Role Emotional Domains Research Articles

Factors associated with health-related quality of life among overweight or obese adults.

To identify factors associated with health-related quality of life among overweight or obese adults. The obesity epidemic presents a global challenge. Obesity is associated with lower health-related quality of life; however, no study has comprehensively examined correlates of health-related quality of life in this population. A cross-sectional design. The physical component score, mental component score and eight domain scores of the Short Form-36 v2 were used to assess health-related quality of life. We identified 23 possible correlates of health-related quality of life, including age, body mass index, health and weight histories, perceived stress, cholesterol-lowering diet self-efficacy, problem-solving, binge eating, dietary intake and physical activity. Correlational analyses were used to examine the bivariate associations between correlates and health-related quality of life variables. All possible subsets regression was used to develop predictive models of health-related quality of life. The sample (n = 210) was predominantly White (84·8%), female (78·1%) and middle-aged (average age = 46·80 years). Age, body mass index, education, having children at home, and being hypertensive were identified as the best predictors of physical component score, explaining about 9% of the variance. Age, marital status, having hyperlipidaemia, perceived stress, problem-solving, self-efficacy, binge eating and barriers to healthy eating predicted mental component score, explaining approximately 48% of the variance. Physical functioning and role physical domains of health-related quality of life had similar sets of predictors, with 15% and 13% of the variance explained, respectively, while similar predictors were identified for bodily pain (6%), general health (26%), vitality (40%), social functioning (32%), role emotional (42%) and mental health (46%) domains. Psychosocial factors were associated with the mental-related quality of life. Further exploration of factors related to physical-related quality of life is warranted in this population. When working with overweight/obese adults who are trying to lose weight, nurses need to consider socio-demographic and psychosocial factors in the development of a treatment plan that will improve health-related quality of life in this population.

The influence of advancing age on quality of life and rate of recovery after treatment for burn

BackgroundWith an ageing population the prevalence of burns in the elderly is increasing. The influence of increasing age on post-burn quality of life (QoL) is unquantified. AimTo examine the effect of ageing on QoL recovery after burn. MethodsThe Burn Specific Health Scale-Brief (BSHS-B) and Short Form Health Outcomes (SF-36), collected up to 24 months post-injury, for patients treated by the Royal Perth Hospital Burn Service were analysed. Multivariable analysis was adjusted for demographic and injury factors. The impact of ageing on rate of recovery was examined using BSHS-B normative data. ResultsThe cohort (n=1051) was 79.6% male with mean TBSA of 8% and age of 37.3 years. The SF-36 showed advancing age predicted poorer outcomes in physical function, role physical, vitality and role emotional domains but reduced bodily pain. The BSHS-B was affected by injury factors, not ageing. The standardised rate of recovery after burn improved with advancing age. The provision of surgery positively affected most outcomes assessed. ConclusionThis study quantified the impact of ageing on post-burn QoL recovery and confirmed that physical function suffered to the greatest degree. The results emphasise the importance of pro-active burn surgery and physical rehabilitation strategies with older patients.

Respiratory Muscle Strength, the Six-Minute Walk Test and Quality of Life in Chagas Cardiomyopathy

Patients with heart failure disease develop respiratory and functional limitations and suffer from the negative influence on their quality of life. This study was designed to evaluate respiratory muscle strength and its relationship to functional capacity, quality of life and rate of perceived exertion in patients with Chagas cardiomyopathy. We evaluated 32 patients divided into groups with and without Chagas heart disease. We measured the Minnesota Living with Heart Failure Questionnaire, the maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), distance walked during the 6-minute walk test, rating of perceived exertion (RPE), heart rate, blood pressure, respiratory rate, oxygen saturation and ejection fraction (EF). The group with Chagas heart disease showed decreased quality of life (overall score: p = 0.001; physical domain: p = 0.002; role-emotional domain: p = 0.031 and general health domain: p < 0.001) and MIP (p < 0.001) when compared with the control group. There was no difference between the distance walked in both groups. The RPE was greater in the group with Chagas heart disease (p = 0.001). The MIP correlated with MEP (r = 0.631, p = 0.009) and EF (r = 0.524, p = 0.037). The inspiratory muscle strength is reduced, and the decreased quality of life has a negative influence on the physical and emotional aspects of the patients with Chagas cardiomyopathy. No correlation was found between perceived exertion and the reduction of respiratory muscle strength.

Abstract No. 324 - Update with longitudinal analysis of quality of life assessment after doxorubicin drug-eluting beads transarterial chemoembolization (DEB TACE) in patients with hepatocellular carcinoma (HCC)

Purpose To investigate the effects on health-related quality of life after doxorubicin DEB TACE in patients with HCC Materials and Methods Single-center IRB-approved prospective health-related quality of life (HRQOL) study with analysis of the Short-Form 36 (SF-36) assessment tool before and after DEB TACE. Scores prior to DEB TACE along with post-treatment, 6-month, and 12-month follow-up scores were obtained. Paired t-test was used to compare the score of each domain before and after treatment. Significance levels were set at .05 for all tests. The SAS statistical package v9.3 (SAS Institute, Inc., Cary, NC) was used for all data management and analyses Results 114 patients with HCC (81 males, 33 females median age 60 years range 24-88) were enrolled into the study. 33 patients have completed 6-month follow-up surveys and 21 patients have completed 12-month follow-up surveys. Patients had decreased baseline scores within all eight domains of the SF-36 compared with healthy age-adjusted norms. There were positive trends in the role-emotional (46.96 vs 54.17, p=0.08), mental health (66.56 vs 68.1, p=0.49), and Social Functioning (58.26 vs 58.58, p=0.89) domains after therapy, although not statistically significant. There were no significant changes in the physical functioning (50.11 vs 48.23, p=0.38), pole-physical (35.49 vs 28.63, p=0.08), vitality (40.27 vs 38.58, p=0.27), bodilypPain (55.93 vs 53.71, p=0.39), and general health (44.92 vs 43.68, p=0.43) domains. There were no significant changes in any domain six months after therapy, although a positive trend in Bodily Pain (51.89 vs 59.85, p=0.06) almost reached significance. There were no significant changes in any domain twelve months after therapy. Longitudinal analysis revealed no significant changes when comparing short-term follow-up (1-3 month) with either 6 or 12-month scores, and no significant change between 6 and 12-month scores Conclusion Patients with HCC are not likely to perceive decreases in any of the HRQOL domains after treatment with DEB TACE

Health related quality of life of survivors of trauma six months after discharge

To investigate the health-related quality of life (HRQOL) of survivors of major trauma at six months following discharge, using two popular HRQOL tools. A cross-sectional study was done on adult trauma survivors in Johannesburg. Subjects completed the EQ-5D and SF-36 HRQOL questionnaires. Additional demographic and clinical data were collected. The majority of subjects reported some problems in usual activities and pain/discomfort as measured with the EQ-5D at six months. The mean EQ-5D VAS was 68 (±26.1). lowest scores were reported in the role physical (44.6 ± 41.6) and role emotional (44.1 ± 45.4) domains of the SF-36. mean SF-36 physical component summary (PCS) score (62.1 ± 27.8) was higher than mental component summary score (58.7 ±20.1). EQ-5D VAS was found to be moderately correlated with age (r=-0.4; p=0.05). A negative correlation was found between SF-36 physical function score and ICU length of stay (LOS), hospital LOS and age (r=-0.4 (p=0.03), -0.4 (p=0.03) and -0.6 (p=0.00) respectively). Statistical significance was observed in the correlation between age and SF-36 general health domain (r=-0.4; p=0.02) as well as age and PCS score (r=-0.5; p=0.01). Trauma survivors in Johannesburg experience limitations in specific emotional and physical domains of HRQOL at six months after discharge. Age was associated with the level of self-rated health as well as limitations in general health and physical function. ICU and hospital LOS were associated with limitations in physical function. There is a need for physical and psychological rehabilitation after discharge from trauma intensive care.

Improved health outcomes with Etanercept versus usual DMARD therapy in an Asian population with established rheumatoid arthritis

BackgroundPatient reported outcomes (PROs) are especially useful in assessing treatments for rheumatoid arthritis (RA) since they measure dimensions of health-related quality of life that cannot be captured using strictly objective physiological measures. The aim of this study was to compare the effects of combination etanercept and methotrexate (ETN + MTX) versus combination synthetic disease modifying antirheumatic drugs (DMARDs) and methotrexate (DMARD + MTX) on PRO measures among RA patients from the Asia-Pacific region, a population not widely studied to date. Patients with established moderate to severe rheumatoid arthritis who had an inadequate response to methotrexate were studied.MethodsPatients were randomized to either ETN + MTX (N = 197) or DMARD + MTX (N = 103) in an open-label, active-comparator, multicenter study, with PRO measures designed as prospective secondary endpoints. The Health Assessment Questionnaire (HAQ), Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-Fatigue), Medical Outcomes Short Form-36 Health Survey (SF-36), Hospital Anxiety and Depression Scale (HADS) and the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH) were used.ResultsSignificantly greater improvements were noted for the ETN + MTX group at week16 for HAQ mean scores and for proportion of patients achieving HAQ score ≤ 0.5, compared to patients in the DMARD + MTX group. SF-36 Summary Scores for physical and mental components and for 6 of 8 health domains showed significantly greater improvements at week16 for the ETN + MTX group; only scores for physical functioning and role-emotional domains did not differ significantly between the two treatment arms. Greater improvements at week16 were noted for the ETN + MTX group for FACIT-Fatigue, HADS, and WPAI:GH mean scores.ConclusionCombination therapy using ETN + MTX demonstrated superior improvements using a comprehensive set of PRO measures, compared to combination therapy with usual standard of care DMARDs plus MTX in patients with established rheumatoid arthritis from the Asia-Pacific region.Trial registrationclintrials.gov # NCT00422227

Improvements in patient-reported outcomes with apremilast, an oral phosphodiesterase 4 inhibitor, in the treatment of moderate to severe psoriasis: results from a phase IIb randomized, controlled study

BackgroundApremilast, a specific inhibitor of phosphodiesterase 4, modulates pro-inflammatory and anti-inflammatory cytokine production.ObjectivesApremilast’s effect on patient-reported outcomes (PROs) in patients with moderate to severe psoriasis was evaluated in a phase IIb randomized, controlled trial (NCT00773734).MethodsIn this 16-week, placebo-controlled study, 352 patients with moderate to severe plaque psoriasis received placebo or apremilast (10, 20, or 30 mg BID). PROs included Dermatology Life Quality Index (DLQI), pruritus visual analog scale (VAS), and Short-Form Health Survey (SF-36) to assess health-related quality of life (HRQOL). Changes from baseline and patients reporting improvements ≥minimum clinically important differences (MCID) were analyzed. Correlations between changes across various PRO instruments were explored.ResultsBaseline DLQI (>10 points) and SF-36 MCS and domain scores indicated impairments in HRQOL. At 16 weeks, greater improvements from baseline in DLQI scores were reported with apremilast 20 (−5.9) and 30 mg BID (−4.4) compared with placebo (1.9; P≤0.005 for both), and a greater proportion of patients reported improvements ≥MCID (20 mg BID, 49.4%, 30 mg BID, 44.3%) versus placebo (25.0%; P<0.04). Greater improvements from baseline in pruritus VAS scores were reported with apremilast 20 (−35.5%) and 30 mg BID (−43.7%) versus placebo (−6.1%; P≤0.005). Significant and clinically meaningful improvements in SF-36 mental component summary scores (P≤0.008) and Bodily Pain, Mental Health, and Role-Emotional domains were reported with all apremilast doses (P<0.05), and Social Functioning with 20 and 30 mg BID (P<0.05) and Physical Functioning with 20 mg BID (P<0.03). Correlations between SF-36 scores and DLQI were moderate (r>0.30 and ≤0.60) and low between SF-36 and pruritus VAS (r≤0.30), indicating they measure different aspects of the disease.ConclusionsApremilast treatment resulted in improved HRQOL, including DLQI and pruritus VAS over 16 weeks of treatment, in patients with moderate to severe psoriasis.

At-home short daily hemodialysis improves the long-term health-related quality of life

Patients with chronic kidney disease treated by in-center conventional hemodialysis (3 times per week) have significant impairments in health-related quality of life measures, which have been associated with increased morbidity and mortality. FREEDOM is an ongoing prospective cohort study measuring the potential benefits of at-home short daily (6 times per week) hemodialysis. In this interim report we examine the long-term effect of short daily hemodialysis on health-related quality of life, as measured by the SF-36 health survey. This was administered at baseline, 4 and 12 months after initiation of short daily hemodialysis to 291 participants (total cohort), of which 154 completed the 12-month follow-up (as-treated cohort). At the time of analysis, the mean age was 53 years, 66% were men, 58% had an AV fistula, 90% transitioned from in-center hemodialysis, and 45% had diabetes mellitus. In the total cohort analysis, both the physical- and mental-component summary scores improved over the 12-month period, as did all 8 individual domains of the SF-36. The as-treated cohort analysis showed similar improvements with the exception of the role-emotional domain. Significantly, in the as-treated cohort, the percentage of patients achieving a physical-component summary score at least equivalent to the general population more than doubled. Hence, at-home short daily hemodialysis is associated with long-term improvements in various physical and mental health-related quality of life measures.

Influência das características sociodemográficas e clínicas e do nível de dependência na qualidade de vida de pacientes com DPOC em oxigenoterapia domiciliar prolongada

To evaluate and correlate the quality of life (QoL) of COPD patients on long-term home oxygen therapy (LTOT) with their sociodemographic/clinical characteristics and level of dependence. This was a cross-sectional analytical study involving COPD patients on LTOT followed at the Oxygen Therapy Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. Sociodemographic, clinical, and biochemical data were collected. We assessed QoL and level of dependence using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and the Katz index, respectively. Multiple linear regression models were constructed in order to determine the influence of these variables on QoL. We included 80 patients in the study. The mean age was 69.6 ± 9.1 years, and 51.3% were female. The lowest SF-36 scores were for the physical functioning and role-physical domains. All sociodemographic characteristics (except gender) were found to correlate significantly with the SF-36 domains mental health, vitality, role-physical, and social functioning. We also found that body mass index, PaO2, post-bronchodilator FEV1, hemoglobin, and Katz index correlated significantly with the physical functioning, mental health, role-physical, and bodily pain domains. In addition, oxygen flows were found to correlate negatively with the physical functioning, mental health, vitality, and role-emotional domains. Low scores for SF-36 domains, as well as the variables that negatively influence them, should be considered and analyzed during the development and implementation of strategies for improving the QoL of COPD patients on LTOT.

A Single, Global Patient‐Centered Measure from the SF‐36 Instrument to Assess Surgical Outcomes and Quality of Life: A Pilot Study

Many quality of life (QoL) and patient-reported outcomes (PRO) measures have been developed to assess the effects of disease processes and treatments. Although these instruments are valuable, the process is hampered because of their number and lack of interchangeability. We identified a cohort of patients across a variety of operations within 3-12 months postoperatively. Patients completed the SF-36, measuring eight domains of QoL (physical functioning, role-physical, role-emotional, bodily pain, vitality, mental health, social functioning, and general health), plus a health transition item: Compared to one year ago, how would you rate your health in general now?. (1) Much better now than one year ago. (2) Somewhat better now than one year ago. (3) About the same as one year ago. (4) Somewhat worse than one year ago. (5) Much worse than one year ago. Additional data included improvement of preoperative symptoms, the occurrence of any postoperative symptoms, and the occurrence of any postoperative complications. Of 217 patients, 28 % were much better, 28 % somewhat better, 27 % unchanged, 13 % somewhat worse, and 3 % much worse. The health transition results were associated with all SF-36 domains, preoperative symptom change (p = 0.03) and persistent or new postoperative symptoms (p = 0.001), but not postoperative complications. Patients with persistent or new symptoms postoperatively had worse scores in the role-emotional (p = 0.01), bodily pain (p = 0.05), social functioning (p = 0.02), and mental health (p = 0.009) domains of the SF-36. This single, global assessment of health transition may be a promising practical alternative to assess postoperative patient-centered outcomes. Improved patients had better QoL scores, preoperative symptoms elimination, and no operation-related symptoms, but the occurrence of complications did not affect improvement.

Quality of Life, Anxiety, and Depression in Patients With an Unruptured Intracranial Aneurysm With or Without Aneurysm Occlusion

Awareness of having an unruptured intracranial aneurysm can affect quality of life and provoke feelings of anxiety and depression, even in treated patients, because of fear of recurrence of aneurysms. To assess quality of life and feelings of anxiety and depression in patients with an unruptured aneurysm with or without aneurysm occlusion. We sent postal questionnaires (Medical Outcomes Study Short Form-36, EuroQol-5D, Hospital Anxiety and Depression Scale) to 229 patients with an unruptured aneurysm and no history of subarachnoid hemorrhage identified from our database. Group mean scores and corresponding 95% confidence intervals (CIs) were compared between the no intervention group and the intervention group and with a reference population using the Student t test and χ(2) test. In total, 173 questionnaires (76%) were returned. There were no statistically significant differences in quality of life and anxiety and depression levels between patients with and those without aneurysm occlusion. Patients in the no intervention group compared with the reference population had a significantly reduced quality of life in the physical function (-10.7; 95% CI, -16.2 to -5.1), role physical (-15.8; 95% CI, -25.5 to -6.0), role emotional (-9.9; 95% CI, -18.7 to -1.1), vitality (-7.2; 95% CI, -12.1 to -2.4), and general health (-11.6; 95% CI, -16.2 to -6.9) domains. Results were comparable in the intervention group except for the role emotional domain, which was not statistically significantly reduced. Patients with an unruptured aneurysm have a reduced quality of life compared with the reference population, mainly in physical domains, but without an apparent effect on mood or anxiety. The extent of reduction in quality of life is similar in patients with and without aneurysm occlusion.

Assessment of quality of life in pregnant Japanese women: Comparison of hospitalized, outpatient, and non‐pregnant women

This cross-sectional study explored the comfort and quality of life in hospitalized, preterm, pregnant women compared with pregnant outpatients, and identified the relationship between comfort, quality of life, and hospitalization. Two-hundred-and-twenty-one hospitalized pregnant women who met the inclusion criteria were recruited from obstetric units, and 1015 outpatient pregnant women were recruited from obstetric outpatient units in Japan. The women were questioned on six domains of the Japanese Short-Form-36 version 2 (bodily pain, general health, vitality, role emotional, social functioning, and mental health) and on their subjective comfort. A total of 189 hospitalized pregnant women and 503 low-risk pregnant women were analyzed. Subjective comfort and all six domains of health-related quality of life showed significantly lower scores for hospitalized women than outpatient women (P < 0.05-0.001). The mean differences in social functioning and role-emotional domains between the two groups were particularly marked. The result of this study suggests that these patients require positive psychological support to improve their comfort and quality of life.

Abstract No. 214: Chemoembolization with drug-eluting beads for inoperable hepatocellular carcinoma: comparison of its safety and effectiveness in stage BCLC-C versus stage BCLC-B

obtained at baseline prior to DEB TACE and were compared and analyzed with post-treatment scores. Paired t-test was used to compare the score of each domain before and after treatment. Significance levels were set at .05 for all tests. The SAS statistical package v9.2 (SAS Institute, Inc., Cary, NC) was used for all data managements and analyses. Results: 51 patients with HCC (37 males, 14 females; median age 63 years; range 53-88) were enrolled into the study. The median length of time from first DEB TACE to follow-up survey was 8 weeks. Patients had decreased baseline scores within all eight domains of the SF-36 compared with healthy age-adjusted norms. There were positive trends in the Mental Health (66.7 vs 69.9, p 0.35) and Role-Emotional (52.4 vs 60.3, p 0.22) domains after therapy, however these results were not statistically significant. There were no changes in the General Health (46.8 vs 44.7 p 0.36), Physical Functioning (46.3 vs 43.0, p 0.34), Bodily Pain (55.4 vs 52.2 p 0.32), Vitality (39.4 vs 39.4 p 0.75), and Social Functioning (59.0 vs 58.1, p 0.63), domains. Scores in the Role-Physical domain (problems with work or daily activities as a result of physical health) worsened after initial therapy (36.2 vs 24.5, p 0.02). Conclusion: Patients with HCC are not likely to perceive decreases in general health, physical functioning, bodily pain, vitality, social functioning, emotional problems, or mental health. Patients with HCC are likely to perceive problems with work or daily activities as a result of physical health following treatment with DEB TACE.

Posttraumatic stress disorder after liver transplantation

Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010. Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires. The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD. PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.

Health-related quality of life in Australian survivors of critical illness*

To document health-related quality of life of an Australian sample of intensive care unit survivors 6 months after intensive care unit discharge and compare this with preadmission health-related quality of life, health-related quality of life of national population norms, and international samples of intensive care unit survivors. Prospective observational single-center study. Eighteen-bed medical-surgical tertiary intensive care unit of an Australian metropolitan hospital. Of the 122 eligible patients, 100 were recruited (intensive care unit length of stay >48 hrs, age >18 yrs, not imminently at risk of death) and the final sample comprised 67 patients, age (median [interquartile range], 61 yrs [49-73 yrs]), 60% male admitted to the intensive care unit for a median [interquartile range] 101 hrs (68-149 hrs). Normative age- and sex-matched Australian Short-Form 36 data from the Australian Bureau of Statistics, selected international cohorts of intensive care unit survivors, and their respective national age-matched normative data were included for comparison. None. Sixty-seven participants provided responses to questions rating health-related quality of life (Australian Short-Form 36) at preadmission (on admission to the intensive care unit or through retrospective recall as soon as able) and 6 months after intensive care unit discharge. Ten additional participants were unable to provide study data without proxy input and were excluded from analysis. Participants reported clinically meaningful improvements in bodily pain (p = .001), social functioning (p = .03), role-emotional domains of the Short-Form 36 (p = .04), and mental component summary score (p = .01) at 6 months after intensive care unit discharge, mostly attributable to the patients undergoing cardiac surgery, whereas remaining Short-Form 36 domains showed no difference between preadmission and 6 months (p > .05). Participants reported clinically meaningful decrements in preadmission Short-Form 36 data compared with the Australian normative population with role-physical (p < .001) and physical functioning (p < .001) most affected at follow-up. Health-related quality of life in this sample was comparable with international samples of intensive care unit survivors. Although the majority of health-related quality of life domains did not differ between preadmission and 6-month follow-up, participants reported significant and clinically meaningful improvements in pain and mental health at follow-up. Critical illness survivors' health-related quality of life remained within 1 sd of Australian norms at follow-up and physical function health-related quality of life was most affected. Health-related quality of life in these Australian survivors of the intensive care unit was comparable with international survivors 6 months after intensive care unit admission.

Cultural and linguistic validation of acne‐QoL in French

Acne-Quality of Life (acne-QoL) is a facial acne-specific quality-of-life instrument developed in English. Our objective was to translate and validate acne-QoL in French and to establish the reliability and responsivity of this measure. Acne-QoL was translated into French (acne-QoLfr) in accordance with international methodological recommendations. The validated French version of the Cardiff Acne Disability Index (CADIfr) was used as a comparator. Acne patients in Quebec (n = 20) and France (n = 14) completed the acne-QoLfr and CADIfr on three occasions over 3 months (day 0, day 2-3, day 60-90). A total of 34 patients were recruited. Pearson's correlation for total acne-QoLfr scores at day 0 and day 2-3 was 0.77. Of the four domains comprising the acne-QoLfr, correlations were highest for symptoms (0.85) and lowest for the role-emotional domain (0.66). At day 60-90, total acne-QoLfr scores increased by a mean of 19.7 points, reflecting improved quality-of-life with acne therapy and demonstrating responsivity of the instrument. Acne-QoLfr is a linguistically and culturally validated tool for facial acne that is both reliable and responsive.

Hepatitis C Virus Adversely Affects Quality of Life

Background: Chronic liver disease secondary to hepatitis C virus (HCV) infection is a common clinical problem. HCV is likely to adversely affect the quality of life (QoL) of the patient. This effect is said to be disproportionate to the severity of the disease. The aim of our study was to evaluate QoL in HCV-positive patients focusing both on health status and subjective satisfaction. Methods: Twenty-four patients with combined HCV and alcoholic liver disease (ETOH-HCV) were enrolled in the study. We adopted two generic tools: SF-36 (a health status questionnaire) and SAT-P (a satisfaction profile) for psychological assessment of the patients. SF-36 and SAT-P scores of ETOH-HCV patients were compared with scores of 23 patients with alcoholic liver disease (ETOH). The scores obtained from the study groups were also compared with the reference scores of the healthy Italian population. Results: Both the groups were comparable with respect to age, histological and clinical severity of liver disease (as assessed by MELD and Child Pugh scores). Patients with ETOH-HCV scored less in the vitality and role emotional status domains of the SF-36 scores and the psychological function, social function and free time domains of the satisfaction profile. Conclusions: These results show a significant impact of HCV infection on health status and subjective satisfaction.

Preoperative Frailty and Quality of Life as Predictors of Postoperative Complications

Prediction of postoperative complications has been based on assessing comorbidities. However, the evaluation of these comorbidities has not consistently identified those at higher risk of complications, primarily due to the inability to assess how these comorbidities affect functional status. We hypothesized that preoperative functional measures of patients' health status can predict postoperative complications. A sample of patients undergoing general surgical operations were reviewed for age, gender, diagnosis (for severity), operations (for complexity), number of comorbidities, preoperative frailty (as determined by the Canadian Study of Health and Ageing Frailty Index), preoperative quality of life (as determined by the SF-36), occurrence of postoperative complications, number of postoperative complications, and severity of complications. Data were analyzed by linear and multiple logistic regression analyses, and the Mann-Whitney U test. Two hundred and twenty-six patients were evaluated, average age 61 ± 13 years, 47% male patients. Frailty Index (FI) correlated with number of comorbidities (r = 0.61, P < 0.001), and all of the domains of the SF-36. Patients who had postoperative complications had higher median preoperative FI than those would did not [0.075 (IQR 0.046-0.118) vs. 0.059 (IQR 0.045-0.089), P = 0.007]. Multiple logistic regression analysis demonstrated that operation complexity, FI, and the role-emotional domain were associated with and increased risk of postoperative complications, whereas the bodily pain domain was associated with a lower risk of postoperative complications. This study demonstrates that preoperative functional status as measured by FI and SF-36 may help identify patients at higher risk of postoperative complications. In our ageing population, use of such measures may help in better patient selection.

Comparison of the Impact of Degarelix and Leuprolide on the Health-Related Quality of Life of Patients with Prostate Cancer: Results of a 12-Month Phase III Clinical Trial

Introduction: The objective of this study was to compare health-related quality of life (HRQoL) with degarelix (240 mg in month 1 and then 80 mg monthly, administered subcutaneously) or leuprolide (7.5 mg/month intramuscularly) in men with prostate cancer. Methods: HRQoL was assessed at baseline and throughout a 12-month randomized, open-label, parallel-group clinical trial using standard SF-12 and EORTC QLQ-C30 questionnaires. HRQoL outcomes were compared between treatments using trend, change score, and response analyses. Results: HRQoL data from 401 subjects were included in this analysis; 205 receiving degarelix 240/80 mg and 196 receiving leuprolide 7.5 mg. Over the 12-month treatment period, patients experienced worsening of most HRQoL domains except for bodily pain, general health (both SF-12), and diarrhea (QLQ-C30). No treatment group differences in HRQoL were noted at day 28 or 6 months. At 12 months, mean SF-12 scores for the mental component summary (p = 0.02) and mental health (p = 0.04) were significantly higher in degarelix- compared with leuprolide-treated patients. Treatment with leuprolide had a seemingly more favorable impact on insomnia (QLQ-C30; p = 0.04) and bodily pain (SF-12; p = 0.006) compared with degarelix. Patients with metastatic disease treated with degarelix reported significant improvements in the role-emotional domain (SF-12; p = 0.02), global health status (QLQ-C30; p = 0.04), and appetite loss (QLQ-C30; p = 0.02) at 12 months compared with leuprolide. Conclusions: After 12 months of treatment, the HRQoL of patients with advanced prostate cancer treated with the GnRH antagonist degarelix is similar to that of patients treated with leuprolide. The study also indicates benefits with degarelix treatment in the metastatic population.

Health‐related quality of life among community‐dwelling patients with intractable neurological diseases and their caregivers in Japan

The aims of this study were: (i) to clarify the general quality of life (QOL) of patients with intractable neurological disease; (ii) to clarify the general QOL of the caregivers of these patients; and (iii) to explore the association of QOL in patient-caregiver pairs. A cross-sectional survey was conducted between November 2003 and May 2004 among community-dwelling patients diagnosed with Parkinson's disease (PD), spinocerebellar degeneration (SCD), multiple system atrophy (MSA), and amyotrophic lateral sclerosis (ALS) and their caregivers using a mailed, self-administered questionnaire. To measure QOL, we used the Medical Outcome Study 36-Item Short Form (SF-36) for patients and the short form of the health-related QOL scale SF-36 (SF-8) for caregivers. A total of 418 questionnaires were analyzed. For the patients, all of the general QOL domains of the SF-36 were significantly lower than the national standard value for all of the diagnoses. Physical function, role physical, and role emotional domains were also low. For caregivers, all of the QOL summary scores of the SF-8 for all diagnoses were significantly lower than the national standard value. Although there were several significant correlations of QOL between patients and caregivers, overall the correlations were low. Support for patients with neurological diseases and their caregivers is needed in order to maintain physical and mental QOL.