Quality Of Life In Such Patients Research Articles

Methods for assessing quality of life in cancer

Background. The problem of a significant reduction in the quality of life (QoL) of oncological patients remains relevant despite current achievements in medicine. The issue of standardizing methods for assessing QoL in such patients is relatively acute. Patients undergo this assessment from the diagnostic stage to the end of rehabilitation, so it’s important to choose an accurate and precise method for QoL evaluation.Objective: to analyze existing questionnaire-based methods for assessing QoL in cancer patients.Material and methods. The search for publications was conducted in the scientific databases PubMed/MEDLINE, ScienceDirect, and eLibrary. Additionally, the sources found by queries in Yandex and Google search engines by each researcher individually were considered. The review included 38 articles.Results. The vast majority of questionnaires used to assess QoL in oncological patients can be divided into two large groups: based on QLQ-C30 and FACT-G. Despite the similarity between QLQ-C30 and FACT-G questionnaires, some shift in their focus was shown. QLQ-C30 is more oriented on physical indicators, and FACT-G is more aimed at social and emotional well-being. Besides them, questionnaires that proved to identify and monitor individual groups of symptoms and syndromes were presented: FSFI, HADS and Russian questionnaire on well-being, activity, mood.Conclusion. The obtained results indicated a fairly wide choice of questionnaires for the overall assessment of QoL and its individual elements. They include both proven screening and monitoring tools and those requiring validation and expansion of the evidence base. Due to high effectiveness of questionnaires as QoL screening and monitoring tools, further work is needed to ensure that they are widely included in clinical guidelines.

Effect of Acne Vulgaris and its Impact on Quality of Life of Adolescents in Bengaluru

Background and Objective: Acne vulgaris is a chronic condition affecting more than 85% of adolescents and young adults. This study was conducted to assess the prevalence of acne vulgaris and its impact on quality of life (QoL) and to study socio-demographic factors, family history and lifestyle among the selected schools at Jalahalli area in Bengaluru. Materials and Methods: This study was a descriptive cross sectional school based study and 200 subjects were included. Predesigned, questionnaire to assess socio-demographic profile and QoL and symptoms of acne vulgaris were administered to the participants fulfilling inclusion criteria. Data were obtained by using different methods such as Global Acne Grading System (GAGS), Cardiff Acne Disability Index and Children’s Dermatology Life Quality Index/Dermatology Life Quality Index (CDLQI/DLQI) respectively. SPSS 18.0 software was used for data analysis. Results: Findings showed that Acne prevalence was 87% affecting both sexes. Self-reported mild acne was present in 85.1% and moderate severe acne in 14.9% of the adolescents. The mean age of the subjects was 14.78 years, with 52.5% females and 47.5% males. A strong relation was found between the severity of acne and QoL (p<0.001). Heredity was correlated with acne and its severity was significant. Conclusion: Acne affects the QoL of an adolescent, and the impact is proportional to the severity of acne. Severe acne is associated with a greater effect on QoL. Evaluation of QoL in such patients may greatly help in the better management of acne, hence improving their quality of life.
 Keywords: Acne vulgaris; Adolescent; Quality of life; GAGS; CDLQI; DLQI.

A study of pattern and assessment of life quality index in patients of nonvenereal dermatoses of external genitalia at a tertiary care center.

Nonvenereal dermatoses (NVD) are the spectrum of disorders involving the genitalia with varied etiology and having a considerable influence on the health-related quality of life (QOL), but it remains under evaluated. To study the prevalence, pattern, and the effect of nonvenereal genital dermatoses on the QOL of patients with the help of dermatological life quality index (DLQI) questionnaire. This was a cross-sectional study conducted for a period of 1 year. A total of 132 patients were included in the study. QOL was assessed by using the DLQI questionnaire. The prevalence was found to be 10.2/1000 cases in our study. Genital scabies (34.8%) was the common dermatoses followed by vitiligo (18.9%) and lichen simplex chronicus (8.3%). These dermatoses were having moderate effect on the DLQI of majority (52.3%) of the patients and its having very large effect on DLQI in 20.5% of patients. Mean DLQI scores were high among the age group of 41-70 years, male sex and in patients who had <1 month duration of the dermatoses. Regarding individual dermatoses, infestation (scabies) was having higher mean DLQI scores and it was statistically significant. This study depicts that NVD are having impact on the QOL and its mainly attributed to the site of dermatoses and also due to the symptoms. Proper counseling about the nature of these disorders and prompt treatment were important, thereby improving the QOL of such patients.

Quantitative and qualitative analysis of the quality of life of Type 1 diabetes patients using insulin pumps and of those receiving multiple daily insulin injections

IntroductionInsulin pump therapy represents an alternative to multiple daily injections and can improve glycemic control and quality of life (QoL) in Type 1 diabetes mellitus (T1DM) patients. We aimed to explore the differences and factors related to the T1DM-specific QoL of such patients in Latvia.Design and methodsA mixed-method cross-sectional study on 87 adult T1DM patients included 20 pump users and 67 users of injections who participated in the quantitative part of the study; 8 pump users and 13 injection users participated in the qualitative part. Patients were invited to participate using a dedicated digital platform. Their QoL and self-management habits were assessed using specially developed questionnaires adapted to Latvian conditions. Multiple logistic regression models were built to investigate the association between social and self-management factors and patients’ QoL. In addition, qualitative analysis of answers was performed.ResultsInsulin pump users were younger, had higher incomes, and reported higher T1DM expenses than users of multiple daily injections. There were no differences in self-management between the groups; Total QoL differed at the 0.1 significance level. In fully adjusted multiple logistic regression models, the most important factor that increased Total QoL was lower T1DM-related expenses (odds ratio, OR 7.02 [95% confidence interval 1.29; 38.0]). Men and those with more years of living with T1DM had better QoL (OR 9.62 [2.20; 42.1] and OR 1.16 [1.05; 1.29], respectively), but the method of administration was not significantly associated with QoL (OR 7.38 [0.87; 62.9]). Qualitative data supported the results of quantitative analysis.ConclusionsQoL was the main reason to use an insulin pump, while the expense was the main reason to avoid the use of it or to stop using it. Reimbursement policies thus should be considered to enable patients to choose the more convenient method for themselves.

Assesment of Quality of Life in Patients Undergoing Hemodialysis in RMI, Peshawar

Introduction: Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. It has been affecting the quality of life (QOL), an important parameter which needs to be addressed. This study assessed QOL keeping in view WHO criteria for patients undergoing hemodialysis at Rehman medical institute (RMI). The study also evaluated the effects of various socioeconomic and demographic factors affecting life of such patients. Materials and Methods: A cross sectional descriptive study was conducted by selecting a convenient non-probability sample of 100 patients with chronic kidney disease (CKD) undergoing hemodialysis at Rehman Medical Institute /Dialysis center. The project duration was five months, and during this period data collection was done using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Patients aged 18 years and above and on regular MHD for at least 3 months were included in this study. Patients with cognitive impairment and coexisting diseases such as stroke, chronic obstructive pulmonary diseases, heart diseases, and chronic liver diseases were excluded from the study as these factors could potentially affect their QOL and act as confounding factors. Results: Out of the 100 hemodialysis patients, 51% were men while 49% of the participants were females. 36% of the subjects were above 60 years old. The total score of quality of life was found to be higher in participants &lt;60 years, of higher educational level, being very informed about the health problem, not experiencing difficulties with social or family environment, had help at home. Among them 43% subjects were not happy with their quality of life, only 13% were satisfied. Conclusion: Patients with chronic kidney disease on dialysis had overall low QOL scores in all four domains. Age, education, marital status and gender affected one or more domains of QOL in such patients. Low income status was the only independent negative predictors of QOL of patients on maintenance hemodialysis. Education level is a positive factor for improving QOL of hemodialysis patients. Keywords: quality of life, hemodialysis, WHOQOL-BREF, chronic kidney disease, End-stage renal disease (ESRD).

Comparison of quality of life (QoL) in survivors of testicular nonseminomatous germ cell tumor (NSGCT) with age-matched controls using EORTC QLQ-C30 questionnaire.

413 Background: Testicular NSGCT is typically diagnosed in young males, and is a highly curable cancer. Data pertaining to the quality of life of testicular NSGCT survivors are limited. Methods: Patients aged 18 or more years with a diagnosis of testicular NSGCT treated in a large tertiary care centre in New Delhi, India between January 2015 and July 2019 were eligible to participate. Patients had to be disease free for at least two years for QoL assessment using EORTC QLQ-C30 questionnaire. Raw scores were transformed as per the EORTC scoring manual. Controls were healthy age-matched adults recruited from the patient accompanying population. Results: We identified 55 survivors and 100 controls. Median age was 32 (range, 18-65) years and 58.2% of patients stage III disease, while the rest were equally divided in stage I and II. Chemotherapy was administered in 94% patients, while 25% had retroperitoneal lymph node resection for residual disease and relapse occurred in 11%, who were treated with salvage chemotherapy and resection of the residual disease. Emotional, social and global scores were significantly lower in survivors as compared to controls. Among symptom scales, fatigue, pain, dyspnoea, insomnia, appetite loss, and financial difficulty were significantly increased in patients as compare to survivors (Table). On a multivariate analysis, neither stage of disease nor treatment were found to be associated significantly with QOL scores. Conclusions: Survivors of testicular NSGCT have lower emotional, social and global functioning and a higher symptom burden. Since NSGCT affects young males, aggressive measures may be needed to improve the QoL in such patients.[Table: see text]

Versatility of Basal Cortical Screw Implants with Immediate Functional Loading.

The purpose of this study is to evaluate the survival rate of the basal cortical screw (BCS) implant system inserted in healed edentulous ridges (E) or extraction sockets (ES) with immediate loading functional protocol in varying clinical situations. A total of 125 BCS implants were placed in 14 patients, immediately loaded and observed for 20.07(± 4.23) months. Ninety-four were placed in E sites and 31 were placed in ES sites. They were evaluated for bone loss, soft tissue shrinkage around the prosthesis, improvement in quality of life (QOL), and their survival after 1year. Total of 121/125(96.8%) implants survived while 4/125(3.2%) failed at the end of follow-up. Average bone loss after 1year was 0.33mm (E) and - 1.57mm (ES), average soft tissue shrinkage was 0.50mm (E) and 1.42mm (ES) and average Patient's Global Impression of Change (PGIC) scale score was 6.36(± 0.63) at 1year. The complications observed were mobility {3(2.4%)}, pain/discomfort {1(0.8%)} and fracture of abutment at the neck {1(0.8%)}, prosthesis loosening {2(9%)} and requirement of relining {3(13%)}. No periimplantitis was observed. This is the only study to report the marginal bone loss and soft tissue changes around BCS implants and an index-based improvement in QOL of such patients. The BCS implant system with immediate functional loading protocol is a versatile modality to rehabilitate a single tooth, a segment or a full arch with healed ridges as well as extraction sites; it gives high success rate and minimal complications.

Effects of coexisting upper gastrointestinal symptoms on daily life and quality of life in patients with gastroesophageal reflux disease symptoms.

Gastroesophageal reflux disease (GERD) is a common disease encountered in daily medical care and clinical problem which hampers daily life and reduces quality of life (QOL). The coexistence of GERD-related symptoms with the typical GERD symptoms, such as heartburn or acid regurgitation, and various upper abdominal symptoms is frequently observed in patients with GERD. However, the effect of these coexisting symptoms on the daily life and QOL of patients with GERD has not been clarified. Therefore, the effects of the various upper abdominal symptoms coexisting with GERD on the daily life and QOL of such patients were compared. A total of 113 newly diagnosed patients who visited our hospital with typical GERD symptoms were assessed using the modified frequency scale for the symptoms of GERD (MFSSG), gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), and short-form 8-item health survey (SF-8) questionnaires. The "gastroesophageal reflux symptom" (7 items) and "dyspepsia symptom" (7 items) groups were divided into two "typical symptoms" and two "atypical symptoms" for a total of four categories. The Pearson's correlation coefficient and multiple regression analysis were used to evaluate the correlations between each symptom category and dissatisfaction for daily life [eating, sleeping, daily activities, mood, as well as dissatisfaction for daily life-symptom subscale (SS), which is the average of the four items in the GERD-TEST, the physical component summary [PCS] and mental component summary [MCS] of the SF-8, and the influence of each symptom category on the daily life and QOL. The incidences of each symptom category in patients with GERD were high: typical GERD (100%), atypical GERD symptoms (67.3%), typical functional dyspepsia (FD) (71.7%), and atypical FD (75.2%). Pearson's correlation analysis demonstrated significant correlations between each symptom category and living status (dissatisfactions of eating, sleeping, daily activities, daily life-SS) and almost all items in SF-8 (PCS, MCS) (P < 0.05). Multiple regression analysis indicated the largest influences of each symptom category on living status and QOL in descending order: dissatisfaction for eating (atypical FD, typical FD), daily activities (atypical FD, typical FD, typical GERD), mood (atypical FD), daily life-SS (atypical FD, typical FD), PCS (typical FD), and MCS (atypical FD) (P < 0.05). Coexisting FD symptoms, particularly atypical FD symptoms, had a large influence on the impairments of daily life and decreases in QOL. Daily medical care of GERD requires attention to coexisting symptoms and their treatment instead of just focusing on the chief complaints by patients.

The Effect of Hallux Valgus Surgery on Quality of Life.

Health-related quality of life (QOL) is defined as a patient's subjective perception of his or her own health. Insufficient data exist on QOL of patients who undergo a hallux valgus (HV) operation. We used a 36-item short form survey (SF-36) to measure QOL of such patients. Our aim was to evaluate the effect of HV on QOL and to identify QOL determinants. Fifty patients who underwent surgery for HV between 2015 and 2017 were included in the study. The SF-36 questionnaire was applied to the patients before and after surgery. Patients' medical records were examined to identify possible factors affecting QOL such as age, gender, body mass index, duration of symptoms, or smoking. The mean age of the patients was 55.6 ± 3.8 years, and 42 of the 50 patients were women. The mean duration of disease was 12 ± 3.7 years. The surgery improved QOL scores for general health, emotional well-being, role limitations due to personal or emotional problems, physical functioning and bodily pain. However, the changes in scores for vitality and social functioning were not statistically significant. Lower postoperative QOL scores for emotional well-being and bodily pain were significantly associated with age and duration of the symptoms. Compared to the mean QOL of healthy adult Turkish population, all scores in subdimensions were lower. This study shows that HV in adults has a negative impact on general health, bodily pain, physical functioning, physical and emotional well-being rather than social well-being and vitality.

SAT-308 QUALITY OF LIFE IN ESRD PATIENTS ON MAINTENANCE HEMODIALYSIS FOR MORE THAN 7 YEARS IN A TERTIARY CARE CENTRE

Assessment of quality of life (QOL) of patients with End-Stage Renal Disease (ESRD) on hemodialysis is very important. In this study, we aim to assess QOL in patients undergoing hemodialysis for a duration more than 7 years and evaluated the effects of various sociodemographic and clinico-laboratory factors affecting QOL of such patients in our dialysis centre in PSG Institute of Medical Science and Research, Coimbatore, Tamil Nadu, India. A cross-sectional study was conducted among 23 patients with ESRD undergoing hemodialysis at our dialysis centre for more than 7 years. Demographic data including age, sex, ethnicity, educational status, marital status, employment, income, duration of illness, duration of travel to dialysis centre and duration on hemodialysis were collected. Clinicolabratory data including native kidney disease, comorbidity, dialysis access, haemoglobin level, ferritin, TSAT, erythropoietin use and dose, albumin, calcium, phosphorous, PTH and viral serology were noted. QOL was assessed using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Four domains (physical, psychological, social, and environmental) of the WHOQOL-BREF were the primary end points of this study. The relationship between sociodemographic factors, clinico-laboratory factors and QOL scores were analysed using independent samples t-test and one-way analysis of variance. In this study we found that the overall Quality of Life in chronic hemodialysis patient with respect to all four Domains were low. The mean of Domain 1 (Physical)- 50.2±12.5, Domain 2 (Psychological)- 55.8±13.1 , Domain 3 (Social)- 62.5±21.4 , Domain 4 (Environmental) - 60.7±14.5. There was statistically significant Domain 2 (Psychological) QOL in male patients. There was statistically significant Domain 4 (Environmental) QOL in age group between 41-60 years. Even though not statistically significant patient group with high income, employed, fistula access, haemoglobin more than 10 mg/dl and erythropoietin usage had marginally better QOL in all Domains. In this study of 23 patients on maintenance hemodialysis for more than 7 years, factors like aetiology of native kidney disease, dialysis through AV fistula, regular dialysis, water quality maintained according to AAMI standards and absence of cardiovascular disease are probably having an impact on long term survival.

Factors Influencing Quality of Life in Patients with Gastroesophageal Reflux Disease in a Tertiary Care Hospital in Pakistan.

To assess the impact of gastroesophageal reflux disease (GERD) on quality of life (QOL) in local population. Cross-sectional, descriptive study. Hepatogastroenterology Department, Sindh Institute of Urology and Transplantation, Karachi, from June 2016 to December 2017. Patients with GERD visiting the outpatients' clinics were enrolled. Those who had history of dysphagia, malignant disease, anemia, weight loss, cardiovascular diseases, renal failure, cirrhosis, rheumatologic diseases and patients taking non-steroidal anti-inflammatory drugs (NSAIDS) or steroids during the last two weeks were exluded. A predesigned questionnaire was used to calculate GERD impact scale (GIS) score, with a value of >18 being considered as impaired QOL. Chi-square test was used to identify factors associated with impaired QOL. A total of 782 patients with mean age of 37.3 ±8.99 years (range: 18-65 years) were studied. Majority (505, 64.5%) were younger than 40 years of age. Predominant study population were females, i.e. 413 (52.8%). Among these, 127 (16.2%) patients had symptoms lasting more than a year, 132 (16.9%) were smokers, 82 (10.5%) had diabetes mellitus (DM), and 63 (8.1%) had hypertension. A total of 297 (38%) patients had impaired QOL. On logistic regression analysis, the impaired QOL was associated with age greater than 40 years (p=0.001), body mass index (BMI) >25 Kg/m2 (p= 0.001), smoking (p=0.001), hypertension (p=0.001) and diabetes mellitus (p=0.001). A significant proportion of patients had impaired QOL due to GERD. Factors affecting QOL in such patients were higher age, increased BMI, history of smoking, hypertension and DM.

OLANZAPINE COMBINED WITH STANDARD ANTIEMETIC REGIMENS FOR PREVENTION OF CHEMOTHERAPY THERAPY-INDUCED NAUSEA AND VOMITING: A SINGLE-CENTER EXPERIENCE FROM SOUTH INDIA

Objectives: Olanzapine, an antipsychotic agent, exhibits significant antiemetic properties due to its inhibitory activity on neurotransmitters at multiple receptors involved in chemotherapy-induced nausea and vomiting (CINV). CINV can have an immensely negative impact on patient’s quality of life (QOL) and daily activities. Our objectives were to determine the effectiveness of adding olanzapine to standard antiemetic regimens for the prevention of CINV in cancer patients and to compare the QOL of such patients with those receiving standard antiemetic regimens.Methods: A prospective, observational, cohort study was done on patients receiving either highly or moderately emetogenic chemotherapy (MEC). The patients who received only the standard antiemetic regimens were considered as the control group and those who received 10 mg of olanzapine once daily on days 1-5 of chemotherapy in addition to the standard antiemetic regimens were considered to be the study group. The patients were assessed for grades of nausea and vomiting using National Cancer Institute common terminology criteria for adverse events and for QOL using European Organization in Research and Treatment of Cancer QOL questionnaire.Results: Patients were evaluated for a total of 168 cycles of chemotherapy. Compared to the control group, the study group patients showed significant improvement in response to acute nausea (p=0.02) but not in acute vomiting (p=0.09). However, response to delayed nausea and vomiting improved significantly (p=0.004 and p=0.05, respectively). The QOL of study group patients showed significant improvement in functional scales and symptom scales (p&lt;0.02). Global health status also increased significantly (p=0.02) in the study group patients.Conclusion: Olanzapine containing pre-medication regimens can reduce acute and delayed nausea and delayed vomiting and improve the QOL of cancer patients receiving highly or moderately emetogenic chemotherapeutic agents as compared to the standard pre-medication regimens.

Assessment of quality of life in patients undergoing hemodialysis using WHOQOL-BREF questionnaire: a multicenter study.

BackgroundAssessment of quality of life (QOL) of patients with end-stage renal disease has become increasingly important, both in order to evaluate the influence of the disease on patients and the type of renal replacement therapy they require. Therefore, in this study, we aimed to assess QOL in patients undergoing hemodialysis and evaluated the effects of various sociodemographic factors affecting QOL of such patients in Nepal.MethodsA cross-sectional study was conducted among 150 patients with chronic kidney disease undergoing hemodialysis at two major centers in Nepal. Demographic data including age, sex, ethnicity, educational status, marital status, employment, income, duration of illness, and duration on hemodialysis were collected. QOL was assessed using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Four domains (physical, psychological, social, and environmental) and two items (overall perception of QOL and health) of the WHOQOL-BREF were the primary end points of this study. Bivariate relationship between sociodemographic factors and QOL scores were analyzed using independent samples t-test and one-way analysis of variance. Multiple linear regression analysis was performed to determine independent predictors of QOL.ResultsFollowing QOL scores were recorded: environmental domain (53.17±15.59), psychological domain (51.23±18.61), social domain (49.86±21.64), and physical domain (45.93±16.90). Older age was associated with a better QOL score in the social domain (p=0.005), and employed patients scored better in the environmental domain (p=0.019). Unemployed patients and those of the Terai/Madhesi ethnic group had significantly low scores in overall perception of health (p<0.05) as compared to other groups. Low income status and increased duration on hemodialysis were found to be the only independent negative predictors of QOL in patients with hemodialysis (p<0.05).ConclusionPatients with chronic kidney disease on dialysis had overall low QOL scores in all four domains. Age, ethnicity, employment status, income, and duration on hemodialysis affected one or more domains of QOL in such patients. Low income status and increased duration on hemodialysis were the only independent negative predictors of QOL of patients on maintenance hemodialysis.

Quality of life of patients from rural and urban areas in Poland with head and neck cancer treated with radiotherapy. A study of the influence of selected socio-demographic factors.

IntroductionThe quality of life (QoL) experienced by cancer patients depends both on their state of health and on sociodemographic factors. Tumours in the head and neck region have a particularly adverse effect on patients psychologically and on their social functioning.Material and methodsThe study involved 121 patients receiving radiotherapy treatment for head and neck cancers. They included 72 urban and 49 rural residents. QoL was assessed using the questionnaires EORTC-QLQ-C30 and QLQ-H&N35. The data were analysed using statistical methods: a χ2 test for independence and a multinomial logit model.ResultsThe evaluation of QoL showed a strong, statistically significant, positive dependence on state of health, and a weak dependence on sociodemographic factors and place of residence. Evaluations of financial situation and living conditions were similar for rural and urban residents. Patients from urban areas had the greatest anxiety about deterioration of their state of health. Rural respondents were more often anxious about a worsening of their financial situation, and expressed a fear of loneliness.ConclusionsStudying the QoL of patients with head and neck cancer provides information concerning the areas in which the disease inhibits their lives, and the extent to which it does so. It indicates conditions for the adaptation of treatment and care methods in the healthcare system which might improve the QoL of such patients. A multinomial logit model identifies the factors determining the patients’ health assessment and defines the probable values of such assessment.

Perceived Stigma and Quality of Life Among Women Living with HIV/AIDS

Background: Quality of life (QoL) is a broad construct and can be influenced by many factors. Perceived stigma is inevitable in patients with HIV. Therefore, it is an important factor to understand their QoL. Objectives: The current study was conducted to investigate the relationship between the perceived stigma among HIV-positive women and their QoL in Shiraz, Iran. Patients and Methods: In this quantitative study, 110 HIV-positive women were selected by simple random sampling method. A questionnaire was designed and used as a tool for data collection. The questionnaire included demographic information, internal stigma scale, and the ACTG short form-21 (SF-21) for measuring QoL. Data were collected from March to August 2015 and analyzed using t- test, Pearson’s correlations, and the multiple regression test with the SPSS software version 21. Results: The mean age of the women was 37.86 ± 9.03 years. Most of the participants were infected with HIV/AIDS through sex with their spouse (78.2%). About one-third of the women had physical symptoms (29.1%) of the HIV disease. The prevalence rate of perceived stigma in the sample was 69.7%. Quality of life was significantly different in terms of employment status, emotional support and physical symptoms (P < 0.05). Conclusions: A higher level of perceived stigma among HIV-positive women is associated with a considerable decrease in all QoL dimensions. Thus, more efforts should be considered to reduce the perceived stigma and improve the QoL of such patients.

Quality of life assessment in dogs and cats receiving chemotherapy-a review of current methods.

This study aimed to review currently reported methods of assessing the effects of chemotherapy on the quality of life (QoL) of canine and feline patients and to explore novel ways to assess QoL in such patients in the light of the experience to date in human pediatric oncology. A qualitative comparative analysis of published papers on the effects of chemotherapy on QoL in dogs and cats were conducted. This was supplemented with a comparison of the parameters and domains used in veterinary QoL-assessments with those used in the Pediatric Quality of Life Inventory (PedsQL™ ) questionnaire designed to assess QoL in toddlers. Each of the identified publications including QoL-assessment in dogs and cats receiving chemotherapy applied a different method of QoL-assessment. In addition, the veterinary QoL-assessments were mainly focused on physical clinical parameters, whereas the emotional (6/11), social (4/11) and role (4/11) domains were less represented. QoL-assessment of cats and dogs receiving chemotherapy is in its infancy. The most commonly reported method to assess QoL was questionnaire based and mostly included physical and clinical parameters. Standardizing and including a complete range of potentially relevant parameters in future QoL assessments may benefit owner decision making.

Influence of Socio-demographic and Clinical Characteristics on Quality of Life in Patients with Head and Neck Cancer among Indian Population

Quality of life (QOL) has been widely used as an adjunct to traditional endpoints of survival in patients with cancer. It is equally crucial to identify the determinants of QOL in such patients especially in a diverse country like India. In a prospective study on quality of life and its relationship with socio-demographic and clinical characteristics among 120 patients with head and neck cancer in India, we found that socio-economic status of patients and had a major impact on their quality of life. Patients from rural areas (P = 0.01), with monthly income less than Rs. 3000 (P = 0.01) and those working as unskilled labourers (P = 0.02) had significantly lower quality of life scores than others. While this is not surprising, these differences in quality of life are deeply disturbing. This data is published as an indicator of the discrepancy that exists and the impact of the illness on socio-economically disadvantaged survivors.

Estimulación audiovisual en niños con limitación grave de la motricidad: ¿mejora su calidad de vida?

Children with neurological diseases that impose severe limitations on their mobility have a deficient quality of life (QL). To study whether the QL of such patients improves with the application of a programme of audiovisual stimulation. A prospective study was conducted on nine children, six of whom were males (mean age: 42.6 ± 28.6 months), with severely limited mobility and who had been hospitalised for long periods. Two audiovisual stimulation programmes were produced and applied, together with videos, by means of a specially designed structure. The stimulus was applied twice a day for 10 minutes over 20 days. The first ten days the stimulus was carried out in a passive manner and the second block of ten days it was performed with the guidance of the observer. Biological, behavioural and cognitive variables were recorded and an adapted QL survey was applied. Three cases of spinal muscular atrophy, two of congenital muscular dystrophy, two of myopathy and two with other conditions were diagnosed. Eight patients completed the follow-up. From the baseline point of view, they presented a regular QL (7.2 ± 1.7 points; median: 7.0; range: 6-10), which improved to good on finishing the therapy (9.4 ± 1.2 points; median: 9.0; range: 8-11), with an intra-individual difference of 2.1 ± 1.6 (median: 2.5; range: -1 to 4; CI 95% = 0.83-3.42; p = 0.006). Improved cognition and a favourable perception in the caregivers were detected. No changes took place in the biological or behavioural variables. Audiovisual stimulation can be used to enhance the quality of life of children with severely limited mobility.

Quality of life and psychological status of patients with pemphigus vulgaris using Dermatology Life Quality Index and General Health Questionnaires

Pemphigus vulgaris with painful chronic blisters and/or erosions on skin and mucosa can impair quality of life (QOL). Therapeutic modalities in the long run can have additional negative impact. There are few studies that have focused on QOL of such patients except in treated cases. The aim of this study was to describe the effect of the disease per se on QOL before receiving treatment and evaluation of psychological status of the patients and its effect on their QOL. A total of 61 patients with newly diagnosed non-treated pemphigus vulgaris participated in the study. The Persian version of the Dermatology Life Quality Index (DLQI) questionnaire was used to evaluate their QOL and the 28-item General Health Questionnaire (GHQ-28) for their psychological status. In this study, the mean DLQI score was 10.9 ± 6.9. QOL was worse in patients with nasal and pharynx involvement, with positive Nikolsky sign, patients with severe skin involvement and those who showed the symptom of itching. There was a negative correlation between DLQI score and duration of the disease. More than 77% of patients experienced anxiety and depression with more impaired QOL. In conclusion, pemphigus vulgaris is responsible for great alteration in QOL, especially in its severe form. The disease in its initial stage may have greater impact on the QOL. The high probability of anxiety and depression in these patients and its negative effect on QOL should be taken into account in the management of these patients right from the start of the treatment.

Quality of Life in CAPD, Transplant, and Chronic Renal Failure Patients with Diabetes

Although quality of life (QoL) is an important outcome measure, there are few studies of QoL in diabetic patients. We performed a cross-sectional study to assess QoL in such patients comparable for age, sex, and co-morbidity. Patients. Group CAPD: DM (n = 19, 12 males), diabetic CAPD patients; group CAPD: no DM (n = 26, 15 males) CAPD patients without diabetes; group TXP (n = 20, 10 males), diabetic transplant patients; and group CKD: DM (n = 20, 11 males), diabetics with chronic kidney disease. Two valid QoL instruments were used: a generic one (SF-36) and one that is disease-specific (RQLP). Results. As a whole, CAPD patients scored badly as far as concerned the physical domain, but with a good mental adaptation. Diabetic CAPD patients exhibited worse QoL for physical functioning, energy, vitality, leisure activity, and eating/drinking limitations. Diabetic transplant patients exhibited the best QoL. The RQLP instrument had better discriminative power for domains such as eating/drinking, treatment effects, and psychosocial aspects. Using analysis of co-variance and adjusting for age, sex, and co-morbidity, QoL differences disappeared.In conclusion, diabetic CAPD patients exhibited the worst QoL though with a satisfactory mental adaptation, a renal-specific instrument had better discriminative power, and the prevention of co-morbidity is likely to improve QoL in such patients.