Assessing the impact of care farms on quality of life and offending: a pilot study among probation service users in England

ObjectivesTo assess the feasibility of conducting a cost-effectiveness study of using care farms (CFs) to improve quality of life and reduce reoffending among offenders undertaking community orders (COs). To pilot questionnaires to assess quality of life, connection to nature, lifestyle behaviours, health and social-care use. To assess recruitment and retention at 6 months and feasibility of data linkage to Police National Computer (PNC) reconvictions data and data held by probation services.DesignPilot study using questionnaires to assess quality of life, individually linked to police and probation data.SettingThe pilot study was conducted in three probation service regions in England. Each site included a CF and at least one comparator CO project. CFs are working farms used with a range of clients, including offenders, for therapeutic purposes. The three CFs included one aquaponics and horticulture social enterprise, a religious charity focusing on horticulture and a family-run cattle farm. Comparator projects included sorting secondhand clothes and activities to address alcohol misuse and anger management.ParticipantsWe recruited 134 adults (over 18) serving COs in England, 29% female.Results52% of participants completed follow-up questionnaires. Privatisation of UK probation trusts in 2014 negatively impacted on recruitment and retention. Linkage to PNC data was a more successful means of follow-up, with 90% consenting to access their probation and PNC data. Collection of health and social-care costs and quality-adjusted life year derivation were feasible. Propensity score adjustment provided a viable comparison method despite differences between comparators. We found worse health and higher reoffending risk among CF participants due to allocation of challenging offenders to CFs, making risk of reoffending a confounder.ConclusionsRecruitment would be feasible in a more stable probation environment. Follow-up was challenging; however, assessing reconvictions from PNC data is feasible and a potential primary outcome for future studies.

Download Full-text

What is the best approach to adopt for identifying the domains for a new measure of health, social care and carer-related quality of life to measure quality-adjusted life years? Application to the development of the EQ-HWB?

The European Journal of Health Economics ◽

10.1007/s10198-021-01306-z ◽

2021 ◽

Author(s):

Tessa Peasgood ◽

Clara Mukuria ◽

Jill Carlton ◽

Janice Connell ◽

Nancy Devlin ◽

...

Keyword(s):

Quality Of Life ◽

Social Care ◽

Domain Identification ◽

Life Years ◽

Health And Social Care ◽

Related Quality ◽

Health Related ◽

Informal Carers ◽

The Impact

AbstractEconomic evaluation combines costs and benefits to support decision-making when assessing new interventions using preference-based measures to measure and value benefits in health or health-related quality of life. These health-focused instruments have limited ability to capture wider impacts on informal carers or outcomes in other sectors such as social care. Sector-specific instruments can be used but this is problematic when the impact of an intervention straddles different sectors.An alternative approach is to develop a generic preference-based measure that is sufficiently broad to capture important cross-sector outcomes. We consider the options for the selection of domains for a cross-sector generic measure including how to identify domains, who should provide information on the domains and how this should be framed. Beyond domain identification, considerations of criteria and stakeholder needs are also identified.This paper sets out the case for an approach that relies on the voice of patients, social care users and informal carers as the main source of domains and describes how the approach was operationalised in the ‘Extending the QALY’ project which developed the new measure, the EQ-HWB (EQ health and wellbeing instrument). We conclude by discussing the strengths and limitations of this approach. The new measure should be sufficiently generic to be used to consistently evaluate health and social care interventions, yet also sensitive enough to pick up important changes in quality of life in patients, social care users and carers.

Download Full-text

The effect of surgery in tenosynovial giant cell tumours as measured by patient-reported outcomes on quality of life and joint function

The Bone & Joint Journal ◽

10.1302/0301-620x.101b3.bjj-2018-0804.r1 ◽

2019 ◽

Vol 101-B (3) ◽

pp. 272-280 ◽

Cited By ~ 3

Author(s):

F. G. M. Verspoor ◽

M. J. L. Mastboom ◽

G. Hannink ◽

W. T. A. van der Graaf ◽

M. A. J. van de Sande ◽

...

Keyword(s):

Quality Of Life ◽

Giant Cell ◽

Diffuse Type ◽

Joint Function ◽

Population Means ◽

Sf 36 ◽

Patient Reported ◽

The Impact

Aims The aim of this study was to evaluate health-related quality of life (HRQoL) and joint function in tenosynovial giant cell tumour (TGCT) patients before and after surgical treatment. Patients and Methods This prospective cohort study run in two Dutch referral centres assessed patient-reported outcome measures (PROMs; 36-Item Short-Form Health Survey (SF-36), visual analogue scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) in 359 consecutive patients with localized- and diffuse-type TGCT of large joints. Patients with recurrent disease (n = 121) and a wait-and-see policy (n = 32) were excluded. Collected data were analyzed at specified time intervals preoperatively (baseline) and/or postoperatively up to five years. Results A total of 206 TGCT patients, 108 localized- and 98 diffuse-type, were analyzed. Median age at diagnosis of localized- and diffuse-type was 41 years (interquartile range (IQR) 29 to 49) and 37 years (IQR 27 to 47), respectively. SF-36 analyses showed statistically significant and clinically relevant deteriorated preoperative and immediate postoperative scores compared with general Dutch population means, depending on subscale and TGCT subtype. After three to six months of follow-up, these scores improved to general population means and continued to be fairly stable over the following years. VAS scores, for both subtypes, showed no statistically significant or clinically relevant differences pre- or postoperatively. In diffuse-type patients, the improvement in median WOMAC score was statistically significant and clinically relevant preoperatively versus six to 24 months postoperatively, and remained up to five years’ follow-up. Conclusion Patients with TGCT report a better HRQoL and joint function after surgery. Pain scores, which vary hugely between patients and in patients over time, did not improve. A disease-specific PROM would help to decipher the impact of TGCT on patients’ daily life and functioning in more detail. Cite this article: Bone Joint J 2019;101-B:272–280.

Download Full-text

P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽

10.1093/rheumatology/keab247.176 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Rosie Barnett ◽

Anita McGrogan ◽

Matthew Young ◽

Charlotte Cavill ◽

Mandy Freeth ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Disease Activity ◽

Axial Spondyloarthritis ◽

Rehabilitation Programme ◽

Spinal Mobility ◽

The Impact

Abstract Background/Aims Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

Download Full-text

Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.114 ◽

2020 ◽

pp. 1-8

Author(s):

S. Patel ◽

M. Clancy ◽

H. Barry ◽

N. Quigley ◽

M. Clarke ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Epilepsy Surgery ◽

Refractory Epilepsy ◽

Post Surgery ◽

Axis I ◽

Patients With Epilepsy ◽

The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

Download Full-text

The course of peripheral neuropathy and its association with health-related quality of life among colorectal cancer patients

Journal of Cancer Survivorship ◽

10.1007/s11764-020-00923-6 ◽

2020 ◽

Author(s):

Cynthia S. Bonhof ◽

Lonneke V. van de Poll-Franse ◽

Dareczka K. Wasowicz ◽

Laurens V. Beerepoot ◽

Gerard Vreugdenhil ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Peripheral Neuropathy ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Eortc Qlq ◽

The Impact

Abstract Purpose To gain more insight into the course of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on health-related quality of life (HRQoL) in a population-based sample of colorectal cancer (CRC) patients up to 2 years after diagnosis. Methods All newly diagnosed CRC patients from four hospitals in the Netherlands were eligible for participation in an ongoing prospective cohort study. Patients (n = 340) completed questions on CIPN (EORTC QLQ-CIPN20) and HRQoL (EORTC QLQ-C30) before initial treatment (baseline) and 1 and 2 years after diagnosis. Results Among chemotherapy-treated patients (n = 105), a high sensory peripheral neuropathy (SPN) level was reported by 57% of patients at 1 year, and 47% at 2-year follow-up, whereas a high motor peripheral neuropathy (MPN) level was reported by 47% and 28%, at years 1 and 2, respectively. Linear mixed model analyses showed that SPN and MPN symptoms significantly increased from baseline to 1-year follow-up and did not return to baseline level after 2 years. Patients with a high SPN or MPN level reported a worse global quality of life and a worse physical, role, emotional, cognitive, and social functioning compared with those with a low SPN or MPN level. Conclusions Future studies should focus on understanding the mechanisms underlying CIPN so targeted interventions can be developed to reduce the impact of CIPN on patient’s lives. Implications for cancer survivors Patients need to be informed of both CIPN and the impact on HRQoL.

Download Full-text

The impact of stigma and discrimination on the quality of life and social disability in persons with a diagnosis of mental disorder. A pilot study

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.844 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S571-S571

Author(s):

T.M. Gondek ◽

K. Kotowicz ◽

A. Kiejna

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Mental Disorders ◽

Mental Disorder ◽

Public Information ◽

Scientific Data ◽

Social Disability ◽

Stigma And Discrimination ◽

The Impact

Stigma and discrimination of persons diagnosed with mental disorder is a common issue. In many European countries, research studies on the prevalence and implications of this problem are conducted in order to better understand how to overcome it. In Poland, there is a scarcity of such studies, what results in neglecting this issue by the policy makers. The objective of the study is to assess the prevalence of stigma and discrimination affecting the patients hospitalized in psychiatric day units and in-patient wards between 2016–2017 as well as to analyze the relationship between the stigma and the quality of life and social disability in persons with a mental disorder diagnosis of F20–F48 according to ICD-10, aged 18–65, in a day ward and an in-patient ward settings. The pilot study presents the data gathered from a preliminary sample of 20 patients of both genders diagnosed with the aforementioned mental disorders, equaling 10 per cent of the targeted total study sample. The quality of life is assessed with WHOQOL-Bref, WHO-5 questionnaire and Rosenberg self-esteem scale, while social disability is measured with the second version of the Groningen Social Disabilities Schedule. The assessment of the impact of stigma on the social disability of persons with mental disorders and their quality of life can be useful in the context of developing evidence-based interventions for these persons, while it could also provide the scientific data to support public information campaigns aiming at tackling the stigma against persons with mental disorders in Poland.Disclosure of InterestThe authors have not supplied their declaration of competing interest.

Download Full-text

Evaluation of the quality of life of patients with oral cancer in Brazil

Brazilian Oral Research ◽

10.1590/s1806-83242006000400002 ◽

2006 ◽

Vol 20 (4) ◽

pp. 290-296 ◽

Cited By ~ 15

Author(s):

Fabiana Paula de Andrade ◽

José Leopoldo Ferreira Antunes ◽

Marcelo Doria Durazzo

Keyword(s):

Quality Of Life ◽

Oral Cancer ◽

Clinical Characteristics ◽

Posterior Part ◽

Self Report ◽

Life Questionnaire ◽

Longitudinal Assessment ◽

The Impact

This study performed a field trial of a Portuguese version of the University of Washington quality of life questionnaire (UW-QOL, 3rd version), aiming at appraising its ability to identify different patterns of health-related quality of life of patients with oral cancer in Brazil. Patients (N = 100) were interviewed as they were undergoing treatment for oral squamous cell carcinoma at a large Brazilian hospital ("Hospital das Clínicas", School of Medicine, University of São Paulo). The results were compared based on categories of socio-demographic and clinical characteristics of the patients. At a one-year follow-up, 20 patients had died, and 24 were considered dropouts. The remaining patients accounted for the longitudinal assessment of modifications in the self report of quality of life. Patients with larger tumours and neoplasms in the posterior part of the mouth presented significantly (p < 0.05) poorer indications of quality of life. Chewing was the poorest rated domain (35.0/100.0), and presented the highest proportion of complaints both at the baseline and at the follow-up assessments. The questionnaire allowed the identification of important contrasts (while comparing clinical characteristics) and similarities (while comparing socio-demographic status) among subsets of respondents, and it can contribute to reduce the impact of treatments and improve subsequent patient management.

Download Full-text

A Pilot Study on Educational Workshops for Caregivers of Patients with Brain Tumors Called AGAPE Showed its Feasibility and the Maintain Caregiver’s Quality of Life Despite Patient’s Disease Progression.

10.21203/rs.3.rs-446542/v1 ◽

2021 ◽

Author(s):

Héloïse Bourien ◽

Elodie Pelotte ◽

Aurélie Thébault ◽

Claire Larible-Lefort ◽

Frédérique Lebrun ◽

...

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Brain Tumors ◽

Disease Progression ◽

Adjuvant Treatment ◽

Progressive Disease ◽

Level Of Satisfaction ◽

The Impact ◽

Very High

Abstract Background Several studies have highlighted the difficulties faced by caregivers of patients with brain tumors. We created the educational workshops called AGAPE. Their aim is to explain precisely the medical aspects of brain tumors, describe resources available, and allow a moment of exchange between caregivers. Purpose To evaluate outcomes of AGAPE. Methods This was an observational uncontrolled pilot study. Feasibility was evaluated by the caregivers’ attendance of the 2 theoretical scheduled sessions and their satisfaction. Additional outcomes were the percentage of caregivers in favour of AGAPE sustainability and the impact on their quality of life according to CarGOQoL questionnaires (Caregiver Oncology Quality of Life) between baseline before the first workshop and after the last one. Results From February 2015 to March 2019, 12 three-month sessions were organized allowing 87 caregivers to participate. 84% of caregivers attended at least 2 theoretical sessions, the level of satisfaction was very high, and all caregivers were in favor of AGAPE sustainability. 36 caregivers submitted completed questionnaires at baseline and after the last workshop attended, separated by more than 2 months. The first workshop took place mostly during or after the adjuvant treatment of their loved ones. Two-thirds of their loved ones had a progressive disease after the first workshop and 21 died. Caregivers’ quality of life was stable between the first and last attended workshop. Conclusion Our study showed that AGAPE helped to maintain caregiver’s quality of life despite patient’s disease progression and its feasibility. Moreover, AGAPE may easily be run in other hospitals.

Download Full-text

Colorectal cancer survivors’ quality of life: a qualitative study of unmet need

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002190 ◽

2020 ◽

pp. bmjspcare-2020-002190

Author(s):

Amanda Drury ◽

Sheila Payne ◽

Anne-Marie Brady

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Supportive Care ◽

Cancer Survivors ◽

Unmet Needs ◽

Unmet Need ◽

Safety Net ◽

The Impact

ObjectiveCancer survivors’ perceptions of healthcare have been identified as a predictor of quality of life (QoL) outcomes. This study aims to explore colorectal cancer (CRC) survivors’ perceptions of how cancer-related healthcare affects their QoL.MethodsSemistructured interviews were conducted with 22 CRC survivors receiving follow-up care between 1 and 5 years post diagnosis. Interviews were recorded, transcribed and analysed thematically.ResultsFive themes described the impact of healthcare experiences on CRC survivors’ QoL. While cancer survivors spoke positively of their relationships with healthcare professionals, many experienced a range of unmet information and supportive care needs. Participants described a range of positive and negative experiences, as power dynamics and navigation of healthcare systems had implications for their QoL. Where negative healthcare events aligned, survivors’ autonomy, dignity and confidence were undermined, and survivorship issues could be inadequately addressed. To address persistent unmet needs, survivors developed a safety net(work) of supports to bridge the gap of unmet needs in healthcare with varying outcomes.ConclusionsCancer survivors’ experience of follow-up and healthcare can positively or negatively affect their QoL. Preparation for cancer survivorship must be incorporated into the acute phase of diagnosis and treatment and interlinked with clear pathways of survivorship care and accessible supportive care, which support survivors to be equal partners in their healthcare. Understanding cancer survivors’ knowledge, expertise and mastery of their condition is essential to ensure delivery of person-centred supportive care that adequately addresses the survivor’s unmet needs.

Download Full-text