The Relative Influence of Surgical Disease and Co-Morbidities on Patient Responses to a Generic Health-Related Quality-of-Life Instrument

2009 ◽  
Vol 75 (11) ◽  
pp. 1084-1090
Author(s):  
Emily France ◽  
Vic Velanovich
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Linear Regression ◽  
Linear Regression Analysis ◽  
Health Related Quality ◽  
Surgical Disease ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Generic health-related quality-of-life (QoL) instruments are increasingly used to assess the outcomes of surgical interventions. However, it is unclear to what extent the patient's associated comorbidities have on the responsiveness of these instruments to measure changes caused by the operation. The purpose of this study was to assess the relative influence of comorbidities to surgical disease in how patients answered the items of the most frequently used generic instrument, the SF-36. Sixty-nine preoperative patients completed the SF-36, which contains 36 items covering eight domains and a health transition question. For each of the 36 items, patients were asked to rate the influence of their surgical disease and their comorbidities on how they answered the items from 1 to 10. The surgical disease, comorbidities, and medications were recorded. Data was analyzed using the Mann-Whitney U test and linear regression analysis. Of the 36 items of the SF-36, patients reported that their surgical disease influences nine items greater than their comorbidities (P < 0.05). Using linear regression analysis, the number of comorbidities did not effect the influence of the surgical disease in any item; however, this number had a direct relationship (P < 0.05) with the influence of comorbidities on how the patient answered the item. However, the magnitude of the influence was low. There was an inverse (negative slope, P < 0.05) relationship between the number of comorbidities and the score of six of eight domains. Although the surgical disease has more of an influence on how patients answered the items of the SF-36, as the number of comorbidities increased, these seem to have more influence. Therefore, the SF-36 would be a good choice for assessing QoL in most surgical disease. However, as the overall magnitude of this influence was low, this may be a cause of the lack of responsiveness of generic QoL instruments in measuring the effect of operations on QoL. Importantly, as the number of comorbidities increased, the scores of the SF-36 decreased, implying that the effect of the surgical disease would be greater in patients with fewer comorbidities.

Determinants of health-related quality of life in colon cancer patients include stoma and smoking habits, but not type of surgery

2019 ◽  
Author(s):  
Catarina Tiselius ◽  
Andreas Rosenblad ◽  
Eva Strand ◽  
Kennet Smedh
Keyword(s):  
Quality Of Life ◽  
Colon Cancer ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background: Health-related quality of life (HRQoL) has gained increased attention in cancer care. Studies have shown that poor QoL might worsen the cancer related prognosis. The aim of this study was to investigate HRQoL in patients with colon cancer and to compare data with reference values from the general population in Sweden at diagnosis (baseline) and at six months of follow-up. Methods : This was a prospective population-based study of colon cancer patients from Västmanland County, Sweden, included between March 2012 and September 2016. HRQoL was measured using the cancer-specific EORTC QLQ-C30 questionnaire. Data on HRQoL was compared with Swedish population reference values. Multiple linear regression analysis adjusted for age, sex, body mass index (BMI), American Society of Anaesthesiology (ASA) physical status classification, emergency/elective surgery, and resection with/without a stoma and tumour stage (TNM), was used. Results : A total of 67% (376/561) of all incident colon cancer patients (196 [52.1%] females) were included. Mean (range) age was 73 (30-96) years. The univariate analysis showed that patients with colon cancer had worse QoL (8/15 parameters) compared with a Swedish reference population both at baseline and at 6 months follow-up. Furthermore, linear regression analysis showed that patients with more comorbidity (ASA 3 and 4), smokers and patients planned to be operated on with a stoma, were at higher risks for poor QoL than the other included patients. Conclusions : The reported determinants of HRQoL may be used to identify risk groups and enable individualized care for patients that need more support from health care.

scholarly journals Impact of overweight and obesity on patient-reported health-related quality of life in systemic lupus erythematosus

Rheumatology ◽  
2020 ◽  
Author(s):  
Alvaro Gomez ◽  
Fawz Hani Butrus ◽  
Petter Johansson ◽  
Emil Åkerström ◽  
Sofia Soukka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Linear Regression ◽  
Social Functioning ◽  
Overweight And Obesity ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Objectives Associations between BMI and health-related quality of life (HRQoL) in SLE have been implied, but data are scarce. We determined the impact of overweight and obesity on HRQoL in a large SLE population. Methods We pooled cross-sectional baseline data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (N = 1684). HRQoL was evaluated using the 36-item Short Form Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and the European Quality of Life 5-dimension questionnaire (EQ-5D). Comparisons between BMI groups were conducted using the Mann–Whitney U test and adjustments using linear regression. Clinical relevance was determined by minimal clinically important differences (MCIDs). Results In total, 43.2% of the patients had BMI above normal and 17.4% were obese. Overweight and obese patients reported worse SF-36 physical component summary (PCS), physical functioning, role physical, bodily pain and FACIT-Fatigue scores than normal weight patients. Divergences were greater than corresponding MCIDs and more prominent with increasing BMI. Despite no clinically important difference in SF-36 mental component summary scores across BMI categories, patients experienced progressively diminished vitality and social functioning with increasing BMI. In linear regression analysis, BMI above normal and obesity were associated with worse PCS (standardized coefficient β = −0.10, P &lt; 0.001 and β = −0.17, P &lt; 0.001, respectively), FACIT-Fatigue (β = −0.11, P &lt; 0.001 and β = −0.16, P &lt; 0.001) and EQ-5D (β = −0.08, P = 0.001 and β = −0.12, P &lt; 0.001) scores, independently of demographic and disease-related factors. The impact of BMI on the PCS and FACIT-Fatigue was more pronounced than that of SLE activity. Conclusion Patients with SLE and BMI above normal experienced clinically important HRQoL diminutions in physical aspects, fatigue and social functioning. A survey of potential causality underlying this association is warranted.

The Impact of Sarcopenic Obesity on Health-Related Quality of Life of Treatment-Seeking Patients with Obesity

2020 ◽  
Vol 16 (6) ◽  
pp. 635-640 ◽  
Author(s):  
Leila Itani ◽  
Dima Kreidieh ◽  
Dana El Masri ◽  
Hana Tannir ◽  
Marwan El Ghoch
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Weight Management ◽  
Linear Regression Analysis ◽  
Sarcopenic Obesity ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Background: There is a paucity of studies on health-related quality of life (HRQoL) and sarcopenic obesity (SO). Objective: This study aimed to assess the potential association between SO and impaired HRQoL. Methods: The ORWELL 97 questionnaire was used to assess HRQoL and body composition was measured using a bioimpedance analyser (Tanita BC-418) in 130 patients with obesity, referred to the Nutritional and Weight Management outpatient clinic of Beirut Arab University in Lebanon. Participants were then categorized on the basis of the absence or presence of SO. Results: Sixty-four of the 130 participants met the criteria for SO (49.2%) and displayed significantly higher total ORWELL 97 scores than those in the group without SO (64.00 vs. 41.00, p=0.001), indicative of poorer HRQoL. Linear regression analysis showed that SO was associated with an increase in ORWELL 97 scores by nearly 24 units (β=24.35, 95% CI=11.45-37.26; p<0.0001). Moreover, the logistic regression analysis showed that SO increased the odds of clinically significant impairment of HRQoL (ORWELL 97 score ≥74.25) by nearly seven-fold (OR=7.37, 95% CI=1.92-28.39; p=0.004). Conclusion: Our findings show that the presence of SO was associated with increased impairment of HRQoL that reaches clinical significance when compared to obesity only. Future studies are needed to clarify whether this may influence clinical outcomes. If this is shown to be the case, weight management programs should incorporate additional strategies to improve HRQoL in individuals with SO.

scholarly journals Health-Related Quality of Life in Stroke Survivors in Relation to the Type of Inpatient Rehabilitation in Serbia: A Prospective Cohort Study

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 666
Author(s):  
Natasa K. Rancic ◽  
Milan N. Mandic ◽  
Biljana N. Kocic ◽  
Dejan R. Veljkovic ◽  
Ilija D. Kocic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Linear Regression Analysis ◽  
Inpatient Rehabilitation ◽  
Stroke Survivors ◽  
Multivariate Linear Regression Analysis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Background and objectives: Health-related quality of life after stroke is an important public health issue. The objective of the study was to investigate the relationship between the perceived health-related quality of life in stroke survivors in relation to the type of inpatient rehabilitation. Materials and Methods: Using a random selection method out of a total of 688 patients, every fourth survivor who had a stroke in the period from 1 January 2017 to 31 December 2019 was selected from the admission protocol of the Clinic for Rehabilitation and Physical Medicine of the Clinical Centre Niš, Serbia. A total of 160 first-ever stroke survivors were included (80 underwent additional inpatient rehabilitation and 80 underwent only inpatient rehabilitation in a tertiary health institution) in a twelve-month prospective study. The EuroQuol-5 Dimension (EQ5D) questionnaire and Stroke Impact Scale were used for the assessment. Multivariate linear regression analysis was done. Results: Multivariate linear regression analysis showed that additional inpatient rehabilitation from six up to eight weeks after discharge was significantly associated with better self-reported health condition by 3.9 times (from 1.9 to 8.2), significantly decreased the ranks of EQ5D by 1.78 times (from 1.02 to 3.11), and showed a higher health-related quality of life. We determined a significant increase of strength, emotions, mobility, and participation role in survivors who underwent additional inpatient rehabilitation compared with those who did not. Conclusions: There was a significant difference in health-related quality of life perceived by stroke survivors who underwent additional hospital rehabilitation in relation to those who underwent only inpatient rehabilitation.

scholarly journals Impact of malnutrition on health-related quality of life in persons receiving dialysis: a prospective study

2021 ◽  
pp. 1-24
Author(s):  
Daniela Viramontes-Hörner ◽  
Zoe Pittman ◽  
Nicholas M Selby ◽  
Maarten W Taal
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Health Related Quality ◽  
Poor Hrqol ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
Over Time

Abstract Health-related quality of life (HRQoL) is severely impaired in persons receiving dialysis. Malnutrition has been associated with some measures of poor HRQoL in cross-sectional analyses in dialysis populations, but no studies have assessed the impact of malnutrition and dietary intake on change in multiple measures of HRQoL over time. We investigated the most important determinants of poor HRQoL and the predictors of change in HRQoL over time using several measures of HRQoL. We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in this prospective study. Nutritional assessments (Subjective Global Assessment [SGA], anthropometry and 24-hour dietary recalls) and HRQoL questionnaires (Short Form-36 [SF-36] mental [MCS] and physical component scores [PCS] and European QoL-5 Dimensions [EQ5D] health state [HSS] and visual analogue scores [VAS]) were performed at baseline, 6 and 12 months. Mean age was 64(14) years. Malnutrition was present in 37% of the population. At baseline, malnutrition assessed by SGA was the only factor independently (and negatively) associated with all four measures of HRQoL. No single factor was independently associated with decrease in all measures of HRQoL over 1 year. However, prevalence/development of malnutrition over one year was an independent predictor of 1-year decrease in EQ5D HSS and 1-year decrease in fat intake independently predicted the 1-year decline in SF-36 MCS and PCS, and EQ5D VAS. These findings strengthen the importance of monitoring for malnutrition and providing nutritional advice to all persons on dialysis. Future studies are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.

scholarly journals Effect of multimorbidity patterns on the decline in health-related quality of life: a nationwide prospective cohort study in Japan

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047812
Author(s):  
Takuya Aoki ◽  
Shunichi Fukuhara ◽  
Yasuki Fujinuma ◽  
Yosuke Yamamoto
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Summary Score ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

ObjectivesLongitudinal studies, which consider multimorbidity patterns, are useful for better clarifying the effect of multimorbidity on health-related quality of life (HRQoL) and for identifying the target population with poorer clinical outcomes among patients with multimorbidity. This study aimed to examine the effects of different multimorbidity patterns on the decline in HRQoL.DesignNationwide prospective cohort study.SettingJapanese adult residents.ParticipantsResidents aged ≥50 years selected by the quota sampling method.Primary outcome measureClinically relevant decline in HRQoL was defined as a 0.50 SD (5-point) decrease in the 36-Item Short Form Health Survey (SF-36) component summary scores for 1 year.ResultsIn total, 1211 participants completed the follow-up survey. Among the multimorbidity patterns identified using confirmatory factor analysis, multivariable logistic regression analyses revealed that high cardiovascular/renal/metabolic and malignant/digestive/urologic pattern scores were significantly associated with the clinically relevant decline in SF-36 physical component summary score (adjusted OR (aOR)=1.25, 95% CI: 1.08 to 1.44 and aOR=1.28, 95% CI: 1.04 to 1.58, respectively). High cardiovascular/renal/metabolic pattern score was also significantly associated with the clinically relevant decline in SF-36 role/social component summary score (aOR=1.23, 95% CI: 1.06 to 1.42).ConclusionsOur study revealed that multimorbidity patterns have different effects on the clinically relevant decline in HRQoL for 1 year. These findings can be useful in identifying populations at high risk and with poor clinical outcomes among patients with chronic diseases and multimorbidity for efficient resource allocation.

Factors Affecting Health-Related Quality of Life After the Arterial Switch Operation

2021 ◽  
Vol 12 (3) ◽  
pp. 344-351
Author(s):  
Julie Cleuziou ◽  
Anna-Katharina Huber ◽  
Martina Strbad ◽  
Masamichi Ono ◽  
Alfred Hager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Arterial Switch Operation ◽  
Health Related Quality ◽  
Switch Operation ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Cardiac Medication

Background: Long-term morbidity and mortality outcomes of the arterial switch operation (ASO) in patients with transposition of the great arteries and Taussig-Bing anomaly are excellent. With an increasing number of patients reaching adolescence and adulthood, more attention is directed toward quality of life. Our study aimed to determine the health-related quality of life (hrQoL) outcomes in patients after the ASO and identify factors influencing their hrQoL. Methods: In this cross-sectional study, hrQoL of patients after ASO was assessed with the German version of the Short Form-36 (SF-36) and the potential association of specified clinical factors was analyzed. Patients of at least 14 years of age who underwent ASO in our institution from 1983 were considered eligible. Results: Of the 355 questionnaires sent to eligible patients, 261 (73%) were available for analysis. Compared to the reference population, patients who had undergone ASO had a significantly higher score in all subscales of the SF-36 except for vitality ( P < .01). Patients with an implanted pacemaker ( P = .002), patients who required at least one reoperation ( P < .001), and patients currently taking cardiac medication ( P < .004) or oral anticoagulation ( P = .036) had lower physical component scores compared to patients without these factors. Conclusions: Patients’ self-assessed and self-reported hrQoL after ASO (using German version of the Short Form 36) is very good. In this population, hrQoL is influenced by reoperation, the need for a pacemaker, and current cardiac medication or anticoagulant use. The development of strategies designed to mitigate or minimize the requirements for, and/or impact of these factors may lead to better hrQoL in this patient population.

scholarly journals Reduced Health-Related Quality of Life in Body Constitutions of Yin-Xu, and Yang-Xu, Stasis in Patients with Type 2 Diabetes: Taichung Diabetic Body Constitution Study

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Chia-I Tsai ◽  
Yi-Chang Su ◽  
Shih-Yi Lin ◽  
I-Te Lee ◽  
Cheng-Hung Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Health Related Quality ◽  
Body Constitution ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Aim. To evaluate how health-related quality of life (HRQOL) and traditional Chinese medicine (TCM) constitutions of Yin-Xu, Yang-Xu, and Stasis are related in type 2 diabetes patients. Method. Seven hundred and five subjects were recruited in 2010 for this study from a Diabetes Shared Care Network in Taiwan. Generic and disease-specific HRQOL were assessed by the short form 36 (SF-36) and the diabetes impact measurement scale (DIMS). Constitutions of Yin-Xu, Yang-Xu, and Stasis were then assessed by the body constitution questionnaire (BCQ), a questionnaire consisting of 44 items that evaluate the physiological state based on subjective symptoms and signs. Results. Estimated effects of the Ying-Xu and Stasis on all scales of the SF-36 were significantly negative, while estimated effects of the Yang-Xu on all scales (except for SF, RE, MH, and MCS) were significantly negative. For DIMS, the estimated effects of the Ying-Xu and Stasis on all scales were significantly negative except for Stasis on well-being, while Yang-Xu has a significantly negative effect only on symptoms. Conclusions. This study demonstrates that TCM constitutions of Yin-Xu, Yang-Xu, and Stasis are closely related to a reduction in HRQOL. These findings support the need for further research into the impact of intervention for TCM constitutions on HRQOL in patients with type 2 diabetes.

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