P1551FAMILY SUPPORT IS CRUCIAL FOR DIALYSIS PATIENTS TREATMENT ADHERENCE AND QUALITY OF LIFE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Lada Trajcheska ◽  
Irena Rambabova Bushljetikj ◽  
Gjulsen Selim ◽  
Aleksandar Sikole ◽  
Goce Spasovski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multivariate Analysis ◽  
Family Support ◽  
Laboratory Data ◽  
Dialysis Patients ◽  
Increased Risk ◽  
The Impact ◽  
Phosphorous Level ◽  
Medical Investigations

Abstract Background and Aims Non-compliant dialysis patients are at increased risk of mortality. Compliance depends on patient demographics, educational level and income. Family support and marital status might also influence the patients compliance, as well as the quality of life. Missed/shortened dialysis sessions, adherence to prescribed medications, excessive phosphate serum values and interdialytic weigh gain, smoking and adherence to medical investigations provide indicators of non-compliance. Aim: To assess the impact of family support on different compliance indicators in the dialysis patients. Method In this observational study 134 dialysis patients were scored for different indicators of compliance from 0-2 and summary scores of compliance were assessed. Clinical and laboratory data were obtained from the previous two years. Patients with mean IDWGs >4.5% of body weight (BW) and/or phosphorous level above 1.6 mmol/L were scored with 1, patients with IDWG/BW more than 5.7% and/or 2.0 for mean phosphorous level were scored with 2. Summary scores of non-compliance were also assessed. Patients were scored for quality of life with SF-36 questionnaire. Patients non-adherence was analysed for predictors in multivariate analysis. Results Estimated rates of noncompliance varied: Medical investigations 63%, phosphorous 33, IDWG 22, therapy 14%, HD treatment 9%. When the complete dietary fluid, medications and treatment regimen were studied noncompliance rate was 73%, and when adherence to medical investigations was added the rate rose up to 87%. Patients with family support above median level (≥25) were significantly more often men (0.049), with diabetes (p=0.014), lower socioeconomic status (0.001) and married (0.003). The quality of life scores were significantly worse in the low family supported patients (56.73±26.15 vs 39.23±24.05, p=0.0001). They also scored worse in overall non-compliance scores 2.04±1.71 vs 2.97±2.06, p= 0.007). In the multivariate analysis the non-compliance was predicted most powerfully in patients with younger age, low social status and lower family support (β=-0.202, p=0.023, β=0.220, p=0.036, β=-0.175, p=0.019, respectively). Conclusion Family support is crucial for dialysis patients adherence to treatment and Quality of life. Efforts should be done to recognize the patients real needs and adequately help those confronting dialysis burden and improve their quality of life.

Quality of Life Following Stroke: A Qualitative Study Across 30 Years

2021 ◽  
Vol 6 (1) ◽  
pp. 151-162
Author(s):  
Steffany M. Chleboun ◽  
Kathryn Brady ◽  
Jennie Zelenak
Keyword(s):  
Quality Of Life ◽  
Grounded Theory ◽  
Qualitative Study ◽  
Family Support ◽  
Resilience Theory ◽  
Grounded Theory Methodology ◽  
Long Period ◽  
The Impact

Much of what we know about stroke is limited to the first 5 years postinjury; however, the effects of having a stroke remain several years, even decades, postinjury, and the impact this has on an individual's quality of life over a long period of time is not completely understood. Purpose The purpose of this study was to understand one woman's experience living with the effects of stroke over multiple decades postinjury and to explore factors that affected her quality of life during this time. Method Using Grounded Theory methodology, data were drawn from 28 years of journals kept by the participant and from semistructured family interviews. Results Four major interacting themes emerged from the data: family support, faith, personality, and journaling. Findings are discussed in the context of resilience theory.

Longitudinal Trends in Quality of Life and Physical Function in Frail Older Dialysis Patients: A Comparison of Assisted Peritoneal Dialysis and In-Center Hemodialysis

2019 ◽  
Vol 39 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Osasuyi Iyasere ◽  
Edwina Brown ◽  
Fabiana Gordon ◽  
Helen Collinson ◽  
Richard Fielding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Mixed Model ◽  
Rating Scale ◽  
Depression Scale ◽  
Dialysis Patients ◽  
The Impact ◽  
Assisted Peritoneal Dialysis

Background In-center hemodialysis (HD) has been the standard treatment for older dialysis patients, but reports suggest an associated decline in physical and cognitive function. Cross-sectional data suggest that assisted peritoneal dialysis (aPD), an alternative treatment, is associated with quality of life (QoL) outcomes that are comparable to in-center HD. We compared longitudinal changes in QoL between modalities. Methods We enrolled 106 aPD patients, matched with 100 HD patients from 20 renal centers in England and Northern Ireland. Patients were assessed quarterly for 2 years using the Hospital Anxiety and Depression Scale (HADS), SF-12 physical and mental scores, symptom score, Illness Intrusiveness Rating Scale (IIRS), Barthel's score, and the Renal Treatment Satisfaction Questionnaire (RTSQ). Mixed model analysis was used to assess the impact of dialysis modality on these outcomes during follow-up. P values were adjusted for multiple significance testing. Results Multivariate analysis showed no difference in any of the outcome measures between aPD and HD. Longitudinal trends in outcomes were also not significantly different. Higher age at baseline was associated with lower IIRS and RTSQ scores during follow-up. One-hundred and twenty-five (60.6%) patients dropped out of the study: 59 (28.6%) died, 61 (29.6%) withdrew during follow-up, and 5 (2.5%) were transplanted. Conclusions Quality of life outcomes in frail older aPD patients were equivalent to those receiving in-center HD. Assisted PD is thus a valid alternative to HD for older people with end-stage kidney disease (ESKD) wishing to dialyze at home.

scholarly journals O26 Non-serious infections in patients with RA: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Katie Bechman ◽  
Kapil Halai ◽  
Sam Norton ◽  
Andrew P Cope ◽  
Kimme L Hyrich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
British Society ◽  
Tnf Inhibitor ◽  
Drug Survival ◽  
Increased Risk ◽  
Serious Infections ◽  
The Impact ◽  
Biologics Register

Abstract Background Patients with rheumatoid arthritis (RA) are at an increased risk of infection. Most attention has been given to serious infections, but these are the tip of the iceberg. Non-serious infections (NSI) are far more frequent, and although not life-threatening, have potential to impact treatment outcomes (drug survival) and quality of life. Our objective was to describe frequency of NSI and compare incidence of NSI by biologic drug within the British Society for Rheumatology Biologics Register (BSRBR-RA). Methods The BSRBR-RA is a prospective observational cohort study. NSI was identified as not requiring hospitalisation, intravenous therapy or leading to disability or death. Infections were captured from clinician questionnaires and patient diaries. Individuals were considered ‘at risk’ from the date of commencing biologic treatment for 3 years. Drug exposure was defined by agent; TNF inhibitor, IL-6 inhibitor, anti-CD20 or csDMARD only. To account for a high frequency of events, a multiple-failure Cox model was used. Multivariable adjustment included age, gender, DAS28-ESR, HAQ-DI, disease duration, smoking, steroid usage, year recruited to BSRBR-RA, line of biologic therapy and cumulative infection number. Results There were 17,304 NSI in 10,099 patients, with an event rate of 27.0 per year (95% CI 26.6 to 27.4). Increasing age, female gender, comorbidity burden, corticosteroid therapy, DAS28 and HAQ-DI were associated with an increased risk of NSI. The rate of NSI was numerically lowest with csDMARDs. Compared to TNFi, IL-6 inhibitor had a higher risk of NSI, whilst the csDMARD cohort had a lower risk. Between the TNFi agents, adalimumab had a higher risk than etanercept (Table 1). Conclusion These results confirm that NSI is a frequent occurrence for patients, which historically has received little attention in research literature. The data suggest biologics increase the risk of NSI, especially IL-6 inhibition. Whilst unmeasured confounding must be considered, the magnitude of effects are large and it seems likely that a causal link between targeted immunosuppression and NSI risk exists. Further research is needed to understand the impact of NSI on clinical outcomes including drug survival and quality of life. Disclosures K. Bechman: None. K. Halai: None. S. Norton: None. A.P. Cope: None. K.L. Hyrich: Honoraria; AbbVie paid to the institution and grant income from Pfizer and Bristol-Myers Squibb for activities outside of this work. J.B. Galloway: Honoraria; for speaking or attending conferences from AbbVie, Bristol-Myers Squibb, Celgene, Janssen, Pfizer and Union Chimique Belge.

scholarly journals Lack of application of the European Work Time Directive: effects on workload, work satisfaction and burnout among Italian physicians

2017 ◽  
Vol 11 (2) ◽  
pp. 159
Author(s):  
Paola Gnerre ◽  
Domenico Montemurro ◽  
Andrea P. Rossi ◽  
Costantino Troise ◽  
Carlo Palermo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Work Conditions ◽  
Public Hospitals ◽  
Burnout Syndrome ◽  
Negative Consequences ◽  
Work Time ◽  
Increased Risk ◽  
Wide Range ◽  
The Impact

The Italian Parliament has excluded hospital physicians from the application of the European Work Time Directive (EWTD), which imposes a maximum workweek of 48 h and compulsory resting periods. This resulted in extended and excessive work time for the category. This paper is aimed at evaluating the impact of this legislation gap, by assessing the presence of excessive work-related stress and risk for burnout syndrome among Italian physicians working in public hospitals. This observational study is based on an on-line survey conducted on a sample of 1925 Italian doctors (covering a wide range of age, work experience and contractual positions) from October 2014 to February 2015. The questionnaire included 30 questions concerning their personal and professional life (<em>e.g</em>., assessment of workloads, number of uncomfortable or extra shifts, unused days-off, <em>etc</em>.). On the basis of the results, it can be inferred that the average Italian doctor working in public hospitals is under considerable stress at work with negative consequences on his health. He is exposed to high risk of suffering from sleep disorders and cardiovascular diseases (due to the lack of time for private practice and eating regular meals). Overall, his perception is that his job worsens his quality of life. This study shows the relevance of the risk of burnout among Italian physicians employed in public hospitals due to severe workload and work conditions. The resulting impact on the quality of care and the significant cost involved - both in human and economic terms - calls for significant emergency measures by the Italian health work organization. An important increase and prolonged working time is associated with a worsening of the objective cognitive performance and an increase of clinical risk, but also to an increased risk of diseases for operators and of the burnout syndrome. Our survey shows that lack of application of the EWTD has adverse effects on the quality of life and performance of Italian doctors. Failure to respond by all Italian doctors is the greatest limitation of our survey.

The importance of support and forms of kinesiotherapeutic activity of family members of persons affected by Parkinson’s disease

2019 ◽  
Vol 6 (1) ◽  
pp. 1-7
Author(s):  
Aleksandra Wróbel ◽  
Piotr Wróbel ◽  
Ewa Otfinowska
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Family Support ◽  
Family System ◽  
Well Being ◽  
Entire Family ◽  
Permanent Disability ◽  
The Impact

Parkinson’s disease is a chronic and progressive degenerative disease of the central nervous system. The disorder is classified as extra pyramidal system diseases. In order to improve the patient’s condition and increase the level of quality of life, pharmacological treatment and rehabilitation are used to eliminate progressive disability. The help of the surrounding environment affects not only the course of the disease, but above all the emotional well-being of the patient. Family support and its participation in the whole therapeutic process greatly optimize its results. The aim of this work is to present the most important issues regarding kinesiotherapy in Parkinson’s disease and to demonstrate the impact of the involvement of the whole family system on the course and results of therapy. Kinesiotherapy as an element of treatment plays a very important role in the process of improving and adapting the patient to perform daily nursing activities. Kinesiotherapeutic treatments have not only a significant impact on the symptoms occurring in the course of the disease, but also on the overall health. The individual selection of therapy and the involvement of the entire team of therapists is extremely important in eliminating both movement and extrinsic symptoms. The correct implementation of the physiotherapist’s recommendations, the patient’s involvement, as well as the active participation of the patient’s environment, is a condition for the effectiveness of the entire process of maintaining health and fitness. Kinesiotherapy prevents permanent disability and helps maintain the longest possible independence and good quality of life. The involvement of the entire family support system has an impact on the results of the therapy.

scholarly journals Impact of malocclusion on the quality of life of Saudi children

2013 ◽  
Vol 83 (6) ◽  
pp. 1043-1048 ◽  
Author(s):  
Irfan Dawoodbhoy ◽  
Elsa K. Delgado-Angulo ◽  
Eduardo Bernabé
Keyword(s):  
Quality Of Life ◽  
Saudi Arabia ◽  
Multivariate Analysis ◽  
The Other ◽  
Arabic Version ◽  
Child Perception ◽  
Clinical Measures ◽  
The Impact ◽  
The Relationship

ABSTRACT Objective: To assess the relationship between malocclusion severity and quality of life in children. Materials and Method: Two hundred and seventy-eight children aged 11 to 14 years were recruited voluntarily from the Dental and Maxillofacial Centre of the Almana General Hospital in Alkhobar, Saudi Arabia. The children were asked to fill out the Arabic version of the Child Perception Questionnaire for 11- to 14-year-old children (CPQ11–14) and were then clinically examined to determine the severity of their malocclusion using the Dental Aesthetic Index (DAI). Multivariate analysis of variance was used to compare the four domains and the total CPQ11–14 scores between the four DAI severity groups. Results: Significant differences were found between DAI severity groups for the four domains and the total CPQ11–14 scores. Although children with very severe (handicapping) malocclusion had significantly higher domain and total CPQ11–14 scores than all the other groups (differences of up to 6 and 22 units, respectively, compared to children with no/minor malocclusion), there were no differences between those with no/minor, definite, and severe malocclusion. Conclusion: These findings suggest that only very severe malocclusion had an impact on the quality of life of the participants. Orthodontists should focus not only on clinical measures of malocclusion but should also consider the impact of severe malocclusion on patients' quality of life.

scholarly journals Atrial fibrillation and clinical outcomes 1 to 3 years after myocardial infarction

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001726
Author(s):  
Anthony P Carnicelli ◽  
Ruth Owen ◽  
Stuart J Pocock ◽  
David B Brieger ◽  
Satoshi Yasuda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Clinical Outcomes ◽  
Oral Anticoagulants ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
History Of ◽  
The Impact

ObjectiveAtrial fibrillation (AF) and myocardial infarction (MI) are commonly comorbid and associated with adverse outcomes. Little is known about the impact of AF on quality of life and outcomes post-MI. We compared characteristics, quality of life and clinical outcomes in stable patients post-MI with/without AF.Methods/resultsThe prospective, international, observational TIGRIS (long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease) registry included 8406 patients aged ≥50 years with ≥1 atherothrombotic risk factor who were 1–3 years post-MI. Patient characteristics were summarised by history of AF. Quality of life was assessed at baseline using EQ-5D. Clinical outcomes over 2 years of follow-up were compared. History of AF was present in 702/8277 (8.5%) registry patients and incident AF was diagnosed in 244/7575 (3.2%) over 2 years. Those with AF were older and had more comorbidities than those without AF. After multivariable adjustment, patients with AF had lower self-reported quality-of-life scores (EQ-5D UK-weighted index, visual analogue scale, usual activities and pain/discomfort) than those without AF. CHA2DS2-VASc score ≥2 was present in 686/702 (97.7%) patients with AF, although only 348/702 (49.6%) were on oral anticoagulants at enrolment. Patients with AF had higher rates of all-cause hospitalisation (adjusted rate ratio 1.25 [1.06–1.46], p=0.008) over 2 years than those without AF, but similar rates of mortality.ConclusionsIn stable patients post-MI, those with AF were commonly undertreated with oral anticoagulants, had poorer quality of life and had increased risk of clinical outcomes than those without AF.Trial registration numberClinicalTrials: NCT01866904.

scholarly journals Urinary Dysfunction in Women Following Total Mesorectal Excision Vs. Partial Mesorectal Excision for Treatment of Rectal Cancer

2021 ◽  
Author(s):  
Henry H. Chill ◽  
Shani Parnasa ◽  
Noam Shussman ◽  
Roie Alter ◽  
Briggite Helou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Urinary Dysfunction ◽  
University Hospital ◽  
Mesorectal Excision ◽  
Increased Risk ◽  
The Impact ◽  
Substantial Morbidity

Abstract Background: Colorectal cancer is a condition which is associated with substantial morbidity and mortality. The aim of this study was to assess urinary dysfunction and its effect on quality of life in women who underwent total mesorectal excision compared to women treated by partial mesorectal excision for treatment of rectal cancer. Methods: We performed a retrospective cohort study at a tertiary university hospital between January 2014 and December 2019. A comparison was performed between women who underwent total mesorectal excision as opposed to partial mesorectal excision for treatment of rectal cancer. Pre-operative, intra-operative and post-operative data were compared between groups. Urinary dysfunction and its impact on quality of life were assessed using UDI-6 and USIQ questionnaires. Further univariate and multivariate analyses were performed in the attempt of assessing risk factors for urinary dysfunction. Results: A total of 107 women were included in the study, 73 women underwent partial mesorectal excision as opposed to 34 women who were treated by total mesorectal excision. Urinary dysfunction following surgery as assessed using the UDI-6 questionnaire did not differ between groups. Similar findings were recorded with regard to the impact of urinary dysfunction on quality of life as assessed using the USIQ questionnaire. Following multivariate analysis longer hospital stay was associated with increased risk of some degree of urinary dysfunction. Conclusions: Women undergoing total mesorectal excision have comparable results to partial mesorectal excision with regard to urinary dysfunction.

scholarly journals Impact of COVID-19 on mental health and quality of life: Is there any effect? A cross-sectional study of the MENA region

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249107
Author(s):  
Ayesha S. Al Dhaheri ◽  
Mo’ath F. Bataineh ◽  
Maysm N. Mohamad ◽  
Abir Ajab ◽  
Amina Al Marzouqi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Family Support ◽  
North Africa ◽  
Psychological Impact ◽  
Mena Region ◽  
Event Scale ◽  
Health Crisis ◽  
The Impact

The COVID-19 pandemic is a major health crisis that has changed the life of millions globally. The purpose of this study was to assess the effect of the pandemic on mental health and quality of life among the general population in the Middle East and North Africa (MENA) region. A total of 6142 adults from eighteen countries within the MENA region completed an online questionnaire between May and June 2020. Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R) and the social and family support impact was assessed with questions from the Perceived Support Scale (PSS). The IES-R mean score was 29.3 (SD = 14.8), corresponding to mild stressful impact with 30.9% reporting severe psychological impact. Most participants (45%–62%) felt horrified, apprehensive, or helpless due to COVID-19. Furthermore, over 40% reported increased stress from work and financial matters. Higher IES-R scores were found among females, participants aged 26–35 years, those with lower educational level, and participants residing in the North Africa region (p<0.005). About 42% reported receiving increased support from family members, 40.5% were paying more attention to their mental health, and over 40% reported spending more time resting since the pandemic started. The COVID-19 pandemic was associated with mild psychological impact while it also encouraged some positive impact on family support and mental health awareness among adults in the MENA region. Clinical interventions targeted towards vulnerable groups such as females and younger adults are needed.

P1474IMPACT OF MALNUTRITION ON HEALTH-RELATED QUALITY OF LIFE IN DIALYSIS PATIENTS: A PROSPECTIVE STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Daniela Viramontes Horner ◽  
Fiona Willingham ◽  
Zoe Pittman ◽  
Nicholas Selby ◽  
Maarten Taal
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Health State ◽  
Dialysis Patients ◽  
Nutritional Interventions ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
State Score

Abstract Background and Aims Health-related quality of life (HRQoL) is severely impaired in dialysis patients compared to the general population. Previous studies have shown that malnutrition, a frequent complication and independent risk factor for mortality in the dialysis population, is associated with poor HRQoL. However, there is no published evidence regarding the impact of malnutrition on change in HRQoL over time. We sought to determine the most important predictors of poor HRQoL as well as the determinants of change in HRQoL over time in dialysis patients, with a particular focus on malnutrition. Method We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in a 1-year single-centre prospective observational study. HRQoL was assessed using the physical and mental component scores (PCS and MCS, respectively) from the 36-Item Short Form Health Survey and the health state and visual analogue scores from the European Quality of Life 5-Dimensions (EQ5D) questionnaire. The 7-point scale Subjective Global Assessment (SGA) was performed to evaluate nutritional status. Energy, protein and fat intake, biochemical variables, anthropometric measurements and handgrip strength (HGS) were also measured. All study assessments were performed at baseline, 6 and 12 months. Results Mean age was 64±14 years. Malnutrition was present in 37% of the population (as determined by 7-point SGA). Patients with malnutrition and diabetes had significantly lower MCS, PCS and EQ5D scores compared to well-nourished and non-diabetic patients, respectively. At baseline, chronological age, serum albumin, energy and protein intake, and HGS correlated positively with PCS and EQ5D health state score. Multivariable analysis at baseline identified malnutrition as the strongest independent predictor of decreased HRQoL, after adjusting for confounders (Table 1). Patients who stayed or became malnourished during one year showed a significant decrease in MCS, PCS and EQ5D health state score at 12 months compared to baseline. This same group of patients had significantly lower MCS, PCS and EQ5D scores at baseline and 12 months compared to those who stayed or became well-nourished during one year. Prevalent/development of malnutrition was independently and significantly associated with the 1-year decrease in MCS and EQ5D health state score. In addition, a decrease in serum total protein and dietary protein intake (markers of malnutrition) were identified as independent determinants of 1-year decrease in MCS, PCS and EQ5D health state score. Conclusion We observed in this prospective observational study that presence of malnutrition was the most important and strongest independent predictor of decreased HRQoL in this dialysis population. Furthermore, prevalence/development of malnutrition and a decrease in markers of nutritional status were independently associated with a decrease in some HRQoL scores over 1 year. These findings strengthen the importance of undertaking screening to identify malnutrition, and providing specialised, individualised nutritional advice to all dialysis patients in order to prevent and/or improve nutritional status. Future studies with larger sample sizes, longer follow-up, and which include evaluation of barriers to effective nutritional interventions are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.

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