Significant Difference In Overall Quality Of Life Research Articles

Is It Possible to Improve the Perceived Quality of Life of Overweight or Obese Older People through a Multicomponent Physical Exercise Program?

Multicomponent exercise is a physical exercise modality in which various physical qualities (strength, cardiorespiratory endurance, flexibility, and balance) are developed with an equal distribution of volume in the same session (approximately 60 min) and that has been little explored in improving the quality of life of older adults. The aim of this study was to verify the effect of multicomponent training on self-perceived quality of life in Chilean overweight or obese older people. To this end, a quasi-experimental study with a control group was designed to evaluate self-perceived Quality of Life using the World Health Organization Quality of Life, brief version [Overall Quality of Life (OQOL); Overall Health (OH); Physical Health (PH); Psychological Health (PsH); Social Relations (SR); Environment (E)]. Seventy overweight or obese people aged between 60 and 86 years participated (M = 73.15; SD = 5.94) and were randomized into a control group (CG, n = 35) and an experimental group (EG, n = 35). The results in the EG (pre vs. post-intervention) indicated that there were statistically significant differences in OQOL (p = 0.005), OH (p = 0.014), PH (p < 0.001), PsH (p < 0.001), E (p = 0.015), and SR (p < 0.001) which were not found in the CG in any of the variables (p > 0.050) except in SR (p < 0.001). Regarding sex, post-intervention differences were only found between CG and EG in women in OQOL (p = 0.002), PH (p < 0.001), PsH (p = 0.003), and SR (p < 0.001), but not in OH or E (p > 0.050). These differences were not found among men in any of the variables (p > 0.050). As a conclusion, we can say that a multicomponent physical exercise program applied for 6 months significantly improves the perception of OQOL, OH, PH, PsH, SR, and E in overweight or obese older people. This perception is greater in men than in women.

Quality of life in women with early-stage and metastatic hormone receptor-positive, HER2-negative breast cancer receiving endocrine therapy.

Early discontinuation of endocrine therapy (ET) is higher among patients with early breast cancer (EBC) compared to patients with metastatic hormone receptor-positive (HR+) breast cancer (MBC). In our clinical experience the reasons for this may includea significant burden of ET side effects impacting quality of life (QOL) in patients with EBC. We hypothesized that QOL is lower in patients with HR + EBC compared to patients with HR + MBC on ET. We conducted a cross-sectional observational study to assess QOL utilizing FACT-ES & EORTC QLQ C30 tools among patients with EBC and MBC receiving ET across 5 Irish hospitals. A total of 417 patients were enrolled-EBC (79% n = 331) and MBC 21% (n = 86). Using the FACT-ES, we found no difference in overall QOL by stage (139.2 vs 141, P = .33). Patients with HR + MBC had a lower symptom burden from ET compared to HR + EBC (61.4 vs 54, P < .01). In adjusted multivariate linear regression models, there was no difference in QOL for patients with EBC and MBC receiving ET. There was no significant difference in overall QOL for patients with EBC and MBC. However, patients with EBC experienced more endocrine symptoms. In adjusted multivariate linear regression models, the stage did not predict QOL. Our results suggest that endocrine symptoms are significant contributors to impaired QOL for patients with EBC but the role of other determinants of QOL (eg, stage) is less clear. Future work could include the development of stage-specific QOL tools and utilization of electronic patient-reported outcomes (ePROs) to identify and manage emergent toxicities.

Quality of life of primary caregivers of children living with cerebral palsy at two clinics in Blantyre, Malawi.

In Malawi, Primary Caregivers (PCGs) of children living with Cerebral Palsy report challenges such as physical strain and lack of resources that affect care giving. Although such experiences affect the PCGs' Quality of Life (QoL), there is paucity of data for Malawi. Understanding their QoL would inform establishment of holistic intervention(s) tailored to meet their needs. Therefore, the purposes of this study were to determine QoL of PCGs of the children who were receiving rehabilitation at Queen Elizabeth Central Hospital (QECH) and Feed the Children (FtC), to identify PCG's and children's socio-demographic factors that may attribute to the perceived QoL, and to compare the PCGs' QoL between the sites. A cross-sectional study was conducted from January to April 2019 on 142 PCGs of children aged between 2 and 18 years of age. All PCGs who were employed for the child-care, or had a chronic sickness were excluded. QoL was assessed using the World Health Organization Brief questionnaire, with a cut-off point of <60% for poor QoL. The severity of children's impairments was assessed using Gross Motor Function Classification System. Descriptive and inferential statistics were conducted to analyze the data. The PCGs' age, sex, marital status and level of education, and child's severity of impairment were compared with QoL. The majority of PCGs (61.30%) had poor QoL, and there was no significant difference in overall QoL of the PCGs between the sites (p<0.31). The PCGs at QECH had significantly higher physical domain mean scores than at FtC (U=1906, p<0.01). The overall QoL differed significantly across the marital statuses of the PCGs (p<0.03). The study has established that most PCGs at both sites possess poor QoL. However, there is need to investigate how the rehabilitation institutions and workers influence the QoL of the PCGs within and between the facilities.

A Pilot Study Evaluating the Impact of Hospital Hospitality Houses (HHH) Programs on the Quality of Life and Mood of Patients and Their Caregivers Following Hematopoietic Stem Cell Transplant (HCT)

Background: The quality of life (QOL) of HCT patients and their caregivers declines steeply with worsening depression during the first 8 days following stem cell infusion (SCI) (El Jawahri et al, Cancer 121;951, 2015). In view of this, unique opportunities to develop programs in the confined environment of HHH to prevent the observed decrease in the QOL and address the depression of the patients and caregivers exist. The aim of this study was to gather pilot data evaluating if staying in a HHH, with its different environment and support systems and programs, has a positive impact on the QOL and mood of HCT patients and their caregivers.Methods: This protocol was approved by the Mayo Clinic IRB and verbal consent was obtained on all participants. Patients scheduled to undergo a HCT and their caregivers were identified and asked to participate in the study. Participants completed research QOL questionnaires (LASA, FACT-G, FACT-BMT, SF-12, HADS, PHQ-8, and PROMIS) at the following time points: 15 days (+/- 15 days) prior to transplant, 1 day (+/-1 day) after SCI, 8 days (+/- 2 days) after SCI, and 30 days (+/- 7 days) after SCI. The pre-defined primary endpoint was differences in overall QOL of patients and their caregivers staying at a HHH vs. hotel, as measured by the single-item LASA.Results: A total of 44 patients and 44 caregivers were enrolled in this study from July 2016 through January 2017. Twenty-two patients completed all QOL questionnaires at all 4 time points (9 Hotel, 13 HHH) and 5 patients did not complete any QOL questionnaires (4 Hotel, 1 HHH). Day 1 post SCIQOL was worse in the HHH patients (mean = 46.9 vs. 67.6, p=0.0069, higher=better) (Figure 1); whereas, caregivers showed no significant difference in overall QOL between the living place post SCI (Figure 2). Patients who stayed at HHH were older (median age=63.2 vs. 55.4 years old, p=0.0279) and 61% of the patients were male versus 90% of the patients who stayed at hotel (p=0.0290).A multivariate analysis showed that the time point of questionnaire administration had the greatest effect on the overall QOL of patients, with day 8 post-transplant showing the most significant worsening in QOL of patients (~20 points, p=0.0006) after adjusting for other baseline characteristics. The QOL results of caregivers showed no significant difference based on place of stay; however, the data showed a tendency to favor the HHH subset. A review of data from the entire cohort of patients revealed that older patients (age >60) reported a significantly lower QOL at day 30 post HCT (mean score 51.6 vs. 75.3, p=0.0170) and lower QOL at other time points (Figure 3). There was a weak positive correlation in QOL between patient and caregiver over time except at baseline, with a correlation coefficient=0.3566.Conclusions: Patients' age and type of HCT significantly influence patients' QOL likely accounting for the observed worse QOL of patients in the HHH subset. Living arrangements do not have a significant impact on caregivers' QOL. Additional research focusing on interventions aimed at improving the QOL and mood of HCT patients older than 60 will be of interest. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Prevalence of Post-traumatic Stress Symptoms and Its Associations With Quality of Life, Demographic and Clinical Characteristics in COVID-19 Survivors During the Post-COVID-19 Era.

Background: The prevalence of post-traumatic stress symptoms (PTSS) in COVID-19 survivors is unclear. This study examined the prevalence of PTSS and its association with quality of life (QOL) among COVID-19 survivors during the post-COVID-19 era in China.Methods: This was a comparative, cross-sectional study. PTSS, depressive symptoms, and QOL were assessed with standardized instruments.Results: A total of 134 COVID-19 survivors and 214 non-infected controls (healthy controls hereafter) were recruited. Among COVID-19 survivors, the PTSS prevalence was 18.66% (95%CI: 11.98–25.34%), which was significantly higher than that (5.61%, 95%CI: 2.50–8.71%) of healthy controls (P < 0.001). After controlling for covariates, an analysis of covariance (ANCOVA) showed that COVID-19 survivors had a higher PTSS total score than did healthy controls [F(1,348) = 4.664, P = 0.032]. A separate ANCOVA revealed there were no significant differences in overall QOL between COVID-19 survivors with and without PTSS [F(1,348) = 1.067, P = 0.304]. A multiple logistic regression analysis showed that more severe depressive symptoms were significantly associated with PTSS in COVID-19 survivors (OR = 1.425, P < 0.001).Conclusions: PTSS were more severe in COVID-19 survivors compared to healthy controls in the post-COVID-19 era. Considering their negative impact on daily life and functional outcomes, regular assessment and appropriate treatments of PTSS should be conducted in COVID-19 survivors.

Comparison of quality of life and depression between hematopoietic stem cell transplantation survivors and their spouse caregivers

BackgroundHematopoietic stem cell transplantation (HSCT) is an exhausting process that impacts both the patient and caregiver.MethodsThis was a cross-sectional, HSCT survivor-spouse caregiver matching study to determine quality of life (QoL) and depression among HSCT survivors and their caregivers. QoL and depression were measured with the World Health Organization Quality of Life: Brief Version (26 items) and the 9-item Patient Health Questionnaire, respectively. Data from 97 married couples were analyzed.ResultsThere were no significant differences in overall QoL and psychological, social, and environmental health between survivors and spouse caregivers (P=0.345, 0.424, 0.415, and 0.253); however, physical QoL was better in the spouse caregiver group (P=0.011). There was no difference in mean depression scale scores (5.3 vs. 5.1, P=0.812) or proportion of severe depression (15.6% vs. 13.7%, P=0.270) between the two groups. We found that family income had a significant impact on overall QoL and environmental health among spouse caregivers (P=0.013 and 0.023), and female gender, co-morbidities, and family income were the important factors associated with depression among spouse caregivers (P=0.007, 0.017 and 0.049).ConclusionThis study found that there were no significant differences in QoL or level of depression between HSCT survivors and their spouse caregivers. Family income, gender, and co-morbidities showed significant association with spouse caregiver distress.

Level of physical activity and aerobic capacity associate with quality of life in patients with temporal lobe epilepsy.

Epilepsy is more than seizures and includes a high risk of comorbidities and psychological disorders, leading to poor quality of life (QOL). Earlier studies have showed a sedentary lifestyle in people with epilepsy (PWE), which could contribute to poorer health and psychological problems. The purpose of the present study was to compare habits of physical activity (PA), aerobic capacity, and QOL between PWE and healthy controls in order to identify the necessity of intervention of habits and information on physical exercise (PE) and to better understand the importance of PE for PWE. The study included 38 patients with temporal lobe epilepsy and 20 normal controls. Both groups answered the WHOQOL-Bref, which assesses the level of QOL, and IPAQ to evaluate the level of PA. In addition, they were submitted to a treadmill maximal cardiopulmonary effort test to identify physical capacity. The continuous variables were compared between groups by t-test and a general linear model, and the frequencies were compared by Chi-Square test through SPSS software. There was no difference in the level of PA between groups by questionnaire evaluation. However, there were significant differences in overall QOL, physical health, and level of PA in relation to work and physical capacity between groups; controls demonstrated better scores than PWE. Controls presented better physical capacity than PWE by cardiopulmonary effort test. According to intra-group analyses, PWE who were physically active had better QOL than inactive PWE. The study concluded that questionnaires about PE may not be the best instrument of evaluation, as demonstrated by the discrepancy of results compared to the validated objective cardiopulmonary evaluation of level of PA and physical capacity in this study.

The Impact of Primary Treatment Strategy on the Quality of Life in Patients with Vestibular Schwannoma

To assess the quality of life (QoL) in a representative sample of patients with vestibular schwannoma and to ascertain the differences in outcomes associated with distinct management strategies. Patients with vestibular schwannoma attending a tertiary referral center were asked to complete the Functional Assessment of Chronic Illness Therapy-Brain Questionnaire, which assesses QoL in 5 domains: physical, social, emotional and functional, and a brain cancer-specific domain. Results were analyzed in the overall cohort and in surgery, stereotactic radiosurgery, and conservative management subgroups. The relationship between patient clinical characteristics and QoL outcome also was analyzed by univariable and multivariable logistic regression. There were 83 survey respondents with an average age of participants of 57 years and a mean follow-up of 4.9 years. QoL was statistically significantly lower in the surgery subgroup within the Physical QoL domain (P=0.039); however, there was no significant difference in overall QoL between the 3 subgroups of surgery, radiosurgery, and conservative management (P= 0.17). A poor QoL outcome was associated with the number of symptoms at diagnosis, greater tumor size, and a surgical management strategy. The QoL within this patient cohort was extremely variable in each management group, mirroring the heterogeneous natural history of this disease process. QoL in patients with vestibular schwannoma cannot be predicted based on management strategy alone, but a poor QoL outcome is more likely in patients with larger, symptomatic tumors that are treated surgically.

WITHDRAWN: Psychological treatments for epilepsy.

BACKGROUND: Psychological interventions such as relaxation therapy, cognitive behaviour therapy, bio-feedback and educational interventions have been used alone or in combination in the treatment of epilepsy, to reduce the seizure frequency and improve the quality of life. OBJECTIVES: To assess whether the treatment of epilepsy with psychological methods is effective in reducing seizure frequency or leads to a better quality of life (QOL), or both. SEARCH METHODS: We searched the Cochrane Epilepsy Group Specialized Register (11 January 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2010) and MEDLINE (1948 to December 2010). No language restrictions were imposed. We checked the reference lists of retrieved studies for additional reports of relevant studies. SELECTION CRITERIA: Randomized or quasi-randomized studies assessing one or more types of psychological or behaviour modification techniques for people with epilepsy. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the trials for inclusion and extracted data. Primary analyses were by intention to treat. Outcomes included reduction in seizure frequency and quality of life. MAIN RESULTS: We found three small trials (total 50 participants) of relaxation therapy. They were of poor methodological quality and a meta-analysis was therefore not undertaken. No study found a significant effect of relaxation therapy on seizure frequency.Two trials found cognitive behavioural therapy (CBT) to be effective in reducing depression among people with epilepsy and a depressed affect, whilst another did not. Two trials of CBT found improvements in QOL scores. One trial of group cognitive therapy found no significant effect on seizure frequency while another trial found a statistically significant reduction in seizure frequency as well as seizure index (product of seizure frequency and seizure duration in seconds) among participants treated with CBT.One small trial compared CBT with yoga and found similar rates of seizure freedom and 50% responder rates at the end of one year. Compared to pretest scores, the CBT group showed an improvement in the World Health Organization quality of life instrument, short version (WHO QOL-BREF) (P ≤ 0.01) while the yoga group had an improvement in their QOL according to the satisfaction with life scale (SWLS) (P ≤ 0.05).Two trials of combined relaxation and behaviour therapy, one of electroencephalographic (EEG) bio-feedback and four of educational interventions did not provide sufficient information to assess their effects on seizure frequency. One small study of galvanic skin response biofeedback reported significant reduction in seizure frequency.Combined use of relaxation and behaviour modification was found beneficial for anxiety and adjustment in one study. In one study EEG bio-feedback was found to improve cognitive and motor functions in individuals with the greatest seizure reduction. Educational interventions were found to be beneficial in improving knowledge and understanding of epilepsy, coping with epilepsy, compliance to medication and social competencies.Two trials investigated the effects of a self management program on QOL measures. One found no significant differences in overall QOL except for an improvement in the QOL in persons with epilepsy (QOLIE-89) role limitations - emotional score. The other study found no significant benefits in any of the outcomes studied except for more positive attitudes about the outcomes associated with taking medications. AUTHORS' CONCLUSIONS: In view of methodological deficiencies and the limited number of individuals studied, we have found no reliable evidence to support the use of psychological treatments and further trials are needed. Since the last version of this review, none of the new relevant studies have provided additional information to change the conclusions. Language: en

Effects of Qigong on Quality of Life, Fatigue, Stress, Neuropathy, and Sexual Function in Women with Metastatic Breast Cancer: A Feasibility Study

Background: Women with metastatic breast cancer (MBC) suffer from psychological and physiological symptoms and side effects of therapy. When the treatment is non-curative, quality of life (QOL) is a major issue. This study aimed to examine the feasibility, safety, and effects of Medical Qigong (MQ: integration of gentle exercise and meditation) in improving QOL in women with MBC. Method: Women with MBC were randomized to a MQ group (n=14) or meditation control group (n=13). QOL, fatigue, stress, neuropathy symptoms and sexual function were measured by the Functional Assessment of Cancer Therapy - Breast (FACT-B), Functional Assessment of Cancer Therapy-fatigue (FACT-F), Perceived Stress Scale (PSS), neurotoxicity subscale of the FACT/GOG-NTX, and Sexual Functioning Questionnaire (SFQ) subscales at pre-intervention and weeks 5 and 10. Results: No serious adverse events were reported during or after MQ intervention. Sixty three percent of participants completed the study (MQ intervention (n=9) and meditation control (n=8)). There were no significant differences in overall QOL (p= 0.84), fatigue (p=0.71), perceived stress level (p=0.52), sexual satisfaction (p=0.55), sexual activities (p=0.95) and sexual relationship (p=0.79) between the groups, although difference in neuropathic symptoms (p=0.014) were significant. Conclusions: A MQ trial in women with MBC is feasible and safe. MQ may have the potential to relieve symptoms experienced by women with MBC and prevent deterioration of neuropathy. A larger study with adequate power to confirm these results and detect clinically relevant effects is needed.

Managing With Pacemakers and Implantable Cardioverter Defibrillators

Implantable cardioverter defibrillators (ICDs) save lives in patients at risk for sudden death attributable to ventricular arrhythmias, pacemakers (PMs) have been improving symptoms in patients with bradyarrhythmias for decades, and, more recently, cardiac resynchronization devices have improved mortality, morbidity, and quality of life for patients with heart failure.1 However, these devices can also be life-changing for the patients receiving them. The need for long-term follow-up, concerns regarding malfunction, and lifestyle restrictions all affect patients with any implanted device. For patients with ICDs, receiving shocks, both appropriate and inappropriate, can impact quality of life (QOL). Lead or device malfunction can result in unnecessary shocks, and recalls can cause anxiety. Shocks at the end of life can be particularly devastating. However, with careful attention by the healthcare team, both shocks and their impact can be reduced. In addition to shocks, restrictions imposed by the ICD can also impact QOL. The possibility of syncopal arrhythmias and loss of control attributable to shocks, as well, has led to concerns regarding the safety of driving and of sports participation for some individuals, a further burden. Remote monitoring increases the ease of follow-up for patients and physicians and may improve timeliness of management. However, a consequence of remote follow-up has been a decrease in the amount of time electrophysiologists may spend face-to-face with patients, emphasizing the importance of communication between electrophysiologist and primary cardiologist. This article will review ways in which electrophysiologists, general cardiologists, and patients can work together to minimize the burdens that can accompany these devices, often weighing issues of patient QOL, safety, and autonomy. Studies of overall QOL for patients with ICDs have shown mixed results. Some studies have found no significant differences in overall QOL between ICD patients and other cardiac patients,2,3 PM patients, or the general population. …

Factors Affecting Quality of Life During and After Stem Cell Transplantation in Long Term Survivors – Comparison of Autologous and Allogeneic Stem Cell Transplantation

AbstractAbstract ▪590▪This icon denotes a clinically relevant abstract Background:Myeloblative conditioning (MAC) or reduced intensity conditioning (RIC) followed by autologous or allogeneic stem cell transplantation (ASCT or AlloSCT) is established and lifesaving treatment in selected indications. The quality of life (QoL) is then very important issue for long term surviving patients. The majority of data is often based on single center evaluation with limited number of patients. Therefore we have started the cross-sectional QoL project and this analysis is based on data collected from eight transplant centers. Methods:Altogether data from 1399 patients are included in the study. The FACT-G questionnaire (Q) was used for this analysis. The questionnaire consists of four parts - physical well-being (PWB), social/family well-being (SWB), emotional well-being (EWB), functional well-being (FWB). The patients completed the Q before the transplantation (at the time of indication or at the time of admission to SCT) n=304, after ASCT n=662 and after AlloSCT n=433. Patients were divided into 7 groups – before SCT, day +100, up to 1y, 1–2y, 2–3y, 3–5y and more than 5y. The clinical characteristics were obtained from national transplant registry; the data was cleaned and updated. Wilcoxon and Kruskall-Wallis tests were used for statistical analysis. Patient′s characteristic:The ASCT and AlloSCT groups (grp.) consist of 869 and 530 pts resp. including 207 pts before ASCT and 97 before AlloSCT. There were 52.8% and 55.7% men in ASCT and AlloSCT grp. resp. The median age in ASCT and AlloSCT grp. resp. was: 55.2 and 43.2y resp., the median follow-up 4.4 and 4.5y resp. The most frequent diagnosis of ASCT group were: Non-Hodgkin′s lymphoma (NHL) 46.1%, multiple myeloma (MM) 36.6%, Hodgkin′s lymphoma (HL) 8.5%. In AlloSCT: acute myelogenous leukemia 29.4%, acute lymphoblastic leukemia 15.7%, chronic myeloid leukemia 11.5% and myelodysplastic syndrome 10.0%. Disease progression/relapse was observed in 148 ASCT (22.4%) and 61 AlloSCT (14.1%) pts. In AlloSCT group MAC was used in 33% pts and matched unrelated donor (MUD) in 59.8% pts., aGVHD gr I-II was observed in 40.3% and gr III-IV 4.2% pts, cGVHD in 37.9% pts. Results:Significant differences in overall QoL before, during and after the AlloSCT (p<0.001) and ASCT (p=0.01) were observed. The QoL was improved from 1y after ASCT as well as from 2y after Allo-SCT. It was due mainly to the PWB and FWB improvement in both SCT groups, SWB and EWB remained unchanged. Long term survivors reported better QoL vs pts before transplant both in the alloSCT gr. (89 vs 80.7 points) as well as in ASCT gr.(82 vs 73.1). Interestingly, significantly better QoL in AlloSCT vs ASCT gr. was reported in all time points except day +100 and 2y. At the time of indication it was 80.7 vs 73.1 (p=0.035) and the most significant difference was among long-term survivors 89.0 vs 82.0 (p<0.001). The overall QoL was not affected by gender, women only reported better SWB in AlloSCT and ASCT grp. and men reported better EWB in ASCT gr. The age had significant impact on overall QoL in ASCT (p=0.005) and AlloSCT (p=0.006) but only due to difference in PWB and FWB resp., which was more profound in AlloSCT (p<0.001). The diagnosis had no impact on QoL in AlloSCT grp. but the MM pts have significantly lower QoL compared to NHL and HL pts. resp. (73 vs 80 vs 82 resp. p<0.001) in ASCT group. There was no significant impact of MAC or RIC on the QoL, patients with MUD has lower QoL compared to sibling donor (84.8 vs 88, p<0.05). Relapse after transplantation was associated with worse QoL, after ASCT 74 vs 81 (p=0.02) and after AlloSCT 81.5 vs 87.5 (borderline significance p =0.065). The long term survivor′s QoL was not affected by aGVHD in contrast to the cGVHD which significantly affects QoL (p<0.001) due to lower PWB (p<0.001) and FWB (p<0.001). Conclusion:We herein demostrate on large cohorts of pts that long term survivors have significantly better QoL compared to QoL in the time of indication of the transplantation and the improvement starts from 1y after ASCT and from 2y after AlloSCT. AlloSCT survivors report better QoL compared to the ASCT survivors. The most important factors affected QoL are age, cGVHD (AlloSCT) and diagnosis (ASCT), the borderline factors are relapse after SCT and type of donor (AlloSCT). Disclosures:No relevant conflicts of interest to declare.

SUBCLINICAL PSYCHOTIC EXPERIENCES AND AFFECTIVE DYSREGULATION IN ADOLESCENTS AND YOUNG ADULTS

Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In addition, this study aims to identify determinants of QoL in AWS by testing relationships between stuttering severity, coping, functioning and QoL and by testing for differences in variable scores between two AWS subgroups: receiving therapy versus not receiving therapy. A total of 91 AWS filled in several questionnaires to assess their stuttering severity, daily functioning, coping style and QoL. The QoL instruments used were the Health Utility Index 3 (HUI3) and the EuroQoL EQ-5D and EQ-VAS. The results indicated that moderate to severe stuttering has a negative impact on overall quality of life; HUI3 derived QoL values varied from .91 (for mild stuttering) to .73 (for severe stuttering). The domains of functioning that were predominantly affected were the individual's speech, emotion, cognition and pain as measured by the HUI3 and daily activities and anxiety/depression as measured by the EQ-5D. AWS in the therapy group rated their stuttering as more severe and recorded more problems on the HUI3 speech domain than AWS in the non-therapy group. The EQ-VAS was the only instrument that showed a significant difference in overall QoL between groups. Finally, it was found that the relationship between stuttering severity and QoL was influenced by the individual's coping style (emotion-oriented and task-oriented). These findings highlight the need for further research into stuttering in relation to QoL, and for a broader perspective on the diagnosis and treatment of stuttering, which would take into consideration quality of life and its determinants.Learning outcomes: Readers will be able to: (1) Understand how the Wilson and Cleary (1995) model of quality of life could be applied to comprehensively assess the quality of life in adults who stutter, (2) describe how health related quality of life is impaired in adults who stutter, (3) mention affected domains of functioning that are related to health related quality of life impairment in adults who stutter, (4) describe the relationship between stuttering severity, functioning, coping and health related quality of life in adults who stutter, (5) describe differences in stuttering severity, coping style, functioning and health related quality of life between adults who stutter who have registered for therapy and adults who stutter who have not.

Quality of life in adults who stutter

Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In addition, this study aims to identify determinants of QoL in AWS by testing relationships between stuttering severity, coping, functioning and QoL and by testing for differences in variable scores between two AWS subgroups: receiving therapy versus not receiving therapy. A total of 91 AWS filled in several questionnaires to assess their stuttering severity, daily functioning, coping style and QoL. The QoL instruments used were the Health Utility Index 3 (HUI3) and the EuroQoL EQ-5D and EQ-VAS. The results indicated that moderate to severe stuttering has a negative impact on overall quality of life; HUI3 derived QoL values varied from .91 (for mild stuttering) to .73 (for severe stuttering). The domains of functioning that were predominantly affected were the individual's speech, emotion, cognition and pain as measured by the HUI3 and daily activities and anxiety/depression as measured by the EQ-5D. AWS in the therapy group rated their stuttering as more severe and recorded more problems on the HUI3 speech domain than AWS in the non-therapy group. The EQ-VAS was the only instrument that showed a significant difference in overall QoL between groups. Finally, it was found that the relationship between stuttering severity and QoL was influenced by the individual's coping style (emotion-oriented and task-oriented). These findings highlight the need for further research into stuttering in relation to QoL, and for a broader perspective on the diagnosis and treatment of stuttering, which would take into consideration quality of life and its determinants. Learning outcomes: Readers will be able to: (1) Understand how the Wilson and Cleary (1995) model of quality of life could be applied to comprehensively assess the quality of life in adults who stutter, (2) describe how health related quality of life is impaired in adults who stutter, (3) mention affected domains of functioning that are related to health related quality of life impairment in adults who stutter, (4) describe the relationship between stuttering severity, functioning, coping and health related quality of life in adults who stutter, (5) describe differences in stuttering severity, coping style, functioning and health related quality of life between adults who stutter who have registered for therapy and adults who stutter who have not.

Preliminary Evaluation of Psychoeducational Support Interventions on Quality of Life in Rural Breast Cancer Survivors After Primary Treatment

Although most cancer survivors are at risk for being lost in the transition from treatment to survivorship, rural breast cancer survivors face special challenges that might place them at particular risk. This small-scale preliminary study had 2 specific aims: (aim 1) establish the feasibility of rural breast cancer survivors participation in a longitudinal quality of life (QOL) intervention trial and (aim 2) determine the effects of the Breast Cancer Education Intervention (BCEI) on overall QOL. Fifty-three rural breast cancer survivors were randomized to either an experimental (n = 27) or a wait-control arm (n = 26). Participants in the experimental arm received the BCEI consisting of 3 face-to-face education and support sessions and 2 face-to-face and 3 telephone follow-up sessions, along with supplemental written and audiotape materials over a 6-month period. Breast Cancer Education Intervention modules and interventions are organized within a QOL framework. To address the possible effects of attention, wait-control participants received 3 face-to-face sessions and 3 telephone sessions during the first 6 months of participation in the study, but not the BCEI intervention. Research questions addressing aim 1 were as follows: (a) can rural breast cancer survivors be recruited into a longitudinal intervention trial, and (b) can their participation be retained. Research questions for aim 2 were as follows: (a) do participants who received the BCEI show improvement in overall QOL, and (b) is the QOL improvement sustained over time. Data were analyzed using repeated-measures general linear mixed models. Results demonstrated the ability to recruit and retain 53 rural breast cancer survivors, that the experimental arm showed improvement in overall QOL (P = .013), and that there were significant differences in overall QOL between the experimental and wait-control groups at both months 3 and 6. Thus, it appears that at least some rural breast cancer survivors can and will participate in a larger trial and will maintain their participation and that those that do participate experience significant QOL benefit.

Comparison of Quality of Life between Kidney Transplant and Hemodialysis Patients

The purpose of this study was to discover kidney transplant and hemodialysis patients' quality of life(QOL) and provide basic data to improve their QOL. One hundred two hemodialysis patients and 106 kidney transplant patients were given a self-administered questionnaire from Mar. 6 to Mar. 31, 2006. The instrument consisted of demographic variables, therapeutic-related characteristics and QOL. Collected data was processed using the SPSS 12.0 statistical program for real numbers, percentages, ANCOVA, t-test, ANOVA, Stepwise multiple regression and the Scheffe test. Kidney transplantpatients' QOL was higher than hemodialysis patients. The demographic variables which showed a significant difference in overall QOL were religion, children and monthly income for kidney transplantpatients and educational background for hemodialysis patients. The therapeutic-related variable which showed a significant difference in overall QOL was the patients' perceived health condition for both groups. The influencing factor on overall QOL for both groups was the health condition perceived by themselves. The total variance of the variable for QOL was 42% for kidney transplant patients and 19% for hemodialysis patients. This study revealed that kidney transplant patients have a higher QOL and how patients perceive their health is the strongest influencing factor for QOL. However, there is a large difference between the demand and supply of kidney donors. To solve this problem the standards for donation should be reviewed and revised.

Quality of Life in 650 Lung Cancer Survivors 6 Months to 4 Years After Diagnosis

To present the results of a quality-of-life (QOL) assessment performed with the current version of the Lung Cancer Symptom Scale (LCSS) questionnaire in a large single-institutional data set of 650 patients with lung cancer. The study group included 650 patients with pathologically confirmed primary lung cancer whose conditions were diagnosed and/or treated at the Mayo Clinic in Rochester, Minn, between January 1, 1997, and December 31, 2001. The QOL assessment was performed using the self-administered LCSS questionnaire (version 2) 6 months to 4 years after the diagnosis of lung cancer. The item response rate for all 9 LCSS questions was 94.2% with a minimum of 92.9%. Significant differences in overall QOL by sex (P=.04), Karnofsky scale (P<.001), weight loss (P<.001), disease stage (P<.001), and histology (P=.001) were found, but no significant differences in overall QOL by age (P=.17) or marital status (P=.06) were observed. Our data suggest that QOL in patients with lung cancer at varying times after diagnosis highly correlates with baseline prognostic factors (disease stage, histology, Karnofsky scale, weight loss, and sex).

The Lancashire Quality of Life Profile: data and experiences with 58 detained mentally disordered offenders

Objectives This study evaluates the quality of life (QOL) of a group of detained mentally disordered offenders (MDOs) from high- and medium-security institutions using the Lancashire Quality of Life Profile (LQOLP). It was predicted that they would show a poorer QOL on the LQOLP when compared with published data on patients using general psychiatric services. Design A cross-sectional study was undertaken using a clinician administered questionnaire. Method The LQOLP was conducted with 58 detained forensic patients: 19 regional secure unit (RSU) patients, 20 high-security recently admitted patients, and 19 high-security pre-discharge patients. Results Contrary to predictions, it was found that there was no significant difference in overall QOL (measured using the LQOLP) between detained forensic patients and published LQOLP data on psychiatric outpatients in general services. Nor was there a difference observed between these two groups on several major life domains. However, there were several domains in which detained patients had significantly worse QOL ratings; these included: living situation (including living arrangements, independence, control and privacy); legal and safety; and health. It was also found that detained patients rated their social relations as significantly better than their non-detained counterparts. Conclusions The LQOLP is a viable instrument to use for evaluating the QOL of detained MDOs. QOL is an important outcome to measure in addition to the usual evaluation of symptoms and patient satisfaction. For detained forensic patients QOL assessment may represent the only way of measuring the totality of their experience in secure environments. QOL data may be used to compare service provision and to help guide the development and improvement of patient care. Future work may involve forensic outpatient and prison populations. Copyright © 2000 Whurr Publishers Ltd.

Quality of life and self-esteem in working and nonworking persons with mental illness.

The purposes of this research were to examine first the relationship between work status and quality of life and self-esteem in persons with severe, persistent mental illness and secondly, the relationship between (a) demographic characteristics, attitudes toward psychotropic medications, and perceptions of the meaning of work and (b) quality of life and self-esteem in working and nonworking persons with severe mental illness. The sample included 92 persons (51 workers and 41 nonworkers). Instruments included the quality of Life (QOL) Interview (Lehman, 1983), Rosenberg's (1965) Self-Esteem Inventory, the Drug Attitude Inventory (DAI) (Hogan, 1983), and a Perception of Work instrument, developed by the researcher. Workers reported significantly higher self-esteem than did nonworkers (t = 2.17, df = 90, p = .033). A significant difference in overall QOL was not found, but workers scored higher on all but one QOL subscale. There were no significant differences in self-esteem, QOL, or valuing of work based on demographic factors. No significant differences in drug attitudes were found based on work status. Workers rated the importance of work higher than did nonworkers (t = 6.46, df = 90, p = .000). Analysis of qualitative data revealed that contrary to the nonworkers' fears, workers reported that work provided a distraction from symptoms and contributed to better mental health.