Total Quality Of Life Score Research Articles

The Effects of Cardiac Implantable Electronic Device Personal Protective Equipment Use in Patients with Pediatric and Adult Congenital Heart Disease.

Pediatric and adult congenital heart disease (ACHD) patients encounter physical and emotional barriers. Cardiac implantable electronic devices (CIEDs), including pacemakers and implantable cardiac defibrillators (ICD) often compound these issues. Patient fear associated with damaging the CIED system can lead to avoidance of physical activity and reduced quality of life (QOL). CIED personal protective equipment (PPE) is a potential treatment for decreasing this fear. We sought to determine the effects of CIED PPE use in the pediatric and ACHD population. Patients 5 years or older with a CIED at a single pediatric and ACHD heart rhythm center received a CIED protector and customized athletic shirt. QOL was assessed using the PedsQL TM 4.0 SF15 prior to and after 6-12months. Of the 77 patients enrolled, 26 completed repeat assessment. The mean age at enrollment was 15.6years (range 5-36) with a mean device age of 2.2years (< 1-10years). Pacemakers were present in 77% and 23% had ICDs. The PPE was used in 92% with no PPE malfunction. Fear associated with physical activity was reduced, z = -4, p < 0.001, with a large effect size (r = 0.55). There was a trend toward increased physical activity. Total QOL scores improved, z = -2.771, P < 0.05, with a medium effect size (r = 0.4). This first study of CIED PPE in children shows that providing CIED PPE to pediatric and ACHD patients may decrease their fear of damaging their device system, increasing physical activity levels, and improving quality of life.

Effects of WeChat follow-up management on the psychological distress, care burden, and quality of life of parents of infants with bronchopulmonary dysplasia: a retrospective cohort study.

The objective was to explore the impact of WeChat follow-up management on the psychological distress, care burden, and quality of life of parents of infants with bronchopulmonary dysplasia (BPD) receiving in-home care. This was a retrospective cohort study. A total of 101 parents of infants with BPD who were followed up from January 2016 to January 2022 were included in this study. According to different follow-up methods, these patients were classified into the WeChat group and the routine group. The Depression, Anxiety, and Stress Scale-21 (DASS-21), Zarit Caregiver Burden Interview (ZBI), and WHOQOL-BREF were used. The data on the psychological distress, care burden, and quality of life of the parents in the two groups were analyzed and compared at discharge and at the 3-month follow-up. There was no significant difference in the DASS-21 and ZBI scores at discharge between the parents in the two groups. During the 3-month follow-up, the scores of the DASS-21 anxiety and stress subscale and the ZBI of parents in the WeChat group were significantly lower than those of parents in the routine group (P < 0.05); however, there was no significant difference in the depression subscale score between the two groups (P > 0.05). A comparison of the WHOQOL-BREF score between the two groups showed that the total quality of life score in the WeChat group was significantly higher than that in the routine group (P < 0.05). The scores of the psychological and social relationship fields in the WeChat group were significantly higher than those in the routine group (P < 0.05). The incidence of adverse events during follow-up was significantly lower in the WeChat group than in the routine group (P < 0.05). WeChat follow-up management is helpful to decrease the anxiety and stress, reduce the care burden, and improve the quality of life of parents of infants with BPD receiving in-home care.

The Interactive Relationship between the Positive Coping Style and Life Quality of Survivors of Pancreatic Cancer and Their Main Family Caregivers Based on the Dyadic Perspective: An Actor-Partner Interdependence Model

Objective. To analyze the interaction of positive coping style and quality of life (QoL) between survivors of pancreatic cancer and their family caregivers based on the Conceptual Framework of Caring Experience of Cancer Family and Actor-Partner Interdependence Model (APIM). Methods. This study adopted a cross-sectional design that selected 200 pairs of survivors of pancreatic cancer and their family caregivers hospitalized in the First and Second Affiliated Hospitals of Nanjing Medical University from August 2020 to February 2021. Survivors of pancreatic cancer and their family caregivers completed Simple Coping Style Questionnaire and 12-item Short-Form Health Survey, whose results successfully built an APIM model. Results. The spousal relationship was the most common type of dyadic relationship. Family caregivers had higher levels of positive coping and QoL than cancer survivors. In terms of actor effects, the positive coping style of both survivors and caregivers significantly affected individual total scores of QoL and personal physical and psychological dimensions of QoL. As for the partner effects, the positive coping style of both survivors and caregivers significantly impacted their partners’ total QoL scores and the positive coping style of survivors significantly impacted their caregivers’ psychological level of QoL. Conclusions. The positive coping style of survivors of pancreatic cancer affects both their own QoL and their partner’s QoL. Examining mutual effects between coping styles and QoL among survivors and their informal caregivers is an essential first step in providing comprehensive and cooperative care. The study has been reviewed by the Chinese Clinical Trial Registry, and registration information has been sent to the central database of the World Health Organization International Clinical Trial Registration Platform for global retrieval. This trial is registered with ChiCTR2300074087.

Relationship between quality of life, fear of disease progression, and coping styles in patients with pulmonary hypertension: A network analysis.

A poor quality of life (QoL) in patients with pulmonary hypertension (PH) is often associated with emotional disturbances and the ability to cope. Little is known, however, about the intrinsic links among the QoL, fear of disease progression (FoP), and coping styles in patients with PH. The purpose of this study was to elucidate the relationships among QoL, FoP, and coping styles in patients with PH. We conducted a cross-sectional survey of 247 patients from a tertiary hospital in Jinan, China and analyzed the relationships using network analysis. Participants completed the World Health Organization's Quality of Life Questionnaire, Fear of Disease Progression Questionnaire and Simple Coping Style Questionnaire during the survey period. The total QoL, positive coping, and negative coping scores were 46.55 ± 10.46, 31.75 ± 6.85, and 18.75 ± 4.66, respectively. The QoL psychological domain had the strongest centrality, deserving more attention than other domains. The coping styles were bridge nodes that connected the whole network, where negative coping and social family FoP, and positive coping and both social and psychological QoL had the strongest positive correlations. There were no significant sex-based or age-based differences in the networks. To improve QoL and psychological well-being in people with PH, healthcare professionals must focus on issues beyond the patient's physical health. Specifically, they should focus on positive coping styles, while developing interventions to promote positive coping and reduce negative coping styles.

Effectiveness of Aromatherapy in Early Palliative Care for Oncology Patients: Blind Controlled Study.

Palliative care is the active holistic treatment of people of all ages who have serious health-related suffering as a result of severe illness, and especially of those who are close to the end of life. Palliative care is provided to cancer patients who experience serious suffering that cannot be relieved without professional intervention and that compromises physical, social, spiritual, and emotional functioning. A straightforward, low-risk, and affordable palliative care approach may be provided through aromatherapy, a type of complementary and alternative medicine. The study objective is to assess the comparative effectiveness of massage, aromatherapy massage, and massage combined with aromatherapy inhalation on cancer patients receiving palliative care. A total of 100 participants who were divided into four groups at random. The first group, designated as the control group, received standard hospital nursing care, the second group received massage only (using the odorless almond carrier oil), the third group received massage with lavender oil, and the fourth group received combined (inhalation and massage) aromatherapy. The Rotterdam Symptom Checklist (RSCL), given two weeks after aromatherapy, was used to examine participants' perspectives of care. On the RSCL, combined aromatherapy performed best. In terms of reported physical symptoms, psychological symptoms, and activities, there were statistically significant differences between the scores of the control group and each of the experimental groups. Nonetheless, the total quality of life score showed no significant difference between the control group and the massage only group (t = 0.529, p = 0.60). When paired with aromatherapy inhalation, massage has a positive effect on physical, psychological symptoms, activities, and overall quality of life for cancer patients receiving early palliative care. Nurses and other healthcare providers are recommended to support programs that provide message therapy to reduce reported bodily symptoms, psychological problems, and limited activities among cancer patients.

Self-rated health and quality of life in female sex workers with substance use disorders in Tehran, Iran

BackgroundWhile self-rated health (SRH) and quality of life (QoL) has been associated with substance use disorders (SUDs) in sex-working populations, little is known about this association in Iran. This study aimed to assess QoL and SRH in Iranian female sex workers (FSWs) in Tehran.MethodFSWs were recruited using convenience sampling methods from substance abuse treatment centers in Tehran that exclusively provided services for women. Participants completed an interviewer-administered demographic questionnaire in Persian and the Iranian version of the Short Form Health Survey (SF-36). Descriptive analyses, means and standard deviations; frequency and percentages, t-test and one-way ANOVA, and Chi-square tests were utilized to analyze the data.ResultsThe mean age among 161 participants clinically diagnosed with SUD was 34.09 years (SD 7.97; range: 18–57). The total mean QoL score was 41.03 (SD: 12.92). The highest and lowest mean scores were observed in the physical functioning (52.23) and role emotional (26.64) dimensions, respectively. Significant differences (p < 0.05) in QoL were observed according to education and marital status, and the average QoL score was lower in women who reported permanent marriages and women who were illiterate. The average score of QoL was significantly higher in employed women. Overall, 51.6% of the women rated their health as sub-optimal, with divorced participants and women who were illiterate more likely to rate their health as sub-optimal (p < 0.05).ConclusionResults emphasize the need for mental, physical, and sexual health screening and gender-specific interventions to improve QoL in this population. Further investigation may elucidate the consequences of poor SRH and QoL on SUD treatment adherence, sexual risk behavior, and morbidity and mortality in FSWs.

The factors associated with quality of life and depression score in adults aged 65 and over

Introduction: In recent years, there has been an increase in the number of elderly population with the improvement of living conditions and the acquisition of healthy life behaviors in Türkiye. In this study, it was aimed to evaluate the quality of life of the elderly and the affecting factors. Methods: Our study is planned with a descriptive and cross-sectional design. Quality of life of the participants was assessed using the World Health Organization Quality of Life-Old module (WHOQOL-OLD), whereas depressive symptoms were evaluated using the Geriatric Depression Scale. Results: Their mean total score on the WHOQOL-OLD module was 56.64 ± 15.57. The total quality of life score was found to be significantly lower among females, elderly, illiterate and those who lacked a regular monthly income, who perceived their health status to be worse than that in the previous year, who considered themselves very old and who suffered from chronic diseases (p ˂ 0.001). The mean score of the participants on the Geriatric Depression Scale was 14.59±5.27, whereas the frequency of depression was 56.5%. There was a negative and significant relationship between depression and quality of life scores (p˂0.001, r=0.658). Conclusion: In our study, the indicators, dimensions, and measurement of quality of life and levels of depression in old age are presented. Additionally, factors influencing the perceptions of aging among the elderly and the individual perspective on aging, as well as their associations with depression, are discussed. Keywords: Elderly, Aging, Quality of life, Depression, Perception of aging, Geriatric Depression Scale

QUALITY OF LIFE IN PATIENTS WITH TOTAL HIP REPLACEMENT – A PILOT STUDY

Introduction: Total hip joint replacement is the most frequent surgery intervention for the treatment of degenerative diseases. Rehabilitation after surgery plays an instrumental role for functional recovery and returning to the labor market or daily activities. Although postsurgical pain and function improvement are widely explored, there is no focus on other aspects of life influenced by total hip replacement. The most used instruments for quality of life measuring are specific ones, but a number of disadvantages lead to the need for broad–ranged concept. Aim: to evaluate the quality of life in total hip replacement patients undergoing a personalized rehabilitation program and to define its influence on physical, psychological, social and environmental dimensions of life. Material and methods: A personalized rehabilitation program was applied for 7 days in 19 patients who underwent conventional total hip replacement surgery. Quality of life was measured on the first and the last day of their hospital stay by using the WHOQOL-BREF questionnaire. Results: Significantly improved QOL total score was reported for all participants after the rehabilitation course. Comparing QOL in domains shows statistically significant improvement in all of them except "Social relationships." Conclusion: Early rehabilitationwith an individual approach could achieve QOL improvement in different life aspects of THR patients. WHOQOL-BREF could be a useful tool for quality of life assessment after rehabilitation surgical interventions such as total hip replacement.

Racial Differences in Nursing Home Quality of Life Among Residents Living With Alzheimer's Disease and Related Dementias.

ObjectivesAmong nursing home (NH) residents with Alzheimer's disease (AD) and AD-related dementias (AD/ADRD), racial/ethnic disparities in quality of care exist. However, little is known about quality of life (QoL). This study examines racial/ethnic differences in self-reported QoL among NH residents with AD/ADRD. Methods: Validated, in-person QoL surveys from 12,562 long-stay NH residents with AD/ADRD in Minnesota (2012-2015) were linked to Minimum Data Set assessments and facility characteristics. Hierarchical linear models assessed disparities in resident-reported mean QoL score (range, 0-100 points), adjusting for case-mix and facility factors. Results: Compared to White residents, racially/ethnically minoritized residents reported significantly lower total mean QoL scores (75.53 points vs. 80.34 points, p < .001). After adjustment for resident- and facility-level characteristics, significant racial/ethnic differences remained, with large disparities in food enjoyment, attention from staff, and engagement domains. Discussion: Policy changes and practice guidelines are needed to address racial/ethnic disparities in QoL of NH residents with AD/ADRD.

Correlations between Nutritional Status and Quality of Life of People with Parkinson's Disease.

To evaluate the correlation between anthropometric variables and the QoL of people with Parkinson's disease (PD). This is a cross-sectional, descriptive, and analytical study, carried out through the collection of anthropometric data and application of the Parkinson's Disease Questionnaire PDQ-39. 33 individuals (23 male) diagnosed with PD participated in the research, with a mean age of 58.9 ± 11.6 years. We observed overweight in 45.4% of participants. The perception of QoL showed lower scores for the subjects in the dimensions of body discomfort (75.3 ± 16.6), social support (62.7 ± 15.7), and mobility (61.0 ± 23.6). The correlation between the total QoL score and age (model 1, B = 0.347; CI 0.004-0.902; p = 0.048), which remained statistically significant in the multiple linear regression, regardless of gender (model 2, B = 0.365; CI 0.016-0.937; p = 0.043) and BMI (model 3, B = 0.363; CI 0.006-0.943; p = 0.047), suggests that, in the participants of this study, this relationship does not depend on gender and nutritional status. The perception of QoL was worse in the dimensions of body discomfort, social support, and mobility, worsening with advanced age. Correlations between the worst scores in QoL dimensions and nutritional status were observed. A positive correlation was also identified between age and overall PDQ-39 score, regardless of gender and nutritional status.

Benzodiazepine use, quality of life and psychiatric symptom burden in oral and injectable opioid agonist treatment: a cross-sectional study

BackgroundUse of benzodiazepines (BZD) in patients receiving opioid agonist treatment (OAT) is common and associated with a variety of negative health and social outcomes. This cross-sectional study investigates the impact of BZD use in OAT patients on their quality of life (QoL).MethodsA convenience sample of patients receiving oral OAT or heroin-assisted treatment in two outpatient centres in Basel, Switzerland was investigated. Participants (n = 141) completed self-report questionnaires on psychiatric symptoms and psychological distress (The Symptom Checklist 27, SCL-27), depressive state (German version of the Center for Epidemiological Studies Depression Scale), quality of life (Lancashire Quality of Life Profile, LQOLP) and use of BZD and other drugs (self-report questionnaire). Substance use was assessed by urine toxicology testing.ResultsIn bivariate analysis, total QoL scores were significantly lower for lifetime, current, and prolonged BZD users compared to participants without the respective use patterns. There was no significant relationship between BZD dose and QoL. In multivariable linear regression models controlling for psychiatric symptom load and depressive state, only lifetime use predicted lower QoL, whereas other BZD use patterns were not significantly associated.ConclusionsThe association of lower QoL and BZD use in OAT patients is strongly confounded by co-occurring depressive state and psychiatric symptoms. Careful diagnosis and treatment of co-occurring mental disorders in OAT is paramount to improve QoL in this patient population and may also help reduce BZD use.

Assessment of impact of comorbidities on quality of life scores among diabetics and non-diabetics: A hospital based case control study in Garhwal division of Uttarakhand, India

Background: Health related quality of life (HRQoL) is an important patient reported outcome in any chronic disease, including diabetes and is the ultimate goal of health interventions. The objective of the study was to compare the Quality of Life (QoL) scores between patients with diabetes and those without diabetes. It also intended to compare QoL scores between the two with respect to comorbidities of various system, assess the association of increasing number of comorbidities on QoL scores in both the groups and find the determinants of QoL scores among diabetics using regression analysis. Methods: The present study was a hospital-based comparative study conducted in Garhwal division of Uttarakhand, India. The QoL scores were obtained using WHOQOLBREF questionnaire. Comparisons were made between 195 diabetics and an equal number of age and sex matched nondiabetics. Results: The total mean QoL score was significantly lower among diabetics in comparison to nondiabetics. Patients with diabetics with comorbidity of cardiovascular system reported highest mean QoL scores while those with respiratory comorbidities reported lowest mean scores. The mean QoL scores decreased with increasing number of co-morbities in both diabetics and nondiabetics, however the inter group differences were not found to be significant. Presence of three or more comorbidities (β= -9.5), income (β= 5.3), type of family (β= -5.9) and use of alcohol (β= 2.4) were significant determinants of QoL among patients of diabetes. Conclusion: The study illustrates the expanding horizons of the effect of diabetes on all the domains of life of an individual and therefore proposes and reinforces the role of interventions not just limited to control of blood sugar levels but also to enhance the quality of life of an individual with diabete

Translation and Validation of the Arabic Version of the Reflux Symptom Score, Short Version 12 (RSS-12)

The Reflux Symptom Score (RSS) is a patient-related outcomes measure (PROM) that was developed to diagnose Laryngopharyngeal reflux (LPR), by assessing the severity and frequency of specific symptoms and their respective impact on quality of life (QoL). To develop the Arabic version of RSS-12 (Ar-RSS-12), and to assess its validity and reliability. The RSS-12 was translated from French into Arabic using the forward-backward translation method, and the translated version underwent transcultural validation. A case-control study was conducted at the otolaryngology clinics of a referral hospital, during the period November to December 2022. It included 61 patients with LPR-related symptoms and a Reflux Symptom Index (RSI) score >13, and 61 control without LPR-related symptoms and negative RSI scores ≤13. The internal consistency, internal and external validity, and Test-Retest reliability of Ar-RSS-12 were analyzed. Patients had significantly higher scores than controls in all 12 items and total Ar-RSS and QoL impact scores, with high Z score values. Item scores showed variable correlation levels with total Ar-RSS score, with ear-nose-throat items showing the strongest correlation (Spearman's rho 0.592-0.866). The QoL scores were more strongly correlated to the symptoms' severity than frequency. The internal consistency was high, with Cronbach's alpha=0.878. Regarding external validity, correlations with RSI score showed high Spearman's rho values for total Ar-RSS (0.905) and QoL total score (0.903). No statistically significant difference was observed between Test and Retest results in any of the 12 items' score or the total score and QoL, indicating the reproducibility of the test. The Ar-RSS is a valid and reproducible tool for the screening, assessment, and monitoring of LPR in Arabic speaking patients. The inclusion of symptoms severity and frequency, as well as their individual effects on patient's QoL, support the superior clinical applications of RSS compared to other existing PROMs.

Investigation on medical security and quality of life of migrant workers with pneumoconiosis

Objective: To investigate and understand the medical security and quality of life of migrant workers with pneumoconiosis, so as to provide scientific basis for the prevention and control countermeasures of migrant workers with pneumoconiosis and targeted poverty alleviation. Methods: Using a stratified random sampling method, 200 migrant workers diagnosed with pneumoconiosis at the Shandong Academy of Occupational Health and Occupational Medicine from January 2016 to December 2021 were selected as the observation group, while 200 non migrant workers diagnosed with pneumoconiosis were selected as the control group. St. George's Respiratory Questionnaire (SGRQ) and Pneumoconiosis Questionnaire were used to collect and compare information on the age, working age of dust exposure, economic sources, employment status, income, medical security and quality of life of two groups of patients. Results: The age of migrant worker pneumoconiosis patients in the observation group was (58.1±8.1) years old, and the working age of dust exposure was (19.3±10.1) years. The main source of income was children support (85.5%, 171/200), employment status was mainly wait for employment or unemployed (69.0%, 138/200), personal monthly income was mainly non income (90.0%, 180/200), and family annual income was mainly less than 10000 yuan (48.0%, 96/200). The average personal annual medical expenditure of 5000-<10000 yuan accounted for 42.0% (84/200). The age of pneumoconiosis patients in the control group was (59.2±8.9) years old, and the working age of dust exposure was (20.2±10.5) years. The main source of income was retirement pension or salary (99.0%, 198/200), with retirement as the main employment status (66.0%, 132/200), the main personal monthly income was 2000-<4000 yuan (61.5%, 123/200), the main family annual income was 20000-<40000 yuan (44.0%, 88/200), and the average personal annual medical expenditure was mostly non-expenditure (92.0%, 184/200). There were statistically significant differences in the distribution of economic sources, employment status, personal monthly income, family annual income and average personal annual medical expenditure between the two groups (P<0.001). The main type of insurance for the observation group was rural cooperative medical care (68.5%, 137/200), and 87.0% (174/200) had no medical reimbursement and a proportion less than 50%. There were statistically significant differences in insurance type and medical reimbursement proportion between the two groups (P<0.001). The respiratory symptoms, activity ability, daily life influence and total quality of life scores of pneumoconiosis patients in the observation group were significantly higher than those in the control group, the differences were statistically significant (P<0.001) . Conclusion: Migrant workers with pneumoconiosis have low income, high medical expenditure, low medical reimbursement proportion and poor quality of life. Therefore, it is necessary to draw high attention from relevant departments and provide timely attention and assistance to improve the quality of life of migrant workers with pneumoconiosis.

Quality of life and physical/psychosocial factors in children and adolescents with orthostatic intolerance

BackgroundOrthostatic intolerance (OI), which is common in children and adolescents, negatively impacts their quality of life (QOL) due to physical symptoms that limit work, school, and daily activities. The purpose of this study is to explore the association of physical and psychosocial factors with QOL scores in children and adolescents with OI.MethodsA cross sectional observational study was conducted. The study participants included 95 Japanese pediatric patients of age 9–15 years who were diagnosed with OI from April 2010 to March 2020. The QOL scores and the QOL T-scores of children with OI assessed using the KINDL-R questionnaire at the initial visit were compared with conventional normative data. The associations of physical and psychosocial factors with the QOL T-scores were examined using multiple linear regression.ResultsPediatric patients with OI had significantly lower QOL scores than healthy children in both elementary (50.7 ± 13.5 vs. 67.9 ± 13.4, p < 0.001) and junior high schools (51.8 ± 14.6 vs. 61.3 ± 12.6, p < 0.001). This finding was observed in the physical, mental, self-esteem, friends, and school domains. Total QOL scores were significantly associated with school nonattendance (β = − 3.2, 95% confidence interval [CI] = − 5.8 to − 0.5, p = 0.022) and poor relationship with school (β = − 5.0, 95% CI = − 9.8 to − 0.4, p = 0.035).ConclusionsThese results suggest that the assessment of QOL, including both physical and psychosocial aspects, especially school factors, needs to be implemented earlier in children and adolescents with OI.

The clinical characteristics and quality of life of 248 pediatric and adult patients with Congenital Adrenal Hyperplasia.

Congenital Adrenal Hyperplasia (CAH) is a chronic disease that requires lifelong treatment. Patients may face stigmatization, which may affect their quality of life (QoL). Therefore, we assessed the clinical characteristics and QoL of patients with CAH in the Middle East. This case-control study included patients with CAH aged >5 years from two tertiary centers (2020-2021). The patients were matched to a healthy control group and were then divided into pediatric and adult groups. Data were collected from their electronic medical records. Additionally, the EQ-5D-5L QoL questionnaire was completed by both the patients and control group to assess five domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). The study included 248 patients with CAH (females: 58.8%), with a family history of the condition (57.3%) and/or parental consanguinity (68.1%). The most frequently reported gene defect was CYP21A2, while the most commonly reported symptoms/signs were ambiguous genitalia and obesity. Almost all female patients had received corrective surgery. The questionnaire response rate was 86.3% (n=214/248). The CAH patient group's mean total QoL score was 85.2 compared with 99.8 in the control. Further, CAH patients had lower QoL scores in all domains compared to those in the control group (p ≤ 0.0001-0.0023). The pain/discomfort and anxiety/depression domains were affected significantly more than the other domains were, with 47.7% and 44.4% participants, respectively, p<0.0001. Additionally, obesity was found to be a predictor of reduced mobility following a logistic regression analysis (p ≤ 0.04, OR (0.18-0.98)). Patients with CAH reported lower QoL overall, particularly in the pain/discomfort and anxiety/depression domains. Based on this, we recommend the early involvement of psychologists in a multidisciplinary team approach, pre-marital screening, and the implementation of awareness programs for people diagnosed with CAH in communities with high consanguineous mating.

Influence of ovarian function supression on quality of life in breast cancer survivors during adjuvant endocrine therapy.

560 Background: Adding ovarian function suppression to adjuvant endocrine therapy (AET) lowers the disease recurrence rates among premenopausal women with hormone receptor-positive (HR+) early breast cancer (EBC). However, a detrimental effect on endocrine symptoms burden (ESB) is expected. Therefore, this study aimed to investigate differences in Quality of life (QoL) and endocrine symptoms in premenopausal women prescribed AET, with/without gonadotropin-releasing hormone agonist (GnRH). Methods: This cross-sectional study included women, with HR+ EBC, premenopausal at diagnosis, treated with AET for more than 3 months, with and without GnRH. The research was conducted with institutional Ethics Committee approval at the University Hospital Centre Zagreb, General Hospital Šibenik, and with online survey. A validated instrument, the Functional Assessment of Cancer Therapy - Endocrine Symptoms (FACT-ES), was used. The collected data were analysed using SPSS v. 29 (p≤0.05). Results: Overall, 314 eligible BC survivors with a median age of 45 years (22-65) and a median duration of AET of 2 years (3 months -12 years) responded to FACT-ES and were included in the analysis. Altogether 45.2% (n=142) of participants were prescribed tamoxifen (TAM), 25.8% (n=81) GnRH+TAM, and 29% (n=91) GnRH+aromatase inhibitor (AI); exemestane (9%), letrozole (13.6%) and anastrozole (6.4%). The total QoL (FACT-ES) score was higher in patients treated with TAM as opposed to patients treated with AI+GnRH (p=0.01). Adding GnRH to TAM did not significantly change QoL when compared to TAM alone or AI+GnRH. In addition, patients on AI+GnRH had lower physical well-being (PWB) score than patients on TAM+GnRH (p=0.03) or TAM alone (p=0.05) and lower endocrine subscale score (ESS-19) than patients on TAM (p=0.01), indicating more endocrine symptoms in premenopausal women treated with AI+GnRH. Among patients treated with AI+GnRH letrozole had lower PWB (p=0.03) and ESS-19 score (p=0.01) than exemestane. Conclusions: This study showed that GnRH+AI in premenopausal women with HR+ EBC results in greater ESB and lower QoL compared to patients treated with TAM or GnRH+TAM. Therefore, interventions helping decrease the ESB in patients treated with AI+GnRH should be explored and developed to help patients adhere to and persist in AET. [Table: see text]

Change in quality of life of metastatic breast cancer patients seeking treatment at Komfo Anokye Teaching Hospital, Ghana.

e24111 Background: Despite developments in breast cancer screening for early diagnosis and treatment, 20-85% of women go on to develop distant metastasis, based on tumor biology, stage at presentation and treatment modalities received. The primary goal of treating metastatic breast cancer (MBC) is to improve quality of life (QoL). This study assessed the change in QoL for patients with MBC seeking treatment at Komfo Anokye Teaching Hospital (KATH). Methods: Women with MBC seen at KATH had QoL assessed using the Functional Assessment of Cancer Therapy Breast (FACT-B) questionnaire before, and 3 months after they were supposed to have received systemic treatment - chemotherapy, hormonal, target therapy. Data was analyzed using STATA v17 software. The higher the FACT scores, the better the QoL. Results: Fifty-six women with MBC were interviewed. Their mean age was 51.7 years. Only 27 (48%) of them received some systemic treatment – chemotherapy, hormonal, target therapy – over the study period. Baseline median QoL scores in the wellbeing domains were physical (PWB) = 17.5, social/family (SWB) = 16.0, emotional (EWB) = 12.0, functional (FWB) = 8.0, breast cancer subscale (BCS) = 22.0. Their median total QoL scores were FACT-B = 77.5; FACT-B TOI = 48.5 and FACT-G = 54.5. At follow up, 28 (50%) of participants were alive. About a third (9/28) of them received no systemic treatment. Of the remaining 19; 4, 1 and 14 received one, two and three cycles of systemic treatment respectively. Their median QoL scores were PWB = 20.5, SWB = 16.0, EWB = 16.0, FWB = 15.0, BCS = 22.5, FACT-G = 72.0, FACT-B = 94.5, and FACT-B TOI = 61.0. Fourteen had improved, and 14 had deteriorated QoL. The median minimally important difference (MID) for the improved QoL group was MID FACT-B = -22, MID FACT-B TOI = -10 and MID BCS = -4, and for the deteriorated QoL group was MID FACT-B = 26.9, MID FACT-B TOI = 18 and MID BCS = 5. Being dead at follow up was related to receiving no treatment (AOR = 6.97, CI: 1.91 – 25.47, p-value = 0.003) and having one metastatic site at baseline (AOR = 5.23, CI:1.43 – 19.12, p-value = 0.01). Conclusions: Mortality among women with MBC was high (50%), especially among those who did not receive any systemic treatment or had one metastatic site. Of the survivors, equal proportions had significantly improved and significantly deteriorated QoL scores albeit varying treatment courses received. Further studies are needed to explore how systemic treatment or not impact QoL changes and survival outcomes of MBC patients in KATH.

The change in occupational participation and quality of life following occupational therapy for people supervised by probation.

The probation system is a penal and enforcement system in which the completion of sentences of individuals who are incarcerated and rehabilitation processes are carried out together. This study considered the change in occupational participation and quality of life following occupational therapy for people supervised by probation. The research was planned as a pre-test and post-test study. Fifteen individuals participated in the study voluntarily. The participants completed the Socio-Demographic Information Form, COPM for occupational participation, and the Nottingham Health Profile (NHP) for quality of life. We implemented an intervention program consisting of, on average, 1 h once a week for 12 weeks. Post-intervention evaluations were completed, and the results were compared. There was a significant difference between the pre-intervention and post-intervention measures of the total quality of life scores (p = 0.003) and the COPM scores for performance (p = 0.001) and satisfaction (p = 0.001). Implementing a client-centred occupational therapy intervention involving personal behaviour, organisational environment, and activity change resulted in an increase in clients' activity performance, satisfaction with their performance, and quality of life.

Construction of the structural equation model of stigma, self-disclosure, social support, and quality of life of breast cancer patients after surgery-a multicenter study.

Stigma is common in patients with breast cancer after surgery, which has a negative impact on the quality of life (QOL). This study aimed to investigate the QOL of breast cancer patients after surgery and to analyze the multiple chains mediating effects of self-disclosure and social support between stigma and QOL. A total 292 patients of breast cancer patients after operation were recruited in this study. A questionnaire survey was conducted using the general information questionnaire, the consumer experiences of stigma questionnaire (CESQ), the distress disclosure index(DDI), the perceived social support scale(PSSS), and the functional assessment of cancer therapy-breast(FACT-B). Path analysis was conducted to test the hypothesized serial multiple mediation model. The total scores of stigma, self-disclosure, social support and QOL were 15 (10 ~ 22), 39 (31 ~ 46), 58 (50 ~ 67) and 88 (74 ~ 104) respectively. QOL of breast cancer patients after the operation was negatively correlated with stigma (p < 0.01), and positively correlated with self-disclosure and social support (p < 0.01). Self-disclosure and social support played a complete mediating effect between stigma and QOL, and the total mediating effect value was 85. 87%. Self-disclosure and social support play a complete intermediary role between stigma and QOL. In order to improve the quality of life of patients, medical staff should pay attention to the assessment of stigma, encourage patients to express their emotions, and encourage their families and friends to respond to their expression and needs of patients.