World Health Organization Quality Of Life-Brief Research Articles

Comprehensive needs assessment tool for informal cancer caregivers (CNAT-ICs): Instrument development and cross-sectional validation study

BackgroundGrowing cancer incidence and its subsequent burden is a worldwide concern. Needs assessment for caregivers has recently received growing attention, as it identifies specific unmet needs. The remaining tools have been established within the healthcare context of Western countries and have been studied only in some Asian populations; it seems appropriate to develop needs assessment tools that apply to a wider ethnic and socio-cultural context. ObjectiveThis study planned to adapt and examine the psychometric properties of the CNAT-C for the Sri Lankan informal caregivers for wider applicability. DesignAn instrument development and cross-sectional validation study was conducted. SettingApeksha Hospital Maharagama, Sri Lanka (National Cancer Institute). ParticipantsA sample of 226 informal caregivers (ICs) providing palliative care for patients with advanced cancer was selected. MethodsA CNAT-C (41 items; seven factors) was incorporated and used after a cross-cultural adaptation following WHO guidelines after the permission and pilot test. ICs completed the socio-demographic and clinical details along with the validated Centre for Epidemiological Studies-Depression (CES-D), and the World Health Organization-Quality of Life-Brief (WHOQOL-BREF). Internal consistency and test-retest were used to check the reliability. Convergent and divergent validity of the Sinhala version of CNAT (S-CNAT) was confirmed using the CES-D scale and WHOQOL-BREF. Construct validity was evaluated using the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). ResultsMost of the participants were female (60 %) and married (72 %), and the mean age was 41.78 (SD+14.54). Face and content validity were established during the cross-cultural adaptation. Cronbach's alpha was 0.903 for the overall S-CNAT and the test-retest reliability was 0.965. The S-CNAT was associated positively with the CES-D while negatively with the WHOQOL-BREF. Both EFA and CFA discovered a structure contained seven factors (35 items); domain named as healthcare staff/nurses’ support and information, physical/practical needs, medical officers’ support, psychological needs, social/family support, spiritual/religious support, and hospital facilities/service. ConclusionsThe Sinhala version of CNAT is shown to have adequate validity and reliability in assessing the comprehensive and multidimensional/unmet needs of informal caregivers of patients with advanced cancer (S-CNAT-ICs). It would be a helpful tool to determine the unmet needs of ICs and guide future interventions to meet those needs and enhance or maintain the quality of life for patients and their informal caregivers.

Analysis of the Effect of Problem-Oriented Nursing Intervention on Patients with Lower Extremity Arteriosclerosis Obliterans in Vascular Surgery

Objective: To analyze the effect of problem-oriented nursing intervention on patients with lower extremity arteriosclerosis obliterans (ASO) in vascular surgery. Methods: The clinical data of 128 patients with lower extremity ASO in vascular surgery were selected and randomly divided into groups A and B, with 64 cases each. Group A is the control group, and Group B is the observation group. Group A received the routine nursing intervention, and Group B received the problem-oriented nursing intervention. The compliance, self-care ability, psychological state, quality of life, and nursing satisfaction of the two groups of patients were evaluated based on various indicators. Results: After the intervention, the evaluation of self-care ability (ESCA) score of the patients in Group B was higher than that of Group A, and the symptom checklist-90 (SCL-90) score was lower than that of Group A. The differences were significant (t = 10.019, t = 3.118, P < 0.01). After the intervention, the World Health Organization Quality of Life Brief (WHOQOL-BREF) index scores of the two groups increased and the increase in Group B was significantly higher than Group A (P < 0.001). The compliance rate of Group B (62/ 96.88%) was higher than that of Group A (52/ 81.25%), and the difference was extremely significant (χ2= 8.020, P < 0.01). Conclusion: Problem-oriented nursing intervention for patients with lower extremity ASO in vascular surgery improved the patient’s self-care ability, and quality of life, reduced the patient’s negative emotions, and enhanced their overall satisfaction.

Role of detailed psychological evaluation and treatment in pulmonary rehabilitation programs for patients with chronic obstructive pulmonary disease.

Psychological co-morbidities are common in chronic obstructive pulmonary disease (COPD) but remain overlooked. Psychosocial interventions are deemed to promote mental health and optimize management. This study aimed to determine the role of detailed psychological evaluation and treatment in the comprehensive management of COPD. COPD patients after screening with the general health questionnaire-12 (GHQ-12) for psychological co-morbidity were divided into three groups (26 patients each): i) group A [GHQ-12 score<3, received pulmonary rehabilitation (PR) and standard medical management]; ii and iii) group B and C (GHQ-12 score>3, in addition, received management by a psychiatrist and counseling by a pulmonologist, respectively). At baseline and 8 weeks of follow-up, all participants were evaluated for respiratory [forced expiratory volume in the first second (FEV1), six-minute walk distance (6-MWD), St. George's respiratory questionnaire (SGRQ), modified medical research council (mMRC) dyspnea scale], and psychological [GHQ-12, patient distress thermometer (PDT), coping strategy checklist (CSCL), World Health Organization-quality of life-brief (WHOQOL-Bref-26), and depression anxiety stress scales (DASS)] parameters. Psychological distress (GHQ-12>3) decreased significantly at follow-up, with 11.5% and 53.8% of patients having psychological distress in groups B and C, respectively, versus baseline (p<0.001). mMRC score, SGRQ score, FEV1 and 6-MWD significantly improved in all three groups. Improvement in mMRC and SGRQ was maximal in group B when compared with the other groups. PDT, CSCL, and WHO-QOL-Bref-26 scores improved significantly at follow-up in all three groups, with maximum improvement in group B, followed by group C, and then group A. The DASS score also improved maximally in group B. Patients should be screened for psychological co-morbidities using simple screening tools. PR plays an important role in improving the psychology of COPD patients. However, results are better with directed psycho-educative sessions by non-experts and best with definitive treatment by psychiatrists.

Minimal clinically important difference in the World Health Organization Quality of Life Brief (WHOQOL-BREF) for adults with neurofibromatosis.

This study aimed to estimate minimal clinically important difference (MCID) values for the World Health Organization Quality of Life Brief version (WHOQOL-BREF) among adults with neurofibromatosis (NF). An MCID is needed to demonstrate clinical meaningfulness of interventions for NF. We estimated MCID for the WHOQOL-BREF: the quality of life (QoL) measure recommended by the Response Evaluation in Neurofibromatosis and Schwannomatosis International Collaboration. We used data from 228 clinical trial participants with NF type 1, NF type 2-related schwannomatosis, or schwannomatosis (SCHWN) who completed 10weeks of a virtual group mind-body program targeting resiliency or a time- and attention-matched control. Following established guidelines, we estimated MCIDs using both anchor-based and distribution-based methods for physical, psychological, social relationships, and environmental domains of the WHOQOL-BREF. MCID results varied across method and QoL domain. Three anchor-based methods, average change (AC), change difference (CD), and regression (REG), yielded the most consistent and comparable MCID across QoL domains. Based on these methods, we recommend ranges for each QoL domain: Physical QoL (3.9-7.3), Psychological QoL (4.7-8.1), Social QoL (2.6-5.9), and Environmental QoL (4.1-6.6). Establishing a rigorous MCID for QoL in NF is a critical step toward evaluating meaningful change in response to psychosocial interventions.

Impact of Post-Acute Sequelae of COVID-19 on Lives of Patients Post-Intensive Care Unit Discharge: A Cross-Sectional Study

Objectives: Post-acute sequelae of SARS-CoV-2 (PASC) are known for their prolonged and persistent effects on patients. This study aimed to investigate the impact of the PASC on the quality of life (QOL) of patients, their levels of activity participation, and satisfaction with these levels, in addition to exploring whether the duration of post-intensive care unit (ICU) discharge is associated with the effects of PASC. Subject and Methods: This cross-sectional study included 134 patients with COVID-19 discharged from an ICU in Kuwait. Data were collected using two validated questionnaires: the World Health Organization Quality of Life-Brief (WHOQOL-BREF) and Satisfaction with Daily Occupations. Additionally, demographic information was collected, and 11 categories of related symptoms were investigated. Results: Most patients reported health issues post-ICU discharge. Furthermore, most PASC-related symptoms decreased over time, whereas a few increased. Notably, we observed a negative association between post-discharge duration and overall improvement in level of participation in activities of daily living. However, patients discharged from the ICU for more than 6 months demonstrated higher satisfaction with functional performance and improved QOL. Additionally, patients who received rehabilitation, and were vaccinated were less likely to have poor QOL. No significant sex differences were observed in the WHOQOL-BREF score. Conclusion: PASC adversely affected the daily functioning of patients, especially in leisure, social, and religious aspects. However, these effects lessened over time, with corresponding improvement in QOL. Additionally, patient satisfaction with functional performance increased over time. These findings shed light on the rehabilitation needs of patients with COVID-19.

Cognitive-Behavioral Therapy (CBT) Versus Cognitive Retraining (CR) in Depression

Mood disorders are recurrent or episodic with significant cognitive deficits and incomplete recovery. Cognitive behavior therapy (CBT) has been a well-established evidence-based intervention, and Cognitive retraining (CR) is emerging to reduce cognitive deficits by application of techniques that improve attention, memory, and/or executive functions that enhance psychosocial functioning. Method: The present study compared CBT and CR delivered as independent interventions as well as combined with medicines employing pre-post intervention and experimental research design. Outcome measures were Beck Depression Inventory (BDI-II), Metacognitive Questionnaire (MCQ30), World Health Organization Quality of Life- Brief (WHOQOLBref), and Global Assessment of Functioning (GAF). Results: CBT group statistically had highest QOL supported by environment and global functioning. The change in mean scores on outcome measures was greater for CR groups. Conclusion: CR with or without medicine is a feasible treatment option when CBT promulgation is inhibited by patient, therapist, or environmental variables.

Effectiveness of Family-Focused Therapy in Bipolar Patients in Zahedan City, Iran: A Randomized Controlled Trial

Background: Family-focused therapy (FFT) has been developed to address the significant impairments in psychosocial functioning among individuals with bipolar disorder (BD). Objectives: This study investigated the effectiveness of FFT combined with drug therapy in patient support in managing this disorder. Methods: In this randomized controlled trial, 50 patients and their caregivers were randomly divided into 2 groups: a drug therapy group that only received medication and a family therapy group that received 15 one-hour sessions of FFT with their caregivers in addition to medication. The Expressed Emotion Questionnaire (EEQ), a modified version of the standard internal label questionnaire for the mentally ill, and the World Health Organization Quality of Life–Brief (WHOQOL-BREF) were used in the present study. Data were analyzed using the t-test. Results: Expressed emotion (EE) significantly decreased in the family therapy group (P = 0.001). Also, mental health and social health were better in the family therapy group than in the drug therapy group (P = 0.001). Nevertheless, no significant change was observed in the dimensions of physical and environmental health in both groups. The results of the study were relatively stable in all measurements in follow-up, except for the stigma. Conclusions: Significant improvements were observed in EE and quality of life (QOL) in the family therapy group. This difference was not statistically significant in the stigma score despite the difference in the means of the 2 groups.

Improvement of Symptoms after Excision of Hydrocele of Canal of Nuck with Korean Medicine: A Case Report

Objective: The purpose of this case study is to report the hydrocele of the canal of Nuck and the effectiveness of Korean medicine in post-surgery improvement of symptoms.Method: A patient who was diagnosed with hydrocele of the Nuck canal and had symptoms after Lichtenstein’s operation was treated using Korean medicine, including acupuncture, herbal medicine, and moxibustion, every day. The evaluation was performed using the Numeral Rating Scale (NRS), the 5-level EQ-5D version (EQ-5D-5L), the EQ visual analogue scale (EQ-VAS), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF).Results: After treatment, changes were observed in NRS (from 8 to 2-3) and EQ-VAS (from 60 to 85), whereas there was no difference in EQ-5D-5L (both 6). There was an overall improvement in the domains of WHOQOL-BREF and subjective symptoms.Conclusion: This study suggests that Korean medicine may improve symptoms after surgery of hydrocele of the canal of Nuck and can be evaluated using an overall QoL questionnaire.

Heart rate variability and tension-type headache: A population-based cross-sectional study

BackgroundThe relationship between tension-type headache (TTH) and autonomic functions is poorly understood, although TTH is one of the most prevalent disorders in the general population. The aim of this study was to investigate the direct and indirect effects of TTH on the autonomic functions measured by heart rate variability (HRV). MethodsThis population-based cross-sectional study was carried out in the general population of Ulaanbaatar between July and September in 2020. After physical examination, trained researchers applied structured interviews to examine the remote history of TTH and mental distress, followed by a recording of HRV to detect autonomic activity. Psychological factors and the quality of life were measured using Hospital Anxiety Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life–Brief (WHOQOL-BREF). Binary logistic regression and GLM mediation model analysis were used to examine the effects of risk factors on the associations between TTH and autonomic functions. ResultsAmong participants (n = 217, mean age=41.8 ± 11.5 years), a total of 117 (53.9%) participants had a remote history of TTH. The age and sex-adjusted prevalence was 43%. Groups did not differ statistically in the HRV indices. LF/HF (ratio of low-frequency to high frequency), the index of sympathovagal balance, was correlated with the HADS anxiety. TTH was associated with mental distress. Binary logistic regression analysis confirms the relationship suggesting that TTH was associated with increased likelihood of mental distress, and decreasing RMSSD (root mean square of the sum of the squares of differences between adjacent NN intervals) and pNN50 (NN50 divided by the total number of NN intervals) were the independent predictors of TTH. GLM mediation model indicated that the relationship between TTH and RMSSD was mediated by mental distress. ConclusionsThe present study suggests that mental distress is a critical factor in the association between TTH and autonomic dysfunction. Additionally, our findings demonstrate the influence of age and gender on TTH. These results highlight the need to understand the mechanisms underlying pathophysiology to facilitate targeted and efficacious prevention and management approaches for TTH.

Quality of life in families under quarantine: a cross-sectional study in seven countries during the first outbreak of COVID-19.

The COVID-19 pandemic has disrupted human well-being worldwide in unforeseen ways. In early 2020, the spread of the virus left its mark on every affected country, impacting mental health by limiting daily activities and causing fatalities amidst public health strategies to mitigate its impact. The influence of COVID-19 on the quality of life (QoL) may vary between countries, underscoring the need to examine its effects on individuals and families during the mandatory home quarantine. We aimed to assess the QoL of individuals and families during home isolation by COVID-19 lockdown. A cross-sectional study was conducted from February to May 2020. We included adult partners (≥18 years) of families from Brazil, Colombia, Spain, Japan, Peru, Russia, and Venezuela. Using the 26-item World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire we assess the impact of COVID-19 on their partner/family member's QoL. The survey was completed by 466 participants (mean age = 38.59 ± 13.75 years; females = 298) and 76% worked mostly as health professionals from South America (69.2%), Europe (18.4%), and Asia (12.4%). The WHOQOL-BREF mean score from 38.38 ± 11.55 (range = 22.8-43.4). The average quality of life in South America (41.9 ± 1.2) was significantly higher than that of European countries (30.9 ± 11.5) (p = 0.002). The social relations dimension was the only one with values close to 100 (mean = 83.3) in 6/7 evaluated countries, where only Spain had a low score (41 ± 33.12). Women had a slightly lower quality of life than men, but it was not significant (40.2 ± 8.8 vs. 41.5 ± 9.9, p = 0.354), while we found differences in the overall QoL between young and older, and by employment type (p < 0.05). According to family structure, we found differences on QoL between nuclear and siblings' families (p = 0.024). Families from seven countries of three continents reported poor QoL during the first outbreak of COVID-19. The pandemic scenario has dramatically weakened the QoL in 3/4 dimensions, where social relationships have remained high. It is important to fully address the impact of this reduced QoL on families after several waves of infection and to provide comprehensive support in the post-COVID future.

Quality of Life and Related Factors Among Final Year Nursing Students During the COVID-19 Pandemic

Background: COVID-19 has significantly influenced to the healthcare educational programs. Final year nursing students did not except, even maybe became the vulnerable respondents in the pandemic. Therefore, their quality of life has considerably reduced. Objectives: To describe the physical quality of life and explore the relationships between demographic information, fear of COVID-19, and physical quality of life among final year nursing students. Methods: This was a cross-sectional descriptive study of 113 final year nursing students at Da Nang University of Medical Technology and Pharmacy, Vietnam, from March to April 2022. All participants completed a questionnaire which consisted of 3 parts including the demographic information, fear of COVID-19, and the World Health Organization Quality of Life Brief (WHOQOL-BREF). Data were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, and Spearman rank correlation. Results: The physical quality of life of participants was at medium level (mean [SD], 87.86 [9.14]). There were statistically significant relationships between gender and fear of COVID-19 to quality of life (P &lt; .05), whereas age, living with, and monthly income were not correlated with quality of life (P &gt; .05). Conclusions: During the COVID-19 pandemic, final year nursing students had medium quality of life. Physical domain and fear of COVID-19 should be improved to increase quality of life.

Frequency of Premenstrual Dysphoric Disorder (PMDD) and Comparison of Quality of Life between Female Medical Students with and without Premenstrual Dysphoric Disorder.

To determine the frequency of Premenstrual Dysphoric Disorder (PMDD) in female medical students, and to compare the quality of life between those with and without PMDD. Descriptive Study. Place and Duration of the Study: Fatima Jinnah Medical University, Lahore, from November 2019 to April 2020. The study included 635 female medical students from the third year to the final year of MBBS. Quality of life was measured by using the World Health Organization Quality of Life Brief (WHOQOL-BREF) Scale and PMDD was diagnosed as per DSM-V Diagnostic criteria. Data were entered and analysed by IBM SPSS version 23.0. Scores of 4 domains of the WHOQOL-BREF scale were compared between the female medical students with and without PMDD. A p-value of ≤0.05 was considered statistically significant. Significant proportion i.e., 12.1% (77) out of 635 female medical students had PMDD. There was a significant difference in the physical and psychological domains scores of the WHOQOL-BREF scale between healthy students and students with PMDD (p-value <0.001). The physical and Psychological aspects of quality of life are significantly lower in female medical students with PMDD. WHOQOL-BREF, Premenstrual dysphoric disorder, Female medical students.

Assessment of quality of life and cognitive dysfunction among patients with Major Depressive Disorder

Introduction Major Depressive Disorder (MDD) is associated with high mortality, disability and morbidity. Studies demonstrated mixed results on effects of depression treatments on quality of life (QOL).ObjectivesTo evaluate the severity of depression among Jordanian patients diagnosed with MDD before and after treatment and to find any relationship between QOL, depression severity and perceived cognitive dysfunction.MethodsPatients from both genders, 18-65 years old and diagnosed with MDD were included to attend two visits; at baseline and 6 weeks after treatment, in each they completed three questionnaires: Patient Health Questionnaire (PHQ-9) for depression severity, patient-rated Perceived Deficit Questionnaire (PDQ-5) for cognitive function, and World Health Organization Quality of Life Brief (WHOQOL-BREF) format.ResultsA total of 92 patients completed the study. The scores of the different questionnaires and their correlations before and after treatment are presented in tables 1 and 2. Correlations between PHQ-9 and PDQ-5 before and after treatment are illustrated in figs 1 and 2, respectively. Table 1:Total scores for WHOQOL-BREF format, PDQ-5 and PHQ-9, before and after treatmentQuestionnaireBeforeAfterP-valueGeneral quality of life2.5±13.5±0.7&lt;0.0001General health satisfaction2.3±13.4±0.9&lt;0.0001Physical health (Domain 1)10±2.613.9±2.6&lt;0.0001Psychological (Domain 2)8±2.312.6±2.3&lt;0.0001Social relationships (Domain 3)9±3.212.8±2.8&lt;0.0001Environment (Domain 4)12.3±314.4±7.50.0003Patient-rated Perceived Deficit 5 (PDQ-5)13±4.47.2±4&lt;0.0001Patient health questionnaire 9 (PHQ-9)19±5.47.1±5.1&lt;0.0001Values are presented as mean±SD. Analysis: Paired t test. P&lt;0.05 is significant.Table 2:Correlations between total scores for all of the domains for WHOQOL-BREF and PDQ-5, and between WHOQOL-BREF and PHQ-9, before and after treatmentDomains/FacetsPatient-rated Perceived Deficit 5 (PDQ-5)Patient health questionnaire 9 (PHQ-9)Before (r, p)After (r, p)Before (r, p)After (r, p)General quality of life-0.38, 0.0001-0.26, 0.01-0.55, &lt;0.0001-0.49, &lt;0.0001General health satisfaction-0.24, 0.02-0.14, 0.2-0.51, &lt;0.0001-0.48, &lt;0.0001Physical health (Domain 1)-0.37, 0.0003-0.50, &lt;0.0001-0.57, &lt;0.0001-0.76, &lt;0.0001Psychological (Domain 2)-0.46, &lt;0.0001-0.43, &lt;0.0001-0.58, &lt;0.0001-0.68, &lt;0.0001Social relationships (Domain 3-0.37, 0.0002-0.37, 0.0002-0.42, &lt;0.0001-0.40, &lt;0.0001Environment (Domain 4)-0.52, &lt;0.0001-0.21, 0.047-0.36, 0.0004-0.12, 0.2Spearman correlation (r); P&lt;0.05 is significant. WHOQOL: World Health Organization Quality of Life.Image:Image 2:ConclusionsSignificant improvements were found in the symptoms of depression, cognition and QOL in patients with MDD after treatment. Depression severity significantly inversely correlated with QOL and cognition of MDD patients.Disclosure of InterestNone Declared

Validation of the abbreviated version of the World Health Organization Quality of Life in Mongolia: a population-based cross-sectional study among adults in Ulaanbaatar.

There is currently no validated tool to measure the quality of life (QOL) in the Mongolian language. This study aimed to validate the Mongolian version of the World Health Organization Quality of Life - Brief (WHOQOL-BREF) questionnaire for the general population of Mongolia. The subjects were 301 adults aged 18-65 years selected randomly by a computer from 30 centers in 8 districts of Ulaanbaatar, Mongolia, in 2020. Reliability was measured using Cronbach's α and intraclass correlation coefficients. Convergent, discriminant, and construct validities were examined using exploratory and confirmatory factor analyses for a four-domain factor structure. Among the participants, 56.1% were women, 32.9% held a bachelor's degree or higher, 48.8% were employed, and 61.8% were married. The overall Cronbach's α coefficient of the WHOQOL-BREF questionnaire was 0.804. Correlations between the component scores of the WHOQOL-BREF ranged from 0.581-0.822. All items showed higher item-total correlations with their corresponding domains than with other domains, except the mobility item from the physical domain. Discriminative validity was evident in physical and psychological domains. Exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 24 items that provided an acceptable fit to the data (RMSEA=0.084; CFI=0.860). In conclusion, the Mongolian version of the WHOQOL-BREF demonstrated evidence of good reliability and validity for assessing QOL in the general population of Mongolia. These findings indicate that it allows the comparison of QOL of adults in Mongolia with those in other countries.

Examining the quality of life of patients living with breast cancer in Southern Sri Lanka: A descriptive cross-sectional study

Introduction: Globally breast cancer (BC) is the most common cancer among women and Sri Lanka is not an exception. Cancer influences the quality of life (QoL) of cancer patients. The survival rates and the QoL of BC patients have improved significantly over the last few decades. However, factors associated with the QoL of patients with BC have not been well studied in Sri Lanka. The aim of the study was to assess the QoL and its correlates among patients with BC treated at a tertiary care hospital in Southern Sri Lanka. Methods: Ninety-seven BC patients were investigated using an interviewer-administered questionnaire. The World Health Organization- Quality of Life- Brief (WHOQOL-BREF) was used to measure QoL. The WHOQOL-BREF measure QoL in four domains: physical, psychological, social, and environmental. Scores range from 0 to 100, and higher scores indicate a greater QoL. Results: The mean age of the sample subjects was 52 years (SD = 8.7), and the majority were married (78%). Physical (60.97±11.56), psychological (63.52±11.63), and environmental (69.05 ±8.79) domains of QoL were at a satisfactory level whereas QoL score related to social relationships was found to be low (47.86±13.89) in this sample. Physical QoL was higher in young participants and psychological QoL was higher among those with a fewer number of comorbidities and disabilities and those with no body image changes. Social QoL was higher among married and environmental QoL was higher among those who reported having no disabilities. Conclusion: Social support in the form of family support and emotional support seems to play a major role in lowering the QoL of BC patients. Psycho-social support services should target patients experiencing physical disabilities, a higher number of comorbidities, and those who were subjected to changes in their body image.

Mapping of the World Health Organization Quality of Life Brief (WHOQOL-BREF) to theEQ-5D-5L in the General Thai Population.

This study aimed at mapping the World Health Organization Quality of Life Brief (WHOQOL-BREF) and the EQ-5D-5L in the general Thai population and to determine the impact on the incremental cost-utility ratio (ICUR) through five hypothetical scenarios. A total of 1,200 Thai participants were randomly allocated into the 'estimation' and 'validation' groups. A curve estimation with nine regression models was performed to identify the best-fit regression model of significant WHOQOL-BREF dimension scores for the EQ-5D-5L index score predictions in the estimation group. The identified model was then used for the calculation of the predicted EQ-5D-5L index scores in the validation group. The percentage change from the hypothetical base-case scenario with predefined parameters was used to determine the impact on the ICUR. An inverse model was the best-fit regression model to predict the EQ-5D-5L index scores. The absolute difference between the predicted and observed index scores was 0.064, and the percentage of the sample that was mispredicted by ≥0.05 and ≥0.1 was 43.8% and 16.8%, respectively. Moreover, the percentage change in ICUR ranged between 0.13 and 1.84% from the hypothetical base-case scenario. An inverse relationship between the studied scores was identified. The minimal impact on the ICUR suggests that the Health Utility Index of the mapped equation can be applied to economic analyses.

Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up.

Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibiteda high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.

Profile, Quality of Life and the Client Satisfaction of Beneficiaries Registered under Rashtriya Bal Swasthya Karyakram (RBSK) at an Urban Primary Health Centre, Ahmedabad: A Retrospective Cohort Study.

Under Rashtriya Bal Swasthya Karyakram (RBSK), children (0-18 years) are screened for a spectrum of 30 health conditions, categorized under 4D's namely defect (birth), disease (chronic), deficiency disorders, and developmental delay, and referred for treatment at higher centers. The aim of this study is to document demographic, clinical profile of children detected with any of 4D's during 2018-20 at one Urban Primary health center to assess their Quality of Life (QOL) and client satisfaction. A total of 102 children <18 years were selected as per Probability Proportionate to Size for different 4D's; within each category required participants were selected randomly. Information was gathered on designed semi-structured proforma. For QOL, customized World Health organization Quality of Life Brief (WHO-BREF) Questionnaire tool was used. Client satisfaction about the RBSK was assessed among RBSK users (N = 46) with Likert scale. Out of 102 cases, 97 were covered including 8 with more than 1 type of 4Ds. Majority beneficiaries were male (53.1%), from 5 to 10 years age (43.8%), and middle social class (52%). Congenital defects (48.5%) especially heart defects were the most common followed by deficiency disorders (40.2%) mostly severe anemia and/or severe acute malnutrition. Out of 46 who availed RBSK services, 82.6% rated service as very good or good. Most children (81.7%) had good QOL. Most detected 4D's belonged to school going age and middle class. They rated program as very good or good. Congenital defects, specifically heart defects were the most common. Overall, most children (81.7%) had good QOL.

Effectiveness of Cognitive Behavior Therapy Combined with Eye Movement Desensitization and Reprocessing on Psychological Problems and Life Quality in Patients' Postfacial Trauma.

Objective To investigate the effectiveness of cognitive behavior therapy (CBT) combined with eye movement desensitization and reprocessing (EMDR) on the esteem, anxiety, depression, posttrauma stress disorder (PTSD), and posttraumatic growth in patients with facial trauma. Methods A total of 92 facial trauma patients in Wenzhou People's Hospital from January 2017 to December 2019 were enrolled in this study. The patients were randomly divided into control group (n = 46) and intervention group (n = 46). Both of the control group and the intervention group received routine treatment, while the intervention group further received CBT combined with EMDR. Questionnaires were used to explore and record the general patient information. The Self-Esteem Scale (SES), Self-Anxiety Scale (SAS), Self-Depression Scale (SDS), Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C), Posttraumatic Growth Inventory (PTGI), and World Health Organization Quality of Life-brief (WHOQOL-BREF) scores between the two groups were compared. Results After CBT combined with EMDR intervention, the SDS and SAS scores in the intervention group were significantly decreased compared with the scores before intervention with statistically significance (P < 0.001). Furthermore, the PCL-C score in the intervention group showed significant decrease in comparison with the control group (P < 0.001), while the PTGI score in the intervention group was significantly higher than the control group (P < 0.001). The WHOQOL-BREF scores were increased after treatment in the two groups compared with the scores before treatment, and the scores in the intervention group were higher than those in the control group after treatment (P < 0.01). Conclusion Psychological intervention therapy can effectively alleviate the anxiety, depression, and PTSD and improve the life quality and the recovery of facial trauma patients.

Relationship Between Childhood Sensory Processing Differences and Quality of Life as Adults.

Research suggests a relationship between sensory processing, motor skills and quality of life (QOL) in a variety of clinical populations of adults and children. There have been no studies which investigated the relationship of childhood sensory processing and integration and related motor performance (sensori-motor) patterns identified using an Ayres Sensory Integration® (ASI) frame of reference and later QOL of those children as adults. This longitudinal follow-up study examined this relationship. Adult QOL was also examined in relation to current adult sensori-motor patterns. Fifty-three adults who received occupational therapy services as children, were identified as having sensori-motor difficulties at that time and completed a sensory history and a quality-of-life measure as adults participated. Measures included the OTA the Koomar Center Sensory History (SXHX), Adult/Adolescent Sensory History (ASH), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF). MANCOVA found that Total childhood sensori-motor scores had a small relationship to Physical Health QOL as adults that approached significance. Pearson Correlations found that adults with childhood sensori-motor challenges who report sensori-motor challenges as adults had a moderate significant relationship among overall sensori-motor functioning and Physical Health (r = −0.56, p = 0.018). Visual (r = −0.76, p = 0.001), movement (vestibular; r = −0.48, p = 0.042) and tactile processing (r = −0.63, p = 0.008) had moderate to large significant relationships with Physical Health. Visual processing (r = −0.54, p = 0.024) was also significantly related to Psychological Health. Motor Coordination trended to significance for Physical Health (r = −0.42) and Psychological Health (r = −0.41). Conversely, adults who reported typical sensori-motor scores as adults, despite childhood sensori-motor challenges, had a good QOL. Furthermore, similar to previous research, there was a relationship between current visual, movement (vestibular) and tactile (touch) sensory processing and adult Physical and Psychological Health. A multivariate linear regression found Sensory Discrimination and Modulation accounted for one-quarter of the variance in QOL in adults with only Discrimination being statistically significant. Therefore, it is important to consider childhood sensori-motor function as well as adult functioning when examining QOL. Further, heretofore unexamined Sensory Discrimination was found to play a role in adult QOL.