Different Domains Of Quality Of Life Research Articles

Psychological intervention improves quality of life in patients with early-stage cancer: a systematic review and meta-analysis of randomized clinical trials

The effectiveness of psychological interventions (PI) for malignant diseases is controversial. We aimed to investigate the effect of PI on survival and quality of life (QoL) in patients with cancer. We performed a systematic search of MEDLINE, Cochrane, and Embase databases to identify randomized controlled trials comparing PI to standard care (PROSPERO registration number CRD42021282327). Outcomes were overall survival (OS), recurrence-free survival (RFS), and different domains of QoL. Subgroup analysis was performed based on the provider-, type-, environment-, duration of intervention; cancer stage, and type. Pooled hazard ratios (HR) and standardized mean difference (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. The OS and RFS did not differ significantly between the two groups (OS:HR = 0.97; CI 0.87–1.08; RFS:HR = 0.99; CI 0.84–1.16). However, there was significant improvement in the intervention group in all the analyzed domains of QoL; in the global (SMD = 0.65; CI 0.35–0.94), emotional (SMD = 0.64; CI 0.33–0.95), social (SMD = 0.32; CI 0.13–0.51) and physical (SMD = 0.33; CI 0.05–0.60) domains. The effect of PI on QoL was generally positive immediately, 12 and 24 weeks after intervention, but the effect decreased over time and was no longer found significant at 48 weeks. The results were better in the breast cancer group and early stages of cancer. PIs do not prolong survival, but they significantly improve the QoL of cancer patients. PI should be added as standard of care 3–4 times a year, at least for patients with early-stage cancer.

Quality of life when switching from a vitamin K antagonist to non-vitamin K antagonist oral anticoagulation in frail older patients with atrial fibrillation

Abstract Background Many older patients with atrial fibrillation (AF) are frail, putting them at high risk of adverse outcomes including mortality, hospitalization, functional decline, and dependency on others. In this special population, management strategies – such as anticoagulation for stroke prevention – need special consideration. To what extent the type of anticoagulation influences the quality of life (QoL) in frail patients with AF is unclear. Purpose To assess QoL in frail older patients with AF switching from a vitamin K antagonist (VKA) to a non-VKA oral anticoagulant (NOAC), as compared to patients continuing a VKA. Methods We used data from the FRAIL-AF trial that randomized frail older AF patients between continuing VKA treatment or switching to any NOAC. At baseline, after six months and twelve months of follow-up, QoL was assessed using the EQ-5D-5L questionnaire. For every timepoint, the mean EQ-5D-5L score was calculated with corresponding 95% confidence intervals (CI), missing data were imputed using ten-fold multiple imputation. Absolute differences in EQ-5D-5L score were calculated between patients switching to a NOAC and patients continuing with a VKA, with corresponding 95% CI. The distribution of the scores on each domain of the EQ-5D-5L was compared using a chi-square test. Results In total 661 patients continued VKA treatment, and 663 switched to a NOAC. The median age was 82.2 years (interquartile range (IQR) 78.7 – 86.5), 61.3% were male. Major bleeding or clinically relevant non-major bleeding occurred in 101 patients (17.8 per 100 person-years) switching to NOAC therapy, and 62 patients (10.5 events per 100 person-years) continuing with a VKA (hazard ratio 1.69, 95% confidence interval 1.23 – 2.32). Mortality occurred in 44 and 46 patients, respectively. In 25 patients data was missing. Table 1 shows the mean EQ-5D-5L scores at baseline, at 6 months follow-up and at 12 months follow-up. Scores were similar between patients switching to NOAC treatment or continuing with a VKA and did not change significantly during 12 months follow-up. Table 2 shows the distribution of the scores on all domains of the EQ-5D-5L, with no significant differences between groups. Conclusion Switching from a VKA to a NOAC in frail older patients with AF was associated with an increased risk of bleeding, yet without any effect on overall and different domains of QoL.

An observational, cross-sectional study to assess the quality of life (QoL) of family caregivers of patients diagnosed with cancer

Globally, cancer has a major impact on society, and the burden continues to grow by exerting physical, emotional, and financial strain on patients, families, societies, and healthcare systems. Cancer greatly affects not only patients, but also their families. Family caregivers are invisible to healthcare teams, but play an important role in the recovery of cancer patients. Cancer can worsen a family caregiver’s health, impair social life, increase anxiety, and cause depression. It is important to identify and deal with various domains affected by cancer to enhance the quality of life (QoL) of family caregivers. This is a prospective, observational, cross-sectional, questionnaire-based study, to assess the impact of cancer on the quality of life of family caregivers. The primary objective is to measure the effect of cancer diagnosis and its treatment on family caregivers’ quality of life using the CarGOQoL (CareGiver Oncology Quality of Life) questionnaire. The secondary objective is to determine the relationship between quality of life, socio-demographic variables, and cancer disease variables. Family caregivers who are associated with the care of cancer patients for at least two–three hours a day will be recruited in the study after signing the voluntary informed consent form. The CarGOQoL questionnaire will be used to record the responses from the participants. Domains such as psychological well-being, burden, relationship with healthcare, administration and finances, coping, physical well-being, self-esteem, leisure, social support, and private life will be recorded. Approximately 100 participants will be recruited for the study. Data analysis will be performed at the end of participant recruitment. Healthcare and social workers can enhance the quality of life of family caregivers by using the results of the CarGOQoL questionnaire, and better understand the different domains of QoL impacted by cancer.

Hemodialysis-induced chronodisruption and chronotype distribution in patients with chronic kidney disease

ABSTRACT Changes in circadian rhythms have been observed in patients with chronic kidney disease (CKD), and evidence suggests that these changes can have a negative impact on health. This study aimed to investigate the existence of hemodialysis-induced chronodisruption, the chronotype distribution, and their association with sleep quality and quality of life (QoL). This was a cross-sectional study that enrolled 165 patients (mean age: 51.1 ± 12.5 y, 60.6% male) undergoing hemodialysis from three local units. The following instruments were used: the Morning-Eveningness Questionnaire (MEQ); a modified version of the Munich Chronotype Questionnaire (MCQT) to estimate hemodialysis-induced chronodisruption (HIC); the Kidney Disease QoL Short Form (KDQOL-SF); the Epworth Sleepiness Scale (ESS); the Pittsburgh Sleep Quality Index (PSQI) and the 10–Cognitive Screener (10-CS). HIC was present in 40.6% of CKD patients. Morning chronotype was prevalent in CKD patients (69%) compared to evening-type (17.1%) and significantly different from a paired sample from the general population (p < 0.001). HIC and chronotype were associated with different domains of QoL but not with sleep quality. This study suggests that there is a HIC and that morning chronotype is associated with CKD patients undergoing hemodialysis, with implications for QoL.

Translation and validation of Cerebral Palsy Quality of Life Questionnaire-Teen in Hong Kong Chinese population [CP QoL-Teen (HK)

Cerebral palsy (CP) is an early onset, non-progressive, neuromotor disorder. Adolescence is the transition from childhood to adulthood when changes in physical and emotional aspects and self-perception occur further imposing an impact to quality of life (QoL) in individuals with CP. Cerebral Palsy Quality of Life (CP QoL) Teen is a questionnaire examining different domains of QoL for adolescents with CP. This study is aimed at translating and validating self-report and proxy-report CP QoL-Teen (HK). Prior approval of translation has been obtained. Forward and backward translations were performed following standardized translation procedures. Participants and their caregivers were asked to complete self-report and proxy-report CP QoL-Teen (HK), and Child Health Questionnaire (CHQ). Internal consistency and test–retest reliability were assessed by Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively. Concurrent validity was evaluated by Spearman’s rank correlation between subscales of CP QoL-Teen (HK) and CHQ as well as expanded and revised version of Gross Motor Function Classification System (GMFCS-E&R). Ninety-six participants completed the study. Of these, twenty participants completed CP QoL-Teen (HK) twice. Cronbach’s α of CP QoL-Teen (HK) ranged from 0.84 to 0.95 suggesting excellent internal consistency. Moderate to excellent test–retest reliability were demonstrated in all subscales of CP QoL-Teen (HK) (self-report: ICC = 0.46–0.8; proxy-report: ICC = 0.40–0.72, p < 0.05). Weak to moderate association between subscales of CP QoL-Teen (HK) and CHQ (self-report: rs = 0.24–0.61; proxy-report: rs = − 0.41–0.60) was reported.Conclusion: This study showed that CP QoL-Teen (HK) has good psychometric properties. It is a valid and reliable tool to assess quality of life of adolescents with CP.What is Known:• Cerebral Palsy Quality of life-Teen (CP QoL-Teen) is a validated tool with strong psychometric properties and clinical utility in gauging the QoL in adolescents with CP during their transition from childhood to adulthood when changes in physical and emotional aspects and self-perception occur. Yet, a locally validated tool is lacking in measuring the QoL for adolescents with CP in Hong Kong.What is New:• The Chinese translated version CP QoL-Teen (HK) is a valid and reliable tool to assess quality of life of adolescents with CP tailoring to the local cultural and social background with good psychometric properties being demonstrated.

A Comparison of Quality of Life, Medication Side-Effect and Adherence among Schizophrenia Patients on Conventional versus Atypical Antipsychotics

Quality of life (QoL) is becoming a widely accepted schizophrenia management outcome. But it is still not very clear if there are any significant differences between the conventional and atypical antipsychotics in terms of QoL improvement among people with schizophrenia (PWS). It is also imperative that antipsychotic drug-related factors, such as medication adherence and side-effect, which could directly or indirectly affect the QoL of PWS, are determined and compared among PWS on different classes of the drugs. Data were collected on Socio-demographic Characteristics, Quality of Life and Medication adherence using Socio-demographic and Schizophrenia Clinical Characteristics questionnaire, World Health Organization Quality of Life (WHOQoL)-Brief, and Morisky Medication Adherence Scale (MMAS) respectively from 250 respondents attending a tertiary health center’s Psychiatric clinic in Kano, Nigeria. Although PWS on the two classes of antipsychotic drugs showed inequalities in different aspects and domains of QoL, as well as in the levels of adherence and side-effects, the differences were all insignificant. However, presence of drug side effects was significantly associated with lower health-related QoL in the conventional antipsychotics group (p = 0.001), and lower score in the physical domain of QoL in the atypical antipsychotics group (p = 0.044). Medication adherence was found to be associated with better scores in different domains of QoL in both groups of PWS. There are no significant differences in terms of QoL, medication side-effect and adherence among PWS on the two classes of antipsychotics. However, drug side-effects and adherence were significantly and respectively associated with lower and higher scores in different domains of QoL in both groups.

A cross sectional study on quality of life of PLHIV and their psychosocial correlates at tertiary care hospital, Lucknow

Background: People living with HIV/AIDS (PLHIV) are prone to psychological illnesses. HIV/AIDS, not only affects physical health but also emotional and mental health, which affects quality of life (QoL). The aim of present study was to assess the psychosocial variables affecting QoL of PLHIV.Methods: A cross sectional study was done at ART plus centre of a tertiary care hospital of Lucknow, among PLHIV. The questionnaire contained details of the socio-demographic, clinical characteristics, QoL and psychosocial factors including stress, depression, anxiety, stigma, coping and self-transcendence. To see any significant correlation Pearson’s correlation was used to identify relationship between different domains of QoL and psychosocial factors associated with PLHIV. Logistic regression was also used to identify predictors of QoL by using SPSS version 23.0.Results: QoL was rated as poor by 12.2% of the study subjects and 14.6% were dissatisfied with their overall health status. QoL score was highest in “physical health” and “level of independence” domain and the minimum mean score was in “psychological” domain. All the domains of QoL were found to be positively correlated with ‘self-transcendence’ and negatively correlated with ‘stress, depression, anxiety and internalized stigma’.Conclusions: Self-transcendence act as a healing role to improve QoL while depression, stress and anxiety negatively associated with QoL.

Quality of life and disability: a study on bipolar disorder patients in remission

Background: Throughout the world bipolar disorder is one of the leading causes of mental disability. But there are only few literature studies found on quality of life (QoL) and disability of patients with bipolar disorder. The study aims to assess inter-relationship between QoL and disability of patients with bipolar I disorder in remission and to assess the pathways of help seeking behaviors by the family members of bipolar I disorder patients.Methods: This study involves non-experimental research design with purposive sampling method. A total of 62 participants from clinical group (outpatient department of mental health institute (Centre of excellence), S. C. B. medical college) and 48 participants from matched healthy control group included. World health organization quality of life assessment (WHO-QoL) Bref Odia version and WHO disability assessment schedule (WHO DAS) 2.0 used.Results: Statistically significant differences (p&lt;0.05) were found in all the four domains of QoL. Statistically significant differences (p&lt;0.05) were found in cognition, mobility, life activity and participation in society domains of WHO DAS. There were significant negative correlations found in different domains of QoL and disability. A majority of family members consulted mental health professionals directly as the first modality of treatment.Conclusions: Both the QoL and mental disability burden are equally affected in chronic suffers of bipolar I disorder, which requires mental health intervention at earliest as possible.

Associations of Physical Activity and Handgrip Strength with Different Domains of Quality of Life in Pediatric Cancer Survivors.

Simple SummaryPhysical activity has been targeted as a leading priority for health promotion in pediatric survivorship care. It is unclear whether regular physical activity can enhance the quality of life among Chinese pediatric cancer survivors. We researched this question in our study of 191 survivors of pediatric cancer. We found that the survivors who engaged in higher levels of physical activity reported higher scores across all domains of quality of life (i.e., physical, emotional, social, and school functioning). We also observed that the survivors with higher PA levels exhibited greater handgrip strength than the survivors with lower PA levels. Notably, the survivors with greater handgrip strength also had better physical and emotional functioning.There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA level and HGS are associated with higher scores in different QoL domains (i.e., physical, emotional, social, and school functioning) in pediatric cancer survivors. PA was assessed with a validated self-reported PA rating scale. In total, 191 Chinese pediatric cancer survivors aged 9 to 16 years were included in the analysis. Results showed that engaging in a higher level of PA was significantly associated with improved QoL in different domains, including physical (β = 0.543, p < 0.001), emotional (β = 0.449, p < 0.001), social (β = 0.434, p < 0.001), and school functioning (β = 0.407, p < 0.001). Greater HGS was also associated with better physical (β = 0.230, p ≤ 0.001) and emotional (β = 0.261, p ≤ 0.001) functioning. Findings from this study provide evidence of the significant beneficial impact of regular PA on pediatric cancer survivors’ QoL along their survivorship trajectory.

Assessing the Quality of Life of Parents of Children With Disabilities Using WHOQoL BREF During COVID-19 Pandemic.

Background: Caring for a child with disabilities is a challenging journey, as the parents must meet greater demands when compared with the parents of children without disabilities. Looking after a child with disablities requires additional financial, social, emotional, and physical resources. Coronavirus 2019 (COVID-19) pandemic has made this even more challenging and impacted the quality of life of parents of children with disabilities.Methods: The study was an analytical cross-sectional design with two comparison groups: parents of children with developmental disabilities and parents of children without disabilities. The Urdu version of the WHO Quality of Life Measure Abbreviated version (WHOQOL-BREF) was used to measure the quality of life (QoL) among parents. Sociodemographic data were also obtained from the parents.Results: Parents of children with disabilities had lower overall scores when different domains of QoL were considered (physical health, psychological health, social relationships, and environment) using WHOQoL-BREF. Statistically significant differences were observed in the physical and environmental domains of parental QoL.

Prognostic Impact of Pretransplantation Quality of Life and Its Post-Transplantation Longitudinal Change after Allogeneic Hematopoietic Cell Transplantation: A Prospective Study That Administered the Short-Form Health Survey (SF-12) and EuroQol 5

In allogeneic hematopoietic cell transplantation (allo-HCT), investigator-based clinical variables have been used for pretransplantation prognostic prediction, risk adjustment, and post-transplantation long-term screenings. Although several studies have investigated the prognostic significance of pretransplantation patient-reported outcomes (PROs) and longitudinal trends in PROs after allo-HCT, few have assessed these outcomes using the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and EuroQol 5 Dimension (EQ-5D) index. The present study used 18 items from the SF-12 and EQ-5D index to evaluate the prognostic impact of pretransplantation quality of life (QOL) on allo-HCT outcomes and longitudinal changes in QOL in allo-HCT recipients. This single-center prospective study included consecutive patients who underwent allo-HCT at our center between October 2014 and September 2016. All participants were followed up until October 2017. The SF-12 and EQ-5D index were administered to assess patient-reported QOL before allo-HCT and at 3 months, 6 months, 1 year, and 2 years after allo-HCT when participants visited the long-term follow-up clinic. Longitudinal trends in the QOL-adjusted means were estimated using linear mixed-effects, adjusting for pretransplantation covariates and reasons for missing QOL data. Among 157 patients who underwent allo-HCT, 145 (92%) were registered in this study, and 143 with available QOL data were analyzed. The median pretransplantation scores were 45.3 for the SF-12 physical component score (PCS), 55.6 for the mental component score (MCS), 38.8 for the role/social component score (RCS), 70.0 for the visual analog scale (VAS), and 49.0 for the EQ-5D index. Overall survival (OS) was significantly improved in patients with higher pretransplantation scores on the PCS, RCS, and EQ-5D index, and multivariable analyses showed that the median pretransplantation RCS was significantly associated with OS after allo-HCT (hazard ratio, 3.66; P=.003). The longitudinal trends in the SF-12 score showed that the PCS was improved at 2 years after allo-HCT and was comparable to the normative score for the general population. The MCS remained comparable to or higher than the normative score after allo-HCT. The RCS improved significantly beginning at 6 months after allo-HCT but remained lower than the normative score at 2 years. The VAS and EQ-5D index values showed a drop at 3 months after allo-HCT. Patient-reported QOL assessed by 18 questions on the SF-12 and EQ-5D predicted prognosis, and may be used as a prognosticator to determine treatment strategies, including preparative regimens. Although we experienced a certain amount of patient attrition in the longitudinal follow-up of QOL data, we demonstrated characteristic trajectories of QOL in different domains after adjusting for background covariates and reasons for the lack of QOL data.

Genetic polymorphisms and haplotypes of ERCC1 and ERCC2 associated with quality of life, depression, and anxiety status among patients with lung cancer

BackgroundPatients with lung cancer (LC) have a poor quality of life (QoL) and easily suffer from psychological diseases. Previous studies focused less on the relationship between genetic factors and QoL, depression, and anxiety status in LC patients. The current study is intended to explore the relationship between SNPs and haplotypes of ERCC1 and ERCC2 and the QoL, depression and anxiety status of patients with LC.MethodsQoL, depression and anxiety status were assessed in 291 LC patients using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30), EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13), SDS and SAS. Nine tag SNPs of ERCC1 and ERCC2 were detected using an improved multiplex ligation detection reaction (iMLDR) technique. Haplotype analysis was conducted using the software Haploview 4.2. The association between SNPs or haplotypes and QoL or depression or anxiety in LC patients was analyzed by regression analysis.ResultsERCC1 rs11615 was associated with emotional functioning (P = 0.027), and ERCC1 rs3212986 was associated with anxiety scores (P = 0.018). ERCC1 rs762562-rs3212986 haplotype was associated with cognitive function (P = 0.029), somatic function (P = 0.014) and dysphagia (OR = 3.32, P = 0.044). Patients with ERCC1 rs3212986-rs11615 AG haplotype had worse cognitive function (adjusted Beta = − 5.42) and somatic function (adjusted Beta = − 6.55) and had severer symptoms of loss of appetite (adjusted OR = 1.67) and dysphagia (adjusted OR = 4.43) (All adjusted P < 0.05). ERCC2 rs13181-rs3916874-rs238416 haplotype was associated with emotional functioning (P = 0.035), pain at other sites (OR 1.88, P = 0.014), chest pain (OR 0.42, P = 0.02), dysphagia (OR 2.82, P = 0.048), and anxiety status (OR 0.23, P = 0.009).ConclusionAfter adjustment for environmental factors, SNPs and haplotypes of ERCC1 and ERCC2 were associated with different domains of QoL, depression and anxiety in LC patients.

Health Related Quality of life of Diabetic and Non-Diabetic Elderly in a Municipality of Central Nepal

Background: Quality of life (QoL) is the perception of an individual about their position in life. Chronic diseases such as diabetes are said to have influence on QoL. Health condition changes with increased age and chronic disease condition. This study aimed to assess Health-Related QoL of diabetic and non-diabetic elderly.&#x0D; Method: A community based cross-sectional study was conducted among 167 elderly in Gaindakot municipality of Nawalpur, Nepal. Health related QoL was assessed using World Health Organization QoL Instrument scale. Data was analyzed using descriptive as well as inferential statistics.&#x0D; Results: Among the diabetic respondents, highest mean score was obtained in social relationship (68.76), whereas environmental health (69.02) holds highest mean score among non-diabetic. Non-diabetics were in better position in terms of both psychological (63.23 vs 55.77) and physical health (62.23 vs 57.15) than diabetics. Overall QoL and overall health perception were found to be significantly correlated with all domains of QoL at (p&lt;0.05) and (p&lt;0.01) respectively among diabetics. Age group, gender, educational status, marital status and employment status were found to be statistically associated with different domains of QoL in both groups but caste, family type smoking and alcohol intake didn’t show any association with any of the domain of QoL in both groups.&#x0D; Conclusion: Three domains of Health Related QoL (physical, psychological and environmental health) except social relationship were better among non-diabetic compared to that of diabetic respondents. Preventing diabetes and focusing on physical, psychological and environmental health of diabetics are required for a healthy elderly life.

ASSESSMENT OF WHOQOL BREF DOMAINS AND ANTIHYPERTENSIVES PRESCRIPTION PATTERN IN HEMODIALYSIS PATIENTS

Background: ESRD is considered as an important cause of mortality worldwide. Patients with CKD on Hemodialysis treatment is very complex requires additional importance in prescribing antihypertensives and also patients on Hemodialysis have effects on functional state and quality of life (QOL). Objectives: The study aimed to assess prescribing pattern of antihypertensives and to demonstrate QOL in different domains of patients with ESRD underdoing hemodialysis. Materials and Methods: Study comprised of 85 patients with ESRD under hemodialysis conducted in multi-speciality hospital between September 2019 to February 2020.The data was collected from the records and by interviewing patients. Results: The mean age of the study population was 54.76±14.32, 72% were males, hypertension is the common cause of ESRD. Calcium channel blockers are the most commonly prescribed drugs followed by alpha blockers, diuretics, beta blockers, vasodilators etc. Comparing the four domains of ESRD patients, environmental domain was the highest with a mean score of 64.56±19.86while the physical health domain was the lowest with a mean score of55.6±12.60. Conclusion: Calcium channel blockers and alpha blockers are most commonly prescribed antihypertensives. The four domains were signicantly and positively interrelated with moderate to strong relationships

Impact of Moringa Oleifera leaves supplementation on quality of life of people living with HIV: A double-blind randomized controlled trial.

Advances in antiretroviral therapy (ART) and increased interest on nutritional interventions have led to improvements in life expectancy of people living with HIV (PLHIV). These have led to greater emphasis on their quality of life (QoL). This study was aimed at exploring the effects of Moringa oleifera leaves supplementation on QoL of HIV-positive adults in Nigeria. A double-blind randomized controlled trial was conducted to determine the six months' impact of consuming Moringa oleifera leaves powder as a nutritional supplement on the different domains of QoL of PLHIV that are on ART. Two hundred consented patients were randomly allocated to either Moringa Oleifera group (MOG) or control group (COG). The WHOQOL-HIV-BREF was used to assess QoL at baseline and at six-month follow-up. One hundred and seventy seven patients completed the study. At six-month follow-up, a significant (p < 0.05) increase in the mean scores of all the six domains of QoL was observed in the MOG. However, in the COG, a significant increase was observed in the social relationship, environment, and spirituality/religion/personal beliefs domains. The comparison between the MOG and COG at 6months' follow-up showed a significant mean score difference in the MOG in the physical, psychological, level of independence, and social relationships domains of QoL. This study shows that supplementation with Moringa oleifera leaves for PLHIV that are on ART improves the QoL domains of physical, psychological, level of independence, and social relationships. Clinical Trial Registry registration number: PACTR201811722056449.

Clinical Outcome, Cognitive Function, and Quality of Life after Endoscopic Third Ventriculostomy versus Ventriculo-Peritoneal Shunt in Non-Tumor Hydrocephalus.

Endoscopic Third Ventriculostomy (ETV) is increasingly being accepted as the treatment of choice in place of Ventriculo-Peritoneal (VP) Shunt for hydrocephalus. However, their differences in cognitive and Quality of Life (QOL) scores have not been studied much in children. To compare the outcome, cognitive function, and QOL between ETV and VP shunt. Patients of non-tumor hydrocephalus treated with ETV or/and VP shunt underwent cognitive assessment (using modified child MMSE standardized as per the age group) and QOL (using PedsQL as per the age group in Physical, Emotional, Social, and School Functioning domains) in addition to the outcome of not requiring additional intervention. Out of 139 patients, there were 29 infants and 40 children upto 14 years. Among these children, ETV was the primary intervention in 45, VP shunt in 24, and could be studied for a mean follow-up of 1.7 years. Though ETV required lesser additional intervention than VP shunt (19.2% vs. 28.6%) in toddlers and older children, there was no overall significant difference. Subnormal cognitive scores were noted in 25%, 40%, and 50% after ETV, single shunt procedure, and multiple shunt procedures, respectively, with no statistically significant difference. Among the different domains of QOL, the child reported scores in the social domain were significantly better after ETV than VP shunt (475[+13] vs. 387[+43], P value 0.03), whereas most other scores were non-significantly better following ETV. Patients who underwent ETV show a trend for better clinical outcome, cognitive function, and QOL with significantly better child-reported QOL scores in the social domain.

Quality of Life in Patients With Methamphetamine Use Disorder: Relationship to Impulsivity and Drug Use Characteristics.

BackgroundThe quality of life (QOL) of patients with methamphetamine use disorder (MAUD) is increasingly recognized as an important outcome. Previous studies have found that impulsivity is negatively associated with QOL in mental disorders, but this relationship is rarely confirmed in patients with MAUD. We hypothesized that impulsivity is negatively correlated with QOL in patients with MAUD based on previous findings. In addition, a variety of drug use characteristics of patients that may potentially affect their QOL need to be further explored. Therefore, the purpose of this study was to explore the relationship between impulsivity, multiple drug use characteristics, and QOL in patients with MAUD.MethodsA total of 379 patients with MAUD were recruited, and the majority of them were male (85.5%), with an average age of 33.93 ± 7.08 years. Two psychiatrists conducted semi-structured interviews with methamphetamine (MA) users in two compulsory drug rehabilitation centers to obtain their demographics and drug use characteristics. The Barratt Impulsiveness Scale-11 (BIS-11) and Brief WHO Quality of Life Assessment (WHOQOL-BREF) were used to assess patients’ impulsivity and QOL, respectively. Correlation and univariate regression analysis were used to explore the relationships between impulsivity, a series of drug use characteristics and patients’ QOL in different domains. Further multiple linear regression analysis was used to identify what extent the above clinical variables explained the variations in patients’ QOL.ResultsAge, marital status, employment, and various drug use characteristics were significantly associated with at least one QOL domain. Among them, married and full-time job were positively correlated with QOL, while others were negatively correlated with QOL. The total score of BIS-11 was significantly negatively correlated with all four domains of QOL. Impulsivity, a range of drug use characteristics and certain demographic characteristics collectively explained varying degrees of variation in different domains of QOL.ConclusionsImpulsivity and various drug use characteristics can significantly predict QOL in all fields of MAUD patients. In addition, we have also found differences in the predictors of QOL in different domains. Overall, this study provides clinical guidance for the treatment of MAUD patients, that is, management of impulsivity in patients with MAUD may help improve their QOL and even sustain their drug rehabilitation.

Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

Background and objectiveA limited number of studies have evaluated the effects of oral contraceptives (OCs) on the quality of life (QOL) of polycystic ovary syndrome (PCOS) patients. This study aimed to compare the effects of using OCs containing levonorgestrel (LNG) and those containing desogestrel (DSG), cyproterone acetate (CPA) or drospirenone (DRSP) for 6 months on the QOL with PCOS.MethodsIn this crossover randomized controlled 6-arm trial, 200 eligible patients with PCOS scheduled for OC therapy were randomly assigned to one of the 6 study arms. All 6 arms include two 6-month treatment periods, one period with OCs containing LNG, and the other with each of the 3 OCs containing DSG, CPA, or DRSP. Outcomes of interest were the total score of QOL and its domains, which were assessed using a specific and valid health-related quality of life questionnaire for PCOS, which is consisted of six domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity– menstrual disorders.ResultsFinally, a total of 88 patients were analyzed for this study. The results showed that use of OCs containing DSG, CPA, and DRSP for 3 months was not associated with significant differences in the total scores of QOL compared to those OCs containing LNG, whereas, after 6 months of treatment, patients treated with OCs containing CPA had more improvements in their total scores of QOL, in comparison to OCs containing LNG (P < 0.042). We found no significant differences in QoL domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders after 3–6 months of treatment with DSG, CPA, or DRSP, compared to LNG. The sequence and period effects were not significant in any of the analyses at 3 and 6 months of treatment. The carry-over effect was not significant for most outcomes assessed.ConclusionsThis crossover study demonstrated non-inferiority of OCs with newer generation progestins on different domains of QOL, in comparison with older compounds, although usage of products containing CPA was significantly associated with more improvement in total QOL of PCOS patients, compared to those containing LNG after 6-month of treatment.Trial registrationIRCT201702071281N2.

Effect of Exercise on Quality of Life in Parkinson's Disease: A Systematic Review and Meta-Analysis.

Background Exercise has an integral impact on the physical and mental wellbeing of patients with Parkinson's disease (PD), yet no comprehensive and quantitative analysis has been conducted on the effect of exercise on quality of life (QoL) in these patients. This study aimed to evaluate the effect of exercise on overall QoL and different domains of QoL in people with PD, as well as investigating the influence of factors such as the exercise type and intervention period. Methods Databases, such as PubMed, Embase, and Cochrane Central Register of Controlled Trials, were searched since inception to August 14, 2018 to identify randomized controlled trials that compare the effect of exercise versus no intervention on QoL in PD patients. Following the subgroup analysis, heterogeneity was further explored. The quality of eligible studies was assessed according to PRISMA guidelines. Results 20 studies were included with 1,143 participants in total. A meta-analysis showed a significant improvement in QoL after exercise intervention in PD patients (SMD = −0.24, 95% CI = −0.36 to −0.12, P < 0.001). A subgroup analysis of exercise types revealed significant QoL improvement with aerobic exercise, martial arts, and dance, but not anaerobic exercise and combined exercise. Interventions lasting 12 weeks or longer improved QoL significantly. Conclusions Exercise interventions, especially aerobic exercise, dance, and Tai Chi, significantly improve QoL in PD patients. At least 12 weeks of exercise is needed to bring about significant benefits.

Subjective Quality of Life and Its Associations among First Episode Psychosis Patients in Singapore.

Background—Mental disorders have been found to affect quality of life (QOL) in patients. The current study aimed to determine QOL among first episode psychosis (FEP) patients and explore its associations with sociodemographic as well as clinical factors. Methods—Data for this study were collected as a part of an Early Psychosis Intervention Program (EPIP)-Smoking and Alcohol use survey. At baseline, 280 outpatients aged 15–40 years old diagnosed with FEP, with no prior or minimal treatment, no history of medical or neurological disorder, and no history of substance abuse, were recruited. Sociodemographic details, diagnosis, length of duration of untreated psychosis (DUP), and World Health Organization Quality of Life assessment—abbreviated version (WHOQOL-BREF) scores were obtained. Results—After adjusting for all covariates, older age (p = 0.036), females, and participants diagnosed with brief psychotic disorder (p = 0.04) were associated positively, whereas separated/divorced participants, those with lower education, unemployed (p = 0.01), and longer DUP were seen to be negatively associated with different domains of QOL. Conclusion—Higher WHOQOL-BREF scores denote better QOL. Overall, female participants as compared to male participants and those diagnosed with brief psychotic disorder in this sample reported better QOL.