Subjective Quality Of Life Research Articles

Factors Influencing the Personal Recovery in Outpatients With Schizophrenia

Objectives: This study aims to quantitatively investigate factors influencing personal recovery in patients with schizophrenia.Methods: This study included 168 outpatients treated for schizophrenia. Patients’ sociodemographic factors (sex, age, education, and marital status), clinical factors (duration of illness, number of hospitalizations, and dose of drug), symptoms, behavior and symptoms, physical and mental health, family attitude, social support, attitude toward drug therapy, insight, self-esteem, hopelessness, and self-stigma were analyzed. The analysis included these 17 factors as explanatory variables for personal recovery to perform regression analysis.Results: Backward elimination was used to select variables, and multiple regression analysis was performed. The five factors (symptoms, self-esteem, insight, physical, and mental health, and social support) accounted for 75.8% of the variance in patients’ perceived willingness for personal recovery.Conclusion: Personal recovery in schizophrenic patients is very important because it means subjective satisfaction and quality of life in society. In this study, social support was the most important variable in predicting personal recovery. These results imply that not only symptoms but also various factors including social support should be emphasized when establishing a recovery strategy for schizophrenic patients.

The Norwegian Counties Public Health Survey (NCPHS)

Abstract Effective public health initiatives should be based upon a thorough understanding of important health-related factors. The purpose of The Norwegian Counties Public Health Survey (NCPHS) is to gain insights from the adult population on topics relevant for planning of public health policy, interventions, and action at the county and municipality levels. The survey includes a core questionnaire on public health-related topics such as health behaviour, subjective quality of life, distress, subjective health, social support, social capital, community contexts, and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register. NCPHS was piloted in three counties in 2015 and in one county in 2018. After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400 000. Expedient data analysis and reporting has enabled the Norwegian Institute of Public Health to present comprehensive reports within six weeks after completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment, and assessment of household economy. Tables are also made available at the municipality level. The NCPHS represent a valuable addition to existing health registries and regional health surveys, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions, and for evaluation of policies and interventions. The value of such a system during times of crises was demonstrated during the COVID-19 pandemic. At the Lisbon 2024 European Public Health conference, a few selected examples of use of data from the NCPHS system will be presented. Key messages • Large-scale community surveys provide important insights for planning of public health policies and action. • Strong involvement and collaboration with regional and local public health personnell as well as with media and local people is a prerequisite for succeeding.

Relationship of chronic low back pain intensity with functional activity, stress and quality of life in working-age adults

Background. Low back pain (LBP) is a global problem in the modern world. A detailed study of the relationship between pain intensity and the indicators with which it may be associated will allow optimising approaches to the treatment and rehabilitation of patients with chronic LBP. The purpose was to eva­luate the relationship between the intensity of chronic LBP and indicators of functional activity, stress and quality of life in subjects of working age. Materials and methods. A survey was conducted among 159 persons aged 18-65 years with LBP lasting more than 3 months. Using a Google-form, the participants were given a questionnaire that included socio-demographic, anthropometric characteristics, lifestyle data, bad habits, physical activity (PhA) and stress levels, quality of life, and impairment. The intensity of pain was measured at the first visit to a PhRM doctor using a visual analogue scale (VAS). Results. The study involved 159 patients, 65.7 % women and 34.3 % men, with a mean VAS pain intensity of 46.5 ± 18.6 mm. A weak positive correlation was found between pain intensity and age (r = 0.30, p < 0.001), but no significant relationship was found between pain intensity and anthropometric parameters. Subjects who smoke, have insufficient PhA and sleep disturbance had higher pain intensity scores (57.6 ± 15.2 mm (p = 0.04), 49.0 ± 18.8 mm (p = 0.12), 49.7 ± 19.9 mm (p = 0.002), respectively). Sitting time more than 6 hours had significant associations with pain intensity (p < 0.001). A weak positive correlation was found between pain intensity on the VAS scale and stress le­vel (r = 0.24, p = 0.002), a moderate positive correlation between pain intensity and impairment (r = 0.36, p < 0.001) and a mo­derate negative correlation between quality of life and pain intensity. ­Conclusions. There was a significant association between pain intensity and age, smoking, sleep disturbance, sedentary work for more than 6 hours, higher stress levels, impaired functioning and lower quality of life.

Chemotherapy-induced cognitive impairment and its long-term development in patients with breast cancer: results from the observational CICARO study.

Chemotherapy-induced cognitive impairment (CICI) is a well-recognized side effect of breast cancer treatment. However, prospective long-term evaluations of CICI using standardized neuropsychological tests are scarce. This prospective longitudinal cohort study investigated cognitive dysfunction and its impact on quality of life and everyday functioning in patients with breast cancer receiving first-line chemotherapy compared to patients with breast cancer without chemotherapy. Assessment occurred prior to chemotherapy, postchemotherapy (median 6 months), and 2-3 years later. We used standardized neuropsychological tests, questionnaires, and scales to assess patients' quality of life and functioning. Additionally, serum analysis for neurodegenerative markers and autoantibodies was conducted. We included n = 53 patients. Overall cognitive function declined statistically significantly (P = .046) postchemotherapy compared to control patients, mostly driven by a reduced figural memory (P = .011). Patients who received chemotherapy showed a greater reduction in quality of life (increased fatigue symptoms, P = .023; reduced Karnofsky index, P<.001); however, without a statistically significant effect on cognitive decline. The neurodegenerative markers Neurofilament light chain (NfL) and phosphorylated Neurofilament heavy chain (pNfH) increased statistically significantly (P<.001) postchemotherapy and pNfH correlated with overall cognitive function. After 2-3 years, both cognitive performance and quality of life were comparable between chemotherapy-treated and control patients. Our findings suggest that chemotherapy statistically significantly contributes to overall cognitive dysfunction in patients with breast cancer, which disappears after 2-3 years, indicating a recovery in both objectively measurable cognitive function and subjective quality of life. Future research should examine larger sample sizes and explore screening indicators, particularly pNfH.

Physical component of SF-36 is associated with measures of disease activity in patients with psoriatic arthritis: a real-life study from a tertiary referral centre.

Psoriatic arthritis (PsA) can lead to chronic disability. The aim of this study was to explore the association between disease activity and quality of life (QoL) in patients with PsA from the usual clinical practice. The study involved 143 consecutive adult patients with PsA (49.6% women and 50.4% males), with mean age of 57.75 ± 10.91 years, and duration of disease 11.6 ± 9 years. Tender (TJC) and swollen joints count (SJC), Disease activity score (DAS) 28, patient's global assessment (PtGA), physician's global assessment (PhGA), enthesitis score, number of fingers with dactylitis, sedimentation rate (ESR) and C-reactive protein (CRP) were evaluated. The functional assessment of chronic illness therapy - fatigue scale (FACIT-F) questionnaire was used in fatigue assessment and physical health domains of Short Form (SF)-36 questionnaire were chosen to assess subjective QoL: physical functioning (PF), role limitations due to physical health (RP), bodily pain (BP) and general health (GH). Significant correlations (p < 0.001) were found between FACIT-F and all SF-36 domains. DAS28, PtGA and PhGA were significantly correlated to two or three SF-36 domains, while ESR and CRP were not significantly correlated to any of SF-36 domains. Regression analysis showed, when controlling for age, that FACIT-F, dactylitis and DAS28 were the most significant predictors of SF-36 physical health domains. Regression and factor analyses confirmed that FACIT-F was most consistently associated with SF-36 physical health domains. In our real-life study most of the analyzed clinical measures of PsA were significantly associated with physical health domains of SF-36 questionnaire. Considering the strength of those associations, we conclude that PsA activity has mild to moderate impact on health-related Qol.

Decomposition of quality changes: focusing on subjective quality of life

Decomposition of quality changes: focusing on subjective quality of life

Psychological Health Outcomes of Older Adult Volunteers: Findings from The Irish Longitudinal Study on Ageing

Abstract Background Volunteering has been shown to alleviate the feeling of loneliness and have indirect positive effects on the subjective quality of life of older adults. Volunteering post-retirement has been shown to have a positive effect on loneliness, quality of life, and depression. This research aimed to examine the relationship between volunteering and depression, loneliness, and quality of life among a nationally representative sample of older adults in the Republic of Ireland. These measures were also examined in the context of volunteering and retirement. Methods Through secondary analysis of five waves of data from the Irish Longitudinal Study on Ageing (TILDA), this research explored the relationships between volunteering, retirement, loneliness, depression and quality of life. To achieve this, both cross-sectional analyses using regression models and longitudinal analysis using mixed-effects modelling were utilised. Results Volunteering had a significant negative association with loneliness [Incident Rate Ratio (IRR)=0.87, 95% CI=0.80,0.95, p&amp;lt;0.01] and depression [IRR=0.88, 95% CI=0.81, 0.96, p&amp;lt;0.01], and a positive association with quality of life [Beta (B)=0.69, 95% CI=0.39, 1.00, p&amp;lt;0.05] at baseline. These associations were not significant over time. Volunteering in retirement was associated with increased quality of life [B=0.7, 95% CI=0.2, 1.1, p&amp;lt;0.05], while associations between depression and loneliness and retirement were not significant. Those who volunteered in retirement experienced less depression over time [IRR=0.90, 95% CI=0.83, 0.99]. Conclusion The findings of this study demonstrate the positive effects of volunteering on the psychological outcomes of older adults. This study also found evidence of the long-term effects of volunteering in retirement on depression, suggesting that continued participation in volunteer activities positively impacts depression. This research demonstrates the importance of increasing opportunities and promoting volunteer participation to contribute to the positive ageing of older adults.

Home-based long-term physical endurance and inspiratory muscle training in children and adults with Fontan circulation.

Regular physical activity is highly recommended for patients with Fontan hemodynamics. Our aim was to investigate the effects of a long-term individualized home-based endurance training (IHET) on a bicycle ergometer in combination with inspiratory muscle training (IMT) in pediatric and adult patients after Fontan palliation. Additionally, factors influencing the trainability of Fontan palliated patients were analyzed. From 2018 to 2021 a single-center prospective study was performed initially including 25 Fontan palliated patients. During study period nine patients were excluded due to incompliance. A Magbike® bicycle ergometer (DKN Technology, France) was used for IHET and a POWERbreathe® Medic plus device (HaB GmbH, Germany) was utilized for the IMT. Over the study period, bike training was increased from 90 min of basic endurance training per week to additional 25 min of interval training per week. IMT consisted of 30 breaths per day for 6-7 days per week with pressure adaption over time. Patients underwent cardiopulmonary exercise testing (CPET) and body plethysmography including measurement of respiratory muscle strength at baseline and at follow-up examinations at 4, 10 and 22 months. Follow-up examinations were completed by 18/25 patients (72.0%) at 4 and 10 months and 16/25 patients (64.0%) at 22 months. Median exercise capacity slightly increased by 0.13 W/kg from baseline to last follow-up (p = 0.055, 95%CI: 0.0-0.36). However, a significant increase of oxygen pulse of 0.7 ml/beat (p = 0.006, 95%CI: 0.38-2.22) was detectable. IMT significantly improved respiratory function with an increase of inspiratory vital capacity (VCin/reference) by 4.0% (p = 0.016, 95%CI: 0.8-8). Median maximal inspiratory pressure increased by 1.2 kPa (p = 0.003, 95%CI: 0.64-3.19) and expiratory pressure by 1.5 kPa (p = 0.036, 95%CI: 0.08-2.29). No adverse events or unplanned interventions occurred during the study. Patients' subjective quality of life did not significantly change over the study period. In Fontan palliated patients, IHET in combination with IMT leads to a significant increase in oxygen pulse, inspiratory vital capacity as well as median maximal inspiratory and expiratory pressure but not to significant improvement of quality of life. Fontan patients should be encouraged to perform regular home-based exercise training.

Efficacy of Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) a Treatment for Cancer-related Cognitive Impairment (CRCI): A Randomized Controlled Trial.

Introduction: The Mindfulness-Based Stress Reduction (MBSR) Program for breast cancer survivors (BCS) is designed to enhance cognitive training through formal and informal meditational practices. This randomized clinical trial (RCT) aimed to evaluate if BCS assigned to either the MBSR(BC), Breast Cancer Education Support (BCES), or Usual Care (UC) regimens experienced greater improvements at 6, 12, and 26 weeks on objective and subjective cognitive performance. Methods: BCS (n = 212) randomized to a three-group RCT: MBSR(BC) (n = 91), BCES (n = 90), or UC (n = 31) were assessed on cognitive performance and symptoms at baseline, 6, 12, and 26 weeks. Linear mixed models were fit to evaluate the effects of the MBSR(BC) program, hypothesizing ordered effect improvements: (MBSR[BC] highest, BCES intermediate, UC lowest) along with baseline characteristics evaluated as moderators. Results: Of the BCS (mean age of 57), 73% were White, and non-Hispanic, and 77% received both chemotherapy (CT) and radiation. Cognitive performance improved in all groups. Although there were no statistically significant between-group differences in cognitive outcomes, significant symptom reductions occurred for the MBSR(BC) group (p = 0.003). Within-group effect size analysis at 26 weeks showed substantial improvements in all three groups (effect sizes >0.50) in subjective impairments and quality of life (effect size >0.50) and objective measures of cognitive performance. MBSR(BC) showed the largest within-group effect size in the reduction of fatigue (effect size = 0.81). Effect sizes occurred in the hypothesized direction for 10 of the 18 outcomes. Discussion: Although the MBSR(BC) program did not show significant differences in cognitive performance compared with BCES and UC, all groups improved and reductions in fatigue were beneficial for MBSR(BC). Results suggest that cognitive performance may improve after CT over time considering one's natural history. Furthermore, BCS enrolled in RCTs may be more motivated to improve their health status (NCT02786797).

Comparative analysis of the efficacy and complications of mid-urethral slings when inserted either in isolation or in conjunction with pelvic organ prolapse surgery

IntroductionStress urinary incontinence (SUI) is a highly prevalent condition that affects between 20 and 50% of the female population. Pelvic organ prolapse (POP) can coexist with SUI and both can be addressed through a vaginal approach. However, it is unclear whether simultaneous surgery for these two conditions can influence the outcome of incontinence treatment.ObjectiveTo evaluate the objective and subjective effectiveness of the transobturator suburethral (TO) band by comparing two groups: group A, of patients undergoing surgery for stress urinary incontinence (SUI) by insertion of TO mesh, and group B, formed for patients requiring simultaneous correction of pelvic organ prolapse (POP) in addition to TO mesh insertion.Materials and methodsThis is an observational, descriptive and retrospective study in which 91 patients participated: 33 (group A) underwent surgery for SUI and 58 (group B) underwent corrective surgery for pelvic organ prolapse (POP) and TO band simultaneously.Variables included: total urinary continence, objective urinary continence, subjective urinary continence (satisfaction levels and two validated questionnaires (PGI-1 and ICIQ-SF)) and complications.ResultsRegarding total continence, from the seventh to the ninth year, statistically significant differences were observed, with total continence being higher in group A. Objective continence decreased in both groups during the follow-up period.No significant differences were found between the two groups regarding subjective urinary continence (ICIQ-SF) and the degree of improvement after surgical treatment (PGI-1). The level of satisfaction after surgery was high in both groups. Regarding complications, there were no statistically significant differences.ConclusionsIsolated surgery for SUI could be considered more effective in achieving total and objective continence. However, the insertion of the TO band in both cases improves subjective urinary continence and quality of life with great safety and without differences regarding complications.

Development and Content Validity of Cervicogenic Headache Patient Questionnaire: New Tool for Assessing Severity and Impact.

Cervicogenic headache (CGH) is a complicated and common headache disorder that may present itself with cervical spine dysfunction, irritation of the nerves, central sensitization, and muscular tension. Theoretically, this diagnosis should be an exclusionary diagnosis, considering the fact that it requires extended clinical assessment of the cervical spine and an evaluation for other primary headache types. CGH represents a clinical challenge as they habitually present with an array of nonspecific manifestations highly variable among patients. Management of CGHs is properly based on accurate diagnosis and sound understanding of the complaints of the individual. The development of CGH still carries with it a palpable gap in meaningful literature related to really effective assessment tools for the condition. The aim of the current study was to develop and investigate the validity of the content of the Cervicogenic Headache Patient Questionnaire. This questionnaire is designed especially to measure pain intensity, its impact on daily activities, disturbance in sleep, and the overall quality of life in subjects with CGHs. The content validity ratio (CVR) and Content Validity Index (CVI) have been used to thoroughly examine the content validity. Each item was rated by 10 experts for relevance and clarity. The scale consists of two main parts: demographic information and symptoms. Under the demographic section, the patient is asked for their age, sex, occupation, and any relevant medical history. The Symptom Checklist contains 10 questions concerning headache frequency, intensity, duration, location, and contributing factors, as well as how headaches affect daily activities, sleep, and quality of life. Item-CVI scores ranged from 0.60 to 1.00, and Scale-CVI/Ave was 0.95, which indicates strong overall content validity. The Scale-CVI/Universal Agreement was 0.83, meaning that most items are of high relevance. The clarity assessments resulted in I-CVI ratings of 1.00 for the majority of items. Using CVR analysis, items 1, 2, 5, 6, 7, and 10 all had a CVR of 1.00, whereas all the rest ranged from 0.40 to 0.80, suggesting unanimous agreement among the experts. Theresults underline the strength of the questionnaire in covering all the critical dimensions of cervicogenic headaches, such as pain, daily functioning, sleep, and quality of life. The scores provided by experts for content validity and clarity were high; hence, it is suitable for use as a comprehensive tool both in clinical and research applications.

10-year outcome trajectories of people with mental illness and their families who receive services from multidisciplinary case management and outreach teams: protocol of a multisite longitudinal study

IntroductionIndividuals with mental illness and their families often undergo their recovery process in their communities. This study explored the long-term outcome trajectories of individuals and families who received case management...

SUCCEED Africa: protocol for a multi-method pilot study of a community-based intervention for people with psychosis in Sierra Leone, Nigeria, Zimbabwe and Malawi

BackgroundRecent reviews have highlighted the need for participatory research to design and evaluate inclusive, community-based interventions that address the diverse needs of people with lived experience of psychosis, within and beyond the health sector. The SUCCEED Africa consortium aims to co-produce a 6-year programme of research across four countries in West (Sierra Leone, Nigeria) and Southeast Africa (Zimbabwe and Malawi). This protocol describes the pilot study in which SUCCEED’s intervention, research tools and processes will be tested on a small scale in each country in preparation for future evaluation research.MethodsThe SUCCEED intervention comprises peer support, case management and livelihood activities for people with lived experience of psychosis. The pilot uses a before-and-after study design investigating change in subjective quality of life in adults diagnosed with a primary psychotic disorder or another mental disorder with psychotic symptoms who are offered the SUCCEED intervention over a 4-month period. Nested within this study are the following: a baseline assessment of the feasibility, acceptability and face validity of the selected measurement tool and validity of proxy versus self-completion; and a multi-method process evaluation examining key process indicators and implementation, service and client-level outcomes. Methods include the following: baseline cognitive interviews; semi-structed observation and routine monitoring and evaluation of service delivery; endline interviews and focus group discussions; and a comparison of provider competencies at endline. At each of the four pilot sites, participants will include the following: ten people with lived experience of psychosis, recruited from either health services or community settings using purposive sampling to maximise variation; up to ten adult family members (one per participant with lived experience) involved in their care; the peer support worker, community support worker and supervisor responsible for delivering the intervention; and the data collectors. Recruitment will take place in July and August 2023.DiscussionTo the best of our knowledge, this will be the first study of a community-based intervention incorporating lay-delivered case management, formal peer support and livelihoods activities for people with lived experience of psychosis in sub-Saharan Africa. Findings will be relevant not only to SUCCEED but also to others interested in promoting rights-based approaches to community mental health in low-resource settings.Trial registrationUS National Library of Medicine (ClinicalTrials.gov), Protocol reference ID 28346. Initially registered retrospectively July 20/2023: In review.

Effects of electroacupuncture on cognitive symptoms in major depressive disorder: a pilot study and randomized controlled trial

Objectives To investigate the impact of electroacupuncture on cognitive function, quality of life (QoL), and depression severity in patients with major depressive disorder (MDD). Methods This double-blinded randomized controlled trial included 60 participants aged 18-55 with cognitive symptoms related to MDD at Thammasat University Hospital. Participants were divided into two groups: the electroacupuncture group combined with standard antidepressant treatment (EG; n=30) and the control group receiving standard care with placebo acupuncture (CG; n=30). The study assessed 1) executive functions using the Trail making test- B and Stroop Color and Word Test, 2) delayed recall, and 3) subjective cognitive complaint and Quality of life (QoL) using WHODAS 2.0. Depressive symptoms were measured using the Thai version of the Patient Health Questionnaire (PHQ-9). Baseline and post-intervention assessments were conducted over 10 weeks. Mann-Whitney U test analyzed treatment effects by comparing median differences between groups. Results Both groups exhibited similar demographics and cognitive traits. Cognitive improvement was observed in both groups at the endpoint. Intention-to-treat analysis revealed significantly higher median scores for subjective cognitive complaints in the EG compared to the CG (EG: Median = 5.5, CG: Median = 0.0, p=0.049). No serious side effects were identified from either electroacupuncture or placebo acupuncture. Conclusions Electroacupuncture improved subjective complaints in MDD patients with cognitive symptoms, but did not show effects on specific cognitive functions, QoL, or depressive symptoms. This study provides initial evidence supporting the potential of electroacupuncture in MDD patients with cognitive symptoms, suggesting opportunities for further research. Trial registration NCT06239740, February 2, 2024, ClinicalTrials.gov.

Роль субъективного возраста в системе психологических факторов течения болезни у мужчин с раком предстательной железы. Часть I. Субъективный возраст и качество жизни у мужчин с раком предстательной железы

&lt;p&gt;&lt;strong&gt;Relevance.&lt;/strong&gt; Prostate cancer remains one of the major public health problems worldwide, as it is accompanied by high rates of morbidity and mortality. Purpose. The work is devoted to the study of the role of subjective age in the system of psychological factors of the course of the disease in men with prostate cancer; in this part of the work, attention is focused on the relationship between subjective age and quality of life. &lt;strong&gt;Materials and methods&lt;/strong&gt;. The study involved 127 men aged 53 to 85 years (М=68; Ме=69; SD=10,27) diagnosed with prostate cancer (stage I of the disease &amp;ndash; 16 men; stage II &amp;ndash; 64; stage III &amp;ndash; 13; IV &amp;ndash; 34; favorable course of the disease &amp;ndash; 40 people, unfavorable - 61). In addition to socio-demographic data, subjective age was studied (B. Barak questionnaire in adaptation by E.A. Sergienko, 2011), quality of life &amp;ndash; subjective health assessments (SF-36 questionnaire in adaptation by K.G. Gurevich, E.G. Fabrikant, 2008). This work consists of two parts describing the role of subjective age in the system of psychological factors in men with prostate cancer. Part I of the article is devoted to the analysis of the role of subjective age and quality of life assessments. Three subgroups were identified according to estimates of subjective age: those who feel younger than their passport age (80 people), adequate to their age (44 people) and older (3 people). &lt;strong&gt;Results and conclusions&lt;/strong&gt;. The analysis of men with different perceptions of subjective age with a favorable and unfavorable course of the disease was carried out. It is shown that men who feel younger concentrate on the physical aspects of health and their own vitality, fearing for the level of their own activity and compliance with gender functioning, regardless of the prosperous/dysfunctional course of the disease.&lt;/p&gt;

Safety and Effectiveness of Coronary Sinus Reducer in the Therapy of Refractory Angina Pectoris-Mid-Term Results of the Real-Life Cohort.

Background: Despite continuous improvements in revascularization techniques, refractory angina without potential revascularization options remains a relevant clinical issue with significant impact on the patient's quality of life. Recently, a novel device, the Coronary Sinus Reducer (CSR), has been introduced into clinical practice as a therapeutic option for patients with disabling angina pectoris. In this single-center, observational study, we evaluated the mid-term (3-month) safety and efficacy of the CSR in a real-world cohort. Methods: The study population consisted of 55 patients with refractory angina without potential revascularization options, who were predominantly men (87.3%) with a high cardiovascular risk factor burden and advanced angina (baseline CCS angina class 3.15 ± 0.6). In terms of procedure safety, all patients underwent successful device deployment with only one periprocedural complication. Results: At the 3-month follow-up, we observed a statistically significant improvement in angina control measured CCS class and SAQ-7 total questionnaire along with increased abolition of physical limitation-6-MWT (233.3 ± 107.1 vs. 305.2 ± 126.8; p < 0.0001). Additionally, we observed significant improvement in terms of quality of life measurements SF-36, the EQ-5D-5L questionnaire, and the EQ-VAS. Conclusions: Our real-world data suggest that CSR implantation is a relatively safe procedure and appears to be particularly effective in relieving angina symptoms and improving quality of life in subjects with refractory angina.

Neurobiological modulation with REAC technology: enhancing pain, depression, anxiety, stress, and quality of life in post-polio syndrome subjects

Post-polio syndrome (PPS) brings new challenges for polio survivors, including muscle decline, pain, depression, and diminished quality of life. This study explored the potential of REAC neuromodulatory treatments to ease pain, improve mood, and enhance quality of life in PPS patients. 17 individuals with PPS (average age 54.8) received three REAC treatments: Neuro Postural Optimization, Neuro Psycho Physical Optimization, and Neuro Psycho Physical Optimization-Cervico Brachial. Pain, depression, anxiety, stress, and quality of life were assessed before and after using established scales. REAC treatments significantly reduced pain across various dimensions, along with depression, anxiety, and stress levels. Additionally, patients reported improved physical and psychological quality of life. This study suggests REAC neuromodulatory treatments as a promising non-invasive option to improve pain, emotional well-being, and quality of life in individuals with PPS.

Quality of life and tolerability of B-cell directed therapy of multiple sclerosis with ofatumumab in a patient-centered real-world observational study

IntroductionOfatumumab (Kesimpta®) is a subcutaneous CD20-targeting antibody approved in Germany in 2021 for the treatment of relapsing multiple sclerosis (RMS). After careful instruction, patients can administer the treatment themselves. We previously reported data of 101 patients (Klimas et al. in Nervenarzt 94:923–933, 2023). The objective of this longitudinal study is to explore the tolerability and acceptability of ofatumumab from a patient perspective over a follow up period of 6 months.MethodsIn this prospective observational real-world study, we report follow up data of 81 patients. We evaluated sociodemographic data, disease duration, duration and side effects of ofatumumab use, expanded disability status scale (EDSS), Beck Depression Inventory II (BDI-II), Short-Form 36 (SF-36), Fatigue Scale of Motor and Cognitive Functions (FSMC), and modified Multiple Sclerosis Functional Composite Test (MSFC). In addition, we asked for subjective treatment outcomes, such as impact on quality of life, walking distance, concentration, mood, medication adherence, fatigue and the subjective course of MS on a numerical rating scale (1 = very negative; 5 = very positive). Furthermore, treatment discontinuations were recorded.ResultsThe average duration of ofatumumab treatment was 10 months. In comparison to previous published data of our cohort, patients reported a significant increase in headache (10% up to 26%, p = 0.004) and limb pain (5% up to 26%, p < 0.001) as persistent side effects after the injections. More patients reported a very positive effect (p < 0.0001) on quality of life. 4 confirmed relapses occurred but no EDSS worsening, and no treatment discontinuations were documented during the observation period.DiscussionAs previously described, our prospective study indicates that patients have a good tolerability of ofatumumab, precisely because of the mild and few side effects at the first administration. However, the longer the observation period, the more headaches and limb pain occurred after the injections. Despite this, patients’ subjective quality of life improved. There were no discontinuations during the follow-up period, with the limitation of a high loss to follow-up.

Discrepancies Between Objective and Subjective Outcomes of and Quality of Life During Molding Helmet Therapy for Cranial Deformities.

Positional skull deformities have been on the rise for decades and can be treated with molding helmets in early childhood. Parents often fear later cosmetic stigmatization, but also a reduced quality of life (QoL) during treatment. The aim of this study was to examine therapy results in our patient collection from a new perspective. Cranial vault asymmetry (CVA), cranial vault asymmetry index (CVAI), and cranial index (CI) were compared before and after molding helmet therapy. Correction was defined by a decrease in CVA <3.5mm and CI <90%. Subjective therapy outcome, side effects and QoL from the parents' perspective were determined using a questionnaire. There were 25 patients included. Differences between pretherapeutic and posttherapeutic CVA, CVAI, and CI were significant ( P <0.01). An objective correction according to the defined values was observed in only 12% of cases. However, 76% of parents stated that their child's skull shape was normal after therapy. There were 60 side effects reported in 23 cases. The QoL of 21 children was assessed as unimpaired during helmet therapy. Even though complete normalization was rarely observed, the parameters were significantly different after therapy, and subjective reduction in skull deformity was common.

Potential Impact of Slowing Disease Progression in Early Symptomatic Alzheimer's Disease on Patient Quality of Life, Caregiver Time, and Total Societal Costs: Estimates Based on Findings from GERAS-US Study.

Impact of Alzheimer's disease (AD) progression on patient health-related quality of life (HRQoL), caregiver time, and societal costs is not well characterized in early AD. To assess the association of change in cognition with HRQoL, caregiver time, and societal costs over 36 months, and estimate the impact of slowing disease progression on these outcomes. This post-hoc analysis included patients with amyloid-positive mild cognitive impairment (MCI) and mild AD dementia (MILD AD) from the 36-month GERAS-US study. Disease progression was assessed using the Mini-Mental State Examination score. Change in outcomes associated with slowing AD progression was estimated using coefficients from generalized linear models. At baseline, 300 patients had MCI and 317 had MILD AD. Observed natural progression over 36 months was associated with: 5.1 point decline in the Bath Assessment of Subjective Quality of Life in Dementia (BASQID) score (for HRQoL), increase in 1,050 hours of total caregiver time, and $8,504 total societal costs for MCI; 6.6 point decline in the BASQID score, increase in 1,929 hours of total caregiver time, and $12,795 total societal costs for MILD AD per person. Slowing AD progression by 30% could result in per person savings in HRQoL decline, total caregiver time, and total societal costs: for MCI: 1.5 points, 315 hours, and $2,638; for MILD AD: 2.0 points, 579 hours, and $3,974. Slowing AD progression over 36 months could slow decline in HRQoL and save caregiver time and societal cost in patients with MCI and MILD AD.