Abstract P158: Lower Extremity Peripheral Artery Disease and Quality of Life among Older Individuals in the Community: The Atherosclerosis Risk in Communities (ARIC) Study

Background: Lower extremity peripheral arterial disease (PAD), commonly identified by an ankle-brachial Index (ABI) <0.9, increases mortality risk and may impair mobility as well as quality of life (QOL). However, most studies assessing reduced QOL in the relation to PAD rely on small data from vascular clinics, leaving uncertainty about the impact of PAD on QOL in the community. Method: Using 5,610 ARIC visit 5 (2011-2013) participants aged 66-90 years, we assessed the associations of ABI with several QOL parameters, including self-evaluated general health status, mental status (the Center for Epidemiologic Studies Depression [CES-D] score and hopeless feeling), social aspect (work interfered by pain and social activity interfered by health status), and physical ability (limited ability to climb stairs and need of walking assistance). Logistic regression models were applied to assess the association of ABI with each QOL parameter, adjusting for potential confounders including comorbidities such as history of heart failure, coronary heart disease, and stroke. Result: With ABI 1.1-1.2 as a reference, lower ABI was consistently associated with poor status of all QOL parameters tested (Table), with overall evident dose-response relationship. Interestingly, a poor status of various QOL parameters was observed even in borderline low ABI (0.9-1.0) and low normal (1.0-1.1). High ABI (>1.3), indicative of arterial stiffness, was only significantly associated with limited ability to climb stairs. Similar results for low ABI and QOL were observed in both genders and white and black participants. Conclusion: Low ABI was independently and consistently associated with poor status of wide range of QOL domains, with potential important implications on quality-maintained life in older individuals. Further studies are warranted to assess whether the association is due to PAD-related leg symptoms or weakness and/or reflects the impact of systemic atherosclerosis on QOL.

Download Full-text

Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

10.21203/rs.2.17909/v1 ◽

2019 ◽

Author(s):

Austyn Snowden ◽

Jenny Young ◽

Jan Savinc

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Health Status ◽

Cancer Type ◽

Cancer Stage ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

Abstract Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.

Download Full-text

The importance of anemia and health-related quality of life in the elderly

Zinc supplementation improves heme biosynthesis in rats exposed to lead ◽

10.18051/univmed.2020.v39.135-149 ◽

2020 ◽

Vol 39 (2) ◽

pp. 135

Author(s):

Raditya Wratsangka ◽

Rully Ayu Nirmalasari Haryadi Putri

Keyword(s):

Quality Of Life ◽

Hemoglobin Concentration ◽

The Elderly ◽

World Population ◽

Health Related Quality ◽

Wide Range ◽

Related Quality ◽

Health Related ◽

The Impact

Anemia is a global health problem with an extremely high prevalence and occurring in nearly 25% of the world population, particularly in the elderly group. Currently Indonesia is facing a rapid growth of the elderly population, with around 21 million elderly (8.2% of the total population), that is projected to increase to 33.7 million (11.8%) in the year 2025. Anemia in the elderly is frequently neglected, although the facts show that low hemoglobin concentration is an important marker of physiological decline and functional limitations. Although the factor of intrinsic aging may cause low hemoglobin concentration, anemia in the elderly is known to have a wide range w88ith regard to etiology, underlying disorders, and possible mechanisms, such that it should be clinically followed up. Whatever its causes or underlying pathophysiological, anemia in the elderly has been proven to play a role in their morbidity and mortality, and may decrease their quality of life, that comprises all aspects of physical, mental, and social health, known as health-related quality of life (HRQoL). The impact of anemia on HRQoL has been studied in various populations, and most studies report the presence of an association between HRQoL and anemia in elderly individuals, which on the subscale level is particularly associated with physical health. Early diagnosis of anemia is important to prevent aggravation of the condition, to retard the progress of the disease, and to improve the health-related quality of life (HRQoL) of the patient. Prior to determining the treatment plan, the primary diagnosis and the comorbidities, especially treatable disorders, had better be identified first. The available data show that the overall prognosis will improve for anemia in patients with well-managed and corrected chronic disorders.

Download Full-text

Impact of musculoskeletal disorders on quality of life of patients visiting tertiary care hospital.

Journal of the Pakistan Medical Association ◽

10.47391/jpma.328 ◽

2021 ◽

pp. 1-11

Author(s):

Shah Khalid ◽

Sayed Zulfiqar Ali Shah ◽

Abid Ali Khalil ◽

Ihsan Ullah

Keyword(s):

Quality Of Life ◽

Health Status ◽

Musculoskeletal Disorders ◽

Teaching Hospital ◽

Adhesive Capsulitis ◽

Care Hospital ◽

Cross Sectional ◽

Quality Of Life Scale ◽

The Impact

Abstract Objective: To determine the impact of musculoskeletal disorders on quality of life of patients visiting Khyber Teaching Hospital, Peshawar. Method and Material: A cross sectional survey conducted in Khyber Teaching Hospital, Peshawar from September 2018 to March 2019 using a validated EQ-5D quality of life scale. The survey questionnaire was attended by 377 respondents having variety of musculoskeletal disorders (MSDs). EQ-5D can be effectively used for assessing the quality of life and health status using the VAS pain scale. Results: There were total 377 respondents. Mean age of the participants was 35.9 ± 12.5 years. Out of 377 participants, 204 (54.1%) were male, while 173 (45.9%) were female. Muscular weakness was the most commonly encountered problem (40.6%), followed by muscle stiffness (13.0%) and adhesive capsulitis (10.3%). The remaining respondents were having different kinds of MSDs. Patients with MSDs were having significantly moderately low score on EQ-5D. Conclusion: The finding of this study suggests that MSDs have negative impact on quality of life and health status of the sufferers. Individuals having any sort of MSDs should seek proper care in order to improve their quality of life, health status and work performance. Key words: Musculoskeletal Diseases, Health, Quality of Life, visual analog scales, Cross Sectional Studies. Continuou....

Download Full-text

Abstract P162: The Baseline Ankle Brachial Index (ABI), but Not Change in the ABI, is Associated With 11-Year Change in the SF-36: The San Diego Population Study (SDPS)

Circulation ◽

10.1161/circ.131.suppl_1.p162 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Christina L Wassel ◽

Matthew A Allison ◽

Joachim H Ix ◽

Julie O Denenberg ◽

Dena E Rifkin ◽

...

Keyword(s):

Quality Of Life ◽

Lower Extremity ◽

Physical Functioning ◽

Ankle Brachial Index ◽

Population Based ◽

Component Score ◽

Lower Baseline ◽

Sf 36

Background: Lower extremity peripheral artery disease (PAD) affects approximately 9 million people in the US. Less well-recognized is that PAD, even when asymptomatic, is associated with decreased functional status and quality of life. Previous studies have largely examined associations of the ankle brachial index (ABI) and quality of life in participants with PAD. To our knowledge no studies have examined the impact of ABI and change in ABI on change in quality of life in a population-based setting. Methods: The SDPS is a population-based prospective study that evaluated non-Hispanic White, African-American, Hispanic and Asian men and women for lower extremity PAD at two examinations approximately 11 years apart. Participants completed the SF-36 questionnaire, and 802 participants had ABI and SF-36 data available at both examinations. Analyses were restricted to these participants who also had a baseline ABI<1.4. Growth curve models were used to assess the associations of baseline ABI and change in the ABI with change in the SF-36 physical component score (PCS) and mental component score (MCS) over time. Change in the ABI was defined as (follow-up ABI - baseline ABI)/baseline ABI. Results: Participants were on average 57±9 years of age at baseline, and 69±9 at follow-up. At baseline, nearly 2 percent had ABI≤0.90, and the mean±SD ABI was 1.12±0.10. After adjustment for age, sex, race/ethnicity, BMI, ever smoking, physical activity, hypertension, diabetes, and dyslipidemia, each SD lower baseline ABI was significantly associated with an average change of -0.63 points (95% CI (-0.10, -1.17), p=0.02) on the PCS. This association was marginally significant for the MCS (-0.54 points (0.14, 1.22), p=0.12). Lower baseline ABI was also associated with negative change in two SF-36 subscales, physical functioning (p=0.02) and vitality (p=0.01). Change in the ABI over 11 years was not associated with change in the MCS (p=0.97) or PCS (p=0.41). Results were similar when excluding participants with ABI≤0.90. Conclusions: A lower ABI at baseline is associated with a significantly worse physical functioning quality of life approximately 11 years later. However change in the ABI was not significantly associated with change in quality of life over this time period. Additional studies are warranted in larger samples, especially to confirm the lack of findings for change in ABI.

Download Full-text

Health-Related Quality of Life in Patients With Progressive Midgut Neuroendocrine Tumors Treated With 177Lu-Dotatate in the Phase III NETTER-1 Trial

Journal of Clinical Oncology ◽

10.1200/jco.2018.78.5865 ◽

2018 ◽

Vol 36 (25) ◽

pp. 2578-2584 ◽

Cited By ~ 80

Author(s):

Jonathan Strosberg ◽

Edward Wolin ◽

Beth Chasen ◽

Matthew Kulke ◽

David Bushnell ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Global Health ◽

Phase Iii ◽

High Dose ◽

Health Related Qol ◽

Health Related ◽

Phase Iii Study ◽

The Impact

Purpose Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life (QoL). We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related QoL. Methods The NETTER-1 trial is an international phase III study in patients with midgut NETs. Patients were randomly assigned to treatment with 177Lu-Dotatate versus high-dose octreotide. European Organisation for Research and Treatment of Cancer quality-of-life questionnaires QLQ C-30 and G.I.NET-21 were assessed during the trial to determine the impact of treatment on health-related QoL. Patients completed the questionnaires at baseline and every 12 weeks until tumor progression. QoL scores were converted to a 100-point scale according to European Organisation for Research and Treatment of Cancer instructions, and individual changes from baseline scores were assessed. Time to QoL deterioration (TTD) was defined as the time from random assignment to the first QoL deterioration ≥ 10 points for each patient in the corresponding domain scale. All analyses were conducted on the intention-to-treat population. Patients with no deterioration were censored at the last QoL assessment date. Results TTD was significantly longer in the 177Lu-Dotatate arm (n = 117) versus the control arm (n = 114) for the following domains: global health status (hazard ratio [HR], 0.406), physical functioning (HR, 0.518), role functioning (HR, 0.580), fatigue (HR, 0.621), pain (HR, 0.566), diarrhea (HR, 0.473), disease-related worries (HR, 0.572), and body image (HR, 0.425). Differences in median TTD were clinically significant in several domains: 28.8 months versus 6.1 months for global health status, and 25.2 months versus 11.5 months for physical functioning. Conclusion This analysis from the NETTER-1 phase III study demonstrates that, in addition to improving progression-free survival, 177Lu-Dotatate provides a significant QoL benefit for patients with progressive midgut NETs compared with high-dose octreotide.

Download Full-text

Predictors of Quality of Life in Young Adults Diagnosed With Cancer

Clinical Nursing Research ◽

10.1177/1054773820928197 ◽

2020 ◽

Vol 29 (8) ◽

pp. 587-597

Author(s):

Charmaine A. McKie ◽

Adeyinka O. Laiyemo

Keyword(s):

Quality Of Life ◽

Young Adults ◽

Health Status ◽

Cancer Survivors ◽

Functional Status ◽

Cancer Type ◽

Health Related ◽

Perception Of Health ◽

The Impact

A cross-section correlational study was conducted to evaluate the overall quality of life in young adults (AYAs) diagnosed with cancer, and the impact of health-related and non-health-related factors on their quality of life. Fifty-six AYA cancer survivors were recruited to elicit the impact of biological function (cancer type and comorbidity), symptoms, functional status, general perception of health status, gender, and characteristics of the environment on quality of life. Participants experienced higher than average quality of life. Symptoms, functional status, and general perception of health status were significant predictors of quality of life in this group of AYAs diagnosed with cancer. In delivering quality cancer care, nurses must be able to thoroughly assess symptom status, AYA cancer survivors’ perception of their health status, and functioning in order to implement supportive measures to help improve their quality of life.

Download Full-text

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

Italian Journal of Medicine ◽

10.4081/itjm.2017.714 ◽

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.

Download Full-text

The impact of compression garments on the quality of life in patients with chronic venous disease

Physiotherapy ◽

10.1515/physio-2016-0011 ◽

2017 ◽

Vol 24 (2) ◽

Author(s):

Iwona Demczyszak ◽

Edyta Sutkowska ◽

Magdalena Jasiak ◽

Małgorzata Fortuna ◽

Justyna Mazurek

Keyword(s):

Quality Of Life ◽

Lower Extremity ◽

Compression Therapy ◽

Chronic Venous Disease ◽

Venous Disease ◽

Compression Garments ◽

Before And After ◽

The Impact ◽

Career Status

AbstractIntroduction. Assessment of quality of life in patients suffering from chronic venous disease of the lower extremity who were treated with compression garments. Methods. Patients of both sexes aged 30-75 years with chronic venous disease and at least varices, but without active ulceration, were qualified for the study. To assess the quality of life, the CIVIQ-20 questionnaire was used before and after 4 weeks of compression therapy with second class compression. Results. The combined results of the CIVIQ scale rose from 61.49% before compression to 75.17% after 4 weeks of compression therapy (p 0.01). No correlation was found between sex, age, career status or type of work and the averaged CIVIQ score. Conclusions. Compression therapy with special garments significantly improves the quality of life in patients with chronic venous disease. Larger studies are still needed in this field.

Download Full-text

The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study

Quality of Life Research ◽

10.1007/s11136-015-1167-4 ◽

2015 ◽

Vol 25 (5) ◽

pp. 1285-1294 ◽

Cited By ~ 4

Author(s):

M. A. C. Van Son ◽

J. De Vries ◽

J. A. Roukema ◽

T. Gosens ◽

M. H. J. Verhofstad ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Lower Extremity ◽

Health Related Quality ◽

Follow Up Study ◽

Related Quality ◽

Health Related

Download Full-text

Quality of Life in Patients with Thalassemia.

Blood ◽

10.1182/blood.v104.11.3786.3786 ◽

2004 ◽

Vol 104 (11) ◽

pp. 3786-3786

Author(s):

Zahra Pakbaz ◽

Marsha Treadwell ◽

Robert Yamashita2 ◽

Drucilla Foote ◽

Elliott Vichinsky

Keyword(s):

Quality Of Life ◽

Health Status ◽

Thalassemia Major ◽

Essential Information ◽

Health Impairment ◽

Severe Impairment ◽

Multiple Domains ◽

The Impact ◽

Overall Health Status

Abstract Introduction: Thalassemia patients have experienced a dramatic increase in lifespan secondary to improved and more complicated therapy. The impact of the disease and its treatment on quality of life is largely unknown. Determining the degree of health impairment as perceived by the patient is essential information needed to recommend suitable therapy. Factors that affect the quality of life of thalassemia major patients may differ from thalassemia intermedia patients. Identifying the specific causes for negative patient assessment of overall health status can result in successful intervention. The objective of this study is to determine the factors that affect quality of life in both transfused and non-transfused thalassemia patients. Methods: The Dartmouth Care Cooperative Chart System (COOP) questionnaire is a standardized, validated, visual screening tool that screens the major domains affecting quality of life. Patients rate quality of life from excellent (1) to poor (5). Scores of 1 and 2 are normal. A Score of 3 are mild to moderate impairment, and 4 and 5 are severe abnormalities. 50 patients were randomly selected during a comprehensive visit to complete a COOP questionnaire. These results were augmented by a brief medical history and chart review. Results: Forty-eight thalassemia patients, including 25 transfusion dependent (Tx) and 23 non-transfused (Non-Tx) patients (50% female) were randomly selected and completed the COOP questionnaire. The mean age of the total population was 19 years (0.9–37.9 yrs) and was similar in both groups. Half of both groups had scores of 3 or less indicating no severe impairment. However, 56% of patients had ratings of 3 indicating mild to moderate impairment of major domains. Four patients (2 Tx, 2 Non-Tx) had repeated 4–5 ratings in multiple domains indicating severe impairment of quality of life. The most commonly reported affected domains were feelings, such as anxiety, depression, and concern of overall health status or indications of recent deterioration in health. Conclusion: At least 50% of transfusion and non-transfusion dependent thalassemia patients demonstrate some impairment in quality of life. Forty-four percent of the population had a severe impairment in at least one domain. In particular, mental health issues are widespread. In contrast to previous beliefs, non-transfusion dependent patients also suffer serious impairment in quality of life. This data suggests all patients should undergo quality of life assessments and intervention, which focuses on affected domains. Studies to determine if quality of life affects patients’ adherence to chelation therapy are needed.

Download Full-text