Summary Measures Of Health Research Articles

A Longitudinal Study of Health Improvement in the Atlanta CHDWB Wellness Cohort.

The Center for Health Discovery and Wellbeing (CHDWB) is an academic program designed to evaluate the efficacy of clinical self-knowledge and health partner counseling for development and maintenance of healthy behaviors. This paper reports on the change in health profiles for over 90 traits, measured in 382 participants over three visits in the 12 months following enrolment. Significant changes in the desired direction of improved health are observed for many traits related to cardiovascular health, including BMI, blood pressure, cholesterol, and arterial stiffness, as well as for summary measures of physical and mental health. The changes are most notable for individuals in the upper quartile of baseline risk, many of whom showed a positive correlated response across clinical categories. By contrast, individuals who start with more healthy profiles do not generally show significant improvements and only a modest impact of targeting specific health attributes was observed. Overall, the CHDWB model shows promise as an effective intervention particularly for individuals at high risk for cardiovascular disease.

Quantifying burden of disease to support public health policy in Belgium: opportunities and constraints.

BackgroundTo support public health policy, information on the burden of disease is essential. In recent years, the Disability-Adjusted Life Year (DALY) has emerged as the most important summary measure of public health. DALYs quantify the number of healthy life years lost due to morbidity and mortality, and thereby facilitate the comparison of the relative impact of diseases and risk factors and the monitoring of public health over time.DiscussionEvidence on the disease burden in Belgium, expressed as DALYs, is available from international and national efforts. Non-communicable diseases and injuries dominate the overall disease burden, while dietary risks, tobacco smoking, and high body-mass index are the major risk factors for ill health. Notwithstanding these efforts, if DALYs were to be used for guiding health policy, a more systematic approach is required. By integrating DALYs in the current data generating systems, comparable estimates, rooted in recent local data, can be produced. This might however be hampered by several restrictions, such as limited harmonization, timeliness, inclusiveness and accessibility of current databases.SummaryRoutine quantification of disease burden in terms of DALYs would provide a significant added value to evidence-based public health policy in Belgium, although some hurdles need to be cleared.

Differences in Quality of Life, Anxiety and Depression in Patients with Paroxysmal Atrial Fibrillation and Common Forms of Atrioventricular Reentry Supraventricular Tachycardias

IntroductionThe aim of this study was to evaluate the differences in quality of life and psychosocial stress parameters among patients with paroxysmal atrial fibrillation (AF) and common forms of atrioventricular reentry supraventricular tachycardias (SVTs). Methods and ResultsThe total study population included 106 patients, 54 patients with paroxysmal AF (32 males, age 56.64±12.50years) and 52 with SVTs (25 males, age 40.46±14.96years). General health (p<0.01), physical function (p=0.004), role emotion (p=0.002) and role physical (p<0.01) scores were lower in patients who suffered AF. SF-36 physical and mental health summary measures were also significantly lower in the AF group compared to those in SVT group (p<0.01 and p=0.001, respectively). Lower SF-36 total score was observed in patients with AF compared to those with SVTs (p<0.01). Comparing the anxiety and depression scores all the values were higher in patients with AF. Higher STAI-state scores (p<0.01), STAI-trait scores (p=0.039) and BDI scores (p=0.077) were seen in patients who suffered AF comparing to those with SVTs. ConclusionsQuality of life is significantly impaired and the level of anxiety is significantly higher in patients with AF comparing to those with common forms of SVTs.

An Information Theory Based Framework for the Measurement of Population Health

This paper proposes a new framework for the measurement of population health and the ranking of the health of different geographies. Since population health is a latent variable, studies which measure and rank the health of different geographies must aggregate observable health attributes into one summary measure. We show that the methods used in nearly all the literature to date implicitly assume that all attributes are infinitely substitutable. Our method, based on the measurement of multidimensional welfare and inequality, minimizes the entropic distance between the summary measure of population health and the distribution of the underlying attributes. This summary function coincides with the constant elasticity of substitution and Cobb-Douglas production functions and naturally allows different assumptions regarding attribute substitutability or complementarity. To compare methodologies, we examine a well-known ranking of the population health of U.S. states, America’s Health Rankings. We find that states’ rankings are somewhat sensitive to changes in the weight given to each attribute, but very sensitive to changes in aggregation methodology. Our results have broad implications for well-known health rankings such as the 2000 World Health Report, as well as the measurement of health inequality.

Functional Status, Change in Function and Outcomes for Patients Awaiting a Kidney Transplant.

Functional status is a summary measure of global health that is a robust predictor of death and disability. Patients with end-stage renal disease commonly have poor function. However, transplant professionals lack guidance on how to integrate functional status into the evaluation and counseling of transplant candidates. Methods: By linking Organ Procurement and Transplantation Network data with data on functional status (physical function [PF] scale of the Medical Outcomes Study Short Form-36) assessed by a national dialysis provider before transplant, we performed a retrospective cohort study of 19,640 adults on dialysis who were wait-listed from 6/1/2000 - 5/31/2006. First, we examined if baseline PF predicted the outcome of transplant. Second, we evaluated the survival benefit associated with transplant compared to dialysis, stratified by quartile of PF score. Last, we examined the relationship of change in function to the outcomes of transplant and mortality. Results: Median age was 50 years; 36% were black and 60% male. Median time between wait-listing and PF measurement was 99 days. Median initial PF score was 56 (out of 100) and among patients with repeat measures, median change in PF was zero (no change). Better PF had a “dose-dependent” association with receiving a kidney transplant (adjusted hazard ratio = 1.43 for highest versus lowest PF quartile, p<0.001). The relationship remained consistent when functional status was examined as a time-varying covariate. Within 9 months post-transplant, patients in every PF quartile derived a survival benefit from transplant compared to dialysis.Figure: No Caption available.Even those candidates (35% of total) with declining functional status scores enjoyed a survival benefit from transplantation. Conclusions: Although lower functional status is a strong independent predictor of lower likelihood of receiving a kidney transplant, patients at every level of functional status can derive a survival benefit from kidney transplant. Studies of observed, objective functional measures are needed.

0217 The NIEHS GuLF STUDY: Mental Health Symptoms Among Participants Involved in the Deepwater Horizon Oil Spill Clean-up

ObjectivesWorkers and communities impacted by previous oil spills have shown increases in adverse mental health outcomes. The GuLF STUDY is investigating potential health effects among workers involved in the Deepwater...

Calculating disability-adjusted life years to quantify burden of disease

The disability-adjusted life year or DALY is a summary measure of public health widely used to quantify burden of disease. In the DALY philosophy, every person is born with a certain number of life years potentially lived in optimal health. People may lose these healthy life years through living with illness and/or through dying before a reference life expectancy. These losses in healthy life years are exactly what is measured by the DALY metric. Ten DALYs, for instance, correspond to ten lost years of healthy life, attributable to morbidity, mortality, or both. On a population level, diseases with a higher public health impact will thus account for more DALYs than those with a lesser impact. DALYs have been the key measure in the four Global Burden of Disease (GBD) studies, each presenting a comprehensive assessment of the worldwide health impact of disease, injury and risk factors (Murray and Lopez 1996; Lopez et al. 2006; World Health Organization 2008; Murray et al. 2013a; Lopez 2013). Table 1 shows the most important diseases according to the different GBD studies. Furthermore, various national and regional DALY calculations have been performed to assess and monitor local health and to set priorities within the local health sector (e.g., Melse et al. 2000; Mathers et al. 2001; Devleesschauwer et al. 2013; Shield et al. 2013). In this Hints and Kinks paper, we summarize the DALY’s basic features and present a description of its calculation. An ‘‘Appendix’’ includes R code to calculate DALYs. The

Assessment of Health-Related Quality of Life in Patients with Psoriasis in Comparison with Normal Subjects in Shiraz Iran

Background: Psoriasis is a chronic inflammatory disease, which decreases the health-related quality of life (HRQOL) of the affected patients. There are various determinants related to the patients' HRQOL. Objectives: The objective of this study was to assess the HRQOL of a group of Iranian psoriatic patients in comparison with healthy adults. Patients and Methods: This cross-sectional study was conducted in Shiraz, Iran. Ninety- six psoriatic patients and a control group of 200 healthy subjects were participated in the study. SF-36 questionnaire was used for the data collection. HRQOL was analyzes according to some selected variables including gender, age, education level, duration of the disease, and also in comparison with the control group. Results: Ninety six patients with psoriasis (mean SD age of 35.72 9.95) included 41 males and 55 ty females. The control group had statistically significant (P-Value < 0.001) higher scores in all 8 scales of HRQOL . Physical and emotional role limitation (RP and RP) scales were significantly different in patient group based on the age. Scores forall the 8 scales and 2 summary measures of mental and physical health increased with increasing educational level. Conclusions: The negative impact of psoriasis on various aspects of patients' QOL is an undeniable fact. The results of the present study indicate the necessity of appropriate therapeutic, social and psychological interventions in psoriasis patients in order to help them have better life quality.

Ranking health between countries in international comparisons

Cross-national comparisons and ranking of summary measures of population health sometimes give rise to inconsistent and diverging conclusions. In order to minimise confusion, international comparative studies ought to be based on well-harmonised data with common standards of definitions and documentation. Calculation methods and results should be communicated clearly and exactly.

The Burden of Parasitic Zoonoses in Nepal: A Systematic Review

BackgroundParasitic zoonoses (PZs) pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY). However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding.MethodologyWe examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs.Principal FindingsBetween 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI): 5450–27,694] and 9255 DALYs [95% CrI: 6135–13,292], respectively), followed by cystic echinococcosis (251 DALYs [95% CrI: 105–458]). Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur.Conclusions/SignificanceIn settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this study would enable additional burden estimates, and a more complete picture of the impact of these diseases.

Equity in Ghanaian Breast Cancer Treatment Outcomes-A modeling study in Komfo Anokye Teaching Hospital

To the Editor: In high-income countries, much progress has been made in reducing breast cancer mortality (1,2). However, the benefits of decreased mortality are not distributed equitably, meaning that some subpopulations suffer more from breast cancer than others. Studies have revealed differences in breast cancer burden by race (3), urbanization (4), insurance status (5,6), and socioeconomic status (SES) (7). While equity in breast cancer has been studied in middle-income countries (8,9), it has rarely been examined in low-income countries. This letter reports on the equity of breast cancer treatment outcomes in Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, where we investigated whether lower SES patients present with more advanced disease and have worse health outcomes than other patients. We applied an existing mathematical model to estimate the cost-effectiveness of breast cancer treatments in Ghana (10) using the World Health Organization’s CHOosing Interventions that are Cost Effective (WHO-CHOICE) methodology and WHO population model templates (WHO PopMod) (11). The model included the four disease stages defined by the American Joint Committee on Cancer (12). As breast cancer stage is a good predictor of survival (earlier stages have higher survival rates than later stages (13)), the model uses a patient population’s stage distribution at diagnosis to predict treatment outcomes. Between November 2009 and January 2010, we identified SES and breast cancer stage at diagnosis for 90 patients who had, or were still receiving, treatment in KATH. SES based on expenditures was retrieved using a validated questionnaire, which also contained a question on insurance status (14). Patients were then categorized into SES quintiles, with the first representing the poorest 20% in the population and the fifth quintile representing the richest 20%. We then compared the averted Disability Adjusted Life Years (DALYs) between SES quintiles. The DALY is a summary measure of population health, which represents the sum of the years of life lost due to premature mortality in the population plus the equivalent “healthy” years lost due to nonfatal health conditions (15). DALYs were discounted at an annual rate of 3%. We compared the treatment outcomes of the SES quintiles in terms of DALYs averted with the population not receiving treatment and experiencing the natural progression of the disease.

Are health inequalities between differently deprived areas evident at different ages? A longitudinal study of census records in England and Wales, 1991–2001

The notion that mortality inequalities between differently deprived areas vary by age is logical since not all causes of death increase in risk with age and not all causes of death are related to the gradient of deprivation. In addition to the cause-age and cause-deprivation relationships, population migration may redistribute the population such that the health-deprivation relationship varies by age.We calculate cross-sectional all cause mortality and self-reported limiting long-term illness (LLTI) rate ratios of most to least deprived areas to demonstrate inequalities at different ages. We use longitudinal data to investigate whether there are changes in the distribution of cohorts between differently deprived areas over time and whether gradients of LLTI with deprivation also change.We find similar deprivation inequalities by age for all cause mortality and self-reported health with less inequality for young adults and the elderly but the greatest inequalities during mid life. Over time there are systematic movements of cohorts between differently deprived areas and associated increases and decreases in the gradient of LLTI across deprivation. It seems likely that population migration does influence inequalities by age. Further work should investigate whether the situation exists for other morbidities and, to better inform public health policy, whether restricting summary measures of area health to ages between 30 and 60 when inequalities are greatest will highlight between area differences.

A comparison of SF-36 summary measures of physical and mental health for women across the life course

Physical and mental component summary scores (PCS and MCS, respectively) are often used to summarise SF-36 quality of life subscales. This paper investigates PCS and MCS across the life course and compares the trajectories obtained from two different methods of calculation. The Australian Longitudinal Study on Women's Health is a population-based study with three cohorts of women and SF-36 surveys taken at multiple time points. Scoring coefficients for each component score were determined using factor analysis with uncorrelated (orthogonal) and correlated (oblique) rotation at the baseline survey, which were then used to compute correlated and uncorrelated PCS and MCS scores at each survey (scaled to have mean of 50 and standard deviation of 10 at baseline). For both methods, PCS declined progressively across the lifespan, while MCS rose in young and mid-age women to a peak and subsequently declined in later life. Differences were apparent between correlated and uncorrelated scores, most notably for MCS in the older cohort, where correlated MCS reached 54.6 but still less than uncorrelated MCS, with a random effects model indicating 1.63 (95% confidence intervals 1.58-1.67) units difference; it then declined to a score of 51.2 by the last survey and the difference widened to 3.44 (3.38-3.50) units compared with the uncorrelated MCS. PCS and MCS have distinct trajectories through life, with differences in results from correlated and uncorrelated component summary scores. The divergence is most notable with MCS, especially for older women, suggesting that correlated MCS and PCS should be used when examining change in health over time in this age group.

Health related quality of life changes in somatising patients after individual versus group cognitive behavioural therapy: A randomized clinical trial

ObjectiveTo assess changes in health related quality of life after a cognitive behavioural program for patients diagnosed with abridged somatization disorder in primary care. MethodA multicentre, randomized, parallel group, controlled trial was designed. 168 patients were recruited from 29 primary health care centres in Spain and were randomly assigned to one of the three study arms: treatment as usual improved with Smith's norms, individual cognitive behavioural treatment, and group cognitive behavioural treatment. Health-related quality of life was assessed using SF-36 Health Survey. ResultsIndividual cognitive behavioural treatment achieves greater changes in health related quality of life than group cognitive behavioural therapy and treatment as usual. Improvement in health related quality of life was fully observed at 12month, and partially at 6months. The modality of intervention interacts with time in all dimensions except for Physical functioning and Vitality. Patients who received individual cognitive behavioural therapy treatment had better scores in Physical and Mental health summary measures at 12month follow-up. ConclusionsIndividual cognitive behavioural treatment is the most effective way to improve health related quality of life in abridged somatization disorder patients, and its effects are sustained over time. Also, regardless of the type of intervention, physical functioning improves compared with treatment as usual.

What are Disability-Adjusted Life Years?

The Disability-Adjusted Life Year or DALY is a summary measure of public health widely used to quantify burden of disease. In the DALY philosophy, every person is born with a certain number of life years potentially lived in optimal health. People may lose these healthy life years through living with illness and/or through dying before a reference life expectancy. These losses in healthy life years are exactly what is measured by the DALY metric. Ten DALYs, for instance, correspond to ten lost years of healthy life, attributable to morbidity, mortality, or both. On a population level, diseases with a higher public health impact will thus account for more DALYs than those with a lesser impact. DALYs have been the key measure in the four Global Burden of Disease (GBD) studies, each presenting a comprehensive assessment of the worldwide health impact of disease, injury and risk factors. Furthermore, various national and regional DALY calculations have been performed to assess and monitor local health and to set priorities within the local health sector. In this workshop session, we will summarize the DALY's basic features and present a description of its calculation. As such, participants will be able to interpret and understand the strengths and weaknesses of the DALY metric.

Small-area health comparisons using health-adjusted life expectancies: A Bayesian random-effects approach

Health-adjusted life expectancy (HALE) is one of the most attractive summary measures of population health. It provides balanced attention to fatal as well as non-fatal health outcomes, is sensitive to the severity of morbidity within the population, and can be readily compared between areas with very different population age structures. HALE, however, cannot be calculated at the small-area level using traditional life table methodology. Hence we propose a Bayesian random-effects modeling approach that recognizes correlations and pools strength between sexes, age-groups, geographical areas, and health outcomes. This approach allows for the calculation of HALE for areas as small as 2000 person years at risk and with relatively modest health state survey sample sizes. The feasibility of the Bayesian approach is illustrated in a real-life example, which also shows how differences in areas' health performances can be adequately quantified. Such information can be invaluable for the appropriate targetting and subsequent evaluation of urban regeneration, neighborhood renewal, and community-based initiatives aimed at improving health and reducing health inequalities.

Abstract 339: Association of the American Heart Association’s Life’s Simple 7 Metric for Cardiovascular Health with Risk of Venous Thrombosis: the Reasons for Geographic and Racial Differences in Stroke Cohort

Background The AHA released a metric, Life’s Simple 7 (LS7), in 2010 to track cardiovascular health. The AHA 2020 Goals include improving population levels of LS7 by 20%. LS7 classifies 7 health components into poor, intermediate or ideal levels. The 7 components are physical activity, diet, smoking, body-mass index, glucose, blood pressure and cholesterol. Associations of these individual components with risk of venous thrombosis (VT) vary in the literature, but we hypothesized a decreased risk of VT with favorable LS7 summary scores. Methods We recruited 30,239 black and white participants age ≥45 across the US in 2003-7. With 4.6 years of follow up we validated 278 cases of first-time VT, including deep vein thrombosis and pulmonary embolus. We considered a 14 point summary score for LS7 and divided it into inadequate (0-4 points), average (5-9 points) and optimum (10-14) cardiovascular health. Cox proportional hazards models were used to relate baseline LS7 score to risk of subsequent VT, adjusting for age, sex, race, income, education and region of residence. Results Cases of VT were older and more likely to be male than noncases. Across categories of optimum, average and inadequate baseline health based on the summary LS7 score, the incidence rates of VT were 1.8, 2.1 and 3.1 per 1000 person years, respectively. Compared to those with inadequate health, persons with average health had an adjusted HR of VT of 0.60 (95% CI 0.42-0.84) while those with optimum health had a HR 0.52 (95% CI 0.36-0.77). The HR for a 1 point improvement in overall score (analogous to improvement of one of the 7 factors from poor–&gt;intermediate or intermediate–&gt;ideal) was 0.87 (95% CI 0.81-0.94). The individual factors of LS7 most strongly related to VT risk were ideal physical activity level (HR 0.61, 95% CI 0.46-0.83) and ideal body-mass index (HR 0.42, 95% CI 0.30-0.60); these associations were independent of each other. All associations were similar in blacks and whites. Conclusions A summary measure of cardiovascular health was strongly associated with reduced risk of VT in this US population sample. Results suggest that lifestyle interventions might be effective in reducing incidence of VT, and that achieving AHA’s 2020 Goals will also reduce VT incidence.

Issues in the measurement of quality of life in hemophilia.

It is widely claimed that can't manage what you don't measure. Likely this quote is derived from statements made by Lord Kelvin to the Institution of Civil Engineers. In his 1883 address, he claimed: ...when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meager and unsatisfactory kind... (1) A number of tools have been developed to accurately assess our hemophilia patients' progress and response to changing treatments. These include radiographic scores (like the Pettersson (X-ray) score and the compatible magnetic resonance imaging score), musculoskeletal assessment tools (like the Hemophilia Joint Health Scale), functional assessment questionnaires (like the Haemo-philia Activities List) or observational tools (like the Functional Independence Scale for Haemophilia), as well as summary measures of health - which are often called quality of life (QoL) or health-related quality of life (HRQL) tools(2-15). These tools have given clinicians and researchers powerful new ways to describe their patients' illnesses, but there are a number of considerations that should be addressed in future work. This commentary will address some of these issues.

Double trouble: the impact of multimorbidity and deprivation on preference-weighted health related quality of life a cross sectional analysis of the Scottish Health Survey

ObjectiveTo investigate the association between multimorbidity and Preference_Weighted Health Related Quality of Life (PW_HRQoL), a score that combines physical and mental functioning, and how this varies by socioeconomic deprivation and age.DesignThe Scottish Health Survey (SHeS) is a cross-sectional representative survey of the general population which included the SF-12, a survey of HRQoL, for individuals 20 years and over.MethodsFor 7,054 participants we generated PW_HRQoL scores by running SF-12 responses through the SF-6D algorithm. The resulting scores ranged from 0.29 (worst health) to 1 (perfect health). Using ordinary least squares, we first investigated associations between scores and increasing counts of longstanding conditions, and then repeated for multimorbidity (2+ conditions). Estimates were made for the general population and quintiles of socioeconomic deprivation. For multimorbidity, the analyses were repeated stratifying the population by age group (20–44, 45–64, 65+).Results45% of participants reported a longstanding condition and 18% reported multimorbidity. The presence of 1, 2, or 3+ longstanding conditions were associated with average reductions in PW_HRQoL scores of 0.081, 0.151 and 0.212 respectively. Reduction in scores associated with multimorbidity was 33% greater in the most deprived quintile compared to the least deprived quintile, with the biggest difference (80%) in the 20–44 age groups. There were no significant gender differences.ConclusionsPW_HRQoL decreases markedly with multimorbidity, and is exacerbated by higher deprivation and younger age. There is a need to prioritise interventions to improve the HRQoL for (especially younger) adults with multimorbidity in deprived areas.Box 1What Is Known?Prevalence and premature onset of multimorbidity increases as socioeconomic position worsens. Previous studies have investigated the effect of multimorbidity on Health Related Quality of Life (HRQoL) on separate physical and mental health states. There is limited data on how HRQoL falls as the number of conditions increase, and how estimates vary across the general population.Leaving physical and mental health as separate categories can inhibit assessment of overall HRQoL. The use of a Preference_Weighted Health Related Quality of Life (PW_HRQoL) score provides a single summary measure of overall health, by weighting mental and physical states by their perceived importance as part of overall HRQoL. The use of a single score enables a simple and consistent assessment of the impact of conditions and how this varies across the population. Economists term PW_HRQoL scores health utilities.What this study adds?This is the first study to estimate how the impact of multimorbidity on PW_HRQoL scores varies by age group and socioeconomic deprivation. Multimorbidity has a substantial negative impact on HRQoL which is most severe in areas of deprivation, especially in younger adults.Measuring the burden of multimorbidity using PW_HRQoL provides consistency with how economists measure HRQoL; changes in which can be used in economic evaluation to assess the cost effectiveness of interventions.

The role of group education on quality of life in patients with a stoma

Stoma education has been traditionally given in a one-to-one setting. Since 2007, daily group education programmes were organised for stoma patients and their relatives by our stoma therapy unit. The programmes included lectures on stoma and stoma care, and social activities in which patients shared their experiences with each other. Patients were also encouraged to expand interaction with each other and organise future social events. A total of 72 patients [44 (61.1%) male with a mean (± SD) age of 56.8 ± 13.6 years] with an ileostomy (n= 51, 70.8%), a colostomy (n= 18, 25.0%) or a urostomy (n= 3, 4.2%) were included in the study. Patients were asked to answer a survey (SF-36) face-to-face before the initiation of the programme, which was repeated 3 months later via telephone call. The comparison of pre-education and post-education SF-36 scores revealed a statistically significant improvement in all 8-scale profiles, but not in vitality scale, and both psychometrically-based and mental health summary measures. Analyses disclosed that married patients and those who were living at rural districts seem to have the most improvement in life quality particularly in bodily pain, general health and role-emotional scales and mental health summary measure. In our opinion, group educations may be beneficial for stoma patients, and stoma therapy units may consider organising similar activities.