Quality Of Life Items Research Articles

P-517 - The predictive factors of the quality of life for persons with depression: a follow up study

Depression is a common mental disorder that substantially impairs a client's functioning. The aim of this study is to examine the predictive factors of quality of life (QOL) for depression from longitudinal perspectives. 237 outpatients with depression were recruited in the study. They were from a psychiatric outpatient clinic in northern Taiwan. All subjects were tested on the baseline and followed up twice during 3-year period. The average age of subjects was 47.1 years. Most subjects were female, married and lived with their spouses.Seventy subjects participated in both follow ups (T2 and T3). There were no significant differences on the demographic characteristics at T1 between the respondents (N = 70) and non-respondents (N = 167) except for gender. The subjects were tested on the WHOQOL-BREF-Taiwan version, occupational self assessment, mastery, social support and Center of Epidemiology Study-Depression Scale (CESD). The data were analyzed by mixed effect model using SAS computer program.The severity of depression could predict overall QOL, overall health and 13 items of QOL. The type of antidepressants had significant impact on the subjects’ QOL in 10 items. The occupational competence and sense of mastery predicted 13 items (50%) and 14 items (53.8%), respectively.In order to advance the treatment outcomes, the professionals should pay more attention on the enhancement of the sense of competence and mastery. We suggested that treatments should target at improving adaptive skills, lifestyle, and occupational competence.

Design of a Physical Activity Program to Prevent Functional Decline in Onco-Geriatric Patients (CAPADOGE): A Randomized Multicenter Trial.

Cancer in older patient favours the development of frailty: feeling of exhaustion, loss of weight, decreased muscle strength, slow gait speed, and low physical activity. To evaluate the efficacy of adapted physical activity phone advices in limiting the cancer-induced loss of autonomy and frailty phenotype development. Multicenter randomized controlled trial. Patients (>70y) undergoing curative treatment for cancer (n=400) will be recruited from 12 centres. The intervention consists in phoned personalized physical activity advices related to strength, aerobic, balance, proprioception, and flexibility. The contacts are performed twice a month during six months and then monthly until 1 year. The intervention complements the PNNS booklet advices (National Nutritional Health Program). The trial compares «individualized phone advices + PNNS» to «usual care + PNNS». Functional, cognitive, clinical and self-reported data are assessed before treatment and at 3, 6, 12, 18, and 24 month follow-up. The primary outcome is the proportion of subjects with a one-year decreased SPPB (Short Physical Performance Battery) score of one point or more, as compared to baseline. The secondary outcomes include quality of life items, rate of hospitalizations, institutionalizations, mortality, Fried phenotype at 1 and 2 years, and the SPPB score at 2 years. This large trial will provide clinical data of the effects of an exercise advices intervention in older patients during cancer therapy on function and cognition evolution, and quality of life. The possibilities of minimizing the development of frailty phenotype due to these advices will be explored.

Psychosocial quality of life of elderly hemodialysis patients using visual analog scale: Comparison with healthy elderly in Japan

BackgroundThe number of elderly hemodialysis (HD) patients is increasing in Japan, and the psychosocial impact of HD to the elderly remains unclear. The main purpose of this study was to evaluate quality of life (QOL) of elderly patients undergoing regular HD. MethodsWe examined the psychosocial status in elderly HD patients and compared it with that in healthy elderly individuals. The correlations between each item of QOL, laboratory data and comorbidities were explored. This study cohort consisted of 142 people (70 healthy elderly participants and 72 elderly HD patients). We assessed 10 items of QOL, i.e., health condition, appetite, sleep, mood, memory, family relationship, friendship, economical status, satisfaction in daily life, and happiness by visual analog scale (VAS). ResultsOverall, elderly HD patients had lower scores of VAS than healthy elderly participants, especially in sleep, mood, and happiness, but not in family relationship and friendship. Lower VAS scores for sleep were significantly correlated with the duration of HD therapy and the troubles in vascular access for HD. VAS scores for family relationship were also correlated with the duration of HD therapy. ConclusionThe QOL of elderly HD patients was poorer than that in healthy elderly individuals, particularly in sleep, mood and happiness. Further study is needed to improve the QOL of elderly HD patients. This is of great importance, since the number of elderly HD patients is estimated to escalate in the future.

Invariance Testing of the SF-36 Health Survey in Women Breast Cancer Survivors: Do Personal and Cancer-related Variables Influence the Meaning of Quality of Life Items?

Quality of life (QoL) is affected by issues specific to illness trajectory and thus, may differ, and potentially take on different meanings, at different stages in the cancer process. A widely used measure of QoL is the SF-36 Health Survey (SF-36; Ware 1993); therefore, support for its appropriateness in a given population is imperative. The current study aimed to examine the conceptual (measurement) model of the SF-36, as well as closely related models, and test the measurement invariance of the SF-36 to determine if meaningful comparisons could be made among three groups of breast cancer survivors (N = 358 (data collected in 2007-2008); divided on time since treatment, type of treat- ment, and age). Good model fit was found for one of three models based on the original design of this instrument—the items to subscales model. Two models were considered for measurement invariance testing: (a) items to physical health/mental health and (b) items to subscales. Strong invariance was found for time since treatment and type of treatment for both models. Weak invariance was found for age in the first model, while strict invariance was confirmed for the subscales model. Group comparisons in QoL were made where justified. Significant differences were found only on age for physical functioning, role limitations due to emotional problems, vitality, mental health, and social functioning. Overall, results suggest that while the SF-36 can be used to examine differences in QoL for various breast cancer survivors, some conceptual issues with this instrument need to be further examined.

The use of Chinese herbal medicine to improve quality of life in women undergoing chemotherapy for ovarian cancer: a double-blind placebo-controlled randomized trial with immunological monitoring

BackgroundThis study aimed to evaluate traditional Chinese medicine (TCM) in improving quality of life (QOL), reducing chemotoxicity and modulating immune function in patients undergoing chemotherapy. Patients and methodsPatients with ovarian cancer were randomized to receive either TCM or placebo in addition to standard chemotherapy. The primary outcome was global health status (GHS) score, assessed by European Organization for Research and Treatment of Cancer questionnaire, while the secondary outcomes were other QOL items, chemotoxicity according to World Health Organization criteria and alterations in immune function as measured by immune cells count and the numbers of cytokines-secreting cells. ResultsThere was no significant difference in the GHS between the two groups. With adjustment for stage, chemotherapy type, disease status, age and baseline value, emotional function, cognitive function and nausea and vomiting were found to be worse or less improved in the TCM group compared with placebo group after six cycles of chemotherapy. The TCM group had less neutropenia after three cycles (0% grade 4 neutropenia versus 28.6%). There were no other significant differences in terms of chemotoxicity. Lymphocyte counts and cytokine activities decreased less in the TCM group. ConclusionsTCM did not improve QOL but did have some effects in terms of maintaining immune function.

Comparison of the psychosocial quality of life in hemodialysis patients between the elderly and non‐elderly using a visual analogue scale: The importance of appetite and depressive mood

The number of hemodialysis (HD) patients is increasing along with their mean age in Japan. The assessment of their psychosocial status and quality of life (QOL) is therefore becoming more and more important along with laboratory data or comorbidities. We examined the psychosocial status of 211 HD patients (72 elderly and 139 non-elderly) and compared the difference between elderly and non-elderly patients using a visual analogue scale (VAS). We then examined how QOL affected mortality rate in 3-year prospective follow up. We assessed 10 items of QOL: health condition, appetite, sleep, mood, memory, family relationships, friendship, economical status, life satisfaction in daily life, and happiness with qualified self-evaluating questionnaires along with laboratory data and comorbidities. Furthermore, we investigated the correlation between the scores of mood and geriatric depression scale (GDS)-15. There was no difference in VAS scores between elderly and non-elderly patients. Lower VAS scores for appetite and mood correlated with higher mortality in HD patients, especially in the non-elderly. VAS scores for mood correlated with GDS-15 in HD patients. More attention should be paid to appetite and the diagnosis and therapy of depressive mood to improve the prognosis of HD patients, especially for the non-elderly.

Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study

We aimed to evaluate the efficacy and safety of combination treatment using anticholinergics with α-blocker for initial treatment of both overactive bladder (OAB) and other lower urinary tract symptoms (LUTS), secondary to BPH. A 12-week, randomized, double-blind, placebo-controlled trial was conducted at four urology clinics in Korea, involving men, aged 50 years or older, with LUTS related to BPH and OAB. A total of 176 patients were randomly assigned to receive doxazosin (4 mg) plus placebo or doxazosin (4 mg) plus tolterodine SR (4 mg), once a day for 12 weeks. Changes from baseline in total International Prostate Symptom Score (IPSS), bladder diary variables, patient perception of bladder condition (PPBC), uroflowmetry, postvoid residual volume and IPSS subscores (voiding and storage) were analyzed. Of the 176 enrolled patients, 91 had doxazosin gastrointestinal therapeutic system (GITS) and placebo, and 85 had combined medication with doxazosin GITS and tolterodine SR. Compared with the doxazosin plus placebo group, the doxazosin plus tolterodine group showed significant reductions in IPSS storage subscore and improvement in the quality of life item, urgency episodes, as well as in micturition frequency at weeks 4 and 12. However, it failed to improve PPBC at week 4 as well as at week 12. Earlier intervention with anticholinergics plus α-blocker was tolerated well, including the questions about urinary retention (n=1) and dry mouth (n=2). Initial combination treatment of anticholinergics plus α-blocker showed positive results for men with LUTS related to BPH and OAB symptoms and did not increase the risk of urinary retention.

Quality of life, geriatric assessment and survival in elderly patients with non-small-cell lung cancer treated with carboplatin–gemcitabine or carboplatin–paclitaxel: NVALT-3 a phase III study

BackgroundElderly patients with advanced non-small-cell lung cancer (NSCLC) may derive similar benefit from platinum-based chemotherapy as younger patients. Quality of life (QoL) and comprehensive geriatric assessment (CGA) is often advocated to assess benefits and risks. Patients and methodsA total of 181 chemotherapy-naive patients [≥70 years, performance score (PS) of 0–2] with stage III–IV NSCLC received carboplatin and gemcitabine (CG) (n = 90) or carboplatin and paclitaxel (CP) (n = 91) every 3 weeks for up to four cycles. Primary end point was change in global QoL from baseline compared with week 18. Pretreatment CGA and mini geriatric assessment during and after treatment were undertaken. A principal component (PC) analysis was carried out to determine the underlying dimensions of CGA and QoL and subsequently related to survival. ResultsThere were no changes in QoL after treatment. The number of QoL responders (CG arm, 12%; CP arm, 5%) was not significantly different. CGA items were only associated with neuropsychiatric toxicity. Quality-adjusted survival was not different between treatment arms. The PC analysis derived from nine CGA, six QoL and one PS score indicated only one dominant dimension. This dimension was strongly prognostic, and physical and role functioning, Groningen Frailty Indicator and Geriatric Depression Scale were its largest contributors. ConclusionsPaclitaxel or gemcitabine added to carboplatin did not have a differential effect on global QoL. CGA was associated with toxic effects in a very limited manner. CGA and QoL items measure one underlying dimension, which is highly prognostic.

Quality of life in patients treated for advanced hypopharyngeal or laryngeal cancer

To study quality of life in patients treated for advanced hypopharyngeal or laryngeal cancer, with laryngeal conservation or laryngectomy. A retrospective 2-center study included 100 patients in remission from squamous cell carcinoma, treated between 1998 and 2009. Seventy patients (24 hypopharynx, 46 larynx) were treated by total (pharyngo-) laryngectomy followed by external radiation therapy, and 30 (13 hypopharynx, 17 larynx) underwent an organ-conservation protocol with concurrent radiochemotherapy or with induction chemotherapy using platin-5FU or taxan-platin-5FU followed by radiation therapy. All patients responded to the quality of life questionnaires (EORTC QLQ-C30 and QLQ-H&N35). Advanced tumor stages IVa and IVb were significantly more frequent in the surgery groups (hypopharynx: 71.6% vs. 45.9%, p=0.01; larynx: 72.4% vs. 37.5%, p<0.01). In pharyngeal cancer, the only significant difference between surgical treatment and laryngeal conservation was for "sensory disorder" (taste and odor), with better results in case of laryngeal conservation (p<0.0001). For the other items, there was a trend for quality of life to appear better in patients with laryngeal conservation (p=NS). In laryngeal cancer, the only significant difference was for "dry mouth", which was significantly less invalidating with surgical treatment (p<0.001). The impairment of the other quality of life items did not differ between surgical and conservative treatment. Quality of life is impaired in all patients treated for pharyngeal or laryngeal cancer. The type of treatment, surgical or conservative, affects differently various aspects of quality of life.

Cognitive difficulties among patients with cancer receiving chemotherapy affects quality of life: A University of Rochester Clinical Community Oncology Program study of 439 patients.

9119 Background: Cognitive difficulties affect up to 75% of cancer patients receiving chemotherapy, and these difficulties linger in up to 35% of survivors years after treatment. The extent to which cognitive difficulties affect quality of life (QOL) in patients receiving chemotherapy is not well-understood. Methods: We examined levels of memory and concentration difficulty in 439 patients undergoing chemotherapy who were enrolled in a randomized trial assessing effects of modafinil on cancer-related fatigue conducted through the University of Rochester Clinical Community Oncology Program (CCOP). Memory and concentration were assessed via the Fatigue Symptom Checklist (FSCL) from those that completed the measure at cycles 2, 3, and 4 of chemotherapy. QOL (i.e., general activity, mood, normal work, and enjoyment of life) items were assessed by the Brief Fatigue Inventory (BFI). Spearman’s rho correlations were used to determine the strength of the relationship between cognitive function and QOL. Logistic regression was used to predict associations between memory and concentration at cycle 2 and 3 with cycle 4 and was also used to predict associations between memory and concentration difficulty at cycle 2 with interference in QOL at cycle 4. Results: Concentration and memory difficulty at cycles 2 and 3 were both significant predictors of concentration and memory difficulty at cycle 4 (OR range=1.94 to 9.08; all p <0.05). At cycles 2, 3, and 4, problems with memory and concentration were significantly correlated with interference in all QOL items assessed (r values range=0.160 to 0.365, all p <0.05). Concentration difficulty at cycle 2 was significantly predictive of interference in all QOLs items at cycle 4 (OR range=2.23 to 3.34; all p <0.05). Memory difficulty at cycle 2 was only significantly predictive of interference in mood at cycle 4 (OR=2.05, p <0.05) and not other items (OR range=1.33 to 2.13; p >0.05). Conclusions: Our results suggest that cognitive difficulties in cancer patients receiving chemotherapy are associated with reductions in QOL. Further research on the long-term effects of cognitive difficulties on QOL are needed.

Descriptive characteristics of a colon disease family registry at an urban hospital

Background: Hospital registries are an important component of cancer screening efforts of individuals and communities. This paper describes the structure and goals of a Colon Disease Family Registry at a metropolitan hospital. Patient characteristics, differences between gastrointestinal diseases among probands, subjective distress in relation to perception of colorectal cancer, and quality of life were examined. Methods: Participants were patients with colorectal cancer (CRC), familial adenomatous polyposis (FAP), hereditary nonpolyposis colorectal carcinoma (HNPCC) and inflammatory bowel disease ulcerative colitis (UC) and Crohn's disease representing a range of colonic diseases. A total of 630 probands were recruited into the registry and administered a questionnaire. Results: Of the 630 probands, 198 (31.4%) were diagnosed with CRC, 36 (5.3%) with FAP or HNPCC and 272 (43.2%) with UC or Crohn's. The majority of all three groups had some level of college education, was white, and reported a household income greater then $70,000. The Impact of Event Scale score was found to be of notable significance when categorized by relation to proband ( p < 0.01) and proband diagnoses ( p ≤ 0.000). On the quality of life item, the largest difference was between FAP or HNPCC and UC or Crohn's without CRC. Conclusion: Subjective distress scores were higher for CRC probands in comparison to probands with other colorectal diseases. Quality of life was relatively high for all probands. Psychological distress should be explored in more depth and more frequently to screen for any concomitant psychiatric disorders like post-traumatic symptoms that have been linked to a cancer diagnosis.

Validity and reliability of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTC QLQ): experience from Kuwait using a sample of women with breast cancer

BACKGROUND AND OBJECTIVES:Although the EORTC QLQ-C30 and its breast-specific module (BR-23) are widely used instruments, the few reports on their psychometric characteristics from Arab and neighboring countries involved limited analyses. Our objective was to assess the psychometric characteristics of both questionnaires using the responses of a larger sample of Arab women.METHODS:Participants were consecutive clinic attendees at the Kuwait Cancer Control Center. The indices assessed were alpha coefficients, item-internal consistency (IIC), item-discriminant validity (IDV), and known-groups validity.RESULTS:The 348 women were aged 48.3 (10.3) years. The intra-class correlation for the test-retest statistic and the internal consistency values for the multi-item scales were >0.7 alpha. With the exception of the pain subscale, all items met the IIC criterion of >0.4 correlation with the corresponding scale. For IDV, the BR-23 performed better than the QLQ-C30. The scale scores discriminated between patients at different disease stages, and between sick and well populations.CONCLUSION:With the exception of the pain subscale, the Arabic version of the questionnaires is psychometrically sound.

On demand treatment and home therapy of hereditary angioedema in Germany - the Frankfurt experience

BackgroundManifestation of acute edema in hereditary angioedema (HAE) is characterized by interindividual and intraindividual variability in symptom expression over time. Flexible therapy options are needed.MethodsWe describe and report on the outcomes of the highly individualized approach to HAE therapy practiced at our HAE center in Frankfurt (Germany).ResultsThe HAE center at the Frankfurt University Hospital currently treats 450 adults with HAE or AAE and 107 pediatric HAE patients with highly individualized therapeutic approaches. 73.9% of the adult patients treat HAE attacks by on-demand therapy with pasteurized pd C1-INH concentrate, 9.8% use additional prophylaxis with attenuated androgens, 1% of the total patient population in Frankfurt has been treated with Icatibant up to now. In addition adult and selected pediatric patients with a high frequency of severe attacks are instructed to apply individual replacement therapy (IRT) with pasteurized pd C1-INH concentrate. Improvement on Quality of Life items was shown for these patients compared to previous long-term danazol prophylaxis. Home treatment of HAE patients was developed in the Frankfurt HAE center in line with experiences in hemophilia therapy and has so far been implemented over a period of 28 years. At present 248 (55%) of the adult patients and 26 (24%) of the pediatric patients are practicing home treatment either as on demand or IRT treatment.ConclusionsIn conclusion, the individualized home therapies provided by our HAE center, aim to limit the disruption to normal daily activities that occurs for many HAE patients. Furthermore, we seek to optimize the economic burden of the disease while offering a maximum quality of life to our patients.

Gitelman syndrome in Gypsy paediatric patients carrying the same intron 9 + 1 G&gt;T mutation. Clinical features and impact on quality of life

Gitelman syndrome is a primary tubular disorder causing hypokalaemic metabolic alkalosis with hypocalciuria. Its prevalence is high in Gypsies, who harbour an identical mutation, intron 9 + 1 G>T, in the SLC12A3 gene. To better define the Gitelman syndrome in Gypsies, the clinical and biochemical features of 34 Spanish paediatric Gypsy patients were analysed. At diagnosis, symptoms, height and weight as well as serum and urinary biochemical data were collected. During a follow-up of 4.5 ± 2.4 years [X ± standard deviation (SD)], therapy, treatment compliance, symptoms, frequency of hospital admissions and, at the last visit, growth and biochemical work-up of 29 patients followed for at least 6 months were analysed. Quality of life items were also assessed by a questionnaire. Muscle cramps (41%) and asthenia (35%) were the most frequent presenting symptoms. Biochemical data at diagnosis were serum K 2.76 ± 0.46 mEq/L, serum Mg 1.32 ± 0.28 mg/dL, blood pH 7.45 ± 0.06, serum bicarbonate 28.2 ± 2.9 mEq/L, urinary calcium/creatinine ratio 0.03 ± 0.04 mg/mg, fractional K excretion 24.4 ± 17.1% and fractional Mg excretion 8.9 ± 8.3%. During follow-up, Mg and K supplements were prescribed to 79 and 86% of patients, respectively; compliance with treatment was good in 35%. Hospital admission rate was 0.03/patient/month. Muscle cramps were the symptom most often referred by the patients (45%) during the follow-up, and 71% of patients considered their health status as excellent or good. Twenty-one patients stated that their disease did not adversely interfere with their mood or social relationships. Height and weight of patients at diagnosis were -0.60 ± 1.17 and -0.49 ± 1.32 SD, respectively, and improved to -0.44 ± 1.28 (P < 0.05) and 0.18 ± 1.79 SD (P < 0.01) at the last visit. Gypsy children with Gitelman syndrome mostly exhibit muscle symptoms and asthenia although the disease is not particularly severe in this ethnic group. Body growth improves with treatment and close follow-up.

Item Banking: A Generational Change in Patient-Reported Outcome Measurement

Patient-reported outcomes are traditionally measured with questionnaires and many have been developed to measure Vision-Related Activity Limitation (VRAL; visual disability or visual functioning), Symptoms, and Quality Of Life (QOL). These vary in quality and can be classified as First or Second Generation instruments. First generation instruments are characterized by simple summary scoring of ordinal responses, which precludes interval measurement. This problem is solved in second generation instruments where Rasch analysis is used to optimize psychometric properties. However, second generation instruments retain limitations; difficulties in comparing scores across instruments, limited applicability to populations and inability to adapt to change. A third generation approach to patient-reported outcomes measurement, item banking, can solve these problems. The aim of this project was to use Rasch analysis to calibrate all items from all instruments to form VRAL, Symptoms, and QOL Item Banks. Six hundred twenty-four people on the waiting list for cataract surgery were recruited. Each participant completed, by self-administration, a number of the 19 instruments. A total of 353 items were calibrated using Rasch analysis (Winsteps v3.67). The psychometric properties of each item bank were optimized; items fitting the Rasch model were retained (Infit and Outfit range, 0.50 to 1.50). Items were sorted into the three traits; 226 tapped VRAL, 22 symptoms, and 60 QOL. Satisfactory measurement of each latent trait occurred with person separation of 8.11 for VRAL, 2.33 for Symptoms, and 3.20 for QOL. Rasch estimates of item difficulty were highly stable with an average standard error of 0.11 logits. Item banks for the measurement of the latent traits of VRAL, symptoms, and QOL have been formed. New items can be added to enable evolution of measurement. Item banking facilitates accurate and precise measurement through computer adaptive testing. This approach provides common measurement scales, facilitating worldwide comparison of results.

Effects of walking on quality of life (QOL) of mastectomy patients in hospitals of Tehran

Background and Aim Breast cancer is the most common malignancy in women with an estimated new cases amount to 178000 in 2007. Although surgery is the most frequent intervention, patients experience problems both from the disease and from surgery, leading to negative impact on their quality of life (QOL). Accordingly, such exercises as walking can improve their QOL. The aim of this quasi-experimental one-group study was to assess the effect of walking on QOL of mastectomy patients in 2007. Materials and Methods 34 subjects selected by purposive and convenience sampling methods took part in the study. A two-part questionnaire including demographic as well as QOL items and a self-report form were used for data collection. After determining content and face validities, the reliability of the questionnaire was figured by internal consistency (α=0.89) and test-retest (r=0.91) methods. Walking was performed in a flat area, 3 times a week and each time 30 minutes over 6 weeks. QOL items in the questionnaire were completed 2 times before and after the intervention. Findings Mean scores of physical domain before and after the intervention were %64.55±8.10 and 78.89±5.81, of psychological domain 52.89±10.74 and 64.92±8.64, of social domain 64.76±9.59 and 79.06±25.62, of economical domain 68.63±16.29 and 73.28±15.32 and of spiritual domain 79.96±12.57 and 82.54±11.18 respectively. Mean scores of total QOL were 66.16±6.30 and 75.74±6.59 before and after the intervention respectively. A significant increase was found in all domains except spiritual. Conclusion It can be concluded that walking has positive effects on QOL of mastectomy patients to overcome their problems. Keywords: Walking, Quality of life (QOL), Mastectomy. * Corresponding Author: Moshtagh Eshgh, Z. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: z.moshtagh@yahoo.com

Treatment Outcomes and Quality of Life in Oropharyngeal Cancer after Surgery-based versus Radiation-based Treatment

ObjectivesAdvances in reconstruction and conservative surgery and the importance of quality of life (QOL) encouraged this reevaluation of surgery-based treatments for oropharyngeal cancer. We tried to compare treatment outcome and QOL after surgery-based versus radiation-based treatment in oropharyngeal cancer.MethodsThe 133 eligible patients were divided into surgery-based and radiotherapy (RT)-based treatment groups. Medical records were reviewed, and EORTC QLQ-C30 and HN65 questionnaires were completed for survivors. Three-year overall survivals, disease-free survivals, locoregional control rates, and QOL scores were compared between the two groups.ResultsDemographic data and overall stages were not significantly different between the two groups, and all survival rates were non-significantly different, either. The scores for most QOL items were equivalent, however, for a few items, scores were significantly better in surgery-based group.ConclusionThe surgery-based group achieved equivalent treatment outcomes and slightly better QOL scores than the RT-based group. The results of this study suggest that surgery could still be considered as a first-line therapy for oropharyngeal cancer.

P01-359 - Overall quality of life among spanish patients with mild cognitive impairment and dementia

ObjectivesDoing there is no consensus for a multidimensional definition of Quality of Life (QoL) in dementia, and that informant- and self-perceptions of QoL differed substantially, lately it has been proposed to analyze Overall QoL using a simple item. Our objective was to investigate Overall QoL and how this perception among people with Cognitive Impairment and Dementia is associated with other variables. Thus, obtained predictor variables of QoL will act as confirmatory indexes to corroborate the self-reported QoL in clinical setting.MethodsWe conducted a cross-sectional survey where 106 participants with Cognitive Impairment (CI) and Dementia completed a face to face interview including diagnosis of dementia (DSM-III-R / DSM-IV), sociodemographic information, health perception and a list of chronic medical conditions, depressive symptoms (GDS-15) and functional ability (Barthel Index). Quality of life was measured with the self-assessment of overall QoL item from WHOQOL-BREF.ResultsMean age was 78.7 y.o. (SD: 7.1, range 55-91); 64.8% were female and 50% had primary school or more. Ordinal Logistic Regression analysis showed four factors correlated with a better QoL: (1) patients rating their health as good or more than good, (2) patients considering themselves healthy, (3) patients reporting not having depression, and (4) patients having less depressive symptoms (lower GDS scores).ConclusionsA single-item global rating of patient QoL could prove useful in assessing QoL of most mild-to-moderate-stage CI and dementia patients. Affective states should be considered when assessing QoL in patients with CI and dementia; consistently, negative mood have a detrimental impact on QoL.

Determinants of global quality of life before and after major cancer surgery: an exploratory study

To explore whether determinants of global quality of life (QOL) change before and after major cancer surgery. Consecutive patients (n = 145) undergoing surgery for upper gastrointestinal cancer were prospectively studied and asked to complete the EORTC QLQ-C30 before and after 6 months. Excluded were patients found to be inoperable (n = 12) and those with missing second questionnaires (because of death n = 20, poor health (n = 10), administrative failure (n = 7) or patient refusal (n = 4)). Multivariable linear regression models investigated associations between global QOL and other scales and items of QOL adjusting for clinical variables. Some 87 patients completed both questionnaires. Before surgery the main predictors of global QOL were physical and emotional function, with adjusted increases in global QOL of 0.55 (95% CI 0.26-0.84; P < 0.001) and 0.30 (95% CI 0.14-0.45; P < 0.001) per unit increase of physical and emotional function, respectively. Six months after surgery, however, fatigue and dyspnea most strongly predicted global QOL, with adjusted differences in global QOL of -0.24 (95% CI -0.44 to -0.04; P = 0.02) per unit increase of fatigue and -6.28 (95% CI -12.64 to 0.07; P = 0.05) for those experiencing any symptoms of dyspnea. Further work is needed to test these findings, but the results suggest that the global QOL scale in the QLQ-C30 is difficult to interpret and it should be considered within the context of other clinical and patient reported outcomes.

The psychometric validation of a US English satisfaction measure for patients with benign prostatic hyperplasia and lower urinary tract symptoms

BackgroundThe purpose of the current study was to validate the US English Patient Perception of Study Medication (PPSM) questionnaire, which measures patient satisfaction with Benign Prostatic Hyperplasia (BPH) treatment and was administered to men with BPH lower urinary tract symptoms (LUTS) enrolled in a multi-national clinical trial.MethodsPatients with moderate to severe BPH symptoms completed three disease-specific measures: The International Prostate Symptom Score (IPSS), the BPH Impact Index (BII) and the PPSM, at baseline (after completion of the placebo run-in period) and at every 13-week clinic visit thereafter for the duration of the study treatment period. The PPSM was analysed to assess its variability, reliability and validity.ResultsThere were 879 patients included in the analyses, with a mean age of 66.7 years. The PPSM was found to comprise two factors – PPSM-Global and PPSM-Pain, with a Total Score ranging from 7 to 49. It demonstrated good internal consistency (Cronbach's alpha ranged from .95 to .97) and also demonstrated convergent validity through significant correlations with the IPSS (.48 to .58), IPSS Quality of Life (QoL) item (.41 to .63) and BII (.31 to .45) and known-groups validity against the IPSS, IPSS QoL item and BII.ConclusionResults support the use of the PPSM as a measure of satisfaction in BPH patient groups.