Abstract W P300: Ethnic Differences in Post-Stroke Quality of Life in the Brain Attack Surveillance in Corpus Christi (BASIC) Project

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Sarah L Reeves ◽  
Devin Brown ◽  
Jonggyu Baek ◽  
Lewis B Morgenstern ◽  
Lynda D Lisabeth
Keyword(s):  
Quality Of Life ◽  
Ethnic Differences ◽  
Short Form ◽  
Mean Difference ◽  
Physical Domain ◽  
Clinical Factors ◽  
Stroke Outcomes ◽  
Post Stroke ◽  
Corpus Christi

Background: Mexican Americans (MAs) have worse stroke outcomes than non-Hispanic whites (NHWs), which could translate into worse quality of life (QOL). Our objective was to investigate ethnic differences in post-stroke QOL across multiple domains in a bi-ethnic community. Methods: Ischemic stroke survivors, identified through the population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project in Nueces County, Texas, participated in in-person interviews 90 days post-stroke from May 2010 - June 2012. The validated short form stroke-specific QOL (SSQOL) was used to assess overall, physical, and psychosocial QOL; scores range from 1-5 with higher scores representing greater QOL. Tobit regression was used to model unadjusted associations between ethnicity and the 3 QOL domains. Models were then adjusted for the following demographic and clinical factors obtained from the medical record and patient interview: age, sex, education, insurance status, marital status, nursing home residence before stroke, prestroke modified Rankin scale, prestroke Informant Questionnaire on Cognitive Decline in the Elderly, initial NIH stroke scale, risk factors, BMI, and a comorbidity index. Results: A total of 335 ischemic strokes with complete data were identified (66% MA, 34% NHW). QOL was lower among MAs compared to NHWs, both overall (mean difference=-0.3, p=0.02) and in the physical domain (mean difference=-0.4, p=0.008); however, there was no difference in the psychosocial domain (p=0.22). After adjustment for demographic and clinical factors, MAs continued to experience poorer QOL compared to NHWs overall (mean difference=-0.5,p=0.049) and in the physical domain (mean difference=-0.3, p=0.006). Conclusions: Ethnic disparities in stroke outcome extend to QOL, with MAs experiencing substantially worse post-stroke QOL than NHWs. Interventions are urgently needed to improve stroke outcomes among the rapidly growing MA stroke population.

scholarly journals Health-related quality of life in Marfan syndrome: a 10-year follow-up

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Thy Thy Vanem ◽  
Svend Rand-Hendriksen ◽  
Cathrine Brunborg ◽  
Odd Ragnar Geiran ◽  
Cecilie Røe
Keyword(s):  
Quality Of Life ◽  
Marfan Syndrome ◽  
Health Survey ◽  
Short Form ◽  
Physical Domain ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background Marfan syndrome, a rare hereditary connective tissue disorder caused by mutations in fibrillin-1, can affect many organ systems, especially the cardiovascular system. Previous research has paid less attention to health-related quality of life and prospective studies on this topic are needed. The aim of this study was to assess changes in health-related quality of life after 10 years in a Norwegian Marfan syndrome cohort. Methods Forty-seven Marfan syndrome patients ≥ 18 years were investigated for all organ manifestations in the 1996 Ghent nosology and completed the self-reported questionnaire, Short-Form-36 Health Survey, at baseline in 2003–2004 and at follow-up in 2014–2015. Paired sample t tests were performed to compare means and multiple regression analyses were performed with age, sex, new cardiovascular and new non-cardiovascular pathology as predictors. Results At 10-year follow-up: a significant decline was found in the physical domain. The mental domain was unchanged. Older age predicted a larger decline in physical health-related quality of life. None of the chosen Marfan-related variables predicted changes in any of the subscales of the Short-Form 36 Health Survey or in the physical or the mental domain. Conclusion Knowledge of decline in the physical domain, not related to organ affections, may be important in the follow-up of Marfan syndrome patients.

scholarly journals Ethnic Differences in Poststroke Quality of Life in the Brain Attack Surveillance in Corpus Christi (BASIC) Project

Stroke ◽  
2015 ◽  
Vol 46 (10) ◽  
pp. 2896-2901 ◽  
Author(s):  
Sarah L. Reeves ◽  
Devin L. Brown ◽  
Jonggyu Baek ◽  
Jeffrey J. Wing ◽  
Lewis B. Morgenstern ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ethnic Differences ◽  
Corpus Christi ◽  
The Brain

Abstract TMP49: Depressive Symptoms After Stroke are Linked Longitudinally between Stroke Survivors and Their Family Caregivers

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
David L Roth ◽  
Orla C Sheehan ◽  
Jin Huang ◽  
J. D Rhodes ◽  
Suzanne E Judd ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Family Caregivers ◽  
Short Form ◽  
Well Being ◽  
Stroke Survivor ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Clinically Significant

Background: Multiple previous investigations have documented persistent elevations in depressive symptoms after stroke for stroke survivors and for family caregivers. However, relatively few studies have examined both groups simultaneously, and none have tested for possible predictive linkages in longitudinal analyses. Methods: We collected interview data from 248 stroke survivors and their primary family caregivers who were enrolled in the Caring for Adults Recovering from the Effects of Stroke (CARES) project. CARES is an ancillary study to the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Stroke survivors and caregivers were interviewed at 9-, 18-, 27- and 36-months after an adjudicated stroke event. Measures administered to both groups included the 20-item Center for Epidemiological Studies Depression Scale (CESD) and the 12-item Short Form Health Survey (SF-12) of health-related quality of life. Cross-lagged panel analyses were used to investigate linkages between stroke survivors and caregivers over time on these measures. Results: Clinically significant levels of depressive symptoms, as defined by a score of 16 or more on the CESD, were found for 17.0% of the stroke survivors and 13.7% of the caregivers at 9-months after stroke. Longitudinal models revealed that high stroke survivor depressive symptoms at 9-months post-stroke predicted increases in caregiver depressive symptoms at 18-months post-stroke (standardized adjusted regression coefficient = 0.18, p = 0.003). No longitudinal predictive effects were found for caregiver depressive symptoms on stroke survivor outcomes or for the SF-12 measures. Conclusions: Clinically significant levels of depressive symptoms were relatively rare 9-months after stroke in this population-based sample of stroke survivors and family caregivers. Stroke survivor depressive symptoms longitudinally predict caregiver depressive symptoms, but caregiver well-being was not found to longitudinally predict stroke survivor depression or quality of life. Treating elevated depressive symptoms in stroke survivors may also improve caregiver well-being.

Surgery for Shoulder Osteoarthritis: A Cochrane Systematic Review

2011 ◽  
Vol 38 (4) ◽  
pp. 598-605 ◽  
Author(s):  
JASVINDER A. SINGH ◽  
JOHN SPERLING ◽  
RACHELLE BUCHBINDER ◽  
KELLY McMAKEN
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Relative Risk ◽  
Short Form ◽  
Surgical Techniques ◽  
Mean Difference ◽  
Cochrane Systematic Review ◽  
Shoulder Osteoarthritis ◽  
Patient Reported

Objective.To determine the benefits and harm of surgery for shoulder osteoarthritis (OA).Methods.We performed a Cochrane Systematic Review of clinical trials of adults with shoulder OA, comparing surgical techniques [total shoulder arthroplasty (TSA), hemiarthroplasty, implant types, and fixation] to placebo, sham surgery, nonsurgical modalities, and no treatment. We also reviewed trials that compared various surgical techniques, reporting patient-reported outcomes (pain, function, quality of life, etc.) or revision rates. We calculated the risk ratio for categorical outcomes and mean differences for continuous outcomes with 95% CI.Results.There were no controlled trials of surgery versus placebo or nonsurgical interventions. Seven studies with 238 patients were included. Two studies compared TSA to hemiarthroplasty (n = 88). Significantly worse scores on the 0–100 American Shoulder and Elbow Surgeons scale (mean difference, −10.05 at 24–34 mo; 95% CI −18.97 to −1.13; p = 0.03) and a nonsignificant trend toward higher revision rate in hemiarthroplasty compared to TSA (relative risk 6.18; 95% CI 0.77 to 49.52; p = 0.09) were noted. With 1 study providing data (n = 41), no differences were noted between groups for pain scores (mean difference 7.8; 95% CI −5.33 to 20.93), quality of life on Medical Outcomes Study Short-Form 36 physical component summary (mean difference 0.80; 95% CI −6.63 to −8.23), and adverse events (relative risk 1.2; 95% CI 0.4 to 3.8).Conclusion.TSA was associated with better shoulder function, with no other demonstrable clinical benefits compared to hemiarthroplasty. More studies are needed to compare clinical outcomes between them and comparing shoulder surgery to sham, placebo, and other nonsurgical treatment options.

Abstract WMP90: Marital Status and Post-Stroke Outcomes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Liming Dong ◽  
Devin Brown ◽  
Erin Case ◽  
Lewis Morgenstern ◽  
Lynda Lisabeth
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Activities Of Daily Living ◽  
Marital Status ◽  
Daily Living ◽  
Stroke Outcomes ◽  
Never Married ◽  
Post Stroke ◽  
Quality Of Life Scale

Introduction: Although the impacts of marital status on health have long been recognized, little is known about its role in stroke outcomes. The study examined the association of marital status with neuropsychiatric, cognitive, functional, and quality of life outcomes at 90 days post-stroke in a population-based sample. Methods: Data were obtained from the Brain Attack Surveillance in Corpus Christi (BASIC) project (2009-2016). Post-stroke outcomes included neurological status assessed by the National Institutes of Health Stroke Scale, cognitive function assessed by the Modified Mini-Mental State Examination, functioning assessed by an activities of daily living (ADL)/instrumental activities of daily living (IADL) score, depression assessed by the 8-item Patient Health Questionnaire, and quality of life assessed by the short-form Stroke Specific Quality of Life scale. Linear or Tobit regression models were used to examine the association between marital status and stroke outcomes, accounting for attrition. Results: Among 1,226 ischemic or hemorrhagic cases, mean age was 67.6 (SD=12.3), half were women, and three-fifths were Mexican American; 23.0% were widowed, 20.1% were divorced/separated, and 8.4% were never married. Widowed participants were more likely to be female, aged above 75, and less educated than other groups. After adjustment for age, sex, ethnicity, education and stroke severity, compared with those married, those widowed had significantly worse cognitive function and quality of life, those never married had worse neurological and cognitive outcomes, and those divorced/separated had more depressive symptoms and poorer quality of life (Table). Conclusions: Being unmarried at stroke onset is associated with worse outcomes after stroke, and the outcome profiles vary by marital status. Further research should investigate potential mechanisms and develop interventions to improve outcomes of unmarried stroke survivors.

scholarly journals Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care results of TELEREH-HF randomized clinical trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Piotrowicz ◽  
A Mierzynska ◽  
M Pencina ◽  
G Opolski ◽  
W Zareba ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Usual Care ◽  
Physical State ◽  
Short Form ◽  
Bodily Pain ◽  
Funding Source ◽  
Physical Domain ◽  
Role Functioning

Abstract Background Heart failure (HF) is a clinical syndrome associated with physical capacity impairment and poor quality of life (QoL). The hybrid comprehensive telerehabilitation (HCTR) consisting of telecare, telerehabilitation and homemonitoring of implantable devices might be an option to improve QoL. Purpose to investigate the influence of HCTR on various facets of QoL in HF pts in comparison to usual care (UC). Methods The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF pts (NYHA I-III, LVEF≤40%). Patients were randomized 1:1 to HCTR plus UC or UC. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home) or UC with observation. The psychology telecare had a form of supportive psychotherapy via phone. The Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after intervention/observation. Results HCTR group showed significant improvement in overall QoL, physical domain, and 4 areas of QoL (physical functioning [PF], role functioning related to physical state, general health, vitality). A significant positive change in QoL in UC group was observed in vitality and social functioning. There were significant differences in QoL after intervention/observation between groups. Results showed higher improvement in HCTR for overall QoL, physical domain and 3 areas of QoL (PF, role functioning related to physical state and bodily pain [BP]), Table 1. Conclusion In comparison to UC, HCTR resulted in significant improvement in overall QoL, physical domain and 3 specific areas of QoL: PF, role functioning related to physical state and BP. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Centre for Research and Development, Warsaw, Poland

scholarly journals Chronic Frequent Headache in the General Population: Comorbidity and Quality of Life

Cephalalgia ◽  
2006 ◽  
Vol 26 (12) ◽  
pp. 1443-1450 ◽  
Author(s):  
NJ Wiendels ◽  
A van Haestregt ◽  
A Knuistingh Neven ◽  
P Spinhoven ◽  
FG Zitman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Rating Scale ◽  
Short Form ◽  
Negative Influence ◽  
Mean Difference ◽  
Headache Frequency ◽  
Dutch Version ◽  
Comorbidity Scores

We studied the nature and extent of comorbidity of chronic frequent headache (CFH) in the general population and the influence of CFH and comorbidity on quality of life. Subjects with CFH (headache on >14 days/month) were identified in a general health survey. We sent a second questionnaire including questions on comorbidity and quality of life to subjects with CFH and subjects with infrequent headache (IH) (1-4 days/month). We recoded comorbidity by using the Cumulative Illness Rating Scale (CIRS) and measured quality of life with the RAND-36, a Dutch version of Short Form-36. CFH subjects ( n = 176) had higher comorbidity scores than the IH subjects ( n = 141). Mean CIRS scores were 2.94 for CFH and 1.55 for IH [mean difference 1.40, 95% confidence interval (CI) 0.91, 1.89]. The mean number of categories selected was 1.92 in CFH and 1.10 in IH (mean difference 0.82, 95% CI 0.54, 1.11). Fifty percent of CFH subjects had a comorbidity severity level of at least 2, indicating disorders requiring daily medication, compared with 28% of IH subjects (mean difference 22%, 95% CI 12, 33). CFH subjects had more musculoskeletal, gastrointestinal, psychiatric and endocrine/breast pathology than IH subjects. Quality of life in CFH subjects was lower than that of IH subjects in all domains of the RAND-36. Both headache frequency and CIRS score had a negative influence on all domains. We conclude that patients with CFH have more comorbid disorders than patients with infrequent headaches. Many CFH patients have a comorbid chronic condition requiring daily medication. Both high headache frequency and comorbidity contribute to the low quality of life in these patients.

scholarly journals Cognitive deficits, social support, depression and quality of life of post-stroke patients

2020 ◽  
Vol 38 (2) ◽  
pp. 153-165
Author(s):  
Flávia Sousa ◽  
Vânia Rocha ◽  
Clara Estima ◽  
São Luís Castro ◽  
Marina Prista Guerra
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Depressive Symptoms ◽  
Cognitive Deficits ◽  
Short Form ◽  
Control Group ◽  
Clinical Group ◽  
Stroke Patients ◽  
Post Stroke

A stroke is a life-threatening event which has physical, emotional and cognitive consequences. Thisstudy aimed to identify differences between participants who suffered a stroke and healthy controls,concerning cognitive performance, depressive symptoms, social support and quality of life; to examinethe associations between these variables among participants who suffered a stroke; and to identify thevariables that best classify patients and controls. The sample included 30 patients who suffered astroke and 30 healthy participants. Both groups presented similar sociodemographic characteristics.All participants were assessed with The Institute of Cognitive Neurology Frontal Screening, theMontreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, the Instrumental-Expressive Social-Support Scale, and the Short Form Health Survey-36. Post-stroke patients had lowercognitive performance, lower social support, lower quality of life and higher depressive symptomsthan the control group. Social support was positively related to quality of life and negatively relatedto depressive symptoms in the clinical group. Cognitive deficits and depressive symptoms correctlyclassified belonging to the clinical group in 85% of cases, and significantly predicted the stroke. Thisstudy underlines the importance of implementing psychological interventions addressing depressivesymptoms and cognitive rehabilitation for post-stroke patients.

Quality of Life in People with Their First Diabetic Foot Ulcer

2009 ◽  
Vol 99 (5) ◽  
pp. 406-414 ◽  
Author(s):  
Kirsty Winkley ◽  
Daniel Stahl ◽  
Trudie Chalder ◽  
Michael E. Edmonds ◽  
Khalida Ismail
Keyword(s):  
Quality Of Life ◽  
Confidence Interval ◽  
Diabetic Foot ◽  
Short Form ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Mean Difference ◽  
Short Form Health Survey ◽  
Short Form Health

Background: People with diabetic foot ulcers report poor quality of life. However, prospective studies that chart quality of life from the onset of diabetic foot ulcers are lacking. We describe change in quality of life in a cohort of people with diabetes and their first foot ulcer during 18 months and its association with adverse outcomes. Methods: In this prospective cohort study of adults with their first diabetic foot ulcer, the main outcome was change in Medical Outcomes Study 36-Item Short Form Health Survey scores between baseline and 18-month follow-up. We recorded baseline demographics, diabetes characteristics, depression, and diabetic foot outcomes and mortality at 18 months. Results: In 253 people with diabetes and their first ulcer, there were 40 deaths (15.8%), 36 amputations (15.5%), 99 recurrences (43.2%), and 52 nonhealing ulcers (21.9%). The 36-Item Short Form Health Survey response rate of survivors at 18 months was 78% (n = 157). There was a 5- to 6-point deterioration in mental component summary scores in people who did not heal (adjusted mean difference, −6.54; 95% confidence interval, −12.64 to −0.44) or had recurrent ulcers (adjusted mean difference, −5.30; 95% confidence interval, −9.87 to −0.73) and a nonsignificant reduction in those amputated (adjusted mean difference, −5.00; 95% confidence interval, −11.15 to 1.14). Conclusions: Quality of life deteriorates in people with diabetes whose first foot ulcer recurs or does not heal within 18 months. (J Am Podiatr Med Assoc 99(5): 406–414, 2009)

scholarly journals 92 Medication Related Quality of Life (MRQoL) in Ambulatory Older Adults with Polypharmacy and Multi-morbidity – a Measurable Outcome?

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Emma Jennings ◽  
Katrine Jorgensen ◽  
Natasha Lewis ◽  
Stephen Byrne ◽  
Paul Gallagher ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Rating Scale ◽  
Short Form ◽  
Median Number ◽  
Mean Difference ◽  
Potentially Inappropriate Medications ◽  
Physical And Mental Health ◽  
Tertiary Teaching

Abstract Background With increasing numbers of older multi-morbid people being exposed to polypharmacy, research needs to focus on medication-related outcomes affecting quality-of-life (QoL). This study examines older-patients’ medication-related QoL (MRQoL), its relationship to medication burden/complexity, frailty, health-related QoL (HRQoL) and potentially inappropriate medications (PIMs. Methods A cross-sectional-study was conducted in older-patients attending out-patients and day-hospital services of a tertiary-teaching-hospital. Participants were aged ≥65 years, first-time attendees, taking ≥5 chronic-medications for ≥3 chronic-conditions and mini-mental state examination score ≥26/30. Demographic, medication, comorbidity, frailty status, PIMs(STOPP/STARTv.2 criteria), MRQoL (MRQoL-LS v1.0) HRQoL (Short-form-12; SF-12) and medication burden (Living with Medicines Questionnaire v.2; LMQv2) data were collected. Drg compliance was measured using the Medication Adherence Rating Scale (MARS). Lower MRQoL-LS v1.0 scores indicate better MRQoL (range 0-84). Higher LMQv2 scores indicate higher medication burden (range from 60-300). A negative age-specific mean-difference score in SF-12 physical and mental health composite scale scores (SF12-PCS, SF12-MCS) indicates poorer health. Results Over 12 months, 234 patients (attending 78 clinics) were screened, 59 met inclusion criteria and 30 were recruited; 3 patients were subsequently identified as ineligible. Eighteen patients were female (66%), mean age was 79.4 years (SD±6.2), median number of daily medications was 10 (IQR 8-13), median number of comorbidities was 11 (IQR 9-14). Participants were generally drug-compliant, median MARS score of 9 (IQR 6.5-10). Patients’ median MRQoL score was 14 (IQR 14-22.5); mean LMQ v2 score was 115.64 (SD± 25.18). Mean age specific mean-difference SF12-PCS and SF12-MCS scores were -22.61 (SD±11.7) and -22.1 (SD±17.5) respectively. There was no significant correlation between MRQoL and number of daily medications, number of comorbidities, LMQ, HRQoL, or PIMs(Pearson’s 2-tailed test). Conclusion This study demonstrates that MRQoL-LS v.1 is not applicable to most patients attending geriatric ambulatory services. Furthermore, polypharmacy, multimorbidity, presence of PIMs poorer HRQoL do not correlate significantly with MRQoL.

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