Significant Increase In Quality Of Life Research Articles

Supporting caregivers of children living with disability in a humanitarian context: realist-informed evaluation of the ‘Mighty Children’ programme in Afghanistan

IntroductionTo ensure that humanitarian action is disability-inclusive, evidence is needed to understand how different strategies to support children living with disabilities and their families can work in these settings. Evidence...

Quality of life of institutionalized older adults. Quasi- experimental study in a residential center in Tlaltenango, Mexico

This chapter presents the results of a study that sought to modify the level of quality of life reported by older adults institutionalized in a residential center. A quasiexperimental study of repeated measures was carried out, without a control group. The study was carried out in three stages. First, users were evaluated using the WHOQOLOLD BREF scale. Second, they were provided with treatment to modify their quality of life. Third, they were re-evaluated using the same scale. Adults in the care home reported a low level of quality of life before treatment. After treatment the levels increased. The Student t test was applied to compare the scores reported by the study participants before and after treatment. The result of this test allows us to attribute a statistically significant increase in quality of life to the treatment developed. This result is relevant in practical terms, because it partially suggests that the treatment is effective and can be expanded for clinical purposes.

Quality of life after pulmonary veins isolation: outcomes from a digital follow-up program

Abstract Introduction Even though symptoms drive indication in AF ablation, they have not been consistently incorporated as standard primary outcomes in ablation trials. Only recently, attention has focused on the benefits of ablation on the quality of life (QoL) associated with AF. Aim This study aims to evaluate the magnitude and durability of clinical benefits provided by AF ablation and explore possible predictors. Methods We implemented a digital follow-up (FUP) program for patients (pts) with AF referred for ablation in our high-volume centre since December 2020. FUP included scheduled visits and remote monitoring through a new digital health platform allowing real-time interaction between patients and doctors. The primary outcome was QoL as measured by the AF Effect on QoL (AFEQT) summary score reported by pts using the digital patient-engagement tool. The primary outcome was analyzed using a repeated-measures non-linear mixed model with random baseline score, time as fixed effects and month 12 response included as an outcome variable. Subgroup analysis examined the effect of baseline AFEQT score on the primary outcome. An explorative analysis of covariance was used to assess the relationship between improvements in QoL and baseline characteristics and the effect of antiarrhytmic drugs at 12 months of FUP. Results From the 305 ablations performed, 253 pts were enrolled until September 2022 (age 60±11 years, 33% female, 78% paroxysmal). During FUP time (mean 11.9±5.8 months), 1225 AFEQT questionnaires were collected from 222 different pts. The overall questionnaire completeness rate was 54.5%. The mean baseline AFEQT score was 64±14 points and 80±16 points at 12 months (absolute improvement of 18±4 points, relative improvement of 33.2±22.0%, p<0.001). The absolute improvement in QoL varied as a function of the baseline AFEQT score (p<0.001). For patients with the lowest tertile (score range 0-57) the mean improvement was 15.6±14.6 points, the middle tertile (score range 57-70) increased by 17.6±1.9 points and the highest tertile had the highest absolute improvement (22.0±2.3 points). Relative improvement was similar between tertiles (p=0.07). Subgroup analysis showed that female gender (p<0.01) and the use of antiarrhytmic drugs (p<0.001) were associated with lower improvements in QoL when compared to respective counterparts, despite significant increase in QoL at 12 months. No significant differences were seen according to baseline age and AF type. During FUP, AF recurred in 34 pts (14.5%), 14 of which during the first month of FUP (6%). Less than 7% of pts had at least one emergency department visit (n=16) and no deaths were reported. Conclusion Among pts with symptomatic AF, ablation led to significant improvements in QoL at 12 months. These differences remained stable 3 months after ablation and were proportional to baseline AFEQT score. Male pts and pts in whom antiarrhytmic drugs were discontinued reported higher improvement in QoL

Music therapy, quality of life and efficacy of immunotherapy for NSCLC

ObjectiveOur study examines how non-small cell lung cancer (NSCLC) survivors undergoing immunotherapy can experience reduced anxiety and psychological distress, improved quality of life (QOL) and increased immunotherapy efficacy.Methods133 men and...

Impact of Cross-Linking Procedure on Perioperative Quality of Life in Keratoconus Patients.

To evaluate the effect of crosslinking (CXL) with riboflavin for keratoconus (KC) therapy on quality of life (QoL): comparison of keratoconus patients with and without treatment. Prospective monocentric study. We recruited patients with progressive KC and with stable disease. Patients with progressive disease received cross-linking treatment; patients with stable disease were monitored. We compared QoL in both groups over 6 months and detected the influence of cross-linking treatment on QoL. QoL was assessed by NEI-VFQ-25, EQ-5D 5L, and EQ-Visual analog scale (VAS). In the evaluation of the Nei VFQ, the subgroups LFVFS and LFSES were calculated. We enrolled 31 eyes of 31 patients in the intervention group and 37 eyes of 37 patients in the control group. Medians with standard deviations (SD) were calculated. All QoL-tests showed equal scores at baseline in both groups. At V2, one day after the treatment, EQ-VAS (56.4), LFVFS (57.4), and EQ5D5L (0.59) were significantly reduced. At V3 (one week after treatment), all results returned to baseline level. LFSES was not affected by the treatment. It remained stable (V2 85.4, V3 84.3). Comparing the baseline scores with the follow-up scores at month 6, we found a significant increase in QoL in all tests in the intervention group. Otherwise, the quality of life in the control group did not change over time. Cross-linking led only to a short-term reduction in QoL. Although the treatment is painful for a few days, no effect on general quality of life LVSES has been demonstrated. QoL already returned to baseline after one week and the patients were not limited anymore.

L-Arginine is a feasible supplement to heal chronic anal fissure via reducing internal anal sphincter pressure: a randomized clinical trial study.

The hypertonicity of internal anal sphincter resting pressure is one of the main causes of chronic anal fissure. Therefore, the aim of this study was to assess the effect of oral administration of L-arginine on the improvement of the anal fissures by relaxing the internal anal sphincter. Seventy-six chronic anal fissure patients (aged 18-65years) who were referred to Rasoul-e-Akram Hospital, Tehran, Iran from February 2019 to October 2020 participated in this randomized, double-blind, placebo-controlled trial. Participants were allocated into treatment (L-arginine) and placebo groups. They took a 1000mg capsule three times a day for 1 month, and then we followed them at the end of the first and third months after the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. The analysis of data showed a significant decrease in bleeding, fissure size, and pain for each group; however, in the L-arginine group was more than the control group at the end of the study (P values < 0.001). Following that, a significant increase in QoL was seen just in patients treated with L-arginine (P value = 0.006). In addition, the comparison of anal pressures at baseline and, between groups at the end of the study showed a significant reduction in sphincter pressure in patients treated with L-arginine (P value < 0.001, = 0.049; respectively). The oral administration of 3000mg L-arginine can heal chronic anal fissures by reducing internal anal sphincter pressure with more negligible side effects. However, we recommend long-term study with more extended follow-up.Clinical trial registry: IRCT20190712044182N1 at Iranian clinical trials, date: 2019-08-27.

Intermittent Fasting-Short- and Long-Term Quality of Life, Fatigue, and Safety in Healthy Volunteers: A Prospective, Clinical Trial.

Background: Intermittent fasting (IF) is defined as an eating pattern without calorie restrictions, alternating between periods of fasting and eating. In the past decades IF has not only become a popular weight-reducing diet but is thought to improve Quality of Life (QoL) and fatigue. However, very little evidence exists for the general population. Thus, we aimed to assess the impact of a 16-h fasting period per day over a three-month study period on QoL and especially fatigue in healthy people. Methods: We conducted a prospective cohort study including healthy subjects. All participants fasted 16 h for at least five days a week while maintaining their normal lifestyle. In the study, we analysed blood samples as well as QoL through standardized questionnaires (WHO-5 questionnaire, Short Form Health 36). Furthermore, we measured the degree of fatigue with the Fatigue Assessment Scale (FAS) and Fatigue Severity Scale (FSS) as well as compliance, activity records, and weight alterations. All endpoints were evaluated at baseline, after two weeks, four weeks, and three months of IF. Results: A total of 30 participants fasted for the entire study period. The results of the WHO-5 questionnaire (15.6 ± 4.6 vs. 18 ± 3.6, p < 0.0019) demonstrated a significant increase in QoL. For long-term QoL six out of eight domains measured by the Short Form Health 36 (SF-36) significantly improved (e.g., physical health: 92.3 ± 11.6 vs. 96.5 ± 6.3, p = 0.015; mental health: 75.5 ± 12.0 vs. 81.7 ± 9.0; p < 0.001 and body pain: 74.1 ± 31.8 vs. 89.5 ± 14.9; p = 0.008) after three months. Fatigue significantly decreased from 10.3 ± 3.2 to 8.4 ± 2.5; p = 0.002 for mental fatigue and from 12.6 ± 3.8 to 10.7 ± 3.3; p = 0.002 measured by the FAS. The mean FSS-Score at baseline was 3.5 ± 1.2 compared to 2.9 ± 1.1 (scale 1–7) after three months (p < 0.001). Notably, the proliferation marker IGF-1 was significantly reduced. No clinically significant changes in laboratory parameters were observed that would have endangered a participant’s safety. Conclusions: IF according to the 16:8 regime over a fasting period of three months significantly improved several aspects of the QoL and decreased fatigue in healthy people, while maintaining a good safety profile. The practicability of this diet was also demonstrated for shift workers and people with a high percentage of active labour. Apart from the improvement in QoL and fatigue, the significant reduction in IGF-1, which can act as an accelerator of tumour development and progression, might be an indicator of the potential benefits of IF for patients with cancer.

6-Month Outcomes of the TricValveSystem in Patients With Tricuspid Regurgitation: The TRICUS EURO Study.

Severe tricuspid regurgitation (TR) is frequently associated with significant morbidity and mortality; such patients are often deemed to be at high surgical risk. Heterotopic bicaval stenting is an emerging, attractive transcatheter solution for these patients. The aim of this study was to evaluate the 30-day safety and 6-month efficacy outcomes of specifically designed bioprosthetic valves for the superior and inferior vena cava. TRICUS EURO (Safety and Efficacy of the TricValve® Transcatheter Bicaval Valves System in the Superior and Inferior Vena Cava in Patients With Severe Tricuspid Regurgitation) is a nonblinded, nonrandomized, single-arm, multicenter, prospective trial that enrolled patients from 12 European centers between December 2019 and February 2021. High-risk individuals with severe symptomatic TR despite optimal medical therapy were included. The primary endpoint was quality-of-life (QOL) improvement measured by Kansas City Cardiomyopathy Questionnaire score and New York Heart Association (NYHA) functional class improvement at 6-month follow-up. Thirty-five patients (mean age 76 ± 6.8 years, 83% women) were treated using the TricValve system. All patients at baseline were in NYHA functional class III or IV. At 30days, procedural success was 94%, with no procedural deaths or conversions to surgery. A significant increase in QOL at 6months follow-up was observed (baseline and 6-month Kansas City Cardiomyopathy Questionnaire scores 42.01 ± 22.3 and 59.7 ± 23.6, respectively; P=0.004), correlating with a significant improvement in NYHA functional class, with 79.4% of patients noted to be in functional class I or II at 6months (P=0.0006). The rates of 6-month all-cause mortality and heart failure hospitalization were 8.5% and 20%, respectively. The dedicated bicaval system for treating severe symptomatic TR was associated with a high procedural success rate and significant improvements in both QOL and functional classification at 6months follow-up.

The Online Strength-Informed Acceptance and Commitment Therapy Among COVID-19-Affected Adolescents.

Purpose: This study develops and investigates the changes in anxiety symptoms and quality of life (QoL) among participants of the online Strength-informed Acceptance and Commitment Therapy (SACT) across three tests. Methods: A small-scale, quasi-experiment with no control group was conducted. Repeated-measures analysis was employed to assess the changes of the three tests, which were the pre-experimental, post-test, and 3-month follow-up test. A total of 47 adolescents (ages 10–12) completed the 45-min intervention that lasted 10 weeks. Results: Compared with the pre-experimental, the post-test indicated significant anxiety symptoms reduction but not a statistically significant increase in QoL. The 3-month follow-up test indicated reduced anxiety symptoms and improved QoL compared with the pre-experimental. The with-in subject changes were substantial. Conclusions: The online SACT is a promising model to reduce anxiety symptoms and promote QoL among adolescents during the current COVID-19 pandemic, which show both short- and long-term benefit to the participants.

Elective surgical versus conservative management of complicated diverticulitis: A systematic review and meta-analysis.

There is no consensus on the optimal treatment for patients with complicated diverticulitis. In this systematic review and meta-analysis we aimed to determine the indications for elective surgery in complicated diverticulitis by comparing conservative treatment with elective surgery. A meta-analysis of recurrence, morbidity and stoma rates was performed using a random effects model. Patient-reported quality of life (QoL) and cost-effectiveness outcomes were synthesized qualitatively. Eleven randomized controlled trials and non-randomized studies with a total of 7415 patients were included. In statistical terms, the recurrence of diverticulitis was significantly higher in the conservatively treated group than in the elective surgery group (odds ratio [OR] 0.24, 95% confidence interval [CI] 0.12-0.51). The stoma rate (OR 2.34, 95% CI 1.88-2.92) and the morbidity rate (OR 4.29, 95% CI 2.24-8.23) were significantly higher in the elective surgery group than in the conservatively treated group. There was some evidence for a significant increase in QoL and long-term cost-effectiveness in the elective surgery group than in the conservatively treated group. Indications for elective surgery should not include the prevention of emergency colostomy or complications. Elective surgical resection may be considered in patients with complicated diverticulitis with the goal of improving their QoL and long-term cost-effectiveness.

Prioritizing compactness for a better quality of life: The case of U.S. cities

Compact development is a common approach employed to achieve sustainable urban forms; however, whether compact development leads to a quality of life (QOL) improvement remains the question. Revealing this dynamic is essential in the United States, where compact development has been advocated to transform the nation's alleged unsustainable lifestyle. This paper applies cross-sectional and longitudinal regression to uncover (1) the relationship between compactness and QOL in forty-four U.S. cities, and (2) the effect of “compacting” on eight Urbanized Areas (UZAs). The finding is that the correlation between QOL and compactness is significantly positive when cities become more compact but significantly negative when they are overly compact. Furthermore, most UZAs have experienced a significant increase in QOL as they transition from sprawl to a more compact status. For cities experiencing sprawl, it is reasonable to support compact development given the objectives of increasing QOL; however, to prevent the negative impacts of “over-compactness,” policies should be aimed at suitable compactness. The paper encourages city officials and planners to focus on local conditions. Professionals should reconsider how they design cities with regard to a high quality of life, rather than focusing exclusively on urban form policies.

Efficacy of fesoterodine fumarate (8 mg) in neurogenic detrusor overactivity due to spinal cord lesion or multiple sclerosis: A prospective study.

Antimuscarinic drugs are the first-line choice in the treatment of patients with neurogenic Detrusor Overactivity (nDO). Fesoterodine fumarate is the newest antimuscarinic drug. Limited data are published about the use of fesoterodine fumarate in patients suffering from neurogenic lower urinary tract dysfunction. Our study aims to determine the efficacy of fesoterodine fumarate on patients with nDO due to spinal cord lesion or multiple sclerosis (MS). This is an open-label prospective interventional study. Eligible patients were 18-80 years old with SCL or MS and nDO confirmed by a urodynamic study (UDS). At baseline, patients underwent a UDS to confirm nDO. Quality of life (QoL) was assessed by the Short-Form (SF) Qualiveen questionnaire. Patients received fesoterodine 8 mg/day for 3 months and were re-evaluated with UDS and SF-Qualiveen. The primary endpoint was the confirmation of the maximum detrusor pressure (Pdetmax ) reduction after treatment. Secondary endpoints were: evaluation of maximum bladder capacity and compliance and QoL effect. Statistical analysis included Wilcoxon-test using SPSSv26. One hundred and twenty-four patients completed the study. Ninety-five of them (76.6%) had SCL, while 29 (23.4%) had MS. Pdetmax , maximum bladder capacity, and compliance had significant reduction after treatment (p < .001) in the whole group and each subgroup. SF-Qualiveen revealed a significant increase in QoL in each group (p < .001). Fesoterodine fumarate (8 mg) is an efficacious drag in patients with SCL and MS, as it significantly decreases the detrusor pressure, increases the bladder capacity and compliance, and improves the QoL.

Quality of life, sexual function, and bariatric surgery: a systematic review

BACKGROUND: Obesity is associated with numerous comorbidities and affects various aspects of life, including quality of life (QOL) and sexual function (SF). Bariatric surgery (BS) is an effective treatment for obese people. Also QOL and SF after BS in the people are not well known.&#x0D; AIMS: To provide insight in the available prospective evidence regarding the short and long-term effects of BS on QOL and SF.&#x0D; MATERIALS AND METHODS: A systematic multi-database search was conducted for quality of life, Sexual function and Bariatric surgery. Only prospective studies with QOL or SF before and after BS were included. The quality assessment tool for beforeafter studies with no control group was used to assess the methodological quality.&#x0D; RESULTS: Twenty-four studies met the inclusion criteria. Most studies were assessed to be of fair to good methodological quality. Seven different questionnaires were used to measure both QOL and SF. A significant increase in QOL after BS and light increase in SF were found in all studies (P0.05).&#x0D; CONCLUSIONS: Both QOL and SF are increased after BS on both the short and long term. However, due to the heterogeneity of the studies and the generality of the questionnaires are them hard to make a distinction among different BS and difficult to see a relation with medical profit. Therefore, designing QOL and SF measurements to the post BS population are recommended as the focus of future studies.

Mesenchymal Stem Cells Transplantation in newly diagnosed type-1 diabetes patients:a phase I/II Randomized Controlled trial

Background & Aim Background Insulin injection is a routine treatment for type-1 diabetes which couldn't result in physiologic reaction to blood glucose changes and patients are encountered with diabetes complications. Therefore, a treatment option that leads to modulate the immune system and mitigate the procedure of insulitis could be a hopeful clinical choice. Mesenchymal Stem Cells (MSC) have been shown to have immunomodulatory and regenerative effects. Aim In this clinical trial, autologous bone marrow-derived MSCs (BM-MSCs) were used for immune response modulation and to assess the safety and efficacy of transplantation in newly diagnosed type-1 diabetes patients. Methods, Results & Conclusion Methods A Crossover triple blinded randomized controlled trial in two 12-months periods conducted between 2015 and 2020, at “Royan Institute” with the collaboration of “Growth and Development Research Center of Tehran University of Medical Sciences” in Tehran, Iran. Patients of 8 to 40 years old who have been diagnosed with type-1 diabetes in no more than 6weeks, and met other inclusion criteria, were randomly assigned to receive either two doses of 1 million per kg of patient's body weight MSCs or placebo. Safety was assessed based on the Common Terminology Criteria for Adverse Events (CTCAE) version 5. Efficacy was defined as a reduction in the number of hypoglycemic episodes and changes in metabolic indices compared to baseline. Patients’ Quality of life (QOL) was assessed by SF36 and Diabetes Specific QOL (DSQOL) Questionnaires. Percent of regulatory T cells population were assessed in patients’ blood before and 48 hours after MSCs transplantation by flow cytometry. Statistical analysis was done by SPSS v.13. Results The primary outcome was safety concluding there were not any major adverse events in this trial. The total number of hypoglycemic episodes was significantly reduced in patients who received MSCs compared to the placebo group. There were not any significant differences in metabolic indices between intervention and placebo groups. DSQOL showed a significant increase in QOL of patients received MSCs after 12 months compared to baseline. SF36 showed a considerable increase in QOL in patients received MSC. The population of regulatory T cells in patients’ blood was significantly increased 48 hours after MSC transplantation compared to baseline. Conclusion Autologous transplantation of BM- MSCs in newly diagnosed type-1 diabetes patients is safe, feasible, and could improve some of the clinical parameters.

Improving Glycemic Control and Quality of Life With Diabetes Self-Management Education: A Pilot Project.

Diabetes self-management education and support (DSME/S) has been demonstrated as an effective intervention and a billable service; however, DSME/S has yet to be successfully translated and diffused into mainstream practice. This project sought to improve glycemic control (measured by A1C or fasting blood glucose [FBG]) and quality of life (QOL) of Medicare patients age 65 years and older with type 2 diabetes (T2DM) using DSME/S. DSME/S included information sharing between patients and providers, psychosocial support, behavioral support with lifestyle modification, multi-disciplinary integration, and care coordination. Patient-specific data were compared before and 4 weeks after project implementation. Use of DSME/S increased by 15% (p < .005). Participants demonstrated a statistically significant decrease in mean FBG and a statistically significant increase in QOL. This project demonstrated the successful translation of evidence related to DSME/S into practice through improving diabetes care and promoting continuing education for all of the providers. [J Contin Educ Nurs. 2020;51(3):119-123.].

4071Early changes in quality of life after transcatheter aortic valve replacement: One-year results from the 3M TAVR Study

Abstract Background In patients with severe calcific aortic stenosis, transcatheter aortic valve replacement (TAVR) has been shown to significantly improve quality of life (QOL). However, changes in QOL at early follow-up (&lt;1 month), and following next-day discharge are poorly understood. Methods A total of 411 patients at 13 centers were enrolled in the Multimodality, Multidisciplinary but Minimalist TAVR (3M TAVR) study in 2015–2017. QOL was evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) in participants with a baseline score and at least one score at 2 weeks, 30 days and 1 year. Study endpoints were change in (1) KCCQ-Overall Summary Score (KCCQ-OS) and (2) minimal clinically important differences (MCID). Mixed effects models were used to explore patterns of change from baseline, with fixed terms for time, status at 1-year and their interaction terms, and a random intercept for subject to account for within subject correlation. Descriptive statistics were used to report MCID. Results Data were available for 358 (87.1%) participants. 216 (60.3%) were men with a median age 84.0 and STS 5.0 There was significant increase in QOL 2 weeks after TAVR (p≤0.01), and further significant improvement at the 1-month timepoint (p&lt;0.01) for participants who were alive at 1 year. Sex, age category, and STS score category did not have a significant effect on the change in QOL (p&gt;0.05). In the first 2 weeks, moderate (10–20 points) and large (&gt;20 points) improvements were observed in 19.9% and 49.0% of the surviving patients, respectively; at 1-year, similar MCID were seen in 14.6% and 64.0% respectively. Figure 1 Conclusion This is the first study to report significant increase in QOL 2 weeks after TAVR, with sustained improvement during the first year in patients treated with the Vancouver TAVR Clinical Pathway with a goal of next-day discharge. Further studies are necessary to determine whether alternative TAVR clinical pathways yield similar findings. Acknowledgement/Funding Investigator-initiated unrestricted research grant, Edwards

The effectiveness of trimetazidine and fabomotizole in the prevention of angina progression and improvement of life quality in patients in area of armed conflict

Aim.To assess the effectiveness of trimetazidine and fabomotizole adding to standard treatment in prevention of stable angina progression and improving of quality of life (QOL) in patients in area of armed conflict.Material and methods. One hundred and twelve patients with stable angina of II-III functional class (FC) living in the area of armed conflict in Chechen Republic. All participants were randomized into two groups. Within 6 months 54 patients from control group used standard therapy (isosorbide dinitrate 40 mg/day, metoprolol tartrate 50-100 mg/day, acetylsalicylic acid 100 mg/day, simvastatin 40 mg/day). In the study group 58 patients additionally took trimetazidine 70 mg/day and fabomotizole 30 mg/day. We used Seattle Angina Questionnaire initially and after 6 months of treatment to determine QOL: frequency of angina attacks, nitroglycerin taking per week and adverse events were evaluated.Results.The frequency of angina attacks and nitroglycerin taking in patients of study group significantly decreased after treatment compared with control group (p&lt;0,05). In the study group, as a result of treatment, there was a statistically significant increase in QOL compared with their initial values. In the control group there was a positive trend in following questionnaire scales: physical activity (p&lt;0,01), angina frequency (p&lt;0,001) and disease perception (p&lt;0,05). According to scales of treatment satisfaction, physical limitation and disease perception, improvement of QOL in the study group were statistically significant comparing with control group (p=0,01; p&lt;0,01 and p&lt;0,01, respectively).Conclusion. In the control group, there is a positive dynamics of QOL parameters on physical activity (p&lt;0,01), frequency of angina attacks (p&lt;0,001) and disease perception (p&lt;0,05) scales. The inclusion of trimetazidine and fabomotizole to the standard treatment carries statistically significant improvement of treatment satisfaction, physical limitation and disease perception scales. The frequency of angina attacks and nitroglycerin taking in patients of study group significantly decreased after treatment compared with control group (p&lt;0,05).

Assessment of quality of life and anxiety in heart failure outpatients.

IntroductionHeart failure (HF) is a chronic disease associated with increased morbidity and mortality. HF prevalence is expected to expand enormously, largely due to population ageing, rising incidence of HF risk factors and increased survival after cardiovascular events. The aim of the study was to assess levels of quality of life (QOL) and anxiety in HF outpatients and the associated factors as well as to explore the impact of anxiety on QOL.Material and methodsOne hundred HF outpatients were enrolled in the study. Data collection was performed by completion of the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Self-rating Anxiety Scale (SAS) and a questionnaire including patients’ characteristics.ResultsOf the 100 HF outpatients, 64% were men and 66% above 70 years old. Regarding QOL, at least 50% of patients scored above 68 (median) in the total score of MLHFQ and in terms of anxiety, 50% scored above 46 (median) in the SAS. These values indicate a large impact of HF on QOL and a moderate impact of HF on anxiety. Furthermore, a statistically significant correlation was observed between QOL and anxiety in HF outpatients (rho > 0.6, p < 0.001). An increase in anxiety score by one unit implies a statistically significant increase in QOL by 1.22 points (95% CI: 0.91–1.52, p < 0.001), after adjustment for potential confounders.ConclusionsThe present findings emphasize the importance of alleviating the emotional burden of anxiety, thus improving patients’ QOL.

Literature review of quality of life and influencing factors in patients of cervical spondylosis treated by ACDF

Introduction: Influence of psychosocial factors on patients of cervical spondylosis need to be calculated as they plays an important role in patient’s quality of life (QOL). As anterior cervical discectomy and fusion (ACDF) has become most common surgical approach, since 1958 introduced by Robinson and Smith in patients affected by cervical disc disease like cervical spondylosis. So we have reviewed the literature of psychosocial factors correlated with the physical conditions in patients treated with ACDF. Method and material: We have searched the literature on Pubmed, MEDLINE, EMBASE, PsycINFO, Psyc ARTICLES, Cochrane Library, Web of Science, Elisver, Google scholar, and Baidu scholar limiting results to those published in the English language without limiting year. The key search terms utilized were ACDF, quality of life, cervical spondylosis, anxiety and depression with ACDF, cervical radiculopathy, cervical myelopathies, neck pain, SF-36, HRQOL. Conclusion: On the base of previous published article men have affected more than women with age >50 years. ACDF was the most common procedure used to treat the cervical spondylosis. When it comes to psychosocial factors anxiety and depression was found to be most common influencing factor and neck pain was the physical condition accompanied to those factors. After surgery it was found a significant increase in QOL as ACDF reduces the neck pain which reflect in psychosocial factors as well by significant decrease in anxiety, depression and working ability.

Effect of Face-to-face Education, Problem-based Learning, and Goldstein Systematic Training Model on Quality of Life and Fatigue among Caregivers of Patients with Diabetes.

Background:Education is a fundamental component for patients with diabetes to achieve good glycemic control. In addition, selecting the appropriate method of education is one of the most effective factors in the quality of life. The present study aimed to evaluate the effect of face-to-face education, problem-based learning, and Goldstein systematic training model on the quality of life (QOL) and fatigue among caregivers of patients with diabetes.Materials and Methods:This randomized clinical trial was conducted in Hajar Hospital (Shahrekord, Iran) in 2012. The study subjects consisted of 105 family caregivers of patients with diabetes. The participants were randomly assigned to three intervention groups (35 caregivers in each group). For each group, 5-h training sessions were held separately. QOL and fatigue were evaluated immediately before and after the intervention, and after 1, 2, 3, and 4 months of intervention.Results:There was a significant increase in QOL for all the three groups. Both the problem-based learning and the Goldstein method showed desirable QOL improvement over time. The desired educational intervention for fatigue reduction during the 4-month post-intervention period was the Goldstein method. A significant reduction was observed in fatigue in all three groups after the intervention (P < 0.001).Conclusions:The results of the present study illustrated that the problem-based learning and Goldstein systematic training model improve the QOL of caregivers of patients with diabetes. In addition, the Goldstein systematic training model had the greatest effect on the reduction of fatigue within 4 months of the intervention.