scholarly journals An Assessment of Long-Term Physical and Emotional Quality of Life of Persons Injured on 9/11/2001

Author(s):  
Robert Brackbill ◽  
Howard Alper ◽  
Patricia Frazier ◽  
Lisa Gargano ◽  
Melanie Jacobson ◽  
...  

Fifteen years after the disaster, the World Trade Center Health Registry (Registry) conducted The Health and Quality of Life Survey (HQoL) assessing physical and mental health status among those who reported sustaining an injury on 11 September 2001 compared with non-injured persons. Summary scores derived from the Short Form-12 served as study outcomes. United States (US) population estimates on the Physical Component Score (PCS-12) and Mental Component Score (MCS-12) were compared with scores from the HQoL and were stratified by Post-traumatic Stress Disorder (PTSD) and injury status. Linear regression models were used to estimate the association between both injury severity and PTSD and PCS-12 and MCS-12 scores. Level of injury severity and PTSD history significantly predicted poorer physical health (mean PCS-12). There was no significant difference between injury severity level and mental health (mean MCS-12). Controlling for other factors, having PTSD symptoms after 9/11 predicted a nearly 10-point difference in mean MCS-12 compared with never having PTSD. Injury severity and PTSD showed additive effects on physical and mental health status. Injury on 9/11 and a PTSD history were each associated with long-term decrements in physical health status. Injury did not predict long-term decrements in one’s mental health status. Although it is unknown whether physical wounds of the injury healed, our results suggest that traumatic injuries appear to have a lasting negative effect on perceived physical functioning.

Author(s):  
Dominik Joskowiak ◽  
Daniela Meusel ◽  
Christine Kamla ◽  
Christian Hagl ◽  
Gerd Juchem

Abstract Background With increasing importance, health-related quality of life (HRQoL) has become a crucial outcome measure of cardiac surgery. The aim of this study was to assess the dynamics of HRQoL change within 12 months after surgery and to identify predictors of deterioration in physical and mental health. Methods The cohort of this prospective study included 164 consecutive patients who underwent elective surgery. HRQoL was assessed on the basis of the Short-Form 36 questionnaire at three different times: upon admission and at 3 and 12 months after surgery. The minimal clinically important difference (MCID) was used to determine whether the surgery resulted in deterioration of HRQoL. Results In general, physical and mental health status improved within the first year after cardiac surgery. However, after 12 months, 7.9 and 21.2% of patients had clinically significant poorer physical (PCS) and mental component summary (MCS) scores, based on the MCID approach. The results of multivariate analysis identified preoperative health status, age < 70 years, coronary artery bypass grafting, and a previous neurological event as predictors of deterioration in postoperative HRQoL. The greatest risks for deterioration were higher preoperative PCS and MCS scores. Conclusion Although we were able to demonstrate a general improvement in the HRQoL following cardiac surgery, in one-fifth of patients, there was no recovery of mental health status even after 1 year. As this effect is mainly determined by preoperative functional status, HRQoL should be an integral part of medical consultation, especially in younger patients with a positive perception of quality of life.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Senoo ◽  
A Yukawa ◽  
T Okura ◽  
H Iwakoshi ◽  
T Nishimura ◽  
...  

Abstract Background and purpose Arrhythmias such as atrial fibrillation (AF) is often associated with depression, with vague anxiety about symptom and the risk of serious complication such as stroke or heart failure. In the geriatric population, geriatric depression often occurs with an increase of physical illness and has substantial costly and quality of life implications for functionality and life satisfaction. However, few studies have investigated relationship between geriatric depression and Quality of Life (QoL), and arrhythmia symptoms (palpitation, dyspnea and chest discomfort). Method Between November 2019 and October 2020, elderly people (≥65 years) who participated in the AF awareness symposium were enrolled in this study. They were divided into 4 groups according to the presence or absence of chest symptom and AF, and were examined geriatric depression by Geriatric depression scale (GDS)-15 and Quality of Life (QoL) by the 12-item Short- Form Health Survey (SF-12) including physical and mental health status. Results Of the 1511 subjects, 1364 were analyzed after excluding 147 with missing values. Among them, 911 were in the non-AF group without symptom (Group A), 43 in the AF group without symptom (group B), 323 in the non-AF group with symptom (group C), and 87 in the AF group with symptom (group D). Geriatric depression rates (defined as GDS-15 ≥10) were 2.7% in non-symptomatic group (2.7% in A [n=25] and 2.3% in B [n=1]) and 7.8% in symptomatic group (7.4% in C [n=24] and 9.2% in D [n=8]). (P&lt;0.05) In multivariate regression analysis, an increased risk of geriatric depression was observed in groups C and D (group C: odds ratio [OR]=2.54, CI: 1.40, 4.61, P&lt;0.01 and group D: OR=3.13 CI: 1.16, 7.57, P=0.02). The mean values of physical and mental health status in SF-12 were 48.5 (±7.9) and 56.7 (±6.8) in A, 44.6 (±10.7) and 57.3 (±7.3) in B, 45.0 (±9.9) and 53.8 (±7.7) in C, and 43.4 (±10.8) and 54.8 (±8.6) in D, respectively. Physical health status in SF-12 was associated with group C (C vs A: estimate −2.95 [CI: −4.03, −1.87], p&lt;0.01) and D (D vs A: estimate −2.93 [CI: −4.88, −0.97], p&lt;0.01), other than heart failure, older age and female. Mental health status in SF-12 was associated with group C (C vs A: estimated −2.34 [CI: −3.72, −1.42], p&lt;0.01), heart failure, hypertension, older age, female and group D (D vs A: estimate −1.63 [CI: −3.31, 0.05], p=0.06), but not statistically significant. Individuals with arrhythmia symptom (group C and D) had lower physical and mental health status than those without (group A and B) (P&lt;0.05). Conclusion Older adults with arrhythmia symptoms were more likely to have geriatric depression and low QoL, especially those with symptomatic AF, with a geriatric depressive complication rate of 9.2%. Further studies are needed to investigate whether improving physical health status can improve QoL and geriatric depression. FUNDunding Acknowledgement Type of funding sources: None.


2021 ◽  
Vol 9 (E) ◽  
pp. 645-652
Author(s):  
Agustina Arundina Triharja Tejoyuwono ◽  
Rangga Putra Nugraha ◽  
Faisal Kholid Fahdi

BACKGROUND: The spread of Coronavirus Disease 2019 (COVID-19) disease which has not been balanced with effective protocols can create mental health problems which could affect the quality of life; as of today, there is not any research that examines the influence of both factors. AIM: This study purpose was to analyze the mental health status on the quality of life amongst medicine students during COVID-19 period. METHODS: This is a cross-sectional survey on 361 students from Faculty of Medicine Tanjungpura University. This study was conducted from June 2019 to November 2020 by spreading Depression Anxiety Stress Scale questionnaire and a WHOQOL-BREF questionnaire through online. The data analysis was administered using Kruskal–Wallis statistics. RESULT: The students’ mental health status was dominantly on the normal category with depression domain by 323 students (89.5%), anxiety domain by 311 students (86.1%), and stress domain by 343 students (95%). The quality of life measurement was in category medium in all domains which are physical health (88.6%), psychological health (92.5%), social relationships (50.7%), and environment (78.7%). There was significant effect of mental health status of depression and anxiety toward the aspect of physical health, psychological health, and social relationships (p < 0.05). Stress significantly influenced all domains of quality of life, and there was no significant effect of mental health status domain depression (p = 0.051) and anxiety (p = 0.881) toward the environment aspect. CONCLUSION: Students’ mental health status in this research belongs to the category normal with moderate level in quality of life. To compare, there was a significant effect of mental health status toward the quality of life domains. The good application of self-coping mechanisms and the social encouragement from the environment is suitable intervention strategies during the pandemic COVID-19 period.


2021 ◽  
pp. 105477382110673
Author(s):  
Karin A. Emery ◽  
Jo Robins ◽  
Jeanne Salyer ◽  
Linda Thurby-Hay ◽  
Gemechis Djira

Guided by the Self and Family-Management framework, relationships between diabetes distress, self-efficacy, resilience and outcomes of A1c, quality of life and health status were explored. A cross sectional descriptive design was used. 78 individuals were enrolled from US clinics. Data were analyzed to test for associations, main effects and interactions and predictors of self-management. Results indicated low diabetes distress ( M = 20.53), high self-efficacy ( M = 7.32), moderate resilience ( M = 80.27), and mean A1c 7.35%/56.88 mmol/mol. 76% scored above the mental health norm, 46% scored above the physical health norm. Average weighted quality of life = −1.74. Diabetes distress was negatively associated with self-efficacy, resilience, physical health, mental health, and quality of life. Self-efficacy was positively associated with resilience, physical health and quality of life. Resilience was positively associated with physical health, mental health and quality of life. Positive associations were found between quality of life, physical and mental health. No associations were found between A1c and variables in the study. Multiple significant interactions were found with A1c, mental health and quality of life outcomes. Terms in the model included treatment regimen, years since diagnosis, provider collaboration and history of diabetes self-management education. Distress was a significant predictor of health status and quality of life. The results confirm self-management facilitators self-efficacy and resilience and barrier diabetes distress and their relationships with outcomes in the framework. This study contributes to the understanding of the emotional aspect of diabetes. Continuing this work will allow researchers to better understand self-management, support self-management efforts and better outcomes.


2020 ◽  
Vol 103 (11) ◽  
pp. 1185-1193

Background: The systemic lupus erythematosus (SLE) patients oftentimes suffer from both physical and psychosocial challenges that may lead to low health-related quality of life (HRQoL). However, limited research has been done in this area. Objective: To examined mental health status and HRQoL among SLE patients in Thailand. Materials and Methods: The present study was a cross-sectional study conducted at the rheumatology clinic of four major hospitals in Thailand. The paper-based questionnaire consisted of demographic, health history such as depression, anxiety, stress Scale (DASS-21), and the Rosenberg self-esteem scale (RSE), and the disease-specific Lupus Quality of Life scale (LupusQoL). Depending on the variable’s level of measurement such as categorical or continuous, Spearman’s Rho or Pearson’s product moment correlation coefficients were used to explore the relationships among the variables. Hierarchical multiple regression was used to identify the predictors of LupusQoL. Results: Among the 387 participants, many might have experienced depression, anxiety, and stress (30%, 51%, and 29%, respectively). Self-esteem among the participants was good (31.8 out of 40). All eight domains of LupusQoL were affected with intimate relationship domain being impacted the most. The overall LupusQoL was significantly associated with the number of prescribed medications (r=–0.23), depression (r=–0.70), anxiety (r=–0.58), stress (r=–0.67), and self-esteem (r=0.59), p<0.001. Significant predictors of the overall LupusQoL were mental health status (depression, anxiety, and stress) and self-esteem, F (3, 81)=43.10, p<0.001, adjusted R²=0.60. Conclusion: SLE patients should be holistically assessed in both physical and psychological aspects. In addition to proper medical treatments, healthcare providers should use a multidisciplinary team approach to resolve the patients’ psychosocial issues, which in turn, may increase the patients’ quality of life. Self-care education may be necessary to help the patients manage the condition and decrease the number of medications. Keywords: Mental health, Quality of life, SLE, Thailand


2020 ◽  
Vol 18 (3) ◽  
Author(s):  
Yi MS ◽  
Wongsa L ◽  
Kittipong S

Background: Over the past few decades, Myanmar has faced mass internal migration to seek job opportunities and pursue a better life. Migration gives rise to unambiguous stress and depression. This study aimed to assess the magnitude of depression and to identify the association between socioeconomic disparity and depression among migrant workers in Myanmar. Methods and Materials: Cross-sectional study was done among 1,201 migrants in Yangon Region. To assess the socioeconomic status, mental health status, accessibility of health care service and Quality of Life by developing self–administered questionnaire. The Generalized Linear Mixed Model was applied to determine the association between socioeconomic disparity and depression after adjusting for other covariates. Result: Their average age was 31.44 ±10.31 years. Gender distribution was not much different. About one third of respondents were factory workers and had low level of education. The magnitude of depression was 38.22% (95%CI= 35.50-41.00). Regarding the socioeconomic disparity, adequacy of income (AOR= 1.79, 95%CI: 1.35-2.37, p value<0.001) and floor surface area of the houses (AOR= 1.21, 95%CI: 1.00-1.47, p value><0.001) were strongly associated with depression. Moreover, other factors that were associated with depression were stress, quality of life and burden of medical service cost. Conclusion: Two-fifth of internal migrant workers suffered depression. The findings highlighted to develop intervention aimed to improve mental health status among migrants. In order to achieve the sustainable development goals, it is important to make investment on mental health of the migrant workers.> <0.001) were strongly associated with depression. Moreover, other factors that were associated with depression were stress, quality of life and burden of medical service cost. Conclusion: Two-fifth of internal migrant workers suffered depression. The findings highlighted to develop intervention aimed to improve mental health status among migrants. In order to achieve the sustainable development goals, it is important to make investment on mental health of the migrant workers.


Medicine ◽  
2016 ◽  
Vol 95 (19) ◽  
pp. e3523 ◽  
Author(s):  
Kyoung In Jung ◽  
Chan Kee Park

2005 ◽  
Vol 53 (12) ◽  
pp. 2145-2152 ◽  
Author(s):  
Nancy L. Keating ◽  
Marie Nørredam ◽  
Mary Beth Landrum ◽  
Haiden A. Huskamp ◽  
Ellen Meara

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