Short Form-36 Mental Summary Scores Research Articles

Influence of bariatric surgery on quality of life, body image, and general self-efficacy within 6 and 24 months—a prospective cohort study

BackgroundIt has been proven that bariatric surgery affects weight loss. Patients with morbid obesity have a significantly lower quality of life (QOL) and body image compared with the general population. ObjectiveTo evaluate QOL, body image, and general self-efficacy (GSE) in patients with morbid obesity undergoing bariatric surgery within clinical parameters. SettingsMonocentric, prospective, longitudinal cohort study. MethodsPatients completed the short form 36 (SF-36) for QOL, body image questionnaire, and GSE scale 3 times: before surgery and within 6 months and 24 months after surgery. Influence of gender, age, and type of procedure, either laparoscopic sleeve gastrectomy (SG) or laparoscopic Roux-en-Y gastric bypass, were analyzed. ResultsThirty patients completed the questionnaires before and within 6 and 24 months after surgery. SF-36 physical summary score improved significantly from 34.3±11.0 before surgery to 46.0±10.4 within 6 months (P<.001) and to 49.8±8.2 within 24 months (P<.001) after surgery. SF-36 mental summary score improved significantly from 42.1±14.7 before surgery to 52.3±8.4 within 6 months (P<.001) and to 48.4±12.2 within 24 months (P<.001) after surgery. There were no significant differences between gender, age, and type of operation. Body image and GSE improved significantly after bariatric surgery (P<.001), and both correlated to the SF-36 mental summary score. ConclusionQOL, body image, and GSE improved significantly within 6 months and remained stable within 24 months after bariatric surgery. Improvements were independent of gender, age, and type of operation. Mental QOL was influenced by body image and GSE.

Prevalence of Depression in Patients With Chest Pain and Non-Obstructive Coronary Artery Disease

Many studies have demonstrated the prevalence of depression in patients with coronary artery disease (CAD), but few have examined this relation in those with chest pain who do not have obstructive CAD on angiography. The aim of this study was to compare the prevalence of depression amongst patients with chest pain in the presence or absence of obstructive CAD and a healthy control group without chest pain. This prospectively designed, observational cohort study used 2 independent data sets: (1) The Queen Elizabeth Hospital Coronary Angiogram Database (n = 1,144), consisting of 819 patients with obstructive CAD and 325 patients with nonobstructive CAD (NoCAD), all of whom had chest pain and (2) the North West Adelaide Health Study (NWAHS; n = 3,168), a population-based biomedical cohort, from which patients with chest pain were excluded. The presence of depression was determined by a previously validated method using the Short Form 36. The prevalence of depression differed among the 3 groups, with 63% in those with NoCAD, 53% in those with CAD, and only 24% in the healthy NWAHS cohort. Analysis of the angiography cohort revealed age, gender, antidepressant medication, previous myocardial infarction, previous airway disease, Short Form 36 physical summary score, Seattle Angina Questionnaire physical limitation score, and NoCAD on angiography to be independent predictors of depression. In conclusion, these findings highlight the importance of screening for depression in patients with NoCAD.

Quality of life in nonfunctioning pituitary macroadenoma patients before and after surgical treatment

Nonfunctioning pituitary macroadenoma (NFMA) is a benign neoplasm that causes visual function disturbances and headaches and can be treated by transsphenoidal surgery (TSS). It is unclear how quality of life (QOL) changes with surgery and which QOL factors are affected by treatment. The aim is to assess the temporal transition of QOL in NFMA patients undergoing TSS and to identify influential factors. The QOL of NFMA patients who underwent endoscopic TSS was investigated with the short-form 36 (SF-36) health survey questionnaire, general health questionnaire 30 (GHQ30), and numerical rating scale (NRS) of pain at the following three time points: immediately before, 1 month after, and 6 months after surgery. Twenty-four of 30 patients had visual deterioration. The SF-36 baseline value of visual function-impaired NFMA patients was lower than that of the normal population. SF-36 results showed that physical summary scores decreased at 1 month after the operation, but recovered up to the normal population level by 6 months. Mental summary scores generally increased at 1 month after surgery and remained stable until 6 months later. The GHQ30 results were similar to the SF-36 mental summary scores. The strongest factor related to the QOL was visual function. The amount of pain and the necessity of hormonal replacement were also influencing factors. The QOL of NFMA patients is affected both physically and mentally by surgical treatment and symptoms. This QOL assessment is important for planning treatment strategies.

Using the Short Form-36 mental summary score as an indicator of depressive symptoms in patients with coronary heart disease

Depression is common in patients with cardiac disease; however, the use of depression-specific health instruments is limited by their increased responder and analyst burden. The study aimed to define a threshold value on the Short Form-36 (SF-36) mental component summary score (MCS) that identified depressed cardiac patients as measured by the Centre for Epidemiologic Studies Depression Scale (CES-D). An optimal threshold was determined using receiver-operating characteristic (ROC) curves on SF-36 and CES-D data from a large cardiac cohort (N = 1,221). The performance of this threshold was evaluated in a further two cardiac populations. In the index cohort, an SF-36 MCS score of ≤45 was revealed as an optimal threshold according to maximal Youden Index, with high sensitivity (77%, 95% CI = 74-80%) and specificity (73%, 95% CI = 69-77%). At this threshold, in a second sample of hospital cardiac patients, sensitivity was 93% (95% CI = 76-99%) and specificity was 64% (95% CI = 49-77%). In a final sample generated from a community population, specificity was 100% (95% CI = 85-100%) and sensitivity was 68% (95% CI = 61-74%) at the cut-off of 45. The SF-36 MCS may be a useful research tool to aid in the classification of cardiac patients according to the presence or absence of depressive symptoms.

Quality-of-Life and Outcome Predictors following Massive Burn Injury

Quality of life is a major criterion when decisions regarding resuscitation, reconstruction, and rehabilitation of patients with massive burn injuries are being considered. There has been little research focusing on quality of life following burn injuries involving more than 50 percent total body surface area in the adult population. The authors' goals were to describe quality of life and identify specific clinical and functional indices that predict good quality of life following massive burn injuries. Using a prospective study design, 47 patients who survived a massive burn between 1980 and 2001 were recruited from a single burn unit. Clinical data were collected from hospital records, function was assessed using the Abbreviated Burn-Specific Health Scale, and quality of life was assessed using the Short Form-36 survey. The Short Form-36 scores were compared with population norms. Univariate and multivariate regression analyses were used to identify factors predicting Short Form-36 scores. Overall, the mean age was 28 +/- 1.8 years, 96 percent (45 of 47) were men, and the mean burn size was 64 +/- 2.1 percent total body surface area. Compared with Canadian population norms, burn patients had significantly lower Short Form-36 scores in the domains of role physical (69.1 versus 82.1, p = 0.0067) and general health perception (67.2 versus 77.0, p = 0.00014). At the time of injury, the amount of total full-thickness burn predicted follow-up Short Form-36 physical summary scores (R2 = 15 percent, p < 0.001). At the time of follow-up, addition of the patient's hand function significantly contributed to the prediction of Short Form-36 physical summary scores (R2 = 44 percent, p < 0.001). At the time of injury, the age of the patient predicted follow-up Short Form-36 mental summary scores (R2 = 25 percent, p < 0.001). At the time of follow-up, addition of the patient's perceived level of social support significantly contributed to the prediction of Short Form-36 mental summary scores (R2 = 44 percent, p < 0.001). Survivors of massive burn injury reported a good quality of life in most Short Form-36 domains. The authors identified the size of the total full-thickness injury and the age of the patient as factors available at the time of injury that predict quality of life. The addition of hand function and the patient's perceived level of social support at the time of follow-up improved prediction of quality of life. Accordingly, this information on quality of life after massive burn injury could aid in decision making at the time of resuscitation, reconstruction, and rehabilitation.