scholarly journals Quality of Life and Cost-Effectiveness of Cochlear Implants: A Narrative Review

2017 ◽  
Vol 22 (4-5) ◽  
pp. 236-258 ◽  
Author(s):  
Matthew G. Crowson ◽  
Yevgeniy R. Semenov ◽  
Debara L. Tucci ◽  
John K. Niparko
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Well Being ◽  
Cost Utility ◽  
Cost Of Care ◽  
Narrative Review ◽  
Profound Hearing Loss ◽  
Economic Implications ◽  
Significant Difference

Objectives: To review evidence regarding the health-related quality of life (HRQoL) and cost-effectiveness of unilateral and bilateral cochlear implantation (CI) among children and adults with severe-to-profound hearing loss. Study Design: Narrative review. Methods: Publications related to quality of life (QoL) and costs of care in CI were acquired through searches in English-language databases. Studies were included if they had identified the HRQoL attainment, cost of care, cost-utility, or cost-effectiveness associated with CI. Results: 57 studies were critically reviewed. The QoL outcome metrics used in these articles were divided into 2 categories - generic and condition specific. In studies investigating children, many reported no significant difference in QoL attainment between CI recipients and normal-hearing peers. In adults, significant improvements in QoL after implantation and higher QoL than in their nonimplanted (hearing-aided) peers were frequently reported. Studies involving an older adult cohort reported significant improvement in QoL after implantation, which was often independent of audiological performance. Overall, the calculated cost-utility ratios consistently met the threshold of cost acceptance, indicating acceptable values for expenditures on CI. Conclusions: Considerable work has been done on the QoL attainment and health economic implications of CI. Unilateral CI across all age groups leads to reported sustained benefits in the recipients' overall and disease-specific QoL. With increased cost associated with bilateral CI, further study is needed to characterize its costs and benefits with respect to the recipients' health, well-being, and contributions to society.

COST-EFFECTIVENESS OF RADIOFREQUENCY ABLATION VERSUS LASER FOR VARICOSE VEINS

2015 ◽  
Vol 31 (5) ◽  
pp. 289-296 ◽  
Author(s):  
Amanda C. Shepherd ◽  
Marta Ortega-Ortega ◽  
Manj S. Gohel ◽  
David Epstein ◽  
Louise C. Brown ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Radiofrequency Ablation ◽  
Varicose Veins ◽  
Cost Effective ◽  
Clinical Severity ◽  
Economic Implications ◽  
Severity Scores ◽  
Significant Difference

Objectives: Although the clinical benefits of endovenous thermal ablation are widely recognized, few studies have evaluated the health economic implications of different treatments. This study compares 6-month clinical outcomes and cost-effectiveness of endovenous laser ablation (EVLA) compared with radiofrequency ablation (RFA) in the setting of a randomized clinical trial.Methods: Patients with symptomatic primary varicose veins were randomized to EVLA or RFA and followed up for 6 months to evaluate clinical improvements, health related quality of life (HRQOL) and cost-effectiveness.Results: A total of 131 patients were randomized, of which 110 attended 6-month follow-up (EVLA n = 54; RFA n = 56). Improvements in quality of life (AVVQ and SF-12v2) and Venous Clinical Severity Scores (VCSS) achieved at 6 weeks were maintained at 6 months, with no significant difference detected between treatment groups. There were no differences in treatment failure rates. There were small differences in favor of EVLA in terms of costs and 6-month HRQOL but these were not statistically significant. However, RFA is associated with less pain at up to 10 days.Conclusions: EVLA and RFA result in comparable and significant gains in quality of life and clinical improvements at 6 months, compared with baseline values. EVLA is more likely to be cost-effective than RFA but absolute differences in costs and HRQOL are small.

scholarly journals The Quality of Life Definition: Where Are We Going?

Uro ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 14-22
Author(s):  
Tommaso Cai ◽  
Paolo Verze ◽  
Truls E. Bjerklund Johansen
Keyword(s):  
Quality Of Life ◽  
Extra Dimension ◽  
Sexual Partner ◽  
Therapeutic Approach ◽  
Well Being ◽  
Narrative Review ◽  
Laboratory Findings

The quality of life (QoL) concept now includes new aspects related to patients’ well-being because QoL has become more of a personal perception than an an objective and measurable entity. Here, we discuss the principal aspects of QoL-related aspects in urology and andrology by using a narrative review. Some aspects concerning the QoL are essential when managing uro-andrological patients. The aim of treatments should not only include the absence of disease or symptoms relief but also the improvement of a patient’s QoL with regard to his/her internal status and relationship with others. In this sense, any therapeutic approach should be based on the patient’s perspectives and not only on the instrumental and laboratory findings. Finally, we discussed the role of a patient’s sexual partner adding an extra dimension to the patient-centerd approach as part of the QoL concept in andrology.

Current measures of distress may not account for what's most important in existential care interventions: Results of the outlook trial

2020 ◽  
Vol 18 (6) ◽  
pp. 648-657
Author(s):  
Karen E. Steinhauser ◽  
Karen M. Stechuchak ◽  
Katherine Ramos ◽  
Joseph Winger ◽  
James A. Tulsky ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Stage ◽  
Well Being ◽  
Primary Analysis ◽  
Significant Difference ◽  
Spiritual Well Being ◽  
Screening For Distress ◽  
Secondary Outcomes ◽  
Stage Renal Disease

AbstractObjectiveCompare the efficacy of two interventions addressing emotional and existential well-being in early life-limiting illness.MethodPrimary trial analysis (n = 135) included patients with advanced cancer, congestive heart failure, or end-stage renal disease; Arm 1 received the Outlook intervention, addressing issues of life completion and preparation, and Arm 2 received relaxation meditation (RM). Primary outcomes at five weeks (primary endpoint) and seven weeks (secondary): completion and preparation (QUAL-E); secondary outcomes: anxiety (POMS) quality of life (FACT-G) and spiritual well-being (FACIT-Sp) subscales of faith, meaning, and peace.ResultsAverage age was 62; 56% were post-high school-educated, 54% were married, 52% white, 44% female, and 70% had a cancer diagnosis. At baseline, participants demonstrated low levels of anxiety (<5 on POMS subscale) and depression (<10 on CESD) relative to population norms. Results of the primary analysis revealed no significant differences in mean Preparation by treatment arm at five weeks (14.4 Outlook vs. 14.8 RM; between-group difference −0.4 [95% CI, −1.6, 0.8], p = 0.49) or seven weeks (15.2 vs.15.4; between-group difference −0.2 [95% CI, −1.5, 1.0], p = 0.73). There were also no significant differences in mean Life Completion by treatment arm between five weeks (26.6 Outlook vs. 26.3 RM; between-group difference 0.2 [95% CI, −1.2, 1.7], p = 0.76) or seven weeks (26.5 vs. 27.5; between-group difference −1.0 [95% CI, −2.7, 0.7], p = 0.23). Compared to RM, Outlook participants did not have significant differences over time in the secondary outcomes of overall quality of life, anxiety, depression, FACT-G subscales, and FACIT-Sp subscales.DiscussionIn early-stage life-limiting illness, Outlook did not demonstrate a significant difference in primary or secondary outcomes relative to RM. Results underscore the importance of pre-screening for distress. Qualitatively, Outlook participants were able to express suppressed emotions, place illness context, reflect on adaptations, and strengthen identity. Screening for distress and identifying specified measures of distress, beyond anxiety and depression, is essential in our ability to adequately assess the multi-dimensional mechanisms that decrease existential suffering.

scholarly journals How to Intervene in the Health Management of the Oncological Patient and of Their Caregiver? A Narrative Review in the Psycho-Oncology Field

2021 ◽  
Vol 11 (7) ◽  
pp. 99
Author(s):  
Gian Piero Turchi ◽  
Marta Silvia Dalla Riva ◽  
Luisa Orrù ◽  
Eleonora Pinto
Keyword(s):  
Quality Of Life ◽  
Health Management ◽  
Psychological Treatment ◽  
Management Strategies ◽  
Well Being ◽  
Narrative Review ◽  
Treatment Modalities ◽  
Oncological Patient ◽  
Post Surgery

Starting from statistical data derived from the oncological field, some articles have highlighted the importance of communication in the patient–caregiver dyad and have considered the various roles involved in a cancer diagnosis situation. Thus, the question of how to intervene in terms of “quality of life” from the time of diagnosis to the recovery or death of a cancer patient, beyond the sanitary and physical dimensions, has become relevant. Therefore, the present narrative review aims to offer an overview of the state of the art in terms of the psychological treatment modalities of cancer patients, from the diagnosis to the post-surgery period. A total of 67 articles were collected and analyzed, in relation to (1) psychological constructs employed in the oncological field, (2) intervention models and (3) quality of life and well-being measurement and evaluation tools. We described these articles, differentiating between those focusing on the role of (1) the patient, (2) the caregiver, (3) the patient–caregiver dyad and (4) healthcare professional roles. The oncological diagnosis and its repercussions in the lives of the patient and caregiver were explored and critical aspects that emerged from the literature were highlighted. In conclusion, the analysis allowed some considerations about the need to define research protocols and useful management strategies for increasing the overall health of patients with cancer diagnoses and the people who surround them.

Beyond vision loss: the independent impact of diabetic retinopathy on vision-related quality of life in a Chinese Singaporean population

2018 ◽  
Vol 103 (9) ◽  
pp. 1314-1319 ◽  
Author(s):  
Eva K Fenwick ◽  
Ryan E K Man ◽  
Alfred Tau Liang Gan ◽  
Neelam Kumari ◽  
Charlene Wong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Well Being ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Significant Difference ◽  
Related Quality ◽  
The Impact

Background/aimsTo assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population.MethodsThe Singapore Chinese Eye Study (n=3353; 2009–2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the ‘Reading’, ‘Mobility’ and ‘Emotional’ domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models.ResultsOf the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR.ConclusionsWe documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.

scholarly journals Occupational Stress, Psychological Well being and Quality of Life among Indian Army Personnel

2020 ◽  
Vol 5 (3) ◽  
pp. 211-216
Author(s):  
Dolly Bansal ◽  
Vijendra Nath Pathak ◽  
J. Pradhan ◽  
Anu Chaudhary
Keyword(s):  
Quality Of Life ◽  
Occupational Stress ◽  
Negative Relationship ◽  
Well Being ◽  
Stress Index ◽  
Cross Sectional ◽  
Psychological Well Being ◽  
Significant Difference ◽  
Army Personnel

The study aims to highlight the occupation level on occupational stress, psychological well-being, and quality of life of Indian Army Personnel. The study was conducted on one hundred fifty Indian male Army Personnel of different rank belonging to 25 years to 45 years of age group. The cross-sectional design was used. The sample was selected through the purposive sampling technique. The tools measures like the Occupational Stress Index, Psychological Well-Being Scale and WHO Quality of Life-BREF Hindi was individually administered. The data were analysed using descriptive and inferential statistics. One way Analysis of Variance results revealed that there is a significant difference in occupational levels on occupational stress, psychological well-being, and quality of life among Indian Army personnel. Pearson product-moment correlations coefficient showed a significant negative relationship between occupational stress with psychological well-being and quality of life and showed a significant positive relationship between psychological well-being and quality of life among Indian Army Personnel.

Assistive Technologies and the Carers of People with Dementia

2016 ◽  
Vol 5 (1) ◽  
pp. 45-59
Author(s):  
Sarmishtha Bhattacharyya ◽  
Susan Mary Benbow
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Assistive Technologies ◽  
Narrative Review ◽  
People With Dementia ◽  
Technological Interventions ◽  
Informal Carers

Assistive technologies have a role in supporting both formal and informal carers of people with dementia, and in maintaining the independence, and quality of life of both people with dementia and their carers. The authors report a narrative review of the use of technological interventions to empower the carers of people with dementia, and relate this to a model of ageing well. They argue that this highlights the importance of empowering and connecting with carers in order to increase their participation and connection in the care of their relative/client; and conclude that both empowerment and connection contribute to maintaining autonomy and well-being of both carers and people with dementia. Technological interventions should not be used as alternatives to connection. The emphasis in practice should be on empowering and connecting with both carers and people with dementia.

Treatment Goals for Patients with Schizophrenia — A Narrative Review of Physician and Patient Perspectives

2020 ◽  
Author(s):  
Gerhard Gründer ◽  
Philipp Bauknecht ◽  
Stefan Klingberg ◽  
Karolina Leopold ◽  
Michael Paulzen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Narrative Review ◽  
Patient Perspectives ◽  
Treatment Goals ◽  
Patient Centered ◽  
Symptom Resolution ◽  
Patient Subgroups ◽  
Physician’S Perspective

Abstract Introduction There are many possible treatment goals for patients with schizophrenia. Two major perspectives on treatment goals are the patient’s and the physician’s perspective. Patient-centered treatment mandates that an individual patient’s treatment goals are taken into account when treatment is planned. In this narrative review, we address the commonalities and differences of the patient’s and physician’s perspectives. Methods We searched for literature on treatment goals for patients with schizophrenia from the last 10 years. Results Fifty-two relevant records were identified, 4 of which directly compare patient’s and physician’s perspectives. Two further articles used the same set of goals to ask patients or physicians for their assessment. Discussion Agreement between patients and physicians regarding valuation of treatment goals was high. However, physicians tended to put more emphasis on the classical “textbook” goals of symptom resolution and functioning, while patients stressed well-being and quality of life more. Results on treatment goals from patients are difficult to generalize, since recruiting representative patient samples is challenging and patient subgroups may have differing priorities.

scholarly journals NOTEWORTHY: THE IMPACT OF A CHOIR FOR OLDER ADULTS WITH DEMENTIA ON THE WELL-BEING AND QUALITY OF LIFE OF CAREGIVERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S752-S752
Author(s):  
Debra J Sheets ◽  
Stuart W MacDonald ◽  
Andre Smith ◽  
Mary Kennedy
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Indicators ◽  
Well Being ◽  
Community Dwelling ◽  
Caregiver Support ◽  
Economic Implications ◽  
Health Quality ◽  
The Impact

Abstract Informal caregivers provide 80% of the care needed to support community-dwelling older adults with dementia. Over time caregivers often face adverse effects on their health, quality of life and well-being; particularly those caring for someone with dementia. This study examines the impact of participation in the Voices in Motion (ViM) choir on caregiver burden, mood and quality of life. A measurement burst approach was used to investigate intraindividual variability on key psychosocial and health indicators. Results indicate that choir participation significantly improves caregiver well-being (e.g. mood, burden) and quality of life. Findings suggest that choirs offer significant caregiver support and respite. The discussion focuses the public policy and on the potential economic implications which suggests a shift is needed in the services available to older adults with dementia and their caregivers.

scholarly journals Quality of Life in Romanian Children with Type 1 Diabetes: A Cross-Sectional Survey Using an Interdisciplinary Healthcare Intervention

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 382
Author(s):  
Constanta Urzeală ◽  
Aura Bota ◽  
Silvia Teodorescu ◽  
Mihaela Vlăiculescu ◽  
Julien S Baker ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Well Being ◽  
Healthcare Intervention ◽  
Type I ◽  
Cross Sectional ◽  
Significant Difference ◽  
Interdisciplinary Healthcare

Background: The purpose of this study was to assess the quality of life in Romanian type 1 diabetes mellitus (T1DM) children attending an early interdisciplinary healthcare intervention. Hypothesis: engaging T1DM children in leisure sports leads to a better quality of life. Methods: This research embeds a cross-sectional observational study, incorporating some clinical characteristics relevant for diabetes management. The Kidscreen 27 questionnaire was issued to 100 T1DM children aged between 7 and 17 years. Parents completed the questionnaire. All subjects received interdisciplinary healthcare in the previous year. Statistics were performed using SPSS, v20. The required sample size of 100 subjects was obtained with a confidence interval of 95% and a sampling error of 0.009. The tests were two-sided, with a type I error set at 0.05. Results: Subjects reached an increased level of physical well-being, psychological well-being, autonomy, parent relationships, peer and social support, and school inclusion. There was a significant difference (p < 0.05) between children who practice leisure activities and children who only participated in physical education (PE) classes, regarding their physical well-being (t = 2.123). ANOVA demonstrated significant differences between age groups regarding physical well-being. Conclusion: The interdisciplinary healthcare intervention increased the efficiency of T1DM management with positive effects on life quality.

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