Quality Of Life Scores Research Articles

Correlation between short-term quality of life improvement and clinical outcomes - a post-hoc ISCHEMIA trial analysis

Abstract Background Patients with symptomatic coronary artery disease (CAD) exhibit improvement in quality of life (QoL) after invasive management (percutaneous coronary intervention [PCI] and coronary artery bypass grafting [CABG]). However, it is not clear how QoL improvements after intervention are related to clinical outcomes. Purpose Using the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) population, we sought to assess the relationship between short-term QoL improvement and long-term clinical outcomes. Methods All participants in the ISCHEMIA trial who were randomized to the invasive arm and who had QoL scores available were included in the analysis. QoL improvement was calculated using the difference between the Seattle Angina Questionnaire (SAQ) score at baseline and at six months regarding randomization. The primary outcome was the trial-defined composite outcome (cardiovascular death, myocardial infarction, cardiac arrest or hospitalization for unstable angina/heart failure) and all-cause death. The secondary outcome was all-cause mortality. Median follow-up was 3.3 years. Cox proportional hazards models included clinically relevant demographic and angiographic covariates. Results After the exclusion of the conservative treatment arm and patients without QoL follow-up or covariate data, 1,577 patients were selected for the final analysis (Fig.1). The median baseline SAQ score was 74 (interquartile range, IQR: 60-88), the change in score at six months was 14 (IQR: 2-26), and 76.1% of patients experienced improvement in QoL. Six-month QoL improvement was not associated with a lower risk of the primary outcome (hazard ratio [HR]: 0.961, 95% confidence interval [CI], 0.920-1.005, p=0.081 – Table 1), but was associated with all-cause mortality (HR: 0.919, 95% CI, 0.859-0.982, p=0.013 – Table 1). In this population, increased age (HR: 2.370, 95% CI, 1.710-3.287, p<0.001, per 10 years) was also associated with higher risk of all-cause mortality. Conclusions Among invasive treated patients in ISCHEMIA trial, six-month QoL improvement was associated with a lower risk of long-term all-cause mortality, but not with a lower risk of major adverse events.Figure 1.Study population.

The relationship between health literacy level and quality of life in bariatric surgery patients

Abstract Background Today, obesity is an important public health problem. In addition to the intervention programmes developed to prevent obesity, the necessity of medical and surgical treatment is increasing with the growing population. This study was conducted to determine the relationship between health literacy and quality of life in patients undergoing bariatric surgery. Methods This cross-sectional study was conducted with the participation of 136 patients aged 18 years and older who underwent bariatric surgery in a general surgery service between January 2021 and December 2023 and whose contact information was available. The survey participation rate was 75.1%. The questionnaire used for data collection consisted of questions about the sociodemographic information of the participants, The European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the Postbariatric Surgery Quality of Life Scale items. Descriptive statistics, Mann Whitney U, Kruskal Wallis H test and Spearman correlation analysis were used to analyze the data. A value of p < 0.05 was considered statistically significant. Results The mean age of the patients who participated in the study was 38.2 ± 10.8 years; mean BMI was 42.3 ± 6.4 before surgery and 29.0 ± 6.2 after surgery. In the study, 44.1% of the patients who underwent bariatric surgery were found to have inadequate/problematic health literacy level. Participants who had less than a bachelor’s degree (p = 0.009) and low income (p < 0.001) had significantly lower health literacy levels. In addition, a moderate positive correlation was found between overall health literacy score and quality of life score (r = 0.252; p = 0.003). Conclusions In conclusion, this study shows that improved health literacy positively affects quality of life in patients undergoing bariatric surgery and that health literacy education should be emphasized in this context. Key messages • The level of health literacy of bariatric surgery patients is a determining factor on quality of life, and therefore health literacy education is important, especially in identified risk groups. • Increased health literacy can have positive results in terms of psychosocial and physical health and improve quality of life after bariatric surgery.

Psychological Distress and Quality of Life Among Military Trauma Patients.

Military trauma has a significant impact on soldiers, affecting many aspects of their lives, with the highest impact on their quality of life and psychological wellness. This study aimed to measure psychological distress and its relationship with the quality of life among Jordanian military trauma patients. A descriptive cross-sectional study was conducted in The Hashemite Protection Departments for military causalities in Amman, Irbid, and Al-Karuk. The authors used the WHO Quality of Life Scale-Brief and Trauma Symptoms Checklist-40 scales for assessing the quality of life and psychological distress among Jordanian military trauma patients. A total of 145 trauma survivors participated in the study and responded to all questionnaires out of 173 distributed. The study was approved by the institutional review board of Al-Zaytoonah University. The result of this study revealed that military trauma survivors had high levels of psychological distress with a mean of 85.66 (SD = 19.418). The subscale of "Dissociation symptoms" had the highest rating (M = 19.92, SD = 5.096), while the "sleep disorders" subscale had the lowest rating (M = 10.000, SD = 3.501). On the quality of life scale, a moderate level of quality of life resulted among the participants with a mean of 61.620 (SD = 17.190). The "general health" subscale scored the highest among the other domains (M = 18.241, SD = 5.434), while the "physical health" domain scored the lowest (M = 4.910, SD = 2.078). Furthermore, a statistically significant negative relationship between psychological distress and quality of life was reported (r =-0.178, P < .05). Jordanian injured military persons had a moderate quality of life level and high level of psychological distress. A structured follow-up program is required to be developed to improve those patients' health and quality of life. Furthermore, additional research is needed to investigate the impact of military trauma and services on soldiers in Jordan and the Middle East.

Clinical Study on the Treatment of Senile Alzheimer’s Dementia with Sodium Oligomannate Combined with Memantine Hydrochloride

Objective: To analyze the clinical effects of sodium oligomannate combined with memantine hydrochloride in the treatment of senile Alzheimer’s dementia. Methods: Sixty-eight cases of Alzheimer’s dementia treated at the Second People’s Hospital of Fujian University of Traditional Chinese Medicine from March 2020 to March 2022 were selected as the study subjects. The patients were divided into two groups based on different treatment methods: the control group (treated with memantine hydrochloride, 34 cases) and the treatment group (treated with sodium oligomannate + memantine hydrochloride, 34 cases). Cognitive function, activities of daily living, neurotransmitters, serum intestinal flora metabolic markers, inflammatory factors, neurotrophic factors, and adverse reactions were compared between the two groups. Results: The treatment group showed better cognitive function, quality of life scores, and levels of relevant metabolic markers in the body compared to the control group, with statistically significant differences (P &lt; 0.05). The incidence of adverse reactions between the two groups (treatment group: 2%; control group: 4%) was not statistically significant (χ² = 0.731, P = 0.393). Conclusion: Sodium oligomannate combined with memantine hydrochloride has better efficacy than the control group for treating senile Alzheimer’s dementia. It significantly improves and restores cognitive function and daily living abilities, benefits neurotransmitter secretion and internal regulation, upregulates the expression of neurotrophic factors, and has fewer adverse reactions, making it a treatment worthy of further clinical promotion and application.

Patient-reported outcomes, postoperative pain and pain relief after day case surgery (POPPY): methodology for a prospective, multicentre observational study.

In the UK, approximately 70% of surgical procedures are undertaken as day-cases. Little information exists about recovery from day-case surgery, yet international data highlights patients are at risk of developing significant longer-term health problems including chronic post-surgical pain and persistent postoperative opioid use. The Patient-reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short- and longer-term patient-reported outcomes, postoperative pain and pain relief after day-case surgery. This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day-case surgical patients were recruited on the day of surgery. Baseline data including patient characteristics; procedure details; pre-operative analgesic use; pre-existing pain; and quality of life scores were recorded. Patients were followed up through automated short message service messages. Short-term (postoperative days 1, 3 and 7) outcomes included: quality of recovery; pain severity; impact of pain on function; and analgesic use. Longer-term outcomes (postoperative day 97) included: quality of life; analgesic use; incidence of chronic post-surgical pain; and incidence persistent postoperative opioid use. Additional outcomes were completed by those patients with chronic post-surgical pain and persistent postoperative opioid use, with 30 patients recruited to a qualitative semi-structured interview study exploring postoperative expectations, recovery, postoperative pain and opioid use. An embedded pilot study at four sites recruited 129 patients. Responses to the automated short message service were gained from 129 patients (100%) at day 1; 116 (89.9%) at day 3; 108 (83.7%) at day 7; and 77 (59.7%) at day 97 postoperatively. The pilot enabled refinement of the methods and processes before the national roll out. This paper outlines the methods for the POPPY study, the largest UK multicentre prospective observational study considering short- and longer-term outcomes following day-case surgery.

The Effect of Seated Baduanjin Exercise on Psychological State, Fatigue Symptoms, and Quality of Life in Maintenance Hemodialysis Patients

Objective: To evaluate the intervention effects of seated Baduanjin exercise on patients undergoing maintenance hemodialysis (MHD). Methods: A total of 108 MHD patients admitted between July 2022 and July 2023 were selected. They were randomly assigned into two groups: the experimental group, with 55 patients, who received seated Baduanjin exercise combined with leg exercises during dialysis; and the control group, with 53 patients, who only performed leg exercises during dialysis. The psychological state, fatigue symptoms, quality of life, and sleep quality scores were compared between the two groups, and exercise endurance was recorded. Results: After the intervention, the psychological state scores in the experimental group were lower than those in the control group, the fatigue symptom scores were lower, the quality of life scores were higher, the sleep quality scores were lower, and the exercise endurance was higher (P &lt; 0.05). Conclusion: Seated Baduanjin exercise can improve the negative psychological state and fatigue symptoms of MHD patients, enhance their quality of life and sleep quality, and effectively increase their exercise endurance.

Variability in patient-reported outcomes among different congenital heart defects: a comparative analysis of 7,498 patients from 32 countries

Abstract Background Patient-reported outcomes (PROs) may not always correlate with the complexity of congenital heart defects (CHDs), as significant variation has been observed between CHDs within complexity levels. Accurate comparisons across various types of CHDs necessitate large sample sizes. Purpose The objective of this study was to compare PROs across different CHDs in a large international sample. Methods ‘Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease – International Study II’ (APPROACH-IS II) was an international cross-sectional investigation, in which 8,415 patients from 32 countries in 6 continents were enrolled (20 high; 7 upper-middle; 4 lower-middle; and 1 low income). For the comparison across different CHDs, conditions with at least 50 patients were included in the analysis. Hence, the sample consisted of 7,498 patients (median age=33y; 53.1% women). Patients completed questionnaires to measure perceived health status (RAND-12 Health Survey; EuroQOL-5D Visual Analog Scale); depressive symptoms (Patient Health Questionnaire-8); anxiety (General Anxiety Disorder-7) and quality of life (Linear Analog Scale). Generalized linear mixed models (GLMMs) were performed with center as random effect. Results Cyanotic heart defects were associated with the lowest scores for physical functioning, mental health, self-rated health, and quality of life (see Figure). Other CHDs found to be associated with poor PRO scores encompassed unrepaired secundum atrial septal defect, Ebstein anomaly, single ventricle, and truncus arteriosus. Conversely, the most favorable scores for all PROs, except for anxiety, were observed with isolated pulmonic stenosis. Other CHDs with favorable PRO scores comprised coarctation of the aorta, isolated small ventricular septal defect, congenital aortic valve disease, and repaired ventricular septal defect. Adjusted for sociodemographic and physiological factors, GLMMs revealed significant differences across defects, using the best score for each PRO as the reference (see Figure). Conclusion Substantial variation in PROs was observed among different types of CHDs. Interestingly, some complex heart defects demonstrated relatively good PRO scores, comparable to some simple defects. On the other hand, unrepaired simple defects or those with residual lesions, were associated with worse PROs.

Modification in Quality of Life and Health in Medical Students across Graduation

Abstract Background Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK study aims to identify and evaluate the quality of life by simultaneously assessing their determinants in Polish medical students during long-term observation. We have also examined the prevalence of chronic diseases, specifically focusing on overweight and obesity, and identified their risk factors. Methods The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. We identified that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domain. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the initial year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in animal products. Conclusions The QoL of medical students and selected indicators of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study. Key messages • Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. • Medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.

Impact of park renovation on children’s quality of life in New York City

Abstract Background Despite increasing interest in the role of parks on children’s health, research on the impact of park interventions is limited. This study uses a quasi-experimental pre-post design with matched controls to evaluate the effects of park redesign and renovation on children’s quality of life (QoL) in underserved New York City (NYC) neighborhoods with predominantly Hispanic and Black populations. Methods Utilizing longitudinal data from the Physical Activity and Redesigned Community Spaces (PARCS) Study, we examined the parent-reported QoL of children aged 3-11 years living within a 0.3-mile radius of 13 renovated parks (N = 201) compared to 11 (N = 197) control parks before and after the park intervention. QoL was measured using the modified KINDL questionnaire, a health-related QoL scale that assessed children’s physical and emotional well-being, self-esteem, and well-being in home, peer, and school settings. A difference in difference (DID) linear mixed model was used to compare QoL between intervention and control groups. Results We found a significant improvement in the physical well-being subscale of KINDL in the intervention vs. control group (DID=6.35, 95% CI = 0.85-11.85, p = 0.024). The differential improvement was strongest among girls (DID=7.88, p = 0.023) and children with parents in the lowest socioeconomic background (education high school or less DID=8.38, p = 0.024; Not employed DID=7.53, p = 0.048; Single/Widowed/Divorced DID=8.67, p = 0.025). No significant differences were found in other subscales. Conclusions Our study indicated a beneficial impact of improving park quality on the physical well-being of children residing in underserved neighborhoods. These findings support investments in neighborhood parks to advance health equity.

Associated factors and outcomes for quality of life in children receiving cochlear implantation before seven years of age.

To evaluate the relationship of cochlear implant-related factors with quality of life (QOL) outcomes in pediatric cochlear implantation (CI) recipients. In this cross-sectional study, data from 146 children who received CI before 7 years of age were collected. QOL was measured using the Children using Hearing Implants Quality of Life (CuHI-QoL) questionnaire. Auditory and language abilities were measured using categories of auditory performance II(CAP-II) scale and speech intelligibility rating (SIR) scale. The reliability and validity of the CuHI-QOL scale were tested using internal consistency tests and correlation analysis, respectively. Bivariate correlations were used to compare CuHI-QOL scores and educational placements to cochlear implant-related factors. QOL scores were further compared using ANOVA in different groups based on age at CI with different durations of implant use. The mean total CuHI-QOL scores was 60.13 (SD 8.97). The Cronbach's alpha of overall CuHI-QOL scale was 0.820. The CuHI-QOL total score was strongly to moderately correlated with CAP score (r = 0.542), SIR score (r = 0.545), duration of implant use (r = 0.403), and educational placement (r = 0.478). ANOVA showed the CuHI-QOL scores after 5 years post-CI were higher than those less than 2 years post-CI in children implanted ≤ 3 years of age. Good QOL could be obtained for children with CI and were significantly associated with young age at implantation, good auditory and speech abilities, speech rehabilitation training pre-CI, long duration of cochlear implant use, and mainstream educational placement.

Examining Long-Term Influences of Frailty on Outcomes for Adults Undergoing Left Ventricular Assist Device Therapy.

Frailty is common in adults with end-stage heart failure receiving a left ventricular assist device (LVAD). Short-term studies show frailty reversal post-LVAD. Little is known about long-term frailty and how frailty relates to key LVAD outcomes, including depression, quality of life (QoL), and cognition beyond 6 months. The purpose of this study was to examine physical frailty, depression, QoL, and cognition from pre-LVAD implantation to 3, 6, and 12 months post-LVAD implantation. Clinical data and measures of physical frailty, depression, QoL, and cognition pre- and post-LVAD were extracted from an existing institutional database. Descriptive statistics and tests for statistical significance were used to describe and compare changes over time. Frailty trajectories were identified to describe physical frailty from pre-LVAD to 12 months post-LVAD. The sample (n = 46) was predominantly male (76%), with a mean age of 64.7 ± 11 years, and over half (n = 25) were physically frail. Physical frailty was reduced by nearly half at 12 months. Frailty, depression, and QoL significantly improved at all time points (P < .001). Improvements in cognition did not reach statistical significance. Recipients of LVAD without improvement in frailty exhibited worse depression, QoL, and cognition scores at 12 months compared with those not frail pre-LVAD or no longer frail post-LVAD implantation. Some recipients of LVADs experienced physical frailty reversal with benefits sustained long-term. Those without improvement recorded worse long-term patient-reported outcomes. Identifying factors that predict physical frailty response to LVAD implantation is a key area of future research.

The Benefits of a Rehabilitation Program Following Medial Patellofemoral Ligament Reconstruction

The medial patellofemoral ligament (MPFL) is critical for patellar stability. This study investigates the efficacy of a one-year physical therapy rehabilitation program following MPFL reconstruction using Synthetic Graft (SG) and Quadriceps Tendon Autograft (QTA). Thirty-five patients aged 18–38 underwent MPFL reconstruction (20 SG, 15 QTA). They participated in a structured rehabilitation program to improve their range of motion (ROM), muscle strength, pain management, and overall quality of life (QoL). The program included physiotherapy and MLS laser, Game Ready Therapy, EMS, TENS, TECAR, and lymphatic drainage. Before and after the program, assessments included knee flexion and extension using goniometry, muscle strength via the Medical Research Council (MRC) scale, knee circumference, pain intensity on the Visual Analogue Scale (VAS), and QoL with the EQ-5D instrument. Significant improvements were observed in knee flexion (37.57° vs. 114.71°, p &lt; 0.001), muscle strength (MRC scale 1–4 points vs. 4–5 points, p &lt; 0.001), and pain reduction (VAS 6.66 vs. 0.46, p &lt; 0.001). The functional coefficient of mobility and QoL scores also markedly increased. Patients with QTA improved some parameters better than those with SG. These findings support the effectiveness of a comprehensive rehabilitation program in enhancing knee functionality, reducing pain, and improving QoL post-MPFL reconstruction. Personalized rehabilitation protocols are recommended to optimize recovery outcomes.

The psychometric properties of Chinese version of the Gilles de la Tourette syndrome-quality of life scale (GTS-QOL) for children and adolescents

BackgroundGilles de la Tourette syndrome (GTS) is a persistent neurological disorder that profoundly affects the quality of life for afflicted individuals, however, tailored health-related quality of life (QOL) measures for Chinese pediatric GTS patients are lacking. This pioneering study aims to develop a QOL scale for Chinese children with GTS.MethodsA cohort of 1,121 children (aged 6–16 years) diagnosed with GTS participated in scale development. Internal consistency was evaluated using Cronbach’s alpha. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess the factor structure of the GTS-QOL-Chinese, examining goodness-of-fit indices, factor loadings of individual items, and covariances between factors. Validity was determined through interscale correlations and comparisons with external measures to establish convergent and discriminant validity.ResultsFollowing reliability and validity analyses, a Chinese version of the 24-item GTS-specific quality of life scale was conclusively established, encompassing five subscales (psychological, compulsive, cognitive, physical, social). The scale demonstrated high internal consistency with a Cronbach’s alpha coefficient of 0.93, and validity was substantiated through interscale correlations ranging from 0.46 to 0.68. EFA identified five factors, explaining 61.26% of the total variation. CFA further confirmed the scale’s robustness, with all goodness-of-fit indicators meeting acceptable criteria (AGFI = 0.86, PCFI = 0.78, GFI = 0.89, CFI = 0.89, RMSEA = 0.07, SRMR = 0.06).ConclusionsThe Chinese version of the GTS-QOL scale has exhibits robust reliability and validity and is valuable for assessing the quality of life of Chinese children and adolescents with GTS. This scale may assist in tailoring interventions and improving patient care.

Quality of life and mental health due to COVID-related lifestyle changes and sociodemographic characteristics among Asian Indians

PurposeTo examine quality of life (QoL) and mental health among Asian Indians in Southwest and Central-west Florida by COVID-related lifestyle changes, and demographic characteristics.MethodsQoL was assessed using SF-12 questionnaire while mental health/healthcare was assessed using the household pulse survey. Face-to-face interviews and self-administered online surveys were conducted among 151 participants in 2021–22. F and Chi-square statistics were used to examine the differences in QoL scores and mental health/mental healthcare by sociodemographic factors and COVID-related lifestyle changes.ResultsMental Component Summary (MCS) scores were lower for those who experienced changes in work expectations (p 0.041), sleep (p 0.002), exercise (p < 0.001), meditation (p.004) and connecting with family (p 0.007) and among those with family testing COVID positive (p.012). Mean Physical Component Summary (PCS) scores were lower for caregivers (p .008). PCS scores were lower for certain income groups (p 0.006), retired (p 0.004), older age groups (p 0.002). Lower MCS scores with college education (p .005), those who were students (p <0 .001), younger age groups (p < 0.001). Those who helped with homeschooling felt anxious (p 0.049), couldn’t stop worrying (p 0.046) and took medications (p < 0.001). Participants’ families who tested COVID positive were anxious (p = 0.019) and worried (p = 0.015). Those with greater work expectations sought counseling (p = 0.009) and those who connected more with their family were anxious (p = 0.008).ConclusionThe pandemic affected QoL, especially the mental component and increased anxiety and worrying. Mental health services for younger individuals, those with caregiving responsibilities and facing increased job demands must be prioritized.

Role of Social Support in Improving Quality of Life among Myanmar Women Migrant Workers in Central and Northern Thailand: Implications for Community Nursing

Background: Social support and quality of life (QoL) are crucial for the well-being of individuals. Myanmar women migrant workers in Thailand represent a vulnerable population, yet there are limited studies on social support and QoL among these migrants. Methods: This cross-sectional study investigated associations between social support and QoL among Myanmar women migrant workers in central and northern Thailandthrough multistage sampling using a structured questionnaire. Social support was measured using the Medical Outcome Study Social Support Survey, and QoL was assessed using the WHOQOL-BREF. Multiple linear regression was analysed to find the association between social support and QoL, adjusting for sociodemographic variables. Results: Among 575 participants, they had an average overall social support score of 61.73 ± 16.47, with low support = 24.35%, moderate support = 46.43%, and high support = 29.22%. The average overall QoL score was 90.54 ± 13.23. Higher social support was positively associated with QoL (B = 4.781 for moderate support and B = 9.721 for high support, p &lt; 0.01). Higher education and easier access to emergency finances were also positively associated with QoL. Conclusion: Tailored social support interventions are recommended to enhance QoL among Myanmar women migrant workers in Thailand. Community nurses play a critical role in these interventions by providing education, facilitating access to resources, and fostering supportive networks.

Stress and Quality of Life of Parents of Children With POLR3-Related Leukodystrophy: A Cross-Sectional Pilot Study.

Background: RNA polymerase III (POLR3)-related leukodystrophy is a rare, neurodegenerative disorder characterized by hypomyelination, hypodontia, and hypogonadotropic hypogonadism. Despite the challenges of caring for a child with POLR3-related leukodystrophy, few studies have examined parents' disease burden. We sought to investigate quality of life and stress levels amongst parents of children with POLR3-related leukodystrophy. Methods: 43 parents of 32 children completed questionnaires on demographics, stress, quality of life, coping mechanisms, and experience of injustice. Detailed clinical data was collected from all patients. Results: Mothers (t[27] = -8.66, P < .001) and fathers (t[16] = -4.47, P < .001) had lower quality of life scores compared to the normative population, yet 80% of parents' stress scores fell within the normal stress range. Parents' experience of injustice scores were high (>60). Correlations were found between and within parents' scores. Years since disease onset and certain life circumstances correlated to mothers' quality of life scores; however, no correlation was found between modifiable factors and fathers' quality of life scores. Helpful coping mechanisms included those that allowed parents to be involved in their child's life. Conclusions: This is the first study to assess stress and quality of life in this population. These results shed light on the importance of implementing services and social support to improve the well-being of parents.

Death Preparation and Quality of Life amongst Family Caregivers of Terminal Cancer Patients: A Multicentre Cross-sectional Study

Objectives: Caring for ill cancer patients imposes a considerable burden on families, significantly reducing quality of life (QoL). This study examined the association between death preparation and QoL amongst family caregivers (FCs) of terminally ill patients with cancer in South Korea. Materials and Methods: A multicentre cross-sectional survey using questionnaires was conducted in nine inpatient palliative care units in South Korea. Data from 170 FCs who answered questions about preparedness for death were analysed. A stepwise multivariate logistic model was used to identify the factors associated with FCs’ QoL. The estimated QoL scores were also compared between the groups according to preparedness level. Results: Factors associated with high QoL included old age, fewer daily caregiving hours, fewer caregiving durations and practical preparedness for death. The well-prepared group had significantly higher QoL scores in the burdensome domain. This significant association remained robust in FCs with low educational or social support levels, poor resilience and dysfunctional families. Conclusion: Practically, well-prepared FCs experienced a high QoL in hospice care settings. FCs are likely to benefit from assessment and encouragement of their preparedness for death.

A controlled study: Evaluating the clinical impact of a nurse-centred multidisciplinary hospice care model on anxiety, depression, and quality of life in patients with advanced malignant tumours.

To explore the clinical effect of a nurse-centred multidisciplinary collaborative hospice care model in patients with advanced malignant tumours. A total of 30 patients with advanced malignant tumours were hospitalised and randomly divided into a study group and a control group, each consisting of 15 cases. The study group received nurse-led multidisciplinary collaborative hospice care, whereas the control group underwent high-quality nursing intervention. Variables such as the self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, quality of life scale (EORTC QLQ-C30) score, patient happiness, and nursing satisfaction were compared between the two groups. Post-intervention, the SAS and SDS scores in the study group were lower than those in the control group (p < 0.01). The overall quality of life score of the study group was higher than that of the control group (p < 0.01). The Memorial University of Newfoundland Scale of Happiness scores in the study group also surpassed those of the control group (p < 0.01). Additionally, nursing satisfaction in the study group exceeded that of the control group (p = 0.027). The nurse-led multidisciplinary collaborative hospice care model substantially alleviated negative emotions among patients, effectively improved their quality of life and happiness, and garnered positive evaluations of nursing satisfaction.

Three vs 6 Cycles of Chemotherapy for High-Risk Retinoblastoma

Adjuvant therapy is an important and effective treatment for retinoblastoma. However, there is a lack of head-to-head clinical trials comparing 3 vs 6 cycles of CEV chemotherapy (carboplatin, etoposide, and vincristine) for enucleated unilateral retinoblastoma with high-risk pathological features. To assess whether 3 cycles of CEV chemotherapy is noninferior to 6 cycles for enucleated unilateral retinoblastoma with high-risk pathological features. This double-center, randomized, open-label, noninferiority trial was conducted at 2 premier eye centers in China and included 187 patients who had undergone enucleation for unilateral retinoblastoma with high-risk pathological features (massive choroidal infiltration, retrolaminar optic nerve invasion, or scleral infiltration) between August 2013 and March 2024. The final date of follow-up was March 21, 2024. Patients were randomly assigned to receive either 3 (n = 94) or 6 (n = 93) cycles of CEV chemotherapy regimen after enucleation. The primary end point was disease-free survival, with a noninferiority margin of 12%. Secondary end points encompassed overall survival, safety, economic burden, and the quality of life of children. All 187 patients (median [IQR] age, 25.0 [20.0-37.0] months; 83 [44.4%] female) completed the trial. Median (IQR) follow-up was 79.0 (65.5-102.5) months. Five-year disease-free survival was 90.4% for the 3-cycle group vs 89.2% for the 6-cycle group (difference, 1.2% [95% CI, -7.5% to 9.8%]), which met the noninferiority criterion (P = .003 for noninferiority). The 6-cycle group experienced a higher frequency of adverse events, greater reduction in quality of life scores, and increased costs compared with the 3-cycle group. Among patients with unilateral pathologic high-risk retinoblastoma, 3 cycles of CEV chemotherapy resulted in 5-year disease-free survival that was noninferior to 6 cycles of CEV chemotherapy. ClinicalTrials.gov Identifier: NCT01906814.

Teverelix is a potential treatment option for the prevention of acute urinary retention recurrence in men suffering from benign prostatic hyperplasia.

To evaluate the efficacy and safety of teverelix in treatment naïve patients aged over 50years with symptomatic benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS), and to explore teverelix' potential in preventing AUR secondary to BPH with the aim to inform a planned Phase 2 trial. This Phase 2, multicenter, randomized, double-blind, placebo-controlled study involved BPH patients with an International Prostate Symptom Score (IPSS) ≥ 13 and uroflow < 13mL/sec. After a 4-week single-blind placebo run-in, patients were randomized to receive teverelix 60mg (n = 41) or placebo (n = 40) subcutaneously on day 1 and day 3. The primary endpoint was IPSS reduction at end of treatment period (Week 16); secondary endpoints included uroflow, prostate volume (PV), pharmacokinetics, pharmacodynamics, quality of life (QoL), and safety. Data were analyzed using analysis of covariance with α set at 0.05. At Week 16, teverelix significantly reduced IPSS by a mean of 6.3 (SD: ± 3.9) versus 1.1 (SD: ± 2.9) for placebo. By Week 2, teverelix showed a mean IPSS reduction of 13.0% compared to 3.8% for placebo, reaching 34.5% by Week 16 versus 5.2% for placebo. Clinically relevant IPSS reductions were observed in 44% of teverelix patients by Week 2, increasing to 83% by Week 12. Teverelix also achieved a significant 11% reduction in PV within 4weeks, improved maximum urinary flow rate, and enhanced QoL scores. Teverelix shows potential as an effective, well-tolerated treatment for LUTS secondary to BPH, with rapid and sustained benefits. The significant prostate volume reduction suggests that teverelix may help prevent recurrent AUR, warranting further dedicated studies.