WHO BREF Research Articles

The quality of life of primary caretakers of children with cerebral palsy

ABSTRACT Background: Cerebral palsy (CP) is a heterogeneous group of disorder affecting the development of movement and posture, which is permanent nonprogressive. Previous studies in different regions have shown links between caregivers’ mental health and children’s well-being. However, the lack of such detailed research for the caretakers of children with CP and correlation of quality of life affected the type and severity of the condition; this necessitates the development of a new study to assess caregivers’ quality of life. Aim: Quality of life among caregivers of disabled children is an important concern in healthcare. We aim to evaluate the quality of life among caregivers of children with CP and to assess the factors affecting the caregivers’ quality of life, namely, age, gender, type, and gross motor function in children with CP. Methodology: This was a cross-sectional observational study, conducted over a period of 6 months. It included the caregivers of children with CP at a tertiary care hospital of Mumbai. Data were collected using the WHO BREF questionnaire. The children were divided into two groups (2 to 7 years and 7 to 12 years). The qualities of life of the caretakers of these two groups were compared in four domains, namely, physical, psychological, social, and environmental. Results: The study included 50 participants. Mothers (80%) and fathers (10%) were the primary caregivers. Caretakers of the children with cerebral palsy showed significant affected quality of life as calculated from WHO QOL BREF score in both age groups (2–7 and 7–12 years) and in all domains. Overall, the most affected domain in our study was of psychological health and the least affected domain was of the environmental domain. Conclusion: This study provides a snapshot of the impact of having a child with cerebral palsy on the lives of the caregivers Most of the caregivers in the study were mothers, and quality of life was affected in all domains mainly in psychological and physical domains. The study showed that there is a need for interventions in caregivers which can have an indirect impact on the children with CP.

Evaluation of health-related quality of life and adherence among pre-extensively drug-resistant tuberculosis patients receiving either Bedaquiline or Delamanid regimen at a teaching hospital in Eastern India

ABSTRACT Background: The foremost concern and challenge in managing drug-resistant tuberculosis is ensuring a high health-related quality of life (HRQoL). The effectiveness of pre-extensively drug-resistant (Pre-XDR) tuberculosis management hinges on patients adhering to therapy, a crucial factor in averting the development of drug-resistant strains, ultimately enhancing HRQoL. Methodology: This analytical longitudinal study spanned two years at a teaching hospital and involved collaboration between the Departments of Pharmacology and Pulmonary Medicine. A case record form was utilized to gather baseline data, encompassing patient demographics, medication details, WHO BREF HRQoL scores, and treatment adherence. Patients were classified as either adherent or nonadherent using three distinct criteria: the guidelines of the Revised National Tuberculosis Programme (RNTCP), the Morisky-Green-Levine Scale (MGLS), and the Batalla test. The sample size was determined based on 30% nonadherence rates from preliminary analysis of prior data, resulting in 86 patients included in the study. The association between the improvement of HRQoL score from the baseline with the predictor variables was assessed with a linear regression model. Comparison of nonadherence with the different predictors of the study population was assessed with binary logistic regression model. Results: Analysis of demographic data revealed no notable differences in age and BMI between the Bedaquiline and Delamanid groups. However, there was a gender-related difference in treatment distribution, with more men in the Bedaquiline group. Other factors, such as marital status, socioeconomic status, employment status, stigma/discrimination, comorbidity, and addiction, showed no significant differences between the groups. Comparing HRQoL scores at baseline and after six months showed substantial improvements in all domains, indicating a positive impact of the treatment. Linear regression analysis revealed a strong association between QoL improvement and adherence. Adherence patterns did not significantly differ between the two treatment groups, as assessed by various criteria. The patients with high stigma, newly diagnosed Pre-XDR cases, and the presence of adverse events had higher odds of nonadherence. Conclusion: This study highlights the substantial impact of Bedaquiline and Delamanid treatment on the HRQoL of Pre-XDR TB patients in Eastern India. Adherence to treatment plays a crucial role in improving QoL, and factors like stigma, newly diagnosed Pre-XDR patients, and adverse drug reactions influence adherence adversely. The findings emphasize the importance of patient support and education to enhance treatment outcomes.

Assessment of Quality of Life and Social Correlates among Drug Sensitive and Multidrug-resistant Tuberculosis Patients

Abstract Background: Tuberculosis (TB) has significant health, social, psychological, and economic impacts on patients. This study aimed to assess and compare quality of life (QOL) among multidrug-resistant (MDR) TB patients and drug-sensitive TB patients. Materials and Methods: A comparative study was conducted among 40 MDR-TB patients and 80 age- and gender-matched drug-sensitive TB patients in Chitradurga district, South India. Sociodemographic data were collected and QOL was assessed using the WHO BREF scale. Data were analyzed using SPSS v20. Results: The study population was predominantly male (65%) and aged 27–35 years. Education level and socioeconomic status differed significantly between MDR and sensitive TB groups (P < 0.05). MDR-TB patients had significantly lower self-rated QOL and health satisfaction compared to sensitive TB patients (P < 0.001). MDR-TB patients scored lower on all four QOL domains (physical, psychological, social relationships, and environmental), with the psychological domain most affected. The majority of both MDR and sensitive TB patients had “fair” QOL across domains. Conclusion: QOL was impaired in both MDR and sensitive TB patients, but more severely in MDR-TB. The psychological domain was most affected. Factors such as poor accessibility to health services, low socioeconomic status, and poor mental health may contribute to reduce QOL in TB patients.

WHO BREF Quality of Life Score as a Prognostic Indicator of Survival in Patients recovered from COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis.

Coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19, this study was designed to assess the QOL in patients with and its predictability for survival in CAM victims. This long term prospective observational study of 290 patients with CAM was conducted over 2years using a standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]), Karnofsky performance scale (KPS), palliative performance scale (PPS) and patient rated improvement (PRI) ranging from 0 to 9. Cut-off values of ≤ median score was considered to indicate poor QOL or poor improvement. The overall 2year survival rate was 78.27% with mean survival time of 763.2 ± 1.2days (Mean ± S.E) (95% CI: 760.76-765.6). The disease specific mortality was 22.1%. The overall mean QOL was 53.5(10.2) with 51% of population exhibiting poor QOL. Spearman rho correlation showed strong positive correlation between the three QOL scales and PRI (ρ-0.72, p < 0.001). On Cox regression analysis the stage, all four domains of WHO BREF, KPS, and PPS were independent predictors of long term survival in CAM patients. Approximately half of the patients with CAM had poor QOL and poor improvement. All 4 domains of WHO BREF score can be used as a predictor of long term survival in CAM patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM.

Evaluating the Quality of Life of Beneficiaries After Providing Financial Aid by a Multi-specialty Tertiary Care Hospital.

Background Financial aid programs offered by multi-specialty tertiary care hospitals play a crucial role in ensuring equitable access to healthcare. This study investigates the effect of financial aid on the quality of life (QoL) of beneficiaries, aiming to provide a comprehensive understanding of the multifaceted relationship between healthcare support and overall well-being. Aim The study's objectives included assessing changes in pre- and post-aid QoL, identifying influencing factors, understanding beneficiary experiences, and evaluating the effectiveness of financial aid programs. Methods The study adopted quantitative assessments through QoL questionnaires developed based on the WHO BREF questionnaire and insights obtained through interviews. A representative sample of beneficiaries was selected, informed consent was obtained, and an institutional ethical certificate was also obtained. Results The findings overwhelmingly support the alternative hypothesis. The alternative hypothesis was that after receiving financial support, recipients' quality of life would increase. Quantitative analysis revealed a statistically significant enhancement in the QoL of beneficiaries across physical, mental, and social well-being domains. The quality of life scores of patients before and after receiving the support was statistically tested using a paired t-test, and the quality of life score has improved significantly with a p-value of 4.156 × 10-28 (p value<0.001). The comparison of quality of life scores of the control group with the patient's group before getting the support was tested using an independent sample t-test and found to be non-significant (p=0.496), while a similar comparison between the control group and the patient's group after receiving the support was found to be statistically highly significant with a p-value of 8.721 × 10-28 (p-value<0.001). Conclusions This research demonstrates the substantial impact of financial aid on the QoL of beneficiaries in a multi-specialty tertiary care hospital setting. It underlines the importance of addressing economic barriers and providing patient-centered, holistic support. These insights have broader implications for healthcare policy and practice, promoting a more comprehensive approach to patient well-being.

EFFECT OF COGNITIVE REMEDIATION THERAPY PACKAGE ON COGNITIVE FUNCTIONS AND QUALITY OF LIFE AMONG ELDERLY AT SELECTED OLD AGE HOMES

Background: Old age, also called senescence, in human beings, the nal stage of the normal life span. Cognitive function declines with advancing age particularly in elderly people. Mild Cognitive Impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia. ·To assess and compare Objectives: pre &amp; post-test level of cognitive functions and quality of life among elderly before cognitive remediation therapy package, both in experimental and control group.·To evaluate the effectiveness of cognitive remediation therapy package on cognitive functions and quality of life among elderly, both in experimental and control group. To correlate the mean differed score of cognitive functions and quality of life among elderly, both in experimental and control group Methodology: A quasi experimental research design was adopted. After screening a total 20 elderly people, 10 for each experimental and control group were selected were selected by using non probability purposive sampling technique in a selected old age homes. The pre test data was collected through the structured interview schedule, cognitive functions were assessed by Montreal Cognitive Assessment scale and quality of life was assessed by WHO bref scale. Cognitive remediation therapy was given for a period of 6 weeks and post test was conducted. Collected data were analysed by using descriptive and inferential statistics. There Results: was a statistically signicant difference in the post test level of cognitive functions and quality of life after administration of cognitive remediation package. Effectiveness of cognitive remediation therapy package of Cognitive functions score was from 60% to 80%, percentage gain score was 20% and QOL score was from 50% to 66%, percentage gain score was 16%.The comparison mean score was statically signicant in post test cognitive functions and QOL score. (p=0.001). There was a signicant positive fair corelation between cognitive functions and QOL in experimental group, there was a signicant positive poor corelation between cognitive functions and QOL in control group. The overall statisticall Conclusion: y signicant difference in the level cognitive functions and quality of life was revealing the effectiveness of the intervention. Nurse directed cognitive remediation therapy was effective in signicantly enhancing the cognitive functions and quality of life thereby reducing the impact of cognitive impairment among elderly

Impact of disability in the quality of life of patients with traumatic brachial plexus injuries based on a questionnaire survey in a tertiary center in South India.

The aim of the study was to assess the disability and its impact in the health-related quality of life (HRQOL) and its various domains in patients with traumatic brachial plexus injury (TBPI). A descriptive cross-sectional questionnaire survey was conducted on 41 patients with TBPI in a tertiary care center in South India. The assessment of disability and HRQOL was done as per the guidelines of the Gazette of India (2001) and WHO BREF questionnaire, respectively. The association between disability and HRQOL was determined using Chi-square test. All patients were males in the age group 16-60 years (mean age 36.8 ± 14.4 years). Etiology was road traffic accident in 90.2% of cases. About 51.2% had pan-plexus injuries and 53.7% had their dominant limb affected. The mean total disability was 80.39 ± 13.86% and the mean total HRQOL score was 188.46 ± 83.44 out of 400. It was found that disability due to TBPI significantly reduced the HRQOL (Fisher's exact P = 0.005) and the psychological domain was the most significantly affected (P = 0.017, Kruskal-Wallis test). Pan-plexus injuries with an involvement of dominant upper limb had significant impact in the HRQOL. Twenty-one patients (51.2%) complained of neuropathic pain and they had a significantly reduced quality of life (QOL) (mean QOL = 23.3, P < 0.001). It was also found that productive age group (26-55 years) had a significantly reduced QOL as compared to the extreme age groups (P = 0.000). Unemployed patients had a significantly reduced QOL as compared to those with permanent/temporary job (P = 0.024). Marital status was found to have no significant relationship with the total HRQOL (P = 0.647). Those belonging to the poor socioeconomic strata (below poverty line) had poor HRQOL as compared to those above poverty line and the relationship was found to be significant (P = 0.000). TBPIs significantly affected all domains of QOL, especially in unemployed patients in the productive age group in the poor socioeconomic strata. The pan-brachial plexus involvement of dominant upper limb and associated neuropathic pain were the most important factors which negatively affected the QOL. Among the codomains of the QOL, psychological domain was the most significantly affected irrespective of the severity of the injury.

An analysis of social dimensions of podoconiosis and leprosy on affected households in endemic health districts of the North West Region of Cameroon

BackgroundPodoconiosis and leprosy are Neglected Tropical Diseases associated with low quality of life, social stigma and isolation of affected people and families. Despite the substantial social burden it imposes, podoconiosis has largely been ignored in the global health literature until recently unlike leprosy. This study assessed and compared the quality of life and social impact of podoconiosis with that of leprosy among affected households and neighborhoods in North West Cameroon. MethodsA comparative cross-sectional design was used. Eighty-six households: 43 podoconiosis and 43 leprosy, plus household neighbours were enrolled from July and August 2015 from three health districts. Podoconiosis patients living in households within Batibo and Ndop health districts were sequentially sampled using a list of confirmed podoconioisis cases from previous studies. Leprosy patients living within communities in Mejang Health Area were sequentially sampled using the Mbingo treatment center register. WHO BREF tool was used to assess quality of life. Franklin Stigma Scale was adapted to assess felt and enacted stigma. Mann-Whitney U test was used to compare differences in stigma and QoL. ResultsPhysical domain showed a significant difference in the distribution in quality of life between groups (p < 0.05, median:70; U:635, r = 0.2). Overall enacted stigma revealed significant differences with p < 0.05 and r = 0.4. Overall stigma from family members (median:17, U:627 and r = 0.3) and neighbours (median:67, U:336 and r = 0.5) showed significant differences with p < 0.05 in the distribution of scores for both diseases. Sex and age showed significant associations with QoL and stigma. ConclusionThis study reveals the quality of life and stigma associated with podoconiosis on affected households to be comparable to that experienced by households with a leprosy patient. There is need for intensified preventive, management and control schemes to fight podoconiosis in Cameroon, just like leprosy.

Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, rom and qol in the management of non-specific neck pain: a randomized controlled trial

BackgroundNon-specific neck pain is the most prevailing musculoskeletal disorder which has a large socioeconomic burden worldwide. It is associated with poor posture and neck strain which may lead to pain and restricted mobility. Physical therapists treat such patients through several means. Post isometric relaxation and Myofascial release therapy are used in clinical practice with little evidence to be firmed appropriately. So, this study was conducted to explore the effect of Post-isometric relaxation in comparison to Myofascial release therapy for patients having non-specific neck pain.MethodologySixty patients were randomly allocated to Post isometric group and the Myofascial group. The treatment period was of 2 weeks. All the patients were evaluated using the Visual analogue scale (VAS), Neck disability index (NDI), Universal Goniometer, and WHO BREF Quality of life-100 in the 1st and 6th sessions. Recorded data was entered on SPSS 21. Data were examined using two-way repeated ANOVA to measure the variance of analysis (group x time).ResultsAnalysis of the baseline characteristics revealed that both groups were homogenous in terms of age and gender i.e. a total of 60 participants were included in this research study 30 in each group. Out of 60 patients, there were 20(33.3%) males and 40(66.7%) females with a mean age of 32.4(5.0) years. Participants in the Post Isometric group demonstrated significant improvements (p < 0.025) in VAS, NDI, Cervical Extension, left side rotation ranges, and QoL (Social Domain) at the 2-week follow-up compared with those in the Myofascial group. In addition, the Myofascial group indicated significantly better improvement in the mean score of CROM (flexion and right and left side bending).ConclusionThe study demonstrated patients with nonspecific neck pain can benefit from the post isometric relaxation with significant improvement in pain, disability, cervical ROM, and Quality of life compared with myofascial release therapy.Trial registrationClinical Trial registered on clinicaltrial.gov (NCT number) NCT04638062, 20/11/2020 (prospectively registered).

MP46-01 COLLABORATIVE RESILIENCE PROGRAM TO ENHANCE QUALITY OF LIFE FOR POST-PENECTOMY PATIENTS: DYADIC COPING PERSPECTIVE

You have accessJournal of UrologyCME1 May 2022MP46-01 COLLABORATIVE RESILIENCE PROGRAM TO ENHANCE QUALITY OF LIFE FOR POST-PENECTOMY PATIENTS: DYADIC COPING PERSPECTIVE George Soko, Mwila Mulubwa, and Tepwanji Mpetemoya George SokoGeorge Soko More articles by this author , Mwila MulubwaMwila Mulubwa More articles by this author , and Tepwanji MpetemoyaTepwanji Mpetemoya More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002612.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The psychosocial impact of Penile cancer treatment generates ripple effect from the patient to his spouse triggering stress, compassion fatigue, and hampering the family’s normal functioning. Fundamental interventions focusing on both the spouse and patients, to improve self-worth and adaptation are generally lacking. Healthcare focus on the patients without regard to the spouses who are generally prone to Vicarious traumatization. The purpose of this study was to assess the impact of a community based resiliency program on the dyadic family care giving congruence and quality of life of post penectomy patients and their spouses. METHODS: 50 dyads participated in a resiliency program in Lusaka, Zambia between February 2021 and August 2021, that involved 4- weekly sessions focused on emotional regulation, self awareness, distress reduction and building resiliency. A Pre- and post-test design using repeated measures was conducted over six months. Each dyad completed a patient and care giver version of the psychometrically validated two-factor Dyadic Relationship Scale (DRS) respectively, to assess negative dyadic strain and positive dyadic interactions. The WHO QoL BREF questionnaire was used to assess the four key domains of physical health, psychological, social relationship and environment, for each member of the dyads. Statistical analyses were performed using IBM SPSS version 23. RESULTS: Mean age: Spouses and patients; 34.5±7.5 and 41.2±7 years, respectively. DRS score on Positive Interaction; Spouses pre- and post intervention 12.7±1.5 and 23.7±0.62, respectively. Patients pre- and post intervention were 13.3±1.26 and 23.9±0.24, respectively. DRS score on Dyadic Strain; Spouses pre- and post intervention was 19.4±0.76 and 6.3±1.15, respectively. Mean score pre-intervention was significantly higher than at post intervention (p<0.001). Patients pre- and post intervention was 15.4±0.75 and 5±0.91, respectively. Mean score pre-intervention was significantly higher than at post intervention (p<0.001). There was significant increase in the QoL scores based on the four domains of the WHO BREF questionnaire, from pre- to post intervention for both spouses and patients (p<0.001). CONCLUSIONS: Psychosocial support for family care dyads as they adapt to post penectomy status can alleviate negative effects on physical and mental health outcomes. Communication improved significantly after the resilient program implying that better reciprocal interactions between spouses can improve coping strategies and quality of life. Source of Funding: 0 © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e772 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information George Soko More articles by this author Mwila Mulubwa More articles by this author Tepwanji Mpetemoya More articles by this author Expand All Advertisement PDF DownloadLoading ...

Understanding Health Related Quality of Life in Hypertensive Patients: Interrogating Effect of Psychological and Environmental Factors

<p style="text-align: justify;"><strong>Background:</strong> Health-related quality of life has become an important aspect in the field of healthcare as an important outcome measure for chronic diseases like hypertension. Improvement in HRQoL have become a focal point in health research, with clinicians, scientists and policy makers realizing the value of individual&rsquo;s self-rated experience, beyond or in addition to objective and clinical measure of health.<strong> Aim:</strong> To study the effect of psychological and environmental factors on HRQoL in patients suffering from hypertension using WHOQOL-BREF questionnaire. <strong>Methods and Materials: </strong>The study was carried out for six weeks in medicine outpatient and inpatient department of a tertiary care hospital. All patients diagnosed with essential hypertension were recruited and socio-demographic and clinical data were noted. Patients were interviewed using WHOQOL-BREF using questionnaire. <strong>Results: </strong>Of total 100 patients, female was more prevalent to hypertension compared to male. Mean score of environmental domain was greater than the psychological domain [72.375 (SD &plusmn;19.23) and 68.91667 (SD &plusmn; 19.59), respectively] suggesting the inverse correlation of quality of life with negative thoughts, blue mood, anxiety and depression. Regarding individual questions, most of the participants felt safe in their daily life, were satisfied with their physical environment and condition of living place with a mean score of 4.58 (SD&plusmn;0.55), 4.03 (SD&plusmn;0.69) and 4.24 (SD&plusmn;0.66), respectively. In contrary, majority of study participants often had negative feelings such as blue mood, anxiety, despair and depression [2.86 (SD&plusmn;0.96)], were dissatisfied with their transport [3.5 (SD&plusmn;0.85)] and lacked opportunity for leisure activities [3.57 (SD&plusmn;0.85)] thus indicating poor quality of life as mean values were low. <strong>Conclusion:</strong> Female gender, older age, negative feelings, co-morbid condition and level of education may be important predictors of QOL in hypertensive patients. <p style="text-align: justify;"><strong>Key words:</strong> Hypertension, Quality of life, WHO BREF QOL, Psychological factors, Environmental factors.

Effectiveness of Interventional Package on Diabetes Distress and Quality of Life among Diabetic Patients

Background of the Study: Diabetes Distress and poor quality of life are commonly seen problems among Diabetic Patients, which usually impede in proper management of diabetes and also can create serious mental issues if not treated properly. Aims: the aim of the study was to assess effectiveness of interventional package on diabetes distress and quality of life among diabetic patients Methodology: This was pre experimental study with one group protest post-test design. The population involved in this study was diabetes patients visiting diabetic club of HSK Hospital and research centre, Bagalkot and 50 subjects were selected using simple random sampling technique for the study. Data was collected using Diabetes Distress Scale and WHO Bref’s Quality of Life scale. Intervention package [Psycho Education &amp; JPMR] was administered for 1 hour for 14 days (4 sessions biweekly). Data were analyzed by using descriptive and inferential statistics in terms of frequency distribution, percentage, mean, mean percentage, Standard Deviation, paired‘t’ test and Chi-square test. Results: Findings related to Comparison of pre-test and post-test Diabetes Distress and Quality of Life scores of Diabetic Patients shows that, Mean post-test Diabetes Distress score is significantly lesser than mean protest Diabetes Distress score [t=12.373, p&lt; 0.001] and Mean post-test Quality of Life score is significantly greater than mean pre-test Quality of Life score.[ t=9.802, p&lt; 0.001]Significant association found between clinical variable, “Status of diabetes” with both Diabetes Distress scores and Quality of Life scores of Diabetic Patients and there was no association found for other socio demographic and clinical variables. Conclusion: The study proved that Interventional package [Psycho education &amp; JPMR] on Diabetes Distress scores and Quality of Life among Diabetic Patients was effective, scientific, logical and cost-effective strategy in managing the Diabetes Distress and in enhancing Quality of Life scores of Diabetic Patients. Keywords: Diabetic Patients, Diabetes Distress, Quality of Life, JPMR Effectiveness, Interventional Package, clinical variables and Socio-demographic variables.

Effectiveness of selected nursing interventions on Fatigue and Quality of life among Chronic Renal Failure patients undergoing Hemodialysis in a selected hospital at Madurai

Title: Effectiveness of selected nursing interventions on fatigue and quality of life among Chronic Renal Failure Patients undergoing Hemodialysis in a selected hospital at Madurai. Background: Non communicable diseases are increasing day by day. Health is wealth is an old saying, which is realised by people who has CKD today. As their wealth is reduced by treating the disease throughout their life time, the restrictions in food and fluid impose lot of stress, affects their Quality of life. Nearly 10% of the populations were affected by CKD and millions of them die each year because they could not afford the treatment. Hemodialysis has been proved to be the effective treatment modality. It results in a marked change in the QOL, due to number of modifications and restrictions, which affect patient’s psychological and physiological wellbeing. Dialytic nurses can play a crucial role in enhancing quality of life and reducing fatigue level through exercises and teaching. Aim: The aim of the study was to evaluate the effectiveness of selected nursing interventions on fatigue and quality of life (QOL) among chronic renal failure patients undergoing hemodialysis in a selected hospital at, Madurai. Methodology: Quasi experimental non-equivalent pretest and post-test control group design was used for the study. The study was conducted in patients undergoing hemodialysis in selected hospital at Madurai. A total of 100 patients were selected using convenient sampling technique. Tools used were Piper Fatigue Scale (PFS) and SF 36 World Health Organisation BREF QOL (SF36 WHO BREF QOL) interview scale. The therapeutic nursing intervention which includes planned teaching about care of patient with haemodialysis, demonstration of dialytic exercises, dietary management, adherence to medication, follow up, teaching on sexual relationship were administered over 4 days in a week for 4 consecutive weeks. Data was analysed using descriptive and inferential statistics. Results: The therapeutic nursing interventions were effective in improving quality of life and reducing fatigue level. Pre-test with 15th day post-test fatigue scores comparison [t =23.05, P(&lt; 0.001)] , Comparison of pre-test with 30th day post-test fatigue scores [t =41.19, P(&lt; 0.001)], Comparison between 15th and 30th day post-test fatigue scores [t= 25.58, P(&lt;0.001)], Comparison of pre-test with 15th day post-test level of quality of life score [t =16.32, P(&lt;0.001)], Comparison of pre-test with 30th day post-test level of quality of life score [t=23.76; P(&lt;0.001)], Comparison between 15th and 30th day post-test quality of life score [t = -15.19, P(&lt;0.001)]. The problems reported by the people were, physiological problems such as anaemia, muscle cramping, difficulty sleeping, itching, fatigue, neurological disturbances, cognitive impairment, Sexual dysfunction and psychological problems such as depression, feeling of loneliness, sadness, problems with adjustment, lack of love and affection, suicidal behaviour, delirium, anxiety and panic symptoms. The post tests in experimental group, the correlation between fatigue and quality of life in post-test-1 (15th day) was r = - 0.372 and it was significant at p = 0.008. Similarly, the correlation between fatigue and quality of life in post-test - 2 (30th day) was r = -0.370 and it was significant at p=0.008. Conclusion: The problems of the people vary from person to person, study findings concluded that, selected nursing interventions are effective intervention to improved Quality of life and reduced fatigue level. There is a real need for nurses to provide physical, mental and social support to treat the health problems and to heighten their spirit.

Assessment of Quality of Life and Activities of Daily Living among the Elderly Population of Rural Andhra Pradesh

Background: Elderly were facing heavy burden of sequel of long-term physical illness, as a result the ultimate effect was on quality of life.There is a need to highlight their medical and psychosocial problems and bring up strategies for improvement in their quality of life.Methods: A community based cross sectional study was conducted among 100 elderly people, aged 60 and above, residing in a retirement home, present in the field practice area of RHTC, Anandhapuram, Visakhapatnam district, Andhra Pradesh, from October 2019 to December 2019.Data was collected by using thestandard WHO BREF questionnairefor quality of life assessment and Katz index of ADL score for activity of daily living assessment.Majority of study population were females (53%) and majority was in the age group of 60-69 years (65%). Social support and relationship domain and environmental domain found with high mean quality of life scores (55.87+ 13.12 and 54.24 +10.12 respectively). 89% of the study population was found with full functional activity and only 1% with severe impairment.Conclusion: Economical independence, social security and support by the family, regular health checkups and health seeking behaviour, legal security and special schemes for elderly will improve their quality of life and helps them to live longer and happier.

Caregiver Burden and Quality of Life among Family Caregivers of Cancer Patients on Chemotherapy: A Prospective Observational Study.

Aim:Informal caregivers of cancer patients have extensive burdens. They are susceptible for deterioration of their quality of life (QOL). We aimed to assess caregiver burden and QOL of family caregivers of cancer patients receiving chemotherapy admitted in the ward/intensive care unit/high-dependency unit.Materials and Methods:This prospective observational study including 178 caregivers was carried out in a tertiary care hospital. The assessment of caregiving burden was done using the Zarit Burden Interview and its impact on QOL using the WHO BREF QOL questionnaire.Results:The mean age and mean Zarit Burden score of caregivers were 38.98 ± 10.53 and 30.697 ± 8.96, respectively. Of the total, 70.22% of caregivers reported mild-to-moderate burden and 21.38% reported moderate-to-severe burden. On assessment of QOL WHO BREF, the mean general score was 5.79 ± 1.84, physical health score was 49.65 ± 16.07, psychological health 51.85 ± 20.43, social relations 59.38 ± 21.43, and environmental 58.73 ± 17.51. The QOL scores were slightly better in mild-to-moderate burden compared to moderate-to-severe burden but not statistically significant except for social relations (P = 0.053). We did not find any difference in burden scores or QOL between male and female caregivers.Conclusion:Mild-to-moderate burden was seen in 70.22% of caregivers and 21.38% had moderate-to-severe burden.

A CLINICAL STUDY ON EFFECTIVENESS OF ASHWAGANDHA (WITANIA SOMNIFERA) ON QUALITY OF LIFE (WHOQOL-BREF) IN APPARENTLY HEALTHY SUBJCETS

WHOQOL- BREF is assessment of a multidimensional concept incorporating an individual’s perception of health status embedded with physical, psychological, social, and environmental domains. Various types of health issues are common around the globe due to improper sleep pattern and lifestyle. Ashwagandha (Withania Somnifera) is the intervention of many clinical conditions like, arresting the aging process, pro-cure the body in debilitating condition by creating a sense of mental wellbeing and increase physical fit-ness. Ashwagandha possesses Vatakaphahara, Jara Vyadhi Nashaka, Balya and Dhatu Vriddhikara prop-erties. Because of these properties, it acts not only preventive but also promotive and curative effects as well as slowdown Jara by breaking the pathogenesis. The present study was opted to analyse the health status (quality of life WHO-QOL BREF)in apparently healthy voluntary subjects. Objective: To evaluate the effectiveness of Ashwagandha (Withania Somnifera) on quality of life (WHOQOL-BREF) in apparent-ly healthy subjects. Methods: The study includes randomized, single blind controlled comparative study with pre-test and post-test design. 408 apparently healthy subjects were screened for the features of health. 108 apparently Healthy subjects were selected by considering the inclusion criteria, and categorised into two group, (Group 1- control Group and Group 2- study Group) 54 subjects in each group. Subjects in the study group consumed 12 gm of Ashwagandha Choorna (powder) once daily with milk 200ml and the control group consumed milk 200 ml daily once. WHO-QOL BREF Questionnaire was utilised for analys-ing the health status of the individuals before intervention, after intervention and follow up. Results: In the control group (n=54), the mean score overall quality of life was found to be 65.75 before intervention, af-ter complete intervention quality of life was found to be 67.55 and at the time of follow up quality of life was found 67.55. In the study group (n=54), the mean score overall quality of life was found to be 64.38 before intervention of study, after complete intervention quality of life was found to be 71.58 and at the time of follow up quality of life was found 71.61. Conclusion: In this study, subjects were improved to the higher scores among the physical, psychological domains as comparison with the environmental and social domains. Found improvement in the quality of life (WHO BREF) in study group as compared to control group.

Quality of Life and Self-care Behavior Among People Living with Diabetes- A Study from Coastal South India.

Diabetes mellitus is a serious chronic condition affecting millions of people globally. The focus of our future health care providers should not lie primarily on increasing the "quantity" of life but also on improving the Quality of Life of the patient. There is a serious lack of awareness and adherence regarding self-care for Diabetes in countries like India. To determine the Quality of Life and self-care behavior among people living with Diabetes. A cross-sectional study was carried out among 190 of all patients diagnosed with Diabetes mellitus type II of the duration of one year and more who came to Government Wenlock Hospital, Mangalore. The Quality of Life was assessed using the WHO BREF questionnaire. Data was entered and analyzed using the Statistical Package for Social Sciences. Amongst 190 participants, 151 (79.5%) of them had a good physical and psychological QOL. In a social relationship and environmental health domain, good quality of life was observed among 81.6% (n=155) and 89.5% (n=170) of study participants, respectively. It was noted that out of 190 people with Diabetes, only 24 (12.6%) participants inspected their feet daily. The Quality of Life was found to be good amongst the majority of the study participants. Results of the study point that the majority of the patients enjoy a good quality of life but also reinstate the importance of self-care activities for the betterment of health.

Quality of Life Assessment of Hypertensive Patients in a Tertiary Care Teaching Hospital in Jaipur

Background: Hypertension is the well-known risk factor for mortality and morbidity. About 7.1 million population worldwide dies each year due to cause of hypertension. It directly effects persons quality of life. Methods: Total number of 128 Hypertension diagnosed Patient’s data were collected under this study who were admitted to the General Medicine wards of tertiary care teaching hospital. WHO BREF questionnaires were given and filled forms by patients were collected. Result: In physical health 42 Patients are with excellent health, 81 Patients are fall under the moderate health and 5 Patients are with poor physical health status. In psychological assessment 36 Patients are with excellent health 83 Patients are fall under the moderate health and 9 Patients are with poor physical health status. In Social relation, 15 Patients are with excellent health, 98 Patients are fall under the moderate health, and 15 Patients are with poor physical health status. In environmental assessment, 57 Patients are with excellent health, 41 Patients are fall under the moderate health and 31 Patients are with poor physical health status. Conclusion: This study has shown overall moderate QOL with mean 3.25 and SD 0.63 among hypertensive patients according all four domains. Physical activities and marital status were important independent factors affecting both domains in QOL. Older age was associated with lower QOL in physical health. Presence of co-morbidity in hypertension patients are an important health issue influencing their satisfaction in physical health. Interventions targeted towards improving QOL of disadvantage patients are needed in the setting.&#x0D; Keywords- Mental Health Assessment, WHO BREF, Quality of Life, Hypertension.

Effectiveness of Reaction Time Training Physical Exercises on Rt &amp; Quality of Life of Epileptics- A Case Series

Quality of Life of Epileptics- A Case SeriesVaijanti JainJr O.T (KEMH) BothAbstractAim: To study Effectiveness of Reaction time training &amp; physical exercises on RT &amp; quality of life ofEpileptics- a case series.Objectives: Finding the effect of RT training &amp; physical exercises on Reaction time (RT) &amp; quality of life(QOL) in Complex partial seizures (CPS)Methodology: 4 subjects (OPD patients,OT dept KEMH) age 20-40 yrs, of Refractory CPS with or withoutsecondary generalization with atleast three years of period of onset were included in a 4 week study. TheOutcome was measured on RT machine, WHO BREF QOL questionnaire, Mini Mental status examination(MMSE) &amp; neurological evaluation. Pre &amp; post intervention changes were assessed with RT machine &amp;WHO BREF QOL questionnaire. The Occupational therapy intervention consisted of 30-45 mins of trainingon 1) RT simulated machine &amp; activities &amp; 2)physical activities twice a week with home programme.Results: The (paired) t value of post intervention RT is 4.0691 (significant at p=0.05). The (paired) t values ofdifferences in individual domain scores for physical domain =23.0638 (significant at p=0.001),psychological=5.6949 (significant at p=0.02) &amp; social =3.4762 ((significant at p=0.05). The study suggests a definiteavenue for OT intervention in patients with epilepsy.Conclusion: RT &amp; QOL can be improved using RT training &amp; Physical exercises. However a study has tobe done on larger sample size with a longer follow up to confirm the efficacy of the study

Literature Review on Development and Validation of Quality of Life Tool among Chemotherapy Patients

Introduction: Cancer is the second commonest explanation for death subsequent to heart diseases and it represented 8.8 million deaths worldwide during 2015. Quality of Life (QOL) is all about personal satisfaction, degree or the standard to which an individual, gathering of individuals or community people can appreciates the significant inclination and experience of life like physically, mentally, socially, etc. Aim: To identify the existing tools or instrument for QOL among chemotherapy patients. Materials and Methods: A systematic review of literature for QOL tool among chemotherapy patients was conducted. Electronic databases were looked: Pubmed, proquest, PsycINFC Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL). Results: Researcher found 673 research papers from electronic data base: from that 353 articles were excluded bases on exclusion criteria. So total retrieved articles were 320 among all 51 duplicate articles, 88 No full text available, 58 not relevant and 47 abstracts were excluded. Final retrieved articles were 76; among them 38 full articles were excluded based on inclusion criteria. Finally, according to 38 studies, out of 14 investigations utilised European Organisation for the Research and Treatment of Cancer (EORTC QOL-C 30) survey, four studies used the Health Related Quality Of Life (HRQOL) tool, four studies used World Health Organisation Quality of Life-BREF (WHOQOL-BREF) is a self-report questionnaire which assesses 4 domains of quality of life (QOL): physical health, psychological health, social relationships, and environment, Twelve studies used self administered questionnaire, four studies used other method like face to face validity, Functional Assessment of Cancer Therapy (FACT) etc. The most-normally utilised instrument was a QOL tool for use in universal clinical preliminaries in oncology having a place with EORTC QOL C-30 survey, HRQOL tool and WHO BREF tool. Conclusion: In this review study variety of instruments has been used by the researcher that explores the QOL of chemotherapy patients. The significance of psychometric properties of the instruments and its effect on discoveries rising up out of various examinations, it appears to be fundamental that more thought be paid to the validity and reliability of tool before conducting the research studies. Literature suggested that the analysts contribute enough consideration regarding the choice of standard instruments and organise the instruments' validity and reliability of their outlook explores. Finding of study suggested that tools along with ideal psychometrics properties which were good with the socio-cultural setting of particular country.