Repatriation for diseases or non-battle injuries (DNBI): long-term impact on quality of life

2019 ◽  
Vol 166 (E) ◽  
pp. e13-e16
Author(s):  
Eelco Huizinga ◽  
F J Idenburg ◽  
T T C F van Dongen ◽  
R Hoencamp
Keyword(s):  
Quality Of Life ◽  
Military Service ◽  
Short Form ◽  
Service Members ◽  
Future Research ◽  
Control Group ◽  
Cross Sectional ◽  
Battle Injuries

IntroductionThroughout history, diseases and non-battle injuries (DNBI) have threatened deployed forces more than battlefield injuries. During the Dutch involvement in Afghanistan, the amount of DNBI that needed medical evacuation out of theatre (60%) exceeded the number of battle injuries (40%). The aim of this study is to explore the long-term quality of life (QoL) of Dutch service members that acquired a DNBI, warranting repatriation during their deployment to Afghanistan between 2003 and 2014.MethodsObservational cross-sectional cohort study in a selected group of Dutch service members who deployed to Afghanistan 2003–2014 and were repatriated due to DNBI. Using the 36-item Short Form, EuroQol-6D, Symptom Checklist 90 and Post Deployment Reintegration Scale questionnaires, their outcomes were compared with a control group of deployed service members who did not sustain injuries or illnesses.ResultsGroups were comparable in age, rank, number of deployments and social status. There were significant differences found in terms of physical functioning, pain and health perspective. No differences were seen in emotional or psychological outcomes.ConclusionThe amount of military service members who contract a DNBI is significant and imposes a burden on the capacity of the medical support, readiness of deployed units and sustainability of ongoing operations. However, regarding QoL, being forced to leave their units and to be repatriated to their home country due to a DNBI seems to have no significant impact on reported psychological symptoms of distress and reintegration experiences. Future research should focus on more in-depth registration of illnesses and not combat related diseases and injuries and even longer-term outcomes.

scholarly journals Health-Related Quality of Life Among Long-Term Rectal Cancer Survivors With an Ostomy: Manifestations by Sex

2009 ◽  
Vol 27 (28) ◽  
pp. 4664-4670 ◽  
Author(s):  
Robert S. Krouse ◽  
Lisa J. Herrinton ◽  
Marcia Grant ◽  
Christopher S. Wendel ◽  
Sylvan B. Green ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Short Form ◽  
Well Being ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Purpose Intestinal stomas can pose significant challenges for long-term (≥ 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). Patients and Methods This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Results Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Conclusion Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75.

scholarly journals Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls

2015 ◽  
Vol 122 (4) ◽  
pp. 833-842 ◽  
Author(s):  
Matthew L. Carlson ◽  
Oystein Vesterli Tveiten ◽  
Colin L. Driscoll ◽  
Frederik K. Goplen ◽  
Brian A. Neff ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stereotactic Radiosurgery ◽  
Short Form ◽  
Individual Treatment ◽  
Control Group ◽  
Treatment Groups ◽  
Sf 36 ◽  
Disease Specific

OBJECT The optimal treatment for sporadic vestibular schwannoma (VS) is highly controversial. To date, the majority of studies comparing treatment modalities have focused on a narrow scope of technical outcomes including facial function, hearing status, and tumor control. Very few publications have investigated health-related quality of life (HRQOL) differences between individual treatment groups, and none have used a disease-specific HRQOL instrument. METHODS All patients with sporadic small- to medium-sized VSs who underwent primary microsurgery, stereotactic radiosurgery (SRS), or observation between 1998 and 2008 were identified. Subjects were surveyed via postal questionnaire using the 36-Item Short Form Health Survey (SF-36), the 10-item Patient-Reported Outcomes Measurement Information System short form (PROMIS-10), the Glasgow Benefit Inventory (GBI), and the Penn Acoustic Neuroma Quality-of-Life (PANQOL) scale. Additionally, a pool of general population adults was surveyed, providing a nontumor control group for comparison. RESULTS A total of 642 respondents were analyzed. The overall response rate for patients with VS was 79%, and the mean time interval between treatment and survey was 7.7 years. Using multivariate regression, there were no statistically significant differences between management groups with respect to the PROMIS-10 physical or mental health dimensions, the SF-36 Physical or Mental Component Summary scores, or the PANQOL general, anxiety, hearing, or energy subdomains. Patients who underwent SRS or observation reported a better total PANQOL score and higher PANQOL facial, balance, and pain subdomain scores than the microsurgical cohort (p < 0.02). The differences in scores between the nontumor control group and patients with VS were greater than differences observed between individual treatment groups for the majority of measures. CONCLUSIONS The differences in HRQOL outcomes following SRS, observation, and microsurgery for VS are small. Notably, the diagnosis of VS rather than treatment strategy most significantly impacts quality of life. Understanding that a large number of VSs do not grow following discovery, and that intervention does not confer a long-term HRQOL advantage, small- and medium-sized VS should be initially observed, while intervention should be reserved for patients with unequivocal tumor growth or intractable symptoms that are amenable to treatment. Future studies assessing HRQOL in VS patients should prioritize use of validated disease-specific measures, such as the PANQOL, given the significant limitations of generic instruments in distinguishing between treatment groups and tumor versus nontumor subjects.

scholarly journals Stigma and quality of life for patients with facial dystonia: a cross-sectional study

2022 ◽  
Author(s):  
MING YI ◽  
Jing LI ◽  
Gang LIU ◽  
Weixi ZHANG ◽  
Ying WANG ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Short Form ◽  
Cross Sectional Study ◽  
Control Group ◽  
Hamilton Depression Scale ◽  
Sectional Study ◽  
Cross Sectional ◽  
Facial Dystonia

Abstract Background Facial appearance and expressions influence social interaction. However, few studies have reported on the stigma associated with spasms from facial dystonia. This study investigated the stigma and quality of life for these patients. Methods This cross-sectional study included 90 patients with facial dystonia (hemifacial spasm [HFS], blepharospasm [BSP], and blepharospasm-oromandibular dystonia [BOD]; 30 patients per group) and 30 individuals without dystonia (control group) from October 2019 to November 2020. All participants underwent stigma, quality of life, and mental health evaluations using seven questions related to stigma, the 36-item Short Form Health Survey, the 14-item version of the Hamilton Anxiety Scale (HAMA), and the 24-item version of the Hamilton Depression Scale. Results Nineteen patients (21.11%) felt stigmatized. Patients with BPS and HFS had more difficulty finding a job and were more susceptible to discrimination than healthy individuals. The role-physical and social function scores were significantly lower in the dystonia groups than in the control group. The vitality score of the BPS group and the mental health scores in the BPS and BOD groups were significantly less than those of the control group. The HAMA scores in the BPS and BOD groups were significantly higher than in the control group. Regression analysis demonstrated that the disease course influenced depression. Conclusion Enacted stigma from a negative public attitude may be the main factor triggering stigma in patients with facial dystonia, with detrimental effects on psychosocial outcomes, including social rights, quality of life, and mood.

scholarly journals The assessment of quality of life in clinical practice in patients with schizophrenia

2014 ◽  
Vol 16 (2) ◽  
pp. 185-195 ◽  
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Negative Symptoms ◽  
Future Research ◽  
Cross Sectional ◽  
Affective Symptoms ◽  
Outcome Criterion ◽  
Pubmed Search

The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words "quality of life" and "schizophrenia" and in a cross-reference search for articles that were particularly relevant. A total of n=432 studies used 35 different standardized generic and specific QoL scales in patients with schizophrenia. Affective symptoms were major obstacles for QoL improvement in patients with schizophrenia. Though positive symptoms, negative symptoms, and cognitive functioning may be seen as largely independent parameters from subjective QoL, especially in cross-sectional trials, long-term studies confirmed a critical impact of early QoL improvement on long-term symptomatic and functional remission, as well as of early symptomatic response on long-term QoL. Results of the present review suggest that QoL is a valid and useful outcome criterion in patients with schizophrenia. As such, it should be consistently applied in clinical trials. Understanding the relationship between symptoms and functioning with QoL is important because interventions that focus on symptoms of psychosis or functioning alone may fail to improve subjective QoL to the same level. However, the lack of consensus on QoL scales hampers research on its predictive validity. Future research needs to find a consensus on the concept and measures of QoL and to test whether QoL predicts better outcomes with respect to remission and recovery under consideration of different treatment approaches in patients with schizophrenia.

Neurodevelopment and Health-Related Quality of Life in Infants Born with Gastroschisis: A 6-Year Retrospective French Study

2016 ◽  
Vol 27 (04) ◽  
pp. 352-360 ◽  
Author(s):  
Meriem Zahed ◽  
Floriane Guimond ◽  
Karine Baumstarck ◽  
Alice Faure ◽  
Fabrice Michel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Tertiary Care ◽  
Outcome Data ◽  
Primary Objective ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome

Introduction Quantify quality of life (QoL) outcomes in gastroschisis children is little assessed. The primary objective was to describe the long-term outcome of newborns with gastroschisis treated in three tertiary care hospitals of France in terms of neurodevelopment and QoL. Materials and Methods The study reported was a cross-sectional, descriptive multicentric retrospective study assessing the outcome of newborns with gastroschisis, born between January 1, 2009, and December 31, 2014, treated at two large and French level III neonatal intensive care units. Long-term outcome data were assessed by questionnaires sent to the infants' parents. Questionnaires explored global health, neurological development, and quality of life (overall assessment including socio-economic and medical), Age & Stages Questionnaire, infants' quality of life (KIDSCREEN), and quality of parents' life (General Questionnaire Short Form-36). Results In this study, 50% of the survivor's families answered the assessment form (n = 33). The average follow-up age was 40 months, ranging from 8 months to 6 years. Cases of simple gastroschisis more often had a normal score for “communication” (p = 0.033), while patients who received morphine for a longer duration had significantly lower scores for the items “communication” and “problem resolving” (p = 0.024 and p = 0.011, respectively). Children's QoL was significantly lower for patients with gestational age younger than 36 weeks (p = 0.023) and for patients born following “fetal cause delivery” (p = 0.022). Parents had a significantly higher physical composite score if their child underwent primary closure (p = 0.012). Conclusion Our analyses confirm the idea that cases of complex gastroschisis and preterm delivery may lead to poorer outcome. Such hindsight (40 months in mean) allowed for an interesting assessment of development long after the patient's initial hospitalization and to confirm these results, a standardized neuropsychological evaluation of patients should be done when at least 6 years old. An accurate assessment of the social environment and its impact on the development and QoL of children will be fundamental to avoid selection bias.

scholarly journals Quality of life is decreased in patients with paragangliomas

2013 ◽  
Vol 168 (5) ◽  
pp. 689-697 ◽  
Author(s):  
L T van Hulsteijn ◽  
A Louisse ◽  
B Havekes ◽  
A A Kaptein ◽  
J C Jansen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Depression Scale ◽  
Long Term Results ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Mutation Carriers ◽  
Health Related Qol

ContextGermline mutations in succinate dehydrogenase (SDH) genes predispose carriers for developing paragangliomas, and studies on their quality of life (QoL) are scarce.ObjectivesThe objectives of this study were to assess QoL in patients with paragangliomas (PGL), to evaluate long-term QoL, and to explore potential differences in QoL between SDH mutation carriers and paraganglioma patients without an SDH mutation.DesignCross-sectional, case–control study.SettingTertiary referral center.SubjectsOne hundred and seventy four paraganglioma patients were included: 25 SDHB, two SDHC, and 122 SDHD mutation carriers and 25 patients without an SDH mutation. They provided 100 peers as control persons. Furthermore, patients were compared with age-adjusted reference populations.Main outcome measuresQoL was assessed using three validated health-related QoL questionnaires: the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Index 20, and the Short Form 36.ResultsPatients reported a significantly impaired QoL compared with their own controls, mainly on fatigue and physical condition subscales. Compared with age-adjusted literature values, patients had significantly impaired scores on physical, psychological, and social subscales. A decreased QoL was mainly related to paraganglioma-associated complaints.There was no difference in QoL between the various SDH mutation carriers or paraganglioma patients without an SDH mutation. QoL in asymptomatic mutation carriers, i.e. without manifest disease, did not differ from QoL of the general population. Long-term results in 41 patients showed no alteration in QoL besides a reduced level of activity.ConclusionQoL is decreased in paraganglioma patients but stable when measured over time.

scholarly journals Adults’ Adherence to Growth Hormone Replacement in Relation to Medication-Related Beliefs, Coping and Quality of Life - An Exploratory Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Sonja Siegel ◽  
Nicole Unger ◽  
Christine Streetz-van der Werf ◽  
Wolfram Karges ◽  
Katharina Schilbach ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Growth Hormone ◽  
Coping Strategies ◽  
Short Form ◽  
Hormone Replacement ◽  
Active Coping ◽  
Future Research ◽  
Cross Sectional ◽  
Adherence To Medication

IntroductionLittle is known about psychological reasons associated with adherence to growth hormone (GH) replacement therapy (GHRx) in adults. As in other chronic diseases, medication-related beliefs, coping strategies and disease impact on quality of life (QoL) might play an important role. We thus explored these psychological factors in relation to adherence in patients with GH deficiency (GHD) in order to find leverage points for the improvement of adherence.Patients and MethodsCross-sectional analysis including 107 adult GHD patients on GHRx who completed self-assessment inventories on health-related QoL (Short-Form SF-36), coping style (Freiburg questionnaire on coping with illness, FKV-LIS) and medication beliefs (Beliefs about Medicine questionnaire, BMQ). Results were correlated to general and GH-specific adherence to medication.ResultsIn the BMQ, 92.5% of the patients (n=99) reported a strong belief in the need for their medication, which correlated significantly with general adherence (rs = 0.325). Active coping was significantly related to general (rs = 0.307) and GH-specific adherence (rs = 0.226). Better mental QoL (rs = 0.210) but worse physical QoL (rs = -0.198; all p &lt; 0.05) were related to higher GH-specific adherence. Older age was associated with a higher degree of active coping, a higher belief in the necessity of medication and worse physical QoL.ConclusionWe provide preliminary data that most GHD patients on GHRx are strongly convinced of their need for medication and that adherence to GHRx is influenced by coping strategies and QoL. Patients with impaired psychological QoL are less able to translate their convictions into good adherence, a phenomenon to be addressed in future research.

scholarly journals Mental and physical health, and long-term quality of life among service members injured on deployment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Cameron T. McCabe ◽  
Jessica R. Watrous ◽  
Susan L. Eskridge ◽  
Michael R. Galarneau
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Health ◽  
Service Members ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Mental Hrqol ◽  
Mental And Physical Health

Abstract Background More than 52,000 casualties have been documented in post-9/11 conflicts. Service members with extremity injuries (EIs) or traumatic brain injury (TBI) may be at particular risk for long-term deficits in mental and physical health functioning compared with service members with other injuries. Methods The present study combined medical records with patient reports of mental health and health-related quality of life (HRQOL) for 2,537 service members injured in overseas contingency operations who participated in the Wounded Warrior Recovery Project. Combined parallel-serial mediation models were tested to examine the pathways through which injury is related to mental and physical health conditions, and long-term HRQOL. Results Results revealed that injury was indirectly related to long-term HRQOL via its associations with physical health complications and mental health symptoms. Relative to TBI, EI was associated with a higher likelihood for a postinjury diagnosis for a musculoskeletal condition, which were related to lower levels of later posttraumatic stress disorder (PTSD) symptoms, and higher levels of physical and mental HRQOL. Similarly, EI was related to a lower likelihood for a postinjury PTSD diagnosis, and lower levels of subsequent PTSD symptoms, and therefore higher physical and mental HRQOL relative to those with TBI. Despite this, the prevalence of probable PTSD among those with EI was high (35%). Implications for intervention, rehabilitation, and future research are discussed.

scholarly journals Impaired quality of life in patients in long-term remission of Cushing's syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism?

2012 ◽  
Vol 167 (5) ◽  
pp. 687-695 ◽  
Author(s):  
M A E M Wagenmakers ◽  
R T Netea-Maier ◽  
J B Prins ◽  
T Dekkers ◽  
M den Heijer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Group ◽  
Cushing’S Syndrome ◽  
Negative Influence ◽  
Cushing's Syndrome ◽  
Control Group ◽  
Cross Sectional ◽  
Impaired Quality

Objective The determinants that cause impaired quality of life (QOL) in patients in long-term remission of Cushing's syndrome (CS) are unknown. The aim of this study was to get more insight into the patient and disease characteristics related to impaired QOL in these patients. Design Cross-sectional study. Methods The QOL of 123 patients in remission of CS (age 52.2±12.0 years, 106 women, duration of remission 13.3±10.4 years, 80% pituitary CS), assessed with seven validated questionnaires, was compared with the QOL of an age- and sex-matched control group (n=105). To investigate the influence of the aetiology of CS on QOL, patients in remission of pituitary and adrenal CS were compared. Furthermore, the influence of hormonal deficiencies, treatment strategy, duration of remission, gender and age on QOL was investigated. Results QOL in the total patient group and each patient subgroup was significantly worse on practically all dimensions of questionnaires compared with the control group (P<0.05), except for patients in remission of pituitary CS without hormonal deficiencies who had an impaired QOL on 50% of the QOL dimensions. Subgroup analysis revealed no difference in QOL between different patient groups, especially no difference between patients in remission of adrenal and pituitary CS. Female gender and a shorter duration of remission had a negative influence on QOL in the patient group. Conclusions QOL remains impaired in patients in long-term remission of CS regardless of aetiology, presence of hormonal deficiencies and treatment strategies. More research is needed to establish the causes.

scholarly journals Perception of the Quality of Life of Tobacco Growers Exposed to Pesticides: Emphasis on Health, Hearing, and Working Conditions

2018 ◽  
Vol 23 (01) ◽  
pp. 050-059 ◽  
Author(s):  
Ana Cazé ◽  
Adriana Lacerda ◽  
Débora Lüders ◽  
Juliana Conto ◽  
Jair Marques ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Working Conditions ◽  
General Health ◽  
Short Form ◽  
Tobacco Plant ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Physical Elements

Introduction Tobacco farming exposes workers to various health risks due to the high application of pesticides needed to control pests, weeds and fungal diseases that prevent the tobacco plant growth. Objective To analyze the perception of the quality of life of tobacco growers exposed to pesticides, with emphasis on general health, hearing, and working conditions. Method This is a descriptive, cross-sectional study using a quantitative approach with farmers from southern Brazil. Data were collected from November of 2012 to November of 2014. For data collection, we opted for the 36-item short form health survey (SF-36) questionnaire, and a questionnaire with closed questions about health, hearing and working conditions. We evaluated a total of 78 subjects; the study group, made up of 40 tobacco farmers exposed to pesticides, and a control group of 38 participants without occupational exposure to pesticides. Both groups are residents of the same municipality, and users of the federal public health system. Results The results showed that tobacco growers had lower quality of life scores compared with the control group. Significant differences were observed in the areas of pain and general health. There were correlations between physical elements and chronic diseases; hearing complaints and a lack of personal protective equipment use, occupation and hearing complaints, as well as general health and hearing complaints. Conclusion Tobacco farming is a risky activity for general and hearing health, and it can impact the quality of life of those working in this field.

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