SF-36 Subscales Research Articles

Karnofsky performance status and visual analogue scale scores are simple indicators for quality of life in long-term AYA survivors who received allogeneic hematopoietic stem cells transplantation in childhood

The purpose of this study was to investigate Karnofsky performance status (KPS) scores and visual analogue scale (VAS) scores to explain which domains in the standardized self-reported quality of life (QOL) are instrumental for long-term hematopoietic stem cell transplantation (HSCT) survivors. We conducted a nationwide cross-sectional questionnaire study on 221 survivors with allogeneic-HSCT in 28 pediatric centers. Patient-reported QOL was assessed at a single time point using the 36-item Short-Form Survey (SF-36), the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), and VAS scores. KPS scores were significantly correlated with both physical and role component summary scores of the SF-36, while the VAS provided by the patient (VASpt) was significantly correlated with the mental component summary score of the SF-36 and many subscales of the FACT-BMT. The VAS provided by the participants' attending physician (VASdoc) was correlated well with KPS scores. A VASpt score more than 40% lower than KPS scores suggested mental health problems. In conclusion, KPS scores might be considered as an indicator for physical and role/social components and VASpt score as an indicator for mental components and HSCT-specific QOL.

Identification of Community-Dwelling Older Adults With Shoulder Dysfunction: A Pilot Study to Evaluate the Disabilities of the Arm, Shoulder and Hand Survey.

IntroductionThe Disabilities of the Arm, Shoulder and Hand (DASH) survey estimates the upper limbs’ dysfunction in one score, but limited evidence exists to justify use of DASH to screen older adults for shoulder dysfunction at routine health maintenance primary care visits. We sought (1) to determine if the DASH, American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) surveys are related to one another and (2) to determine the relationship of DASH, ASES and SST scores with 36-Item Short Form (SF-36) subscales, shoulder forward flexion range of motion (FF-ROM) and abduction (ABD-ROM) in older adults.MethodsProspective pilot study of 23 community-dwelling adult volunteers [mean age (± standard deviation), 69.3 ± 6.7 years; range, 61-84 years, with no rotator cuff repair or joint replacement. Shoulder MRI, ROM testing, DASH, ASES, SST, SF-36, Katz activities of daily living (ADLs), and Lawton-Brody instrumental ADLs (IADLs) were completed at one time point. Descriptive and correlation analyses were performed.ResultsMeans: DASH, 17.4 ± 19.5; ASES, 81.3 ± 19.7; SST, 71.7 ± 28.5; Katz ADLs, 5.9 ± .3; Lawton-Brody IADLs, 8.0 ± .0; FF-ROM, 140.2° ± 31.5°; and ABD-ROM, 128.3° ± 31.9°. Nearly 48% had supraspinatus tendon tear. Correlation among DASH, ASES, and SST was strong (|rho ≥.88|; P < .001). DASH, ASES, and SST had strong correlation (|rho ≥.71|;P < .001) with shoulder FF-ROM and ABD-ROM. DASH had near equivalent or slightly stronger correlation for all SF-36 subscales relative to ASES and SST. DASH showed strong or moderate correlation (P < .05) to most SF-36 subscales.ConclusionDASH, ASES and SST strongly correlated with one another. DASH, relative to ASES and SST, has similar correlation to shoulder FF-ROM, ABD-ROM and SF-36 subscales in older adults. Our pilot study suggests that the DASH survey has potential utility to identify occult shoulder dysfunction in community-dwelling older adults who have normal Katz ADLs and Lawton-Brody IADLs if administered during routine health maintenance primary care visits.

Continuing Care Bundle in Elderly Patients with Rectal Cancer after Radical Resection with Permanent Stoma.

Objective A continuing care bundle can achieve a better outcome than a single implementation after discharge. This study aims to investigate the effect of this intervention in elderly patients with rectal cancer after radical resection with a permanent stoma. Methods Elderly patients diagnosed with rectal cancer underwent radical resection with permanent stoma, they were divided into the control group (n = 42) and bundle group (n = 42). The control group received the conventional care, and the bundle group received the continuing care bundle in addition to the conventional care. At 1- and 3-month after discharge, self-efficacy, self-care knowledge, ability to change stoma appliances, negative emotions, quality of life, and patient satisfaction were observed. Results The increased levels of self-efficacy, self-care knowledge, and ability to change stoma appliances were displayed in the bundle group after discharge as compared with that in the control group, along with the enhanced score of SF-36 subscales, including physical function (PF), role physical (RP), global health (GH) and vitality (V), social function (SF), and mental health (MH). Furthermore, patients showed alleviated depression and anxiety after the continuing care bundle as compared to those after conventional care. Besides, the bundle groups had higher patient satisfaction than the control group. Conclusions Continuing care bundle can serve as an effectiveness intervention in elderly rectal cancer patients after radical resection with permanent stoma via increasing self-efficacy and self-care knowledge, enhancing the ability to change stoma appliance, reliving the negative emotion, and improving quality of life and patient satisfaction.

Evaluation of Xiaoyao-san for treatment of irritable bowel syndrome: A systematic review and meta-analysis of randomized controlled trials

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder, and Xiaoyao-san (XYS) has been prescribed for gastroenterological and neurological diseases in traditional Chinese medicine (TCM). This meta-analysis evaluated the efficacy and safety of XYS on IBS. RCTs were searched for in nine electronic databases to April 30, 2021. RCTs that applied XYS or modified XYS as an experimental intervention and adopted Rome Criteria for IBS diagnosis were included. There were no limits for IBS-subtypes, patient information or publication language. Trials with improper randomization were excluded. The following indices were extracted from each identified trial: efficacy rate, symptom scores, IBS symptom severity score (IBS-SSS), IBS quality of life (IBS-QoL), Short Form Health Survey (SF-36), and adverse effects. Data analysis was conducted using RevMan 5.3, and Cochrane's risk of bias tool was used to assess the risk of bias in each trial. Twenty-one RCTs with 1858 patients were included in this review. XYS appeared to be better than conventional therapies in improving the clinical efficacy. Furthermore, XYS significantly reduced abdominal pain, abdominal distention, diarrhea, and IBS-SSS. XYS was also effective on five of the IBS-QoL subscales; dysphoria, interference with activity, body image, food avoidance, and social reaction. In addition, XYS was effective on four of the SF-36 subscales: physical functioning, bodily pain, physical role functioning, and emotional role functioning. XYS may have a potential benefit for managing IBS. Moreover, we also recommend future large-scale RCTs with recognised global IBS symptom scales.

Thyroid Hormones and Health-Related Quality of Life in Normal Pressure Hydrocephalus Patients before and after the Ventriculoperitoneal Shunt Surgery: A Longitudinal Study.

Objective: The aim of this study was to explore the serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3), and to correlate the hormone levels among iNPH patients with their self-reported quality of life before and three months after the surgery. Methods: Twenty-five patients (52% women), mean age 63.5 (SD 9.5) years, were operated on by inserting a VP shunt. Patients with FT3 level ≤3.34 pmol/L were diagnosed as having low T3 syndrome. Results: The changes in thyroid hormones resulted in a U-shaped curve throughout the follow-up period. The significant changes occurred the next day after the surgery, including a decrease in TSH, FT3, and an increase in FT4. Additionally, the decrease occurred in mean FT3 for six patients with preoperative low T3 syndrome. Three months after the surgery, thyroid hormones were restored to their baseline and/or normal values. All six patients with preoperative low T3 syndrome had significant improvement in all SF-36 subscales (except for the role emotional and physical). Patients with preoperative normal high FT3 and low FT4 had increased FT3/FT4 ratio which was associated with deterioration in all SF-36 subscales 3 months after the surgery. Conclusion: Routine assessment of the FT3/FT4 ratio might be a simple and effective tool for the risk stratification of iNPH patients before VP shunt surgery.

The Psychological and Physical Benefits of the Supervised Individual Exercise Program During Radiotherapy in Breast Cancer Patients: A Randomized Prospective Study

Treatment side effects lead to a negative impact on quality of life in breast cancer survivors. Exercise is reported to improve the physical and psychological status of these patients. The aim of the study is to investigate the effect of exercise during radiotherapy on physical and psychological status in breast cancer patients. A randomized prospective study was set in an outpatient rehabilitation clinic. Histologically proven stage I-III breast cancer patients referred for adjuvant radiotherapy were randomly assigned to a supervised aerobic and strengthening exercise program (10 patients) or usual medical care without exercise training (10 patients). The primary outcome parameters were Rosenberg Self Esteem Scale (RSES), Short Form-36 (SF_36) Quality of life, Coping Orientation to Problems Experienced (COPE) Inventory, Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI). End points were assessed 1 week prior to and 1 week following 6 weeks exercise training. In the repeated measures analysis, BAI and FSS scores decreased, while general health (GH) and energy/fatigue (E) subscores of SF-36 increased in the exercise group (p=0.045, Cohen d=0.757 for BAI, p=0.02, Cohen d=0.863, p=0.010, Cohen d=1.02 for GH, p=0.032, Cohen d=0.801 for E). In addition, the use of problem-based coping score decreased in the control group (p=0.049, Cohen d=0.641). No significant differences were found between two groups in scores for BDI and RSES (p&gt;0.05). In conclusion, supervised combined exercise training during adjuvant radiotherapy improved anxiety, fatigue, energy, and general health perceptions and also prevented decrease in using effective coping strategies.

Predictors of health-related quality of life among Iranian people with type 2 diabetes

Introduction: Diabetes is a common disease with several macro-vascular and microvascular complications, which can result in long-term damage of various organs. Health-related quality of life (HRQOL) is commonly impaired in patients suffering from prolonged diseases. Inadequate attention to HRQOL leads to decreased compliance with treatment and health-care interventions. Objectives: This study was aimed to identify possible determinants of HRQOL in Iranian people with type 2 diabetes mellitus (T2DM). Patients and Methods: A cross-sectional study of 160 patients with T2DM registered at endocrinology clinic of the Alzahra teaching hospital of Isfahan university of medical sciences, Iran, was conducted in 2019-2020. HRQOL was measured using the Short Form 36 Health Survey Questionnaire (SF-36). Multivariate linear regression models were used to analyze the variables associated with HRQOL. Results: A total of 160 patients took part in this study. The mean age of the respondents was 59.3 (9.9) years. Around 107 patients (66.9%) were women. The mean (SD) for sub-scales of SF-36 in all patients were physical functioning 57.1(32.5), role limitation due to physical health 62.4 (42.1), role limitation due to emotional health 82.3 (35.8), energy/fatigue 58.8 (21.4), emotional well-being 72.5 (17.5), social functioning 80.4 (28.3), pain 70.5 (26.9) and general health 46.9 (26.3). The most common factors contributing to lower SF-36 subscales were being female, having a higher body mass index (BMI), and having macro-vascular complications. Conclusion: HRQOL among Iranian people with T2DM is mostly influenced by gender, weight, and diabetes complications. By reducing complications of diabetes, especially macrovascular complications, and implementing obesity prevention policies, HRQOL could be improved. A patient-centered approach is needed to improve HRQOL for each patient.

Resilience Improves the Quality of Life and Subjective Happiness of Physiotherapists during the COVID-19 Pandemic

Resilience is an individual characteristic that protects mental health. However, its impact on the lives of Brazilian physiotherapists during COVID-19 is not known. This study aimed to analyze whether resilience modulates the perceived quality of life (QoL) and subjective happiness (SH) of physiotherapists who work with COVID-19 patients, compared with those who do not. A cross-sectional study was conducted between 22 August and 22 October 2020. Physiotherapists working in critical and non-critical hospital sectors were invited to participate in the study. The participants completed sociodemographic questionnaires and were graded on the 14-item Resilience Scale, 36-item Short-Form Health Survey (SF-36), and the Subjective Happiness Scale. In total, 519 physiotherapists were enrolled in the study. Physiotherapists with low resilience who worked with COVID-19 patients reported lower scores on the SF-36 subscales (except for social functioning) and the Subjective Happiness Scale, compared with those with high resilience who did not work with COVID-19 patients. These responses were modulated by age, sex, absence from work, receipt of personal protective equipment, host leadership, and practice and maintenance of regular physical activity. In conclusion, physiotherapists with low resilience who worked with COVID-19 patients presented lower perceptions of QoL and SH, compared with the other study participants.

Supervised physical therapy versus surgery for patients with lumbar spinal stenosis: a propensity score-matched analysis

BackgroundPrevious studies comparing surgical with nonsurgical treatment for lumbar spinal stenosis (LSS) reported that surgery is superior to nonsurgical treatments, but intensive and adequate volume of physical therapy were rarely performed. The purpose of this study was to compare the 1-year follow-up outcomes of patients with LSS treated with supervised physical therapy or surgery using propensity score-matched analysis.MethodsA total of 224 patients with LSS who received supervised physical therapy (n = 38) or surgery (n = 186) were included, of which 66 were matched on baseline demographics, radiological findings, and patient-reported outcomes. The physical therapy group received supervised physical therapy twice weekly for 6 weeks. The physical therapy sessions included manual therapy, individually tailored exercises, cycling, and body-weight supported treadmill walking. The surgery group underwent decompression surgery with or without spinal fusion. A propensity score analysis was performed using a one-to-one nearest neighbor approach.ResultsThe surgery group showed greater improvements in Zurich claudication questionnaire symptom severity and physical function, SF-36 physical functioning, bodily pain, and mental health, but had more severe stenosis and symptoms and mental health problems than the physical therapy group at baseline (P < 0.05). After propensity score matching, there were no significant differences in baseline characteristics, and all clinical outcomes at 1 year, except for a higher percentage of responders achieving minimum clinically important difference in the role-emotional subscale of SF-36 in the surgery group (P < 0.05).ConclusionsWhen baseline characteristics were considered, supervised physical therapy yielded similar effects to lumbar surgery. These results suggest that supervised physical therapy is preferred over surgery as first-choice treatment, to prevent complications and to minimize health care costs, especially in mild to moderate cases of LSS.

Prevalence and determinants of persistent symptoms after infection with SARS-CoV-2: protocol for an observational cohort study (LongCOVID-study)

IntroductionA substantial proportion of individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), report persisting symptoms weeks and months following acute infection. Estimates on prevalence vary due to differences in...

Assessing the impact of religious resources and struggle on well-being: a report from the American Cancer Society's Study of Cancer Survivors-I.

The current study examined the relationships between religious resources (i.e., certainty of belief in God and attendance at religious services), religious struggle (e.g., belief that cancer is evidence of God's punishment or abandonment), and physical and mental health-related quality of life (HRQoL), including fear of cancer recurrence (FCR), in a large, geographically and clinically diverse sample of long-term survivors of cancer. Participants were 2021 9-year survivors of cancer from the American Cancer Society's Study of Cancer Survivors - I. Religious resources included belief in God and attendance at religious services. Items from the Brief RCOPE and the PROMIS Psychosocial Impact of Illness were combined to assess religious struggle. Survivors also completed the Fear of Cancer Recurrence Inventory, SF-12, and Meaning and Peace subscales of the FACIT-Sp. Regression models were used to predict HRQoL and FCR from religious resources and struggle. In multivariable models, certain belief in God predicted greater mental HRQoL (B = 1.99, p < .01), and attendance at religious services was associated with greater FCR (B = .80, p < .05) as well as better mental (B = .34, p < .01) and physical (B = .29, p < .05) HRQoL. In addition, religious struggle predicted greater FCR (B = 1.32, p < .001) and poorer mental (B = - .59, p < .001) and physical (B = - .29, p < .001) HRQoL. Many of these relationships were mediated through Meaning. With the exception of FCR, religious resources predicted better HRQoL outcomes in these long-term survivors of cancer. Conversely, religious struggle consistently predicted poorer HRQoL, including greater FCR. Given the documented importance of its role in coping with the cancer experience, religion/spirituality should be a consideration in every survivorship care plan. Multidisciplinary assessment and support of religious resources and identification of and referral for religious struggle are needed to ensure the well-being of most long-term survivors of cancer.

Submucosal tunneling endoscopic septum division for esophageal diverticulum with a median follow-up of 39 months: a multicenter cohort study

Submucosal tunneling endoscopic septum division (STESD) is an endoscopic minimally invasive technique for treating esophageal diverticulum. The objectives of this study were to evaluate the safety and efficacy of STESD and its impact on patients' quality of life. This study included consecutive patients who underwent STESD for esophageal diverticulum from April 2016 to August 2020 in 2 centers (Zhongshan Hospital, Fudan University and Tianjin First Central Hospital). Esophagogram and endoscopic examination were performed before STESD and 30 days after STESD. Patients completed the 36-item Short Form survey (SF-36) before STESD and 1 year after surgery. Clinical symptoms were assessed via telehealth every 6 months until August 2021. Costamagna and Eckardt scores were used to evaluate changes in symptoms. Twenty-one patients were included. Mucosal injury 1 to 2 cm below the septum occurred in 2 patients. No severe surgical adverse events were observed. Median duration of follow-up was 39 months (range, 12-63). Total SF-36 scores increased from 118.7 ± 18.6 before STESD to 132.4 ± 9.1 at 1 year after the procedure (P= .007). SF-36 subscales of general health (P= .002), vitality (P= .004), social functioning (P= .030), and mental health (P= .020) improved significantly after STESD. The mean Costamagna score decreased from 3.83 ± 1.33 to 1.67 ± 1.51 (P= .010), whereas the mean Eckardt score decreased from 3.50 ± .90 to 1.25 ± 1.76 (P= .002). One patient developed symptom recurrence at 10 months after STESD. STESD is a safe and valid endoscopic minimally invasive surgery for esophageal diverticulum, which can reduce symptoms and improve quality of life.

A New Educational Program could Reduce Disability and Improve Quality of Life in Patients with Chronic Low Back Pain

This randomized clinical trial examined the efficacy of a designed educational program versus oral drug treatment in Iran. A total of 197 patients with chronic low back pain were randomized into either intervention group (n = 97) receiving a five 2 hour– session educational program followed by continued monthly booster sessions and telephone counseling plus medication or to control group (n = 100) receiving just medication. At baseline and 3 months of follow up, participants completed demographic characteristic questionnaires as well as three other questionnaires including Short – form General Health Survey (SF-36 item), Quebec Disability Scale (QDS) and Ronald – Morris Disability Questionnaire (RDQ). Data were analyzed by SPSS 18. The two groups were comparable at baseline in terms of all baseline characteristics and the mean scores of the scales. However, after three months, the intervention group was significantly different from control group in all subscales of SF-36, QDS and RDQ (P values &lt; 0.05). Furthermore, this study showed a statistically significant difference between two groups (P&lt; 0.05) in terms of mean difference scores for SF -36, RDQ and QDS over time. The findings revealed that the designed educational program could improve all quality of life domains and reduce disability in chronic low back pain patients during a period of 3 months.

Personally Generated Quality of Life Outcomes in Adults With Juvenile Idiopathic Arthritis

To explore quality of life (QOL) using the individualized Patient Generated Index (PGI) in young adults who were diagnosed with juvenile idiopathic arthritis (JIA) in childhood, and to examine associations between PGI ratings and standardized health-related outcome measures. Patients (N = 79, mean age 25.1 [SD 4.2] yrs, 72% female) completed the PGI and the standardized measures: Health Assessment Questionnaire-Disability Index, 12-item Short Form Health Survey (SF-12; physical and mental health-related QOL [HRQOL]), Brief Pain Inventory (pain severity and interference), 5-item Hopkins Symptom Checklist, and visual analog scale for fatigue. Information on morning stiffness, medications, and demographics was also collected. Patients were compared to 79 matched controls. The most frequently nominated areas of importance for patients' personally generated QOL (assessed by PGI) were physical activity (n = 38, 48%), work/school (n = 31, 39%), fatigue (n = 29, 37%) and self-image (n = 26, 33%). Nomination of physical activity was associated with older age, morning stiffness, and more pain interference. Nomination of fatigue was associated with current use of disease-modifying antirheumatic drugs, whereas nomination of self-image was associated with polyarticular course JIA and pain interference. Nomination of work/school was not associated with other factors. Higher PGI scores (indicating better QOL) correlated positively with all SF-12 subscales except role emotional, and negatively with disability, pain severity, pain interference, and morning stiffness. Compared to controls, patients had more pain, poorer physical HRQOL, and less participation in full-time work or school. Physical activity, work/school, fatigue, and self-image were frequently nominated areas affecting QOL in young adults with JIA. The PGI included aspects of QOL not covered in standardized measures.

P201 Sleep disturbance in early rheumatoid arthritis and fibromyalgia and its association with mood and quality of life

Abstract Background/Aims Rheumatoid arthritis (RA) and fibromyalgia (FM) are common musculoskeletal conditions associated with pain, mood and sleep disturbance, functional limitations and poor health-related quality of life (QOL). Studies report sleep problems in 50-75% established RA and 70-90% FM. The aim of this study is to quantify the presence of sleep disturbance amongst patients with newly diagnosed RA or FM, to describe any association with measures of anxiety or depression, and to investigate the impact of sleep disturbance on QOL in this patient group. Methods Patients with a clinical diagnosis of early RA or FM were recruited from Rheumatology clinics over 12 months (ethics reference: IRAS Project 252762). Patients completed baseline patient reported outcome measures prior to commencing treatment: Insomnia Severity Scale (ISS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Physical Activity Calculator (PAC) and the Short Form-36 Health Survey (SF-36). Students t-test, Mann-Whitney and Chi-squared test were used to compare normal, non-normal and binary data respectively. Regression modelling was used to investigate the association between sleep disturbance and the general health subscale of SF-36 (GHSF-36), adjusting for age, sex and rheumatic condition. Results 161 participants were recruited: 84 had a diagnosis of early RA and 77 had FM, mean age 50 (16) years, 118 (73%) females. Moderate-to-severe insomnia was present in 34/84 (41%) of early RA patients and 56/77 (72%) of FM patients. Table 1 shows further baseline characteristics according to rheumatological diagnosis. Overall, there was a significant relationship between insomnia severity and general health (r=-0.39, p &amp;lt; 0.001), anxiety (r = 0.49, p &amp;lt; 0.001) and depression (r = 0.64, p &amp;lt; 0.001). Regression analysis confirmed an association between baseline sleep disturbance and general health after adjusting for age, sex and diagnosis (ß=-0.79, 95% CI -1.22 to -0.36, p &amp;lt; 0.001). Conclusion Although there is greater sleep and mood disturbance in patients with FM, 41% of patients with early RA also reported moderate-to-severe insomnia at the time of diagnosis. Activity levels remain similar between the two groups and insomnia severity was significantly associated with reduced health related QOL. This highlights the importance of addressing sleep, and mood, in Rheumatology clinics to help improve health related QOL. Disclosure A.J.W. Wall: None. A. Delmestri: None. N.W.I.L. Silva: None. A. Soni: None.

Effect of a 6-month sedentary behavior reduction intervention on well-being and workplace health in desk workers with low back pain

BACKGROUND: Research suggests reducing sedentary behavior improves low back pain; however, the impact on presenteeism, health, productivity, and sleep in desk workers with chronic low back pain is not known. OBJECTIVE: Evaluate the effect of a sedentary behavior intervention on multiple dimensions of workplace health. METHODS: 24 participants with chronic low back pain and desk jobs were randomized to either a sedentary behavior reduction intervention group or control. Outcomes included a modified Global Physical Activity Questionnaire (GPAQ), the Stanford Presenteeism Scale (SPS), Profile of Mood States (POMS), Health and Work Questionnaire (HWQ), SF-36 Health Survey (SF-36), and Pittsburgh Sleep Quality Index (PSQI). Six-month changes in outcomes were compared across intervention groups using ANCOVA regression, adjusting for baseline values. Cohen’s d effect sizes were calculated for outcomes to explain the magnitude of group differences. RESULTS: The intervention group reported 1.5 hours/day less sitting time (p &lt; 0.001) compared to controls at 6 months. SF-36 subscales of energy/fatigue, social functioning, and pain improved, and sleep disturbance was reduced among intervention participants. Productivity, concentration, and presenteeism were unchanged. CONCLUSIONS: A sedentary behavior reduction intervention may improve well-being and workplace health without impacting productivity and concentration in desk workers with chronic low back pain.

THE CULTURAL ADAPTATION, VALIDATION, AND RELIABILITY OF THE TURKISH VERSION OF THE LIFE SPACE ASSESSMENT

Purpose: The aim of this study was to determine the reliability and validity of the Turkish version of the Life Space Assessment (LSA) in older adults. &#x0D; Methods: A hundred fifty-two elderly people with a mean age was 72.81±7.63 years recruited to the study. Following the forward-backward translation procedure, the LSA scores were compared with a number of mobility and general health related variables, including the Physical Activity Scale for the Elderly (PASE) and the 36-Item Short Form Health Survey (SF-36) to test the concurrent validity. &#x0D; Results: None of the items in the LSA were changed. Cronbach’s α coefficient was 0.714 for the initial evaluation. The intraclass correlation coefficient for the test-retest reliability was 0.991 with a 95% confidence interval of 0.986–0.994. It found that the highest consistence was obtained in the equipment scores. All the subscores of LSA found to have a significant relationship with PASE scores and SF-36 subscores. A very strong positive correlation found between the total score of LSA and PASE (r = 0.896). Similarly, a very strong correlation observed between SF-36's subscore physical function, and LSA composite score (r = 0.841). Conclusion: The results of the study showed that the Turkish version of LSA has strong measurement features and that the LSA is a sensitive tool for assessing the life domains of elderly individuals related to their general health and physical activity level. Therefore, the Turkish version of the LSA could be used as a reliable and valid scale in research and practice areas related to elderly people.

Does individualization of dialysis dose positively influence the quality of life of peritoneal dialysis patients while preserving adequate dialysis?

Our objective is to evaluate the impact of individualization of the dialysis dose on the quality of dialysis and the quality of life of our peritoneal dialysis patients.&#x0D; Quality of life was assessed at least 3 months after individualization of the dialysis dose, by self-questionnaires using the SF-36 (short form) version of the KDQOL (Kidney Disease Quality Of Life) scale. The results of the KDQOL-SF36 are used as quantitative variables related to the achievement of a Kt/V&gt;1.7. Dialysis dose was calculated from dialysate and 24-hour urine, blood samples from patients encoded in the French Language Peritoneal Dialysis Registry (RDPLF). https://www.rdplf-db.org. Pearson's significance test is used to look for a correlation between the SF-36 subscores of the KDQOL scale and Kt/V.&#x0D; Fifteen patients (eight men, seven women) with a mean age of 65.93 years were eligible for the study.&#x0D; Our results did not show a direct relationship between Kt/V and quality of life. There was an existing but weak correlation between the sub-scores "physical functioning" and Kt/V as well as between "role limitation due to physical problems" and Kt/V. These correlations do not appear to be significant according to Pearson's significance test. The individualization of the treatment does not seem to have a negative impact on the Kt/V and certain dimensions of the KDQOL SF36 score seem to be less altered (social interactions, social support, life in relation with others). Further studies taking into account the limitations of our study are necessary to generalize such a therapeutic approach.

Intensive Circuit Class Therapy in Patients with Relapsing-Remitting Multiple Sclerosis.

ObjectiveLong-term physiotherapy is of considerable benefit to patients with multiple sclerosis (MS) who have motor dysfunction or gait impairment. The aim of this study was to determine the effectiveness of a 12-week intensive circuit class therapy for patients with MS, with a wider focus on fatigue and gait ability.MethodsA total of 46 patients with relapsing-remitting MS were divided randomly into 2 groups: 23 patients (mean Expanded Disability Status Scale (EDSS) 2.33 ± 0.74) participated in an intensive 12-week course of intensive circuit class therapy, and 23 patients (mean EDSS 2.04 ± 0.63) served as a control group. The EDSS, Timed Up and Go (TUG) test and Four-Stage Balance Test (FSBT) made up the physical testing part, supplemented by questionnaires such as the Modified Fatigue Impact Scale (MFIS), 12-Item Multiple Sclerosis Walking Scale (MSWS-12), Beck Depression Inventory (BDI) and 36-Item Short Form Survey (SF-36).ResultsSignificant improvements were found among intensive circuit class therapy-exercising patients in FSBT (p < 0.05), TUG test (p < 0.01), MFIS (p < 0.01), BDI (p < 0.05), MSWS-12 (p < 0.05) and the 3 subscales of SF-36 after 12 weeks of intensive circuit class therapy, while there were no significant changes in the control group.ConclusionIntensive circuit class therapy is an effective therapeutic approach for improving gait and balance problems in patients with MS. It has also proved to alleviate fatigue and symptoms of depression.LAY ABSTRACTGait impairment and fatigue are among the most common manifestations of multiple sclerosis (MS). In this study we aimed to test the effect of 12-week intensive circuit class therapy (ICT) on motor skills and fatigue in MS patients. Forty-six MS patients with mild to moderate disability were randomly assigned to those who underwent the ICT, or to the control group. The ICT patients exercised intensively one day per week on nine different stations with two experienced physiotherapists, the control group patients continued their routine daily exercise. Intensively exercising MS patients then improved significantly in the overall balance, gait and fatigue parameters, while there was no significant improvement in the control group. These findings indicate that ICT is an effective therapy for MS patients with gait, balance or fatigue problems.

The impact of the work environment on the health-related quality of life of Licensed Practical Nurses: a cross-sectional survey in four work environments

BackgroundNurses are known to have negative health outcomes related to their work. While it is acknowledged that nursing work is associated with things like back injuries and burnout, there is limited evidence as to what factors in the work environment contribute to these issues.PurposeThe aims of this study were to assess how Licensed Practical Nurses (LPNs) report their Health-related quality of life (HRQoL), and how nurses’ health is impacted by their work environment.MethodsThese data used for analysis comes from a cross-sectional survey administered online to all LPNs in Alberta (2018). The survey collected data on the following variables: participant’s demographics, the SF-36 HRQoL, Practice Environment Scale of the Nursing Work Index (PES-NW) and the CD-RISC measure of resilience. The beta distribution was used to model HRQoL outcomes. In instances where optimal health (score of ‘1’) was observed then an extended version of beta distribution (called one—inflated beta) was applied.Results4,425 LPNs responded to the survey. LPNs (mean age: 40) report lower scores on each SF-36 subscale than the general Canadian population aged 35–44. LPNs who work ‘causal’ had better physical health, (OR 1.21, CI 1.11–1.32, p = 0.000), and mental health (OR 1.22, CI 1.12–1.30, p = 0.000) than LPNs who work full time, even after controlling for resilience. LPNs’ views on the adequacy of staffing and resources in their workplaces have an influence across all dimensions of health.ConclusionThis study suggests that improvements in the work environment could positively impact health outcomes and that adequate resourcing could support the nursing workforce.