World Health Organization QOL-BREF Research Articles

The phenotype of recovery XII: A reinforcer pathology perspective on associations between delay discounting and pain catastrophizing in substance use disorder recovery

BackgroundSubstance use disorder (SUD) and pain are highly comorbid conditions and several pain indices (e.g., pain intensity) are associated with an increased risk of relapse. However, the cognitive-emotional experience of pain (i.e., pain catastrophizing) is understudied in SUD recovery. Further, how the association between pain catastrophizing and delay discounting - a posited biomarker of addiction, impacts multidimensional aspects of SUD recovery, including remission and quality of life (QOL), has yet to be examined. MethodsIndividuals (n = 170) in SUD recovery reporting pain were asked about their chronic pain status, completed the Brief Pain Inventory, the Pain Catastrophizing Scale, an Adjusting Amount Delay Discounting Task, and the World Health Organization QOL-BREF scale. Univariate logistic and linear regressions examined associations between delay discounting and several pain indices with remission and QOL. Mediation analyses were investigated whether pain catastrophizing mediates the relationship between delay discounting and 1) sustained remission and 2) QOL. ResultsSignificant negative associations were found between delay discounting (p < .001) and pain catastrophizing (p = .001) with sustained remission. Pain catastrophizing significantly mediated the relationship between delay discounting and physical QOL (p = .044), psychological QOL (p = .009), social (p = .018), and environmental QOL (p = .014). Pain catastrophizing did not mediate the relationship between DD and sustained remission. ConclusionIndividuals with greater DD exhibited greater pain catastrophizing, contributing to poorer QOL in SUD recovery. Our findings support that a Reinforcer Pathology framework is useful to understanding the cognitive-emotional experience of pain within the context of SUD recovery. Interventions that target both delay discounting and maladaptive cognitive and emotional responses to pain may lessen the negative impact of pain on SUD recovery and improve SUD outcomes.

Anxiety, Depression, and Quality of Life in the Postnatal Period: A Cross-sectional Analysis in a Tertiary Care Setting in Khammam, Telangana, South India

Abstract Introduction: The postpartum period is a crucial phase marked by significant physical and emotional changes for women. Mental health issues, especially anxiety and depression, can profoundly affect maternal well-being and maternal–infant interactions. Despite growing recognition, comprehensive research on perinatal mental health in India is lacking. Materials and Methods: A cross-sectional study surveyed 236 postnatal women in a tertiary care center in Khammam, Telangana. Participants completed standardized questionnaires for depression (Edinburgh Postnatal Depression Scale), anxiety (Perinatal Anxiety Screening Scale), and quality of life (QOL, World Health Organization QOL-BREF). Data analysis utilized descriptive statistics and inferential tests to examine associations between variables. Results: The study revealed a significant prevalence of depression (25.42%) and anxiety (24.57%) among postnatal women, with 11% experiencing both. Demographic analysis highlighted age, residency, and education as significant factors associated with mental health outcomes. Participants without depression or anxiety generally reported a higher QOL across various domains compared to those with mental health disorders. Significant differences were observed in physical, psychological, and social relationship domains between participants with and without depression and anxiety. Conclusion: This study provides valuable insights into anxiety and depression prevalence among postnatal women and their impact on QOL. Addressing postnatal mental health is crucial for fostering positive maternal–infant relationships. Future interventions should prioritize comprehensive, culturally sensitive approaches to mental health care for postnatal women in India.

The Burden of Caregiving and Quality of Life of Family Caregivers of Bipolar Patients: A Cross-sectional Study

Abstract Background: Caring for patients with severe mental illness could be stressful. Information regarding the burden and quality of life (QOL) of the family caregivers of patients with bipolar affective disorder (BD) is scant from India. It was intended to study the burden and QOL of the caregivers of patients with BD and their association with sociodemographic factors. Materials and Methods: It was a cross-sectional study in a tertiary-level psychiatric hospital. Caregivers (n = 60) of patients with BD were assessed using the Family Burden Interview Schedule and World Health Organization QOL-BREF, along with their sociodemographic data. Results: Caregivers reported considerable burden in various areas, and a large proportion (71.7%) had higher burden and this group had significantly lower QOL in all domains. Burden and QOL had variations among demographic groups. There was no difference in the burden reported by male and female caregivers, however, the former appeared to have better QOL. Caregivers with the lowest income had considerable burden and poor QOL, besides the caregivers with lower education and from nuclear families. Conclusions: Family caregivers of patients with BD experienced considerable burden and had poorer QOL. Caregivers with lower education, the lowest income, and nuclear families had greater challenges. Assessment of caregivers’ needs and provision of appropriate support require prioritization.

Psychiatric comorbidities, quality of life, and cardiovascular risk factors in patients with heart failure

Background: Heart failure (HF) leads to various changes including physiological (neurohormonal) changes and an increase in stress level, which can become a risk factor for the development of various psychiatric disorders, further worsening quality of life (QOL). Methods: Patients of HF between 18 and 60 years of age attending the outpatient department of the Department of Cardiology were enrolled. Patients were screened for psychiatric illness by applying Mini International Neuropsychiatric Interview 7.0.2. The diagnosis was made through the Diagnostic and Statistical Manual of Mental Disorders-5. The severity of anxiety and depression was assessed by applying the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. Sleep quality was measured by applying the Pittsburgh Sleep Quality Index. Subsyndromal symptoms were assessed via SADS-CB. QOL was measured by the World Health Organization QOL-BREF. Data were statistically analyzed. Results: Out of 70 enrolled patients, 32 patients did not have any psychiatric illness (Group A), 20 patients were in the subsyndromal group (Group B), and 18 patients had psychiatric disorders (Group C). Tobacco use and the number of risk factors of HF present were significantly higher in Group C. A significantly higher number of patients in Group C were lying in the New York Heart Association (NYHA) II class (patients lying in NYHA III and NYHA IV classes were excluded) than in other groups. In addition, sleep and QOL (especially among patients under NYHA I class) were significantly impaired in Group C. Conclusion: Psychiatric illness is common in patients with HF. Despite guidelines to screen for them, clinicians either do not screen for them or otherwise miss the psychiatric illness. These psychiatric illnesses may further impair the outcome of heart diseases and worsen QOL.

The reluctance to the vaccine, mental health, fear of covid-19 and quality of life among Palestinians: an exploratory comparative study in different geographical areas

PurposeThis study aims to explore the effect of mental health in terms of depression, anxiety, stress, fear of COVID-19 and quality of life (QoL) on the reluctance to be vaccinated in a population of Palestinian adults living in occupied Palestinian territories and Israel.Design/methodology/approachThe authors recruited 1,122 Palestinian adults who consented to participate in the study; 722 were females, and the mean age of the sample was 40.83 (SD 8.8). Depression, anxiety, and stress scale (DASS), World Health Organization QoL-BREF, FCov-19 and reluctance to the vaccine scale were administered; hierarchical regression analysis was applied to test vaccine reluctance as a dependent variable, and mental health, fear of COVID-19 and QoL as independent variables. This study hypothesized influence of such variables on the vaccine choice with differences due to the participants’ geographical locations.FindingsFindings showed an effect of mental health, particularly depression, QoL and fear of COVID on vaccine reluctance, with depression and fear of COVID in the West Bank and Gaza, while in Israel, QoL played a role in vaccination choices.Research limitations/implicationsThe future needs to be comprehended more thoroughly to discover mutations and fluctuations over time in vaccine hesitancy and the increasing role of psychological distress, diminished QoL and fear of Covid-19. Online recruitment might not have allowed the study to include the most disadvantaged strips of the Palestinian population.Practical implicationsHuman rights perspectives must be considered in public health and public mental health policies to ensure the QoL and well-being for the Palestinian population during and following the pandemic.Social implicationsThe crumbling of the Palestinian health-care system exacerbated the sense of dread among the population and made them less likely to vaccinate. The pandemic-like spread of Covid-19 prompts a plea for the global community to actively advocate for the urgent re-establishment of equity, autonomy and durability of the medical infrastructure in the occupied territories and equal entitlements for the Palestinians in Israel.Originality/valueThe results demonstrated the importance for public mental health to consider the multiple levels implied in the vaccine refusal in Palestine and Israel among the Palestinian population.

Quality of life and its determinants in people living with Human Immunodeficiency Virus infection in Kannur District, Kerala

Introduction: The prevalence of Human Immunodeficiency Virus (HIV) infection in India is on decline. Since the introduction of Anti Retroviral Therapy, the survival of HIV positives has improved a lot. HIV/acquired immunodeficiency syndrome (AIDS) is now a chronic yet manageable disease. However, social factors like stigma and discrimination still exist, affecting the quality of life (QoL) of people living with HIV (PLHIV)/AIDS. The objectives of the study were to assess the QOL among HIV-positive patients using the World Health Organization-QOL BREF (WHO-QOL BREF) questionnaire, the factors determining the QoL of HIV-positive patients, and the stigma and discrimination faced by HIV positives in the medical field. Methods: A cross-sectional study was done during the study period of 1 year. A total of 150 PLHIV from Kannur district in Kerala participated in the study. The WHO-QOL BREF, Scale and the HIV stigma scale were used to collect the data. Results: The QoL score found in the study was 15.36 ± 2.18, 2.18. The overall QoL was influenced by education, the Stigma Scale score, having a constant income or an increased income after diagnosis, and a Perceived Social Support Scale score. The study also found that 22% (33) of the participants faced stigma and discrimination from the medical field in one form or another. Conclusion: The study found that the QOL of PLHIV in the Kannur district of Kerala revealed no difference between men and women. The determinant factors for QOL were found to vary in each domain. Education was found to have a negative impact on QOL.

Addictive Behaviors, Depression, and Quality of Life among Korean Fishermen.

This study investigated addictive behaviors (alcohol dependence and gambling tendencies), depression, and quality of life (QoL) among Korean fishermen in the Jeju Island region, Korea. The study utilized the Alcohol Use Disorder Identification Test-Korean version, the Korean version of the Canadian Problem Gambling Index, the Center for Epidemiological Studies Depression Scale, and the Korean version of the World Health Organization QOL-BREF to measure the study variables. The results showed that 18.1% of the fishermen had alcohol dependence and 9.9% abused alcohol, 13.6% were categorized as problem gamblers, 15.2% were moderate risk gamblers, and 14.4% were low-risk gamblers; 25.1% and 20.8% suffered from severe and mild depression, respectively. The mean QoL score was 3.13 ± 0.56, and the psychological health section scored the highest. The degree of alcohol dependence varied by age, education level, and job satisfaction; gambling tendency varied by age, job position, and job satisfaction; depression varied by religion and job satisfaction; QoL varied by religion and job satisfaction. Alcohol dependence, gambling tendency, and depression were significantly negatively correlated with QoL. Specifically, higher levels of alcohol dependence were associated with lower QoL scores in the subcategories of physical health and psychological health, while higher levels of gambling tendencies were associated with lower QoL scores in the subcategories of physical health, psychological health, social relationships, and general subcategories. Finally, higher levels of depression were associated with lower QoL scores across all five subcategories. Overall, participants exhibited remarkably elevated levels of alcohol dependence, gambling tendencies, and depression, and lower QoL compared with the general population. Further efforts are required to increase Korean fishermen's job satisfaction to improve these problems. In addition, public health policies must address and promote fishermen's QoL.

Health-related quality of life and stigma in opioid dependence: Comparison between buprenorphine users and non-users.

Opioid dependence leads to reduced quality of life (QOL) and stigma. There is scarcity of literature on impact of buprenorphine on QOL of patients with opioid dependence from India. This study reports QOL and stigma in patients taking buprenorphine and compare it with those who were not on any treatment. A cross-sectional, descriptive, comparative study was conducted among three groups (n = 100 each). Group 3 comprised patients who were already taking buprenorphine for at least 3 months from a government outpatient opioid-assisted treatment center. Group 2 comprised patients who were not on any treatment but had come to enrol in buprenorphine treatment and Group 1 comprised patients who had come to get some other treatment and were not willing for buprenorphine. After fulfilling inclusion and exclusion criteria, sociodemographic pro forma, Hindi self-stigma scale, and World Health Organization QOL-BREF Hindi were applied. Appropriate statistical analyses were done. Patients already taking buprenorphine had significantly better QOL and it improved as the duration of treatment increased. Patients on buprenorphine treatment had significantly lesser stigma than patients not already on treatment. Stigma negatively impacted QOL in the three groups. QOL and factors affecting it should be an integral part of management of opioid dependence. Efforts should be made to enrol maximum number of patients in treatment to enhance their quality of life and reduce stigma.

Impact of Yoga Intervention in Lower Limb Amputees following Trauma in Relation to Behavior and Quality of Life: A Randomized Controlled Trial.

Yoga is an emerging intervention causing improvement in physical, mental, and spiritual well-being. Its role in improving outcomes in patients with amputation was investigated. Patients with traumatic lower limb amputation (n = 50) were enrolled and randomized to the Yoga group (n = 26) against control (n = 24). Sociodemographic details, quality of life (QOL) (World Health Organization QOL-BREF), Depression anxiety stress scale (DASS), Rosenberg self-esteem scale, and amputee body image score were applied at baseline, 6,-18 weeks of amputation. Sociodemographic and clinical variables were comparable between groups. At 18 weeks, the Yoga group had better QOL (P = 0.005) than the control group. Symptoms of depression (0.02) and anxiety (<0.001) reduced, and self-image (P = 0.015) improved significantly at 6 weeks, while stress (P = 0.003) reduced at 18 weeks in the yoga group. Despite comparable body image scores, the prosthesis usage (hours/day) was more (P = 0.005) in the Yoga (6.9 ± 3.2) group against the control (12 ± 2.7). Yoga improves QOL and self-esteem and reduces depression, anxiety, and stress symptoms in patients with traumatic amputation.

The Added Value of Remote Technology in Cardiac Rehabilitation on Physical Function, Anthropometrics, and Quality of Life: Cluster Randomized Controlled Trial

Cardiovascular diseases (CVDs) cause most deaths globally and can reduce quality of life (QoL) of rehabilitees with cardiac disease. The risk factors of CVDs are physical inactivity and increased BMI. With physical activity, it is possible to prevent CVDs, improve QoL, and help maintain a healthy body mass. Current literature shows the possibilities of digitalization and advanced technology in supporting independent self-rehabilitation. However, the interpretation of the results is complicated owing to the studies' high heterogeneity. In addition, the added value of this technology has not been studied well, especially in cardiac rehabilitation. We aimed to examine the effectiveness of added remote technology in cardiac rehabilitation on physical function, anthropometrics, and QoL in rehabilitees with CVD compared with conventional rehabilitation. Rehabilitees were cluster randomized into 3 remote technology intervention groups (n=29) and 3 reference groups (n=30). The reference group received conventional cardiac rehabilitation, and the remote technology intervention group received conventional cardiac rehabilitation with added remote technology, namely, the Movendos mCoach app and Fitbit charge accelerometer. The 12 months of rehabilitation consisted of three 5-day in-rehabilitation periods in the rehabilitation center. Between these periods were two 6-month self-rehabilitation periods. Outcome measurements included the 6-minute walk test, body mass, BMI, waist circumference, and World Health Organization QoL-BREF questionnaire at baseline and at 6 and 12 months. Between-group differences were assessed using 2-tailed t tests and Mann-Whitney U test. Within-group differences were analyzed using a paired samples t test or Wilcoxon signed-rank test. Overall, 59 rehabilitees aged 41 to 66 years (mean age 60, SD 6 years; n=48, 81% men) were included in the study. Decrement in waist circumference (6 months: 1.6 cm; P=.04; 12 months: 3 cm; P<.001) and increment in self-assessed QoL were greater (environmental factors: 0.5; P=.02) in the remote technology intervention group than the reference group. Both groups achieved statistically significant improvements in the 6-minute walk test in both time frames (P=.01-.03). Additionally, the remote technology intervention group achieved statistically significant changes in the environmental domain at 0-6 months (P=.03) and waist circumference at both time frames (P=.01), and reference group achieve statistically significant changes in waist circumference at 0-6 months (P=.02). Remote cardiac rehabilitation added value to conventional cardiac rehabilitation in terms of waist circumference and QoL. The results were clinically small, but the findings suggest that adding remote technology to cardiac rehabilitation may increase beneficial health outcomes. There was some level of systematic error during rehabilitation intervention, and the sample size was relatively small. Therefore, care must be taken when generalizing the study results beyond the target population. To confirm assumptions of the added value of remote technology in rehabilitation interventions, more studies involving different rehabilitees with cardiac disease are required. ISRCTN Registry ISRCTN61225589; https://www.isrctn.com/ISRCTN61225589.

Prevalence and effects of menstrual disorders on quality of life of female undergraduate students in Makerere University College of health sciences, a cross sectional survey

BackgroundMenstrual problems affect as high as 90% of adolescent females and are the main reason for gynecology visits. Dysmenorrhea was the most frequent menstrual disorder for which adolescents and their parents were referred to a physician. Many undergraduate students are adolescents who undergo several hormonal changes that affect menstrual patterns. This study aimed to determine the prevalence of menstrual disorders and to determine the effect of menstrual disorders on quality of life (QOL) of female undergraduate students at Makerere University college of health sciences.MethodsA cross sectional study design using a self-administered questionnaire. WHO (World Health Organization) QOL-BREF (QOL-Best Available Reference document) questionnaire was used to assess QOL of participants. Collected data was double entered into EPIDATA, and transferred to STATA for analysis. Data was presented using tables, and analyzed using percentages, frequencies, medians, interquartile range, means and standard deviations, t-test and ANOVA were used to establish statistical significance. P < 0.05 was considered statistically significant.ResultsOf the participants, 275 were included in the data analysis. The median age of the participants was 21 years with range of 18–39 years and interquartile range of 20–24 years. All the participants had attained menarche. Of the participants, 97.8% (95%CI: 95.2–99.0) (269/275) reported some form of menstrual disorder. Premenstrual symptoms were the commonest disorder (93.8% (95%CI: 90.2–96.1), N = 258) followed by dysmenorrhea (63.6% (95% CI: 57.7–69.1), N = 175), irregular menstruation (20.7% (95%CI: 16.3–25.9), N = 57), frequent menstruation (7.3% 95% CI:4.7–11.0, N = 20) and infrequent menstruation (3.3% (95% CI:1.7–6.2), N = 9). Dysmenorrhea and premenstrual symptoms significantly reduced the QOL scores of participants.ConclusionMenstrual disorders were highly prevalent with negative effects on QOL and class attendance. Efforts should be made to screen and possibly treat menstrual disorders among university students as well as to conduct further studies to elucidate more on the effects of menstrual disorders on quality of life.

The Effect of Exercise Therapy Along with Relaxation Technique on Patients with Hematologic Cancer Undergoing Chemotherapy-Occupational Therapy Approach

Background: Cancer is the second leading cause of premature death in India. In India, it is estimated that there are approximately 2–2.5 million cases of cancer. Cancer and its treatment are often associated with adverse physical side effects, including muscular atrophy, decreased muscle strength, and reduced aerobic capacity. These side effects may contribute to the development of cancer-related fatigue (CRF). The authors across the world have agreed that there is a paucity of studies in this field to encapsulate the fatigue caused to cancer patients while undergoing chemotherapy. About 70% of cancer patients report fatigue complaints during chemotherapy and/or radiotherapy. Fatigue is usually caused by a combination of factors. Recent research suggests, however, that weariness may be induced by changes in the muscle energy systems produced by cancer and its treatment. Through evidential studies, occupational therapy by an exercise program and relaxation techniques has helped to avoid this fatigue and lessen the severity while undergoing chemotherapy. Objective: To study the effect of exercise programs and relaxation techniques on fatigue, physical performance, and quality of life (QOL) in patients with hematologic cancer undergoing chemotherapy. Study Design: The study design was an experimental study. Methods: The total number of patients with a diagnosis of hematology cancer selected was 240; the patients in the control group were 120 and the patients in the experimental group were 120. The patients were selected from the day-care and indoor patient division of Nil Ratan Sarkar Medical College and hospital, Kolkata, West Bengal, India; pre- and post-intervention data were taken using the Fatigue Severity Scale, Physical Performance Test, and World Health Organization QOL-BREF. The experimental group received 30 min for relaxation and 30 min for exercises and the experimental group was treated thrice a week for 12 weeks periodically over 3 years. The control group was under conventional therapy (chemotherapy as per their prescription) along with home-based OT program. They have also reassessed after 12 weeks. Results: Independent t-test indicated statistically significant differences between groups in fatigue, physical performance, and QOL (P &lt; 0.05). At last, the Chi-square (χ2) test showed that there was no significant association between the status of health at last contact and the age of the patient (P = 0.23). Conclusion: Exercise therapy and relaxation techniques decrease fatigue and improve physical performance and QOL in cancer patients undergoing chemotherapy.

A study of psychiatric comorbidities and quality of life in type 2 diabetes mellitus patients in a tertiary care hospital in Telangana

ABSTRACT Background: Diabetes affects physical and psychological and social health. Sufficient literature exists on management by self and psychosocial methods for diabetes, but there exists a paucity of literature on psychological response and unaddressed emotional distress on overall health. Many studies have shown that diabetes has a bad impact on quality of life (QOL). This study is done for estimating psychiatric morbidity prevalence and its influence on QOL in diabetic patients. Aim: We aimed to study psychiatric comorbidities and QOL in type 2 diabetes mellitus (T2DM) patients in a tertiary care hospital. Methodology: This was a study done cross-sectionally over a period of 18 months on a sample of 108 subjects at the Psychiatry Department and General Medicine Department, Government Medical College and General Hospital, Nizamabad. The Mini International Neuropsychiatric Interview PLUS 5.0 and World Health Organization QOL-BREF scales were the survey tools used. Data analysis was done using statistical methods. Results: The prevalence of psychiatric comorbidities among diabetic patients was found to be 58.3%, with Depression (17.6%) being the most common comorbidity, followed by Dysthymia (13.8%). QOL of patients with T2DM with psychiatric comorbidity was significantly poorer (P = 0.001) in physical health domain (P = 0.04) and psychological domain (P = 0.01), while it was relatively better in environment domain (P = 0.2) and social relationships domain (P = 0.5). Conclusion: This study concludes that psychiatric comorbidities are common comorbidities in persons with T2DM. Moreover, psychiatric comorbidities further reduce QOL in individuals having T2DM.

Quality of life among health care workers in Arab countries 2 years after COVID-19 pandemic.

Assessment of the quality of life (QoL) among healthcare workers (HCWs) is vital for better healthcare and is an essential indicator for competent health service delivery. Since the coronavirus disease 2019 (COVID-19) pandemic strike, the frontline position of HCWs subjected them to tremendous mental and psychological burden with a high risk of virus acquisition. This study evaluated the QoL and its influencing factors among HCWs residing in the Arab countries. This was a cross-sectional study using a self-administered online questionnaire based on the World Health Organization QoL-BREF instrument with additional questions related to COVID-19. The study was conducted in three different languages (Arabic, English, and French) across 19 Arab countries between February 22 and March 24, 2022. A total of 3,170 HCWs were included in the survey. The majority were females (75.3%), aged 18-40 years (76.4%), urban residents (90.4%), married (54.5%), and were living in middle-income countries (72.0%). The mean scores of general health and general QoL were 3.7 ± 1.0 and 3.7 ± 0.9, respectively. Those who attained average physical, psychological, social, and environmental QoL were 40.8, 15.4, 26.2, and 22.3%, respectively. The income per capita and country income affected the mean scores of all QoL domains. Previous COVID-19 infection, having relatives who died of COVID-19, and being vaccinated against COVID-19 significantly affected the mean scores of different domains. A large proportion of the Arab HCWs evaluated in this study had an overall poor QoL. More attention should be directed to this vulnerable group to ensure their productivity and service provision.

The Association of Depression and Quality of Life in Patients with Neurocognitive Disorder in a Tertiary Care Center

Objective: Depression can be a psychological reaction of a patient toward the diagnosis of neurocognitive disorder, and it can be a part of the complex biological response involving both illnesses. Both depression and neurocognitive disorders can cause low quality of life (QoL), especially in the elderly population. In this present study, we intended to assess the association of depression and the QoL among patients suffering from mild to major neurocognitive disorder at a tertiary hospital. Methods: This observational study was carried out at the department of psychiatry in a tertiary care hospital, among 100 patients, whose diagnosis was made according to DSM-5 criteria for mild to major neurocognitive disorder. Patients were administered semi-structured pro forma for collection of sociodemographic data, Addenbrooke'sCognitive Examination III R, Mini-Mental State Examination (MMSE) to assess the severity of mild and major neurocognitive disorders, Cornell Scale for Depression in Dementia was administered to assess the depression, World Health Organization (WHO) QoL-BREF Scale to assess the QoL among patients with mild to major neurocognitive disorders. Results: The mean age ± standard deviation of the study population was 70.31 ± 6.9 years. The sum of 43.3% of the study population belonged to the category of mild cognitive impairment, 46.7% the moderate, and 10% the severe type of cognitive impairment. The sum of 29.2% of the study population had depressive episodes, and 6.7% of the study population belonged to the category of definite major depression. Domain 2 of WHO QoL-BREF was maximum affected by mild and major neurocognitive disorders (p &lt; 0.001). Conclusion: This study found that majority of the patients with neurocognitive disorders was affected by higher levels of depressive scores with a remarkable decrease in their QoL. Compared to neurodegenerative disorders, depression is much easily been effectively treated, this study stresses the importance of the aggressive diagnosis and treatment for depression for all patients with neurocognitive disorder.

Quality of Life among Malnourished Elderly Population in Rural Puducherry, South India

Context: Health of the elderly will be an important issue in defining the health status of a population in coming years. There is a paucity of information with regard to quality of life (QOL) among malnourished elderly. Aims: To assess the QOL among malnourished elderly in a rural field practice areas of tertiary care hospital, Puducherry, and to find the sociodemographic factors associated with QOL among malnourished elderly population. Settings and Design: A community-based cross-sectional study in the rural field areas of Government Medical College of Puducherry. Subjects and Methods: After obtaining ethical approval, the study was conducted among 225 malnourished elderly (&gt;60 years) from April to June 2019 using multistage random sampling technique. Sociodemographic data were obtained using a semistructured questionnaire. Malnutrition was screened using Mini Nutritional Assessment Short Form and QOL was assessed using World Health Organization QOL-BREF questionnaire. Results: The mean and standard deviation of the study participants' age was 69.89 + 6.3 years. 57.8% of them were female, 81.3% were unemployed, and 73.3% were dependent on their old age pension for their livelihood. QOL of malnourished elderly was poor in all the domains when compared to those without malnourished and this is found to be statistically significant. In binomial logistic regression analysis, the presence of comorbidity (adjusted odds ratio [AOR]: 2.4 and 95% confidence interval: 1.3–4.4), unemployed (AOR: 4.8; 1.4–15.9), and living without family (AOR: 0.2; 0.06–0.7) revealed the statistically significant association with low QOL score among malnourished elderly. Conclusions: The mean score of QOL among malnourished elderly was below average in all four domains in which psychosocial domain was badly affected.

Health-Related Quality of Life and its Association with Depression in Type II Diabetes Mellitus Patients

Background: Diabetes mellitus is noncommunicable disease that in most cases affects the whole life after diagnosis with long-standing effects and debilitating complications. It is also one of the top five causes of mortality and contributes significantly to morbidity. Besides limitations and complications to physical health, it also significantly affects the mental health and affects the quality of life (QOL) among the patients. The current study aimed at finding the QOL among the patients living with diabetes. Methodology: A cross-sectional study was conducted among diabetic patients attending a diabetic clinic at a district hospital in East Delhi between December 2016 and March 2018. A total of 250 study subjects were included in the study. The Physical Health Questionnaire (PHQ 9) and the World Health Organization QOL-BREF questionnaire were used along with a pretested, semi-structured questionnaire for data collection. Data analysis was done on SPSS 23. Results: The prevalence of depression was found to be 17.6% as per the PHQ-9. Health-related QOL was highest for social domain (63.81 ± 12.74) and lowest among the psychological domain (40.83 ± 8.93) followed by environment (46.92 ± 8.34). The score of all the domains was lowest among depressed group as compared to nondepressed study subjects. Conclusion: Mental health can be adversely affected in the case of patients with diabetes which in turn can affect the QOL of the cohort. Hence, it is important to focus on mental well-being of the diabetics and timely intervention.

The Quality of Sex Life Among Patients Before and After Lung Transplantation: A Single-Center Study

BackgroundLung transplantation (LTx) is the only effective method of treatment for patients with end-stage lung diseases; LTx prolongs and increases the quality of life (QoL). An important aspect of QoL that changes in the course of severe diseases is the quality of sex life. This aspect is yet to be discussed in relationship to LTx. We aim to compare patients’ quality of sex life at the qualification process with patients’ who underwent LTx. MethodsThe studied group consisted of 100 patients (24 women before and 16 after LTx, 39 men before and 21 after LTX) who were admitted to the lung transplantology department for qualification or to control the function after LTx. To assess the patients' quality of sex life, we used The Changes in Sexual Functioning Questionnaire (CSFQ) and World Health Organization (WHO) QoL-BREF. To assess lung function, patients underwent a 6-Minute-Walk-Test (6MWT). ResultsPatients after LTx obtained higher results—compared to patients qualified for LTx—in the WHO QoL-BREF in every domain (somatic, psychological, social, and environment). Men after LTx got more points in every domain and better total score (53 ± 5.62 vs 44.23 ± 10.28 point; P < .05) in CSFQ. Women before and after LTx obtained comparable results in CSFQ. Results of 6-Minute-Walk-Test were better among patients after LTx than in qualified patients (523.62 ± 95.71 vs 333.14 ± 145.38 and 524.12 ± 56.17 vs 317.20 ± 141.6, respectively for men and women). ConclusionsPatients after LTx show better pulmonary function and quality of sex life than qualified. Preliminary results encourage us to conduct research on a larger group.

Ashtanga Yoga Ethics-Based Yoga Versus General Yoga on Anthropometric Indices, Trigunas, and Quality of Life in Abdominal Obesity: A Randomized Control Trial.

The philosophical tenets of yoga such as Ashtanga yoga (AY) and Trigunas are seldom considered while designing yoga programs for chronic diseases. This randomized control trial explored the impact of AY principle-based yoga on the anthropometric indices, personality traits, and quality of life (QoL) in abdominal obesity (AO). Sixty-two participants with AO were randomized (n = 31 in each arm) into an AY arm or general yoga (GY) arm. For 12 weeks, both the AY and the GY received the same yoga protocol; however, the AY received an additional AY-based orientation session fortnightly. Changes in waist circumference, hip circumference (HC), height, weight, body mass index (BMI), waist-hip ratio, Vedic Personality Inventory for gunas, and World Health Organization QoL-BREF were measured at baseline and at the end of 12 weeks. By the end of 12 weeks, the AY arm significantly differed from the GY arm in HC (P = 0.05) and BMI scores (P = 0.03). The AY arm has shown a significant increase in the sattva guna (P < 0.001) and reduction in the rajas (P < 0.001) and tamas gunas (P = 0.03). There was a significant improvement in the physical and social QoL domain, whereas the other variables examined remained insignificant. The increase in sattva guna was negatively correlated with waist circumference (P = -0.489) and BMI (r = -0.553). Exposing participants to progressive AY philosophy can change the personality traits which are further associated with melioration in the determiners of AO. Future yoga programs for chronic disorders may consider including AY philosophy for substantive outcomes.

Quality of life in lower limb amputees: a cross-sectional study from a tertiary care center of South India.

Various literature have dealt with the physical aspect of amputation and the functional outcome after amputation. There are a few studies that give focused attention to the quality of life (QOL) of amputees. These studies are mostly from the developed countries. This study analyzed amputation as a whole and how it affects an individual physically, psychologically, emotionally, and socially, which would enable the health care providers to help the amputees to attain a better QOL. Cross-sectional study. This cross-sectional study was conducted on lower limb amputees. Data were collected using a proforma for demographic details and two pretested questionnaires-the World Health Organization QOL-Bref and prostheses-specific Trinity Amputation and Prosthesis Experience Scales-Revised questionnaires. The data were analyzed using SPSS software, version 20. Amputation significantly affects all domains of the QOL. Age was a significant determinant of QOL of amputees, and it was found that the QOL decreased with an increase in age. 48.1% of the amputees were using a prosthetic device, and they were found to have a significantly better QOL. The prevalence of residual limb pain and phantom limb pain was 52.9% and 37%, respectively. Nearly half of the population perceived that their QOL was neither poor nor good. The QOL of the physical domain was better than the other domains. The most important factors that were found to be associated with QOL of amputees were age, duration since amputation, and use of prosthesis.