingsThe mean age of participants was 72.19 years (range 31–96 years). Each patient was approximately accompanied by an average of 11.19 symptoms (range 0–31), and the top six most common symptoms of Chinese HF patients were shortness of breath, difficulty sleeping, difficulty breathing when lying flat, lack of energy, lack of appetite and cough. Both physical symptom cluster and psychological symptom cluster were the mediators of the relationship between heart failure symptom cluster and QOL. ConclusionsThere were mediating effects of physical symptom cluster and psychological symptom cluster between heart failure symptom cluster and QOL in Chinese patients with HF. Operative assessment, management and alleviation of physical symptoms and psychological symptoms should be prioritised in symptom management strategies for the clinical caregivers.

Comparing the effects of depression, anxiety, and comorbidity on quality-of-life, adverse outcomes, and medical expenditure in Chinese patients with acute coronary syndrome.

Background:Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL), adverse outcomes, and medical expenditure in patients with acute coronary syndrome (ACS). However, the relevant data are lacking for Chinese ACS populations, especially regarding different effects of major depression, anxiety, and comorbidity. The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression, anxiety, and comorbidity on QOL, adverse outcomes, and medical expenditure in Chinese patients with ACS.Methods:For this prospective longitudinal study, a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015. Among them, 531 patients (82.1%) completed 12-month follow-ups. Logistic regression model was utilized for analyzing the association of baseline major depression, anxiety, and comorbidity with 12-month all-cause mortality, cardiovascular events, QOL, and health expenditure.Results:During a follow-up period of 12 months, 7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac re-hospitalization. Baseline comorbidity, rather than major depression/anxiety, strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]: 1.77, 95% confidence interval [CI]: 1.22–2.52, P = 0.003). Regarding 12-month non-fatal MI and cardiac re-hospitalization, baseline anxiety (OR: 2.83, 95% CI: 1.33–5.89, P < 0.01; OR: 4.47, 95% CI: 1.50–13.00, P < 0.01), major depression (OR: 2.58, 95% CI: 1.02–6.15, P < 0.05; OR: 5.22, 95% CI: 1.42–17.57, P < 0.03), and comorbidity (OR: 6.33, 95% CI: 2.96–13.79, P < 0.0001, OR: 14.08, 95% CI: 4.99–41.66, P < 0.0001) were all independent predictors, and comorbidity had the highest predictive value. Number of re-hospitalization stay, admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity.Conclusions:Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization. However, comorbidity has the highest predictive value with greater medical expenditure and worse QOL in Chinese patients with ACS. And depression with comorbid anxiety may be a new target of mood status in patients with ACS.

Predicting changes in quality of life and emotional distress in Chinese patients with lung, gastric, and colon-rectal cancer diagnoses: the role of psychological resilience.

Patients with cancer often experience considerable emotional distress, which decreases their quality of life (QOL). Resilience is defined as the psychological characteristics that promote positive adaptation in the face of stress and adversity; however, the relationships among QOL, resilience, and emotional distress in patients with cancer, especially Chinese patients with cancer, are under-researched in the literature. Quality of Life Questionnaire Core 30 items, Zung Self-Rating Anxiety Scale, and the Zung Self-Rating Depression Scale were applied in this study. Univariate correlated analysis and multivariate logistic regression analysis were used to test the associations among resilience, emotional distress, and QOL with a sample of 276 participants. A Sobel test was conducted to determine whether the indirect effect of resilience was significant. The mean ratings of QOL (59.2), resilience (20.8), anxiety (43.1), and depression (47.7) were reported. The correlations between resilience and QOL in patients with lung cancer were significantly increased compared with patients with gastric or colorectal cancer (Spearman coefficient squares of 0.284, 0.189, and 0.227, respectively). The highest quartile of the resilience level was associated with a 64% (odds ratio=0.36, 95% confidence interval=0.17-0.75, P=.006), 70% (odds ratio=0.30, 95% confidence interval=0.14-0.63), and 90% (odds ratio=0.10, 95% confidence interval=0.04-0.26, P<.001) reduction in the risk of emotional distress compared with the lowest quartile. The Sobel test indicated a buffering effect of resilience that was significant for depression (Sobel value=2.002, P=.045) but not anxiety (Sobel value=1.336, P=.182). The present study suggests that psychological resilience is positively associated with QOL and may comprise a robust buffer between depression and QOL in Chinese patients with cancer.

Validity and reliability of the Brief version of Quality of Life in Bipolar Disorder” (Bref QoL.BD) among Chinese bipolar patients

BackgroundPrevious literatures on quality of life (QoL) in bipolar disorder (BD) strongly suggested that a disease-specific QoL measure for patients with BD should be developed to evaluate QoL more specifically and reliably. To our knowledge, “Quality of Life in Bipolar Disorder” (QoL.BD) is the first and only questionnaire produced to specifically measure QoL in people with BD. In China, there is no disease-targeted measure available to specifically measure QoL in Chinese patients with BD. ObjectiveThe aim of the study is to revise and validate the brief version of the QoL.BD (Bref QoL.BD ) into Chinese version. MethodsAll the items of the Bref QoL.BD was translated into Chinese language, using the Brislin translation mode. The questionnaire was administered to a total sample of 231 subjects, including 101 BD patients and 130 healthy controls, to test the psychometric properties of Bref QoL.BD (e.g. internal consistency, retest reliability, content validity, item analysis, confirmatory factor analysis, criterion validity, convergent validity, discriminative validity and feasibility). ResultsThe Chinese version of the Bref QoL.BD had very high internal consistency (Cronbach’s alpha=0.815) and retest reliability (intraclass correlation coefficient (ICC )=0.808). Confirmatory factor analysis (CFA) validated the original one-factor structure. The direction and magnitude of correlations with 36-item Short-Form Health Survey (SF-36; rs= 0.313, P<0.001) and 17-Hamilton Depression Rating Scale(HAMD; rs=−0.328, P <0.001) suggesting the criterion validity and convergent validity, respectively. The scores of Bref QoL.BD in subsyndromic BD group (HDRS≥4 and BRMS≥3), asymptomatic BD group (HDRS≤3 and BRMS≤2) and the control group significantly decreased successively, suggesting a discriminative validity of the instrument. LimitationsCross-sectional design and a small sample size from only one tertiary care center. And BD patients enrolled were euthymic, excluding the acute BD patients. ConclusionsThe Chinese version of the Bref QoL.BD is a feasible, reliable and valid tool for the assessment of QoL for Chinese BD patients.

Validation of the Simplified Chinese Version of the Quality of Life Instrument EORTC QLQ-LC43 for Patients with Lung Cancer

Purpose: To validate the simplified Chinese version of the EORTC QLQ-LC43 for lung cancer patients. Methods: The simplified Chinese version of the QLQ-LC43 was used to measure quality of life (QOL) of 181 in-patients with lung cancer at three time points before and after treatment. Psychometric properties of the instrument were evaluated based on the QOL data collected from the patients using correlation analysis, factor analysis and paired t-test. Results: The test-retest reliability r for most domains was higher than 0.60 with a range from 0.53 to 0.80. The internal consistency α for all domains was higher than 0.65 except for cognitive functioning (0.32). Correlation analysis and factor analysis demonstrated good construct validity. The instrument reflected the differences in QOL scores among different age groups, indicating known-groups validity, and revealed good criterion-related validity when FACT-L was used as the criterion. The instrument detected changes of QOL with higher standardized response mean for the patients before and after treatment. Conclusion: The Chinese version of QLQ-LC43 can be used to measure QOL for Chinese patients with lung cancer with good validity, reliability and responsiveness.

P4-203: The effect of cognitive function and depressive mood on the activity of daily living and quality of life in Chinese elderly patients with Alzheimer’s disease

Patients with Alzheimer's disease (AD) are characterized by cognitive decline and depressive mood, resulting in deterioration of their activity of daily living (ADL) and quality of life (QoL). However, how their ADL and QoL are affected have been greatly ignored and not been emphasized in Hong Kong. To validate the assessment “Chinese Version of Quality of Life in Alzheimer's Disease” (CQoL–AD) and to evaluate the effect of cognitive function and depressive mood on ADL and QoL in Chinese patients with AD. This is a cross–sectional study. 121 Chinese AD patients and their caregivers were recruited from three clinical settings by purposeful sampling. The cognitive function was measured by the Cantonese version of Mini Mental State Examination (CMMSE); the depressive mood was measured by the Chinese version of Geriatric Depressive Scale (CGDS); the ADL was measured by the Chinese version of Disability Assessment for Dementia (DAD) and the QoL was measured by the Chinese version of Quality of Life in Alzheimer's Disease (CQoL–AD). Internal consistency, test–retest reliability and inter–rater reliability of CQoL–AD measure from patient report were 0.917, 0.964 and 0.993 respectively, while those from caregiver report were 0.746, 0.966 and 0.996 respectively. Both CQoL–AD scores from patient and caregiver report were not correlated with CMMSE score but had a moderate negative correlation with the CGDS score (r=–0.668 and r=–0.313 respectively). The mean CQoL–AD scores from both patient and caregiver reports were significantly higher in the non–depressed group (34.2 and 31.0 respectively) than in the depressed group (23.8 and 28.9 respectively). The CDAD score was positively correlated with CMMSE score (r=0.652) and negatively correlated with CGDS score (r=– 0.191). The mean CDAD score was significantly higher for those with mild AD (37.8) than those with severe AD (20.6). The mean CDAD score was significantly higher for those non–depressed AD patients (30.2) than those depressed AD patients (26.9). The CQoL–AD is a promising instrument in Chinese AD patients. AD patients with higher cognitive function and lesser depressive symptoms had better performance of ADL than those with lower cognitive function and greater depressive symptoms.