scholarly journals Severe reflux, sleep disturbances, and health-related quality of life after esophageal cancer surgery

Author(s):  
Pernilla Lagergren ◽  
Asif Johar ◽  
Helen Rosenlund ◽  
Lars Arnberg ◽  
Lena Haglund ◽  
...  

Abstract Purpose Esophagectomy for cancer is an extensive procedure often followed by severe complications. This study investigated whether patients with severe symptoms of reflux are more likely to have sleep disturbances and reduced health-related quality of life (HRQL) after esophagectomy. Methods This Swedish nationwide prospective cohort study encompassed all patients who had undergone esophagectomy for cancer between 2013 and 2018. One year after surgery, the patients responded to three questionnaires on reflux (EORTC QLQOG25), sleep disturbances (KSQ), and HRQL (EORTC QLQ-C30). Multivariable logistic regression provided odds ratios (OR) with 95% confidence intervals (CI) for sleep disturbance/reduced HRQL between patients with and without reflux, adjusted for potential confounders. Results Among 241 esophagectomy patients, 66 (27%) reported severe reflux. Patients with reflux had an increased risk of sleep disturbances (OR 2.3, 95% CI: 1.3–4.3) compared to patients without reflux. More specifically, these patients were more likely to suffer from poor sleep quality (OR 4.9, 95% CI: 1.9–12.4). Patients with reflux and sleep disturbances reported reductions in global quality of life, role function, emotional function, social function, and more symptoms in all scales, except for dyspnea. Conclusions This study suggests that patients with severe symptoms of reflux after esophagectomy have an increased risk of sleep disturbances and poor sleep quality, which in turn are associated with reduced HRQL. Implications for Cancer Survivors Alleviating reflux after oesophageal cancer surgery is important, since this common symptom might reduce HRQL and well-being.

Clinics ◽  
2021 ◽  
Vol 76 ◽  
Author(s):  
Alberto C. Helito ◽  
Livia Lindoso ◽  
Sofia M. Sieczkowska ◽  
Camilla Astley ◽  
Ligia B. Queiroz ◽  
...  

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Edmond Pui Hang Choi ◽  
Eric Yuk Fai Wan ◽  
Jojo Yan Yan Kwok ◽  
Weng Yee Chin ◽  
Cindy Lo Kuen Lam

Abstract Background Even though the negative impacts of nocturia on sleep quality and health-related quality of life (HRQOL) have been documented in previous research, their interrelationship has been poorly studied. This study aimed to explore whether nocturia would affect sleep quality, which in turn affects HRQOL. Methods Participants aged 40 and above were randomly recruited from a Hong Kong public primary care clinic. Participants were asked to report the average number of nocturia (waking up at night to void) pisodes per night over a 1-month period. The Pittsburgh Sleep Quality Index (PSQI) and the 12-Item Short Form Health Survey version 2 (SF-12 v2) were administered. The mediation analysis was tested using multistage regression approach and bootstrap method. Results Of the 500 subjects who completed the survey, 31.2% reported symptomatic nocturia (having ≥2 nocturia episodes per night), and 60.4% experienced poor sleep quality (a PSQI global score > 5). Respondents with symptomatic nocturia had a poorer HRQOL in the domains of physical functioning (PF), role physical (RP) and social functioning (SF), general health (GH), vitality (VT) and physical component summary (PCS) of the SF-12 v2 than those without. Compared with the respondents without poor sleep quality, those with poor sleep quality had poorer HRQOL across all domains and summaries of the SF-12 v2. Mediation analysis found that sleep quality fully mediated the association between nocturia and the PF, RP and SF domains of the SF-12 v2, respectively, and partially mediated the association between nocturia and the GH, VT and PCS domains of the SF-12 v2, respectively. Conclusions We found that sleep quality mediated the association between nocturia and HRQOL. To enhance the HRQOL of patients with nocturia, clinicians should not only focus on nocturia symptoms, but also on their sleep quality.


2021 ◽  
Vol 21 (1) ◽  
pp. 112-120
Author(s):  
Sugunesvaran Parasuraman ◽  
Tan Chung Keat ◽  
Nurhayati Binti Mohd Marzuki

In Malaysia, chronic respiratory disease including COPD is responsible for 7% of the total Disability-Adjusted Life Years (DALYs). Sleep disturbance in COPD patients is often underestimated and overlooked clinically. Respiratory symptoms caused by COPD often leads to poor sleep quality and insomnia. Poor sleep quality contributes to frequent episodes of exacerbation which directly increases mortality risk. This study aims to determine health-related quality of life and sleep quality among COPD patients and their associations with severity. In this cross-sectional study, 102 COPD patients classified according to Global Initiative for Chronic Obstructive Lung Disease were evaluated. EQ5D and Pittsburgh Sleep Quality Index (PSQI) questionnaires were used to assess health-related quality of life and sleep quality respectively. Results showed the severity of COPD is significantly associated (p<0.05) with all 5 dimensions of EQ5D among COPD patients in Kuala Lumpur. In this study, 71 patients (69.9%) were reported to be poor sleepers (PSQI>5) with a mean g l o b a l score of 6.93 ± 4.072. Sleep quality was also found to be significantly associated (p <0.05) with COPD severity, in which patients with lower severity showed better sleep quality. In this study, COPD severity was found to be significantly associated with health-related quality of life. As the disease severity progresses, both quality of life and sleep quality worsens gradually. Findings from this study highlight the importance to consider the quality of life and sleep quality as part of the management plan for COPD patients.


2017 ◽  
Vol 13 (5) ◽  
pp. e463-e473 ◽  
Author(s):  
Laura C. Pinheiro ◽  
Stephanie B. Wheeler ◽  
Katherine E. Reeder-Hayes ◽  
Cleo A. Samuel ◽  
Andrew F. Olshan ◽  
...  

Purpose: Endocrine therapy (ET) underuse puts women at increased risk for breast cancer (BC) recurrence. Our objective was to determine if health-related quality of life (HRQOL) subgroups were associated with underuse. Methods: Data came from the third phase of the Carolina Breast Cancer Study. We included 1,599 women with hormone receptor–positive BC age 20 to 74 years. HRQOL was measured, on average, 5 months postdiagnosis. Subgroups were derived using latent profile (LP) analysis. Underuse was defined as not initiating or adhering to ET by 36 months postdiagnosis. Multivariable logistic regression models estimated adjusted odds ratios (ORs) between HRQOL LPs and underuse. The best HRQOL LP was the reference. Chemotherapy- and race-stratified models were estimated, separately. Results: Initiation analyses included 953 women who had not begun ET by their 5-month survey. Of these, 154 never initiated ET. Adherence analyses included 1,114 ET initiators, of whom 211 were nonadherent. HRQOL was not significantly associated with noninitiation, except among nonchemotherapy users, with membership in the poorest LP associated with increased odds of noninitiation (adjusted OR, 5.5; 95% CI, 1.7 to 17.4). Membership in the poorest LPs was associated with nonadherence (LP1: adjusted OR, 2.2; 95% CI, 1.2 to 4.0 and LP2: adjusted OR,1.9; 95% CI, 1.1 to 3.6). Membership in the poorest LP was associated with nonadherence among nonchemotherapy users (adjusted OR, 2.1; 95% CI, 1.2 to 5.1). Conclusion: Our results suggest women with poor HRQOL during active treatment may be at increased risk for ET underuse. Focusing on HRQOL, a modifiable factor, may improve targeting of future interventions early in the BC continuum to improve ET initiation and adherence and prevent BC recurrence.


1999 ◽  
Vol 17 (2) ◽  
pp. 706-706 ◽  
Author(s):  
Marianne J. Hjermstad ◽  
Stein A. Evensen ◽  
Stein O. Kvaløy ◽  
Peter M. Fayers ◽  
Stein Kaasa

PURPOSE: To evaluate health-related quality of life (HRQOL) in adults treated with high-dose chemotherapy followed by allogeneic (SCT) and autologous (ASCT) stem-cell transplantation 1 year after transplantation, using data from concurrent lymphoma patients receiving combination chemotherapy (CT) as a reference. MATERIALS AND METHODS: Forty-one leukemia patients (SCT group), 51 lymphoma patients (ASCT group), and 85 CT patients completed the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire at baseline and after 1 year. RESULTS: The SCT group (median age, 36 years) had better functioning scores and less symptomatology at baseline compared with the ASCT (median age, 41 years) and CT (median age, 37 years) groups. Statistically significant differences of 10 or more points on the 0 to 100 scales were found for 10 of 15 scales and items (P ≤ .01) between the SCT and ASCT groups. Global quality of life (79 v 58, P < .0001), role function (83 v 65, P = .001), sleep disturbances (6 v 28, P < .0001), and fatigue (25 v 44, P = .0001) deviated most. The differences were 10 or more points for seven of 15 scales and items comparing the SCT and CT groups, with sleep disturbances (6 v 35, P < .0001) and pain (11 v 29, P < .01) deviating most. Differences across groups were smaller after 1 year; cognitive function was the only scale with a statistically significant difference (ASCT 80 v CT 89; P = .002). Patterns of change in HRQOL scores were different between groups during follow-up. A great improvement was found in the ASCT group (P < .01 for emotional and role function, fatigue, appetite, and constipation), whereas no significant changes were observed for the SCT group. CONCLUSION: Prospective studies with extended follow-up periods are necessary to separate a slow recovery process from more permanently reduced HRQOL after transplantation and to examine the late side effects from previous treatment.


2017 ◽  
Vol 40 ◽  
pp. e73-e74
Author(s):  
N. Oniani ◽  
M. Supatashvili ◽  
I. Sakhelashvili ◽  
M. Eliozishvili ◽  
T. Basishvili ◽  
...  

1999 ◽  
Vol 13 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Ingela Wiklund

Arthritis is a painful and disabling condition. To suppress the pain and the inflammatory process, patients are often chronic nonsteroidal anti-inflammatory drug (NSAID) users. Chronic use of NSAIDs may induce peptic ulcer, dyspeptic problems and heartburn. Therefore, these patients are often provided with treatment to relieve and/or protect against gastrointestinal problems. Rheumatic disorders also affect a range of health-related quality of life domains. In one study, patients with NSAID-associated gastroduodenal lesions complained about lack of energy, sleep disturbances, emotional distress and social isolation in addition to pain and mobility limitations. The degree of distress and dysfunction differed markedly from scores in an unselected population. Clinical trial data suggest that acid-suppressing therapy with omeprazole is superior to therapy with misoprostol and ranitidine in healing gastroduodenal lesions and preventing abdominal pain, heartburn and indigestion symptoms during continued NSAID treatment. Because arthritic patients are severely incapacitated by their condition regarding most aspects of health-related quality of life, it is important to offer a treatment that is effective in healing and preventing NSAID-induced ulcers and gastrointestinal symptoms during continued NSAID treatment without further compromising the patients’ quality of life. Treatment with omeprazole once daily has been shown to be superior to that with ranitidine and misoprostol in this respect.


Critical Care ◽  
2008 ◽  
Vol 12 (4) ◽  
pp. R97 ◽  
Author(s):  
Lotti Orwelius ◽  
Anders Nordlund ◽  
Peter Nordlund ◽  
Ulla Edell-Gustafsson ◽  
Folke Sjoberg

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Marília Pilotto de Oliveira ◽  
Luciana Kusumota ◽  
Vanderlei José Haas ◽  
Rita de Cássia Helú Mendonça Ribeiro ◽  
Sueli Marques ◽  
...  

Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death.


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