Different Domains Of Quality Of Life Research Articles

Patient-reported cosmetic satisfaction and the long-term association with quality of life in irradiated breast cancer patients

PurposeTo evaluate patient-reported cosmetic satisfaction in women treated with radiation therapy for breast cancer and to determine the association between dissatisfaction and quality of life (QoL) and depression.MethodsWithin the prospective UMBRELLA breast cancer cohort, all patients ≥ 1 year after breast conserving treatment or mastectomy with immediate reconstruction were selected. Self-reported cosmetic satisfaction was measured on a 5-point Likert scale. QoL, social functioning, and emotional functioning were measured using EORTC QLQ-C30 and BR23 at 1, 2, and 3 years after inclusion. Mixed model analysis was performed to assess the difference in different domains of QoL between patients with good versus poor self-reported cosmetic satisfaction over time after adjustment for potential confounders. Depression scores were collected by means of the HADS-NL questionnaire. Chi-square test or Fisher's exact test was used to assess the difference in proportions of HADS score ≥ 8, indicating increased depression risk, between satisfied and dissatisfied patients.Results808 patients were selected for analysis. Respectively one, two, and three years after surgery, 8% (63/808), 7% (45/626), and 8% (31/409) of patients were dissatisfied with their cosmetic outcome. Poor patient-reported cosmetic satisfaction was independently associated with impaired QoL, body image, and lower emotional and social functioning. Scores ≥ 8 on the HADS depression subscale were significantly more common in dissatisfied patients.ConclusionsDissatisfaction with cosmetic outcome was low after breast cancer surgery followed by radiation therapy during 3 years follow-up. Knowing the association between dissatisfaction with cosmetic outcome and QoL and depression could help to improve the preoperative counseling of breast cancer patients.

Association between suffering experiences from precollege peer bullying at different stages and the quality of health-related life among college students

Objective: To explore the effects of precollege peer bullying at different stages, on quality of life (QOL) among college students. Methods: A stratified cluster sampling method was used to select participants in October, 2018. Cluster sampling method was adopted to recruit a sample of 4 034 college students from four universities in Hefei city, Anhui province. Relations between peer bullying at different stages before entering college, and the quality of life, were investigated. t test and analysis of variance were used to compare the differences of QOL in different groups. Multiple linear regression models were used to assess the associations between various types of peer bullying at different stages and the QOL at precollege days. Results: Among all the 4 034 college students under study, mean scores of the 4 dimensions of QOL appeared as physical (12.61±2.02), psychological (14.09±2.62), social relationship (13.72±2.71) and environment (13.77±2.46), respectively. After adjusting the confounding factors, data from multiple linear regression showed that, factors as verbal bullying victimization during primary school (β=-0.21)/secondary school (β=-0.27)/or at both periods (β=-0.56), relational (β=-0.21) and physical (β=-0.38) bullying victimization in secondary school, and physical bullying victimization in both periods (β=-0.67) were negatively correlated with the physical dimension of QOL. Verbal bullying victimization in both periods (β=-0.41) and relational bullying victimization in secondary school (β=-0.42) were negatively correlated with psychological dimension of QOL. Factors as relational (β=-0.32) and physical (β=-0.51) bullying victimization in secondary school, physical/cyber bullying victimization in both periods (β=-0.57) were negatively correlated with the social dimension of QOL. Verbal bullying victimization during primary school (β=-0.20) and both periods (β=-0.46), relational bullying perpetration during primary school (β=-0.35) or at both periods (β=-0.90) were negatively correlated with the environmental dimension of QOL (All P<0.05). Index related to bullying victimization (β=-0.33, -0.36, -0.30, -0.33) and bullying perpetration β=-0.28, -0.31, -0.23, -0.28) were both negatively correlated to all the 4 dimensions (physical, psychological, social relationship and environment) of QOL (P<0.001). Conclusions: Various forms of peer bullying experiences occurring before college, were associated with the decreased scores of QOL in different domains, among the university students. Programs on prevention and control of peer bullying in different stages before college days seemed important thus should be strengthened.

PROutine: a feasibility study assessing surveillance of electronic patient reported outcomes and adherence via smartphone app in advanced cancer.

In advanced cancer, quality of life (QoL) is a major treatment goal. In order to achieve this, the identification of suffering by screening for patient-reported-outcomes (PROs, i.e., symptoms) is of utmost importance. The use of paper-pencil questionnaires is associated with significant shortcomings due to missing data, recall bias and transcription errors. Other than that, the electronic recording of PROs by mobile Health (mHealth) offers a number of advantages. The aim of this study was to test whether the routine assessment of PROs via a newly developed smartphone application (MeQoL®) is feasible. A prospective, uncontrolled, multi-center, feasibility trial was performed in adult outpatients with advanced, solid cancer. Patients under anti-cancer therapy and with regular outpatient visits were eligible. Patients daily recorded the degree of perceived distress (NCCN Distress Thermometer®), pain intensity {average and worst [numerical rating scale (NRS), 0-10]}, the number of breakthrough pain episodes (BPE) and ten questions from a modified version of the Edmonton Symptom Assessment Scale (ESAS). Weekly, five questions concerning different domains of QoL from the short-form 8 (SF-8) questionnaire were obtained. Also, patients recorded the intake of their opioid rescue medication. According to the main scope of the trial (feasibility), no primary endpoint was defined. Rather, the following main feasibility criteria were assessed: missing data, drop-out- and acceptance-rate, patient satisfaction, patients' judgement of practicability, patients' and physicians' suggestions for improvement and basic clinical and demographic data of the participating patients. The study was registered in the German Clinical Trials Register (ID: DRKS00008761). In three German cancer centers, 40 patients {female: 28 (70%); average age, 57 years [range, 27-73 years; standard deviation (SD), 12]} were included. As three devices were lost on transport, 37 devices could be evaluated. The median investigation period per device was 99.5 days (SD, 31). Patient adherence in using the smartphone app to document their distress and symptoms was high and missing data were low: In median daily reviews were performed on 70 (SD, 29) of these days (70%) and median weekly recordings were 13 weeks (87%). Most often, patients recorded symptom intensity (89%, MIDOS) and distress (85%, NCCN thermometer). On feedback forms, patients reported a good to very good user friendliness of MeQoL® and a high motivation to use this tool again. Even though participants were asked to record PROs rather frequently (daily), missing data were low and patient satisfaction was high. Having in mind the findings of other working groups, such routine implementation of mHealth solutions may substantially improve outcomes of cancer therapy and increase the value of trials' findings. For the individual patient, MeQoL® allows for monitoring adherence to pharmacotherapy and can facilitate patient guidance.

Abstract P3-03-25: Quality of life and cost-effectiveness in patients undergoing level I versus level II and III axillary lymph node dissection for breast cancer: A double blind randomised controlled trial with non-inferiority hypothesis

Abstract Background: Asian patients present with advanced breast cancer, necessitating full, level III axillary lymph node dissection (ALND). Full axillary dissection is associated with complications like seroma, surgical site infection, shoulder dysmobility and lymphedema. These complications lead to impaired activities of daily life and poor quality of life (QOL). Management of these morbidities escalates the cost of care. We designed this trial to ascertain and compare the quality of life and cumulative incidence and severity of complications of patients undergoing a level I vs level III axillary dissection. Methods: In this two-group parallel design randomized trial with non-inferiority hypothesis, 70 patients were randomized. Patients were scheduled for level I axillary clearance. Those with no palpable nodes in the remaining axilla after level I clearance were randomized in OR to receive either complete ALND(level II,III clearance) or limit to level I only. Patients were followed for 3 months postoperatively(week 1,2,3,12). Baseline and postoperative quality of life scores calculated by EORTC-QLQ-C30 and BR23 module were compared between the two groups. Indirect cost for patients in each group was calculated based on the duration of OR time consumed and direct costs included the expenditure in the treatment of complications following surgery. Number of successfully managed patients was identified in each group(those patients not associated with incidence of seroma requiring aspiration and SSI). Cost effectiveness was calculated for each group by dividing the total cost of patient care in each group by the number of successfully managed patients. Findings: There was a significant difference in the duration of procedure between the two groups[level I: 18.57 min vs level III: 32.48 min, p value = 0.000]. Significant differences with worse trend was found in level III patients for QOL[ Global Health Status/QOL- Level I: 77.25(8.92) vs Level III: 71.71(6.89), p value= 0.005; Physical functioning- Level I: 96.21(3.34) vs Level III: 92.92(2.32), p value= 0.000; Role functioning- Level I:91.44(8.44) vs Level III:78.78(11.23), p value= 0.000]. Significant differences were also found in symptom scales of fatigue, pain and arm symptoms. 72.9 % and 54.5 % of patients were successful in level I and level III groups, respectively(p value= 0.137), which yielded a cost-effectiveness ratio of Rs 2,240.46 for level I group and Rs 5.299.12 for level III group. Comparison of different domains of QOL between 2 groupsOutcomeLevel ILevel IIIp valueGlobal Health Status77.25 (8.92)71.71 (6.89)0.005Physical Functioning96.21 (3.34)92.92 (2.32)0.000Role Functioning91.44 (8.44)78.78 (11.23)0.000Fatigue11.11 (0-33.33)22.22 (0-44.44)0.000Pain0 (0-33.33)33.33 (0-33.33)0.000Arm Symptoms0 (0-22.22)33.33 (11.11-44.44)0.000 Conclusion: Level I dissection was associated with significantly better quality of life and was more cost-effective method of ALND as compared to level III ALND. Citation Format: Gour KS, Kataria K, Ranjan P, Dhar A, Srivastava A, Singh K. Quality of life and cost-effectiveness in patients undergoing level I versus level II and III axillary lymph node dissection for breast cancer: A double blind randomised controlled trial with non-inferiority hypothesis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-25.

The quality of life and satisfaction rate of patients with upper limb hyperhidrosis before and after bilateral endoscopic thoracic sympathectomy.

Background:Hyperhidrosis is a functional disorder identified by excessive sweating. Its incidence is approximately 1% in any population. Bilateral endoscopic thoracic sympathectomy (BETS) intervention is the definitive treatment of choice for palmar and axillary hyperhidrosis.Aims and Objectives:The purpose of this study is to evaluate and compare the quality of life (QOL) and satisfaction rate of patients with upper limb hyperhidrosis before and after BETS surgery and the influence of compensatory hyperhidrosis (CH) on patients’ QOL after surgery.Settings and Design:This study is a cross-sectional study designed to generate longitudinal data.Subjects and Methods:This study is a cross-sectional study designed to generate longitudinal data pre- and postbilateral BETS prospectively. This study was conducted in the surgery department of University Hospital in Riyadh, Saudi Arabia. Hundred patients with upper limb hyperhidrosis who underwent BETS from 2014 to 2017 were included. A modified and validated QOL questionnaire for hyperhidrosis was completed by the patients themselves in order to compare the QOL for patients both before and after BETS. Patients’ satisfaction and the occurrence of CH were obtained postoperatively.Statistical Analysis Used:Data were analyzed using the SPSS® statistical package for social studies, version 22.0 (SPSS 22; IBM Corp., New York, NY, USA) for Windows®.Results:A total of 100 patients completed the questionnaire; 94% of patients had a positive QOL outcome after the surgery. The mean decrease in QOL scores was −42.0 points toward better QOL. The site of sweating had a significant effect on the patients’ QOL before and after the surgery (P value < 0.001). Moreover, 76% of patients reported a high satisfaction rate.Conclusion:Primary hyperhidrosis can negatively impair patients’ QOL in different domains. BETS showed to be an effective option for improving the QOL of patients and it provided both short- and long-term effectiveness in treating upper limb hyperhidrosis. CH did not interfere with the rate of patient satisfaction or their QOL postoperatively.

A comparative study on quality of life of older adults

Old age is a critical period which requires special attention in adapting to the changes of life. A descriptive comparative research study was conducted to assess the quality of life (QOL) and its components among the older adults staying in old-age home and staying with family in selected area of Kolkata, West Bengal. A total of 100 senior citizens above the age of 60 years were selected as samples for the study, of which 50 were from old-age home and 50 from those staying with family. Standardised tool Short-Form 36 Version 2 - Health Survey and Multidimensional Scale for perceived social support were used to measure the QOL. Descriptive and inferential statistics were used to analyse the data. The study findings showed that there was a significant difference in the mean scores of QOL and the different domains of QOL of older adults staying in old-age home and family at (P < 0.05). Older adults staying in old-age home perceived better QOL as compared to those staying with family.

Evaluation of Quality of Life in Type 2 Diabetes Mellitus Patients Using Quality of Life Instrument for Indian Diabetic Patients: A Cross-Sectional Study.

Background:Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease with major impact on the quality of life (QoL) in terms of various domains such as social, physical, and mental well-being.Aim:This study aimed to study the factors determining the QoL in T2DM patients.Materials and Methods:A prospective, observational study was conducted in a tertiary care hospital for 6 months. Patients of age ≥18 years and diagnosed with T2DM for ≥6 months (with and without comorbidities) were enrolled for the study. The sociodemographic and clinical characteristics were noted in the self-designed pro forma. The QoL was assessed by the Marathi-translated version of QoL Instrument for Indian Diabetes Patients questionnaire of 34 items and 8 domains. The reliability was validated by Cronbach's alpha. The differences were analyzed by Mann–Whitney U-test and Kruskal–Walis test.Results:Out of 153 T2DM patients, majority were elderly males with mean age of 61.23 ± 11.4 years, married (83%), lower-middle income (57%), urban (51.6%), primary education (46.4%), had diabetes for 5 years or less (42.5%), had positive family history of diabetes (32.6%), and were treated by intensive therapy mainly insulin (41.2%). Statistically significant (P < 0.05) association was found between different domains of QoL and family history, hypertension, body mass index, educational status, marital status, income status, treatment, and complications. The domains of diet satisfaction and general health with the least mean estimates of 7.70 ± 2.62 and 8.25 ± 3.08, respectively, were predominantly affected.Conclusion:QoL is an important parameter in diabetes treatment modality. Different factors affected QoL in diabetics in our study. Further studies are definitely needed for better data generation at national level.

Quality of life in Japanese couples during the transition to parenthood

ABSTRACTObjective: This study aimed to examine the quality of life (QOL) in Japanese couples during the transition to parenthood with their first child.Background: Relevant literature suggests that the health status of women drop during pregnancy and the postpartum period. However, less is known about their partner’s well-being during the transition to parenthood and little research has addressed the relationship between couples’ QOL across multiple domains.Method: Participants included 9216 married Japanese men and women, including 3729 couples, who were expecting or raising their first child under the age of three. They independently completed questionnaires on baseline demographics and on WHOQOL-BREF.Results: Men showed higher scores for psychological QOL, while women had higher scores for social and environment QOL. A significant interaction between gender and stage of transition to parenthood was found. The moderating effect of age between the stage and QOL was found for men on the physical and psychological domains. Couples’ QOL scores were weakly to moderately correlated.Conclusion: Findings suggest that both men and women had lower QOL, with the exception of women’s physical QOL, after childbirth, but they showed different trends during the transition to parenthood across different domains of QOL.

Effect of cognitive and executive functions on perception of quality of life of cognitively normal elderly people dwelling in residential aged care facilities in Sri Lanka

BackgroundAlthough cognitive functions affect the health related quality of life (QoL), the relationship between perceived QoL and cognition including executive functions has not been studied adequately. Available studies show moderate to weak correlations. We evaluated the association of cognition and executive functions, namely working memory (WM) and inhibitory control (IC) with the perceived QoL of a sample of elderly people dwelling in residential aged care facilities (RACFs) in Southern Province of Sri Lanka.MethodsCognition was assessed using Mini-Mental State Examination (MMSE), while verbal WM (VWM), visuo-spatial WM (VSWM) and IC (interference control, inhibition of pre potent and ongoing responses) were assessed using VWM, VSWM tasks, colour word Stroop (CWS), go/no-go (GNG) and stop signal (SS) tasks respectively. WHOQoL-Bref (Total score and domain scores) were used to assess QoL. The relationship was analysed using Pearson correlation and hierarchical multiple regression analysis.ResultsStudy included 237 elderly people with a mean age of 71.11 ± 6.44 years. Participants scored the highest in the domain of environment (63.48 ± 10.63) and lowest in the domain of social relationships (55.43 ± 21.84) of QoL. Psychological health domain positively correlated with MMSE, VSWM and VWM scores and negatively correlated with CWS, SS and GNG task errors. Both physical health domain and total QoL demonstrated positive correlations with MMSE, VSWM and VWM scores, while negative correlations were observed with CWS task errors. Social relationships domain demonstrated a significant positive correlation with VSWM score. Environment domain positively correlated with MMSE, VSWM and VWM scores and negatively correlated with CWS and SS task errors. All were significant but weak correlations. When controlled for covariates, such as educational status, physical activity and marital status, cognition was a predictor of the domain of environment of QoL, while executive functions were not predictors of total QoL and domains of QoL.ConclusionCognition and executive functions weakly but significantly correlated with different domains of QoL. Only the level of cognition measured by MMSE was a predictor of the domain of environment of QoL and executive functions were not predictors of total QoL and domains of QoL in elderly people with normal cognitive functions dwelling in RACFs.

Quality of life among geriatric population: A cross-sectional study in a rural area of Sepahijala District, Tripura.

Quality of life (QOL) among elderly is an important area of concern which reflects the health status and well-being of this vulnerable population. The objective of this study is to find out different domains of QOL and its association with sociodemographic factors among geriatric population. A community-based cross-sectional study was done among 76 persons aged 60 years and above from August 2016 to October 2016 in rural areas of Madhupur, Sepahijala district, Tripura. The World Health Organization QOL-BREF scale was used and analysis was done using SPSS version 20.0 statistical software. P < 0.05 was considered as statistically significant. The mean QOL score was maximum in social health domain (67.32 ± 15.30), followed by environmental health (51.64 ± 10.11), lowest was in psychological domain (44.29 ± 11.50). Better physical health domain score was found among participants <70 years age. Psychological health was better among Hindu and persons from nuclear family and higher socioeconomic class, whereas male, illiterate, and businessman had better social relationship. Environmental domain score was significantly better among primary educated, businessman, and higher socioeconomic class people. The present study revealed social relationship domain had higher mean QOL score in comparison to other domains, but contrastingly psychological domain was affected worst in "old age group." Further research can be done to explore the factors affecting psychological domain.

Assessment of health-related quality of life among adult patients with type 2 diabetes mellitus

&amp;lt;p&amp;gt;Introduction.The aim of the study was to find out the determinants of thequality of life in primary health care patients with type 2 diabetes.Methods. The cross-sectional study included 181 patients, aged 37 to 89 years,with diabetes mellitus type 2, registered with four family medicine practices.The assessment of health status was conducted using medical history, objectiveexamination, laboratory analyses, dilated eye exam, screening for distalsymmetric neuropathy and ankle-brachial index measurement. In evaluatingthe impact of diabetes mellitus on patients&amp;amp;rsquo; health status, a generic instrument,the self-administered WHOQOL-BREF questionnaire, was used. Multivariatelinear regression models were used to analyze the variables associated withthe quality of life.Results. Out of 181 adult patients with type 2 diabetes mellitus, 73 (40.3%)had diabetes for less than 5 years. The mean glycated hemoglobin (A1C) was7.55% and the mean serum levels of fasting glucose, total cholesterol, LDL-cholesterol,HDL-cholesterol and triglycerides were above the recommendedvalues. Most of the patients had comorbidities, chronic diabetes complicationsand used oral hypoglycemic agents in combination with insulin. Themultivariate regression analysis showed that the age, psychological health,nephropathy and environment were associated with the domain of physicalhealth. The determinants of psychological health were age, marital statusand environment. Older and single patients had lower scores, whereas thosewith a better living environment had higher scores in the domain of socialrelationship. The levels of glycemic control and gender have not been shownto be significant determinants of any of the four domains.Conclusion. The factors associated with the different domains of quality oflife in patients with type 2 diabetes are multiple, but mainly relate to age,living environment and diabetes complications. The results can be used as aguideline for defining measures that can improve the quality of life of patientswith type 2 diabetes&amp;lt;/p&amp;gt;

Factors associated with the quality of life of people living with HIV in Finland

ABSTRACTIn recent years, the concept of quality of life (QoL) has received significant attention in the HIV/AIDS literature. In Finland, however, the factors associated with the QoL of people living with HIV/AIDS (PLWHA) still remain unknown. The aim of this study was to identify the sociodemographic and HIV-related factors associated with the different domains of QoL of PLWHA in Finland. The sample of this cross-sectional study consisted of 453 HIV-infected patients (Mean age = 46.5 years; 76.5% male) followed at the Infectious Disease Clinic of Helsinki University Hospital. Participants completed a self-reported questionnaire covering sociodemographic and HIV-related information, and the Finnish version of the WHOQOL-HIV-Bref questionnaire. Participants reported rather high scores in the six QoL domains, which ranged between 68.48 (Social relationships) and 78.05 (Environment) on a 0–100 scale. Multiple regression analyses revealed that male gender, being married or living in a partnered relationship, being employed, having fewer financial concerns, and not having depression and other medical comorbidities were the main factors positively and consistently associated with higher scores in the different domains of the QoL. HIV-related variables were not significantly associated with QoL ratings. Sociodemographic factors were independently associated with the QoL of PLWHA in Finland. Psychosocial support should reflect these factors in order to improve the health status and well-being of PLWHA.

Hearing and Quality of Life Among Community-Dwelling Older Adults.

Hearing loss is a common health concern in older people, and the prevalence of hearing loss increases with aging. Poor hearing may cause difficulties in everyday life situations and reduce quality of life (QoL). The aim of this study was to assess the associations between different domains of QoL (physical, psychological, social, and environmental), perceived hearing difficulties in various everyday situations, and audiometrically measured hearing level among community-dwelling older adults. Cross-sectional analysis of 76- to 91-year-old community-dwelling adults. Data on QoL (WHO Quality of Life Assessment short version) and perceived hearing difficulties were gathered via postal questionnaires (n = 706) and screening pure-tone audiometry was performed at the participants' homes for a random subsample (n = 161). Data were analyzed with linear regression models. Factor analysis on the perceived hearing difficulties questionnaire identified three dimensions: speech hearing, socioemotional effects, and spatial hearing. All the perceived hearing difficulty factors, but not the pure-tone audiometry results, were significantly associated with poorer values in all the QoL domains and the total QoL score. Perceived hearing difficulties in various everyday life situations are more strongly associated with older adults' QoL than audiometrically assessed hearing impairment.

Mediation analysis of relationships between chronic inflammation and quality of life in older adults

BackgroundThis article summarizes exploratory analyses of relationships between chronic inflammation, its physical consequences, and quality of life (QoL). It summarizes key findings from preliminary analyses, and contextualizes these results with extant sociomedical literature to recommend directions for future research.MethodsCross-sectional data from the National Social Life, Health, and Aging Project (NSHAP) were used to explore these relationships. Inflammation was assessed via the biomarker C-reactive protein (CRP). We examined associations between CRP levels and two different domains of QoL: happiness with life in general and happiness with intimate relationships. We used ordinal logistic regression with companion OLS models and Sobel-Goodman tests to assess potential mediation, and also conducted a variety of sensitivity analyses.ResultsFindings suggest that mediation pathways for the overall association between chronic inflammation and QoL may differ markedly across particular outcome constructs. Specifically, it shows mediation potential for the clinical sequelae of chronic inflammation in frameworks using happiness as an outcome measure, but not in those using relationship satisfaction. Disability appears to mediate the effect of inflammation by 27 %; chronic pain appears to exert a similar mediation effect of 21 %.ConclusionsPain and disability linked to chronic inflammation appear to play a small but significant mediating role in the overall reduction in QoL observed among older adults with biomarker evidence of chronic inflammation. We note that these patterns are best framed as dynamic elements of a complex causal fabric, rather than powerful determinants that override other factors contributing to QoL. Hypotheses for further exploration using longitudinal data from the NSHAP are thus offered, pending availability of Wave III data in future years.

The effects of Gilles de la Tourette syndrome and other chronic tic disorders on quality of life across the lifespan: a systematic review.

Gilles de la Tourette syndrome (GTS) and other chronic tic disorders are neurodevelopmental conditions characterized by the presence of tics and associated behavioral problems. Whilst converging evidence indicates that these conditions can affect patients’ quality of life (QoL), the extent of this impairment across the lifespan is not well understood. We conducted a systematic literature review of published QoL studies in GTS and other chronic tic disorders to comprehensively assess the effects of these conditions on QoL in different age groups. We found that QoL can be perceived differently by child and adult patients, especially with regard to the reciprocal contributions of tics and behavioral problems to the different domains of QoL. Specifically, QoL profiles in children often reflect the impact of co-morbid attention-deficit and hyperactivity symptoms, which tend to improve with age, whereas adults’ perception of QoL seems to be more strongly affected by the presence of depression and anxiety. Management strategies should take into account differences in age-related QoL needs between children and adults with GTS or other chronic tic disorders.

ASSOCIATION BETWEEN NUTRITIONAL STATUS AND QUALITY OF LIFE IN (PRE)FRAIL COMMUNITY-DWELLING OLDER PERSONS

BACKGROUND: For developed countries, healthy aging is one of the challenges and the number of healthy life years and especially the quality of life (QoL) are important. OBJECTIVE: This study aimed to assess the association between nutritional status and different domains of QoL in (pre)frail community-dwelling elders. DESIGN: Baseline data from persons, who participated in a 12-week nutritional and physical training intervention program, conducted from September 2013 - July 2015. Setting: (Pre)frail community-dwelling elders living in Vienna, Austria. PARTICIPANTS: A total of 83 older persons living at home, 12 men and 71 women (86%) aged 65 to 98 years. Measurements: Structured interviews were conducted at participants’ homes. Mini Nutritional Assessment® long-form (MNA®-LF) was used to investigate the nutritional status. The QoL domains were assessed with the World Health Organization Quality of Life questionnaires. Simple and multiple linear regression analyses were performed to evaluate the association between nutritional status and QoL domains, adjusted for possible confounders. RESULTS: 45% of the participants were at risk of malnutrition and 3% were malnourished. Compared to normal nourished people, persons who had an impaired nutritional status, significantly differed in the QoL domain ‘autonomy’ with mean (SD) scores of 50.0 (14.9) vs. 57.3 (13.7); p=0.022 and in the QoL domain ‘social participation’ with scores of 40.1 (13.6) vs. 47.0 (11.2); p=0.014, respectively. According to linear regression analyses, the MNA®-LF score was significantly associated with ‘overall QoL’ (β=0.26; p=0.016) and the QoL domains ‘physical health’ (β=0.23; p=0.036), ‘autonomy’ (β=0.27; p=0.015), and ‘social participation’ (β=0.28; p=0.013).CONCLUSIONS: There was a significant association between nutritional status and QoL in elderly (pre)frail community-dwelling people, in particular for the QoL domains ‘autonomy’ and ‘social participation’. However, it remains unclear whether malnutrition was the cause or the consequence, or it was mediated through a third possible factor e.g. the functional status.

Quality of Life during the First Two Years Post Stroke: The Restore4Stroke Cohort Study

Background: Little information is available about the course of quality of life (QoL) post stroke and how dependency on activities of daily living (ADL) influences this course. The aim of this study was therefore to describe the course of QoL from 2 months up to 2 years post stroke and to study the influence of ADL dependency in the first week post stroke. Methods: This is a multicenter prospective longitudinal cohort study in which 368 stroke patients were included and data were collected at 1 week, 2 months, 6 months, 12 months and 24 months post stroke. QoL assessment included measures of health-related quality of life (HRQoL) (short stroke-specific Quality of Life Scale), emotional functioning (Hospital Anxiety and Depression Scale), participation (Utrecht Scale for Evaluation of Rehabilitation-Participation), and life satisfaction (2LS). Dependency on ADL was defined as having a Barthel Index score ≤17 four days post stroke. Generalized Estimating Equations analyses were performed to examine the course of the 4 domains of QoL. Furthermore, the possible confounding effect of age, gender, marital status, level of education and discharge destination was examined. Results: Results showed that HRQoL, participation and life satisfaction improved during the first year post stroke, with most changes occurring in the first 6 months. Furthermore, patients dependent in ADL scored consistently lower on all 4 QoL domains and test occasions compared to ADL-independent patients. In both patient groups separately, no changes over time were found in emotional functioning. ADL-independent patients improved in HRQoL (p = 0.002), participation (p < 0.001) and life satisfaction (p = 0.020) between 2 and 6 months and in life satisfaction (p = 0.003) between 6 and 12 months also. ADL-dependent patients improved in HRQoL (p = 0.009) between 2 and 6 months and in participation between 2 and 6 months (p = 0.001) and between 6 and 12 months (p = 0.031). Furthermore, they experienced no changes in life satisfaction. No confounding effect was found after adding age, gender, marital status, level of education and discharge destination. Conclusions: Most improvement in QoL occurred up to 6 months post stroke and showed different patterns for specific domains of QoL and for patients with and without dependency in ADL in the first week post stroke. It is therefore important to differentiate between these different domains of QoL when the long-term perspective is considered. Furthermore, patients dependent in ADL consistently scored lower on all QoL domains and did not reach the level of QoL of patients independent of QoL.

DIABETES MELLITUS PATIENTS

Objectives: To observe Quality of Life (QoL) in diabetes mellitus patientsafter fabrication of immediate dentures. Setting: Department of Prosthodontics in HamdardUniversity Dental Hospital, Karachi. Period: Two years from October 2011 to September 2013.Methodology: Thirty patients with established diagnoses of diabetes mellitus reported. In thisstudy by purposive non-probability sampling technique. In this study patients were selected,male and female patients were 24 and 6 respectively with the age range of 22- 74 years. Aftergetting consent Questions mention in OHIP-14 were asked from the patients on 1st visit and2 months later after fabrication of immediate denture to assess the QoL of in these patients.Data was obtained after using SPSS-version 19. For analysis Wilcoxon Signed Ranks Testwas applied to get results. Probability level of P&lt; 0.05 was considered statistically significant.Results: There was marked improvement in different domains of QoL in diabetes mellituspatients after fabrication of immediate dentures, most of the patients were pleased with theirprosthesis. Three patients had complained of pain on buccal side which was corrected bytrimming the overextended flange of their denture. All patients had improvement in phonetics(P value 0.01), better choice of food (P value 0.00), eating ability (P value 0.01), decreaseembarrassment (P value 0.08) and self-assurance (P value 0.025). However, effect of immediatedenture on variable like tension was not advantageous having P-value of 0.157. Conclusion: Byfabrication of immediate dentures to diabetes mellitus patients, QoL can be markedly improvedin such patients.

Quality of Life Outcomes of Bariatric Surgery: A Systematic Review.

Bariatric surgery is often pursued to improve quality of life (QOL). This paper systematically reviews the literature examining QOL following bariatric surgery. Fifteen controlled trials examined changes in QOL in obese (BMI > 30) adults (18–65 years) following bariatric surgery; seven compared bariatric surgery to non-surgical interventions and six compared different types of bariatric surgery. Bariatric surgery resulted in greater improvements in QOL than other obesity treatments. Significant differences in QOL improvements were found between different types of bariatric surgery. QOL improvements were more likely to occur within the first 2 years following surgery, with greater improvements in physical QOL than mental QOL. Bariatric surgery improves QOL. Future research is needed to investigate changes in QOL in different domains in the short- and long-term following bariatric surgery.

Interaction of physical function, quality of life and depression in Amyotrophic lateral sclerosis: characterization of a large patient cohort.

BackgroundDue to lack of any curative therapy for ALS, symptomatic treatment and maintenance of quality of life (QoL) is very important. We aimed to characterize the affected domains of QoL in ALS patients and to identify factors which are associated with reduced QoL and increased depression.Methods159 ALS patients answered standardized questionnaires (Beck Depression Inventory-II, SF-36 Health Survey questionnaire, revised ALS functional rating scale). Multiple regression analysis was used to identify correlations between clinical features of ALS patients and depression/QoL scores. In addition, QoL data from ALS patients were compared to age-matched reference values representing the German normal population.ResultsQoL of ALS patients was reduced in nearly all SF-36-categories. Progression of physical impairment was positively correlated with depression but reduced QoL scores only in items directly related to physical function. However, QoL was considerably influenced by depression, independently from physical impairment. Regarding distinct patient characteristics one of the most interesting findings was that increasing age was correlated with significantly worse QoL results regarding social functioning.ConclusionsDepressive symptoms had a strong influence on QoL, hence their detection and treatment is of particular importance. Different domains of QoL are differently affected in subgroups of ALS patients. Being aware of these differences can be valuable for both ALS professional and family caregivers and physicians.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0340-2) contains supplementary material, which is available to authorized users.