Deterioration in the health-related quality of life of persons with multiple sclerosis: the possible warning signs

2007 ◽  
Vol 13 (8) ◽  
pp. 1038-1045 ◽  
Author(s):  
K.V.L. Turpin ◽  
L.J. Carroll ◽  
J.D. Cassidy ◽  
W.J. Hader

Baseline data from a population-based study examining the health-related quality of life (HRQL) of MS patients about to begin disease modifying therapy was used to determine the factors associated with the HRQL of Saskatchewan adults with relapsing-remitting MS. Participants completed a self-report questionnaire regarding demographic and socioeconomic status, fatigue, comorbid medical conditions, disability level (EDSS), number of attacks in past 6 months, illness intrusiveness (Illness Intrusiveness Ratings Scale), depression (Beck Depression Inventory), and HRQL (SF-36 Health Status Survey). Multiple linear regression models were used to identify the factors associated with the physical and mental health summary scores of the SF-36. We found poorer physical HRQL in those who are female; older; not working; have musculoskeletal or respiratory problems; greater fatigue, higher disability scores, and more MS attacks. High illness intrusiveness; digestive system problems; genitourinary problems; and headaches were associated with poorer mental HRQL. Interestingly, we found an interaction between sex and age in mental HRQL, with worse mental health in older men but better mental health in older women. These findings may assist health care providers in identifying patients who may be at risk for decline in their HRQL, permitting appropriate and timely interventions. Multiple Sclerosis 2007; 13: 1038—1045. http://msj.sagepub.com

Author(s):  
Wilma M. Hopman ◽  
Helen Coo ◽  
Cathy M. Edgar ◽  
Evelyn V. McBride ◽  
Andrew G. Day ◽  
...  

Background:Much research has gone into the assessment of function and health-related quality of life (HRQOL) in those with multiple sclerosis (MS). The Medical Outcomes Study 36-item short form (SF-36) has been widely used in this population but current recommendations are that it be supplemented with condition-specific measures such as the MS Quality of Life Inventory (MSQLI) and the MS Functional Composite (MSFC). The goal of the baseline component of this study was the measurement of generic and condition-specific HRQOL, and the identification of factors associated with these outcomes.Methods:HRQOL was assessed at the baseline phase of a longitudinal study. Participants completed the assessment during their regularly scheduled clinic visit.Results:300 of 387 eligible patients agreed to participate, for a response rate of 77.5%. Age ranged from 22 to 77 years, while duration of MS ranged from 1 to 47 years. Mean SF-36 scores were well below age- and sex-adjusted normative data. Only 240 completed the MSFC component. Higher EDSS, use of support services, pain medications, clinical depression and antidepressant use were associated with poorer HRQOL, while higher income and education were associated with better HRQOL.Conclusions:There is a substantial burden of illness associated with MS when compared to normative HRQOL data. This was more pronounced in physically- than in mentally-oriented domains. Assessment of HRQOL provides a valuable complement to the EDSS by providing information about the patient perception of function and HRQOL beyond that which can be obtained by physical assessment alone.


Author(s):  
Wilma M. Hopman ◽  
Helen Coo ◽  
Andrey Pavlov ◽  
Andrew G. Day ◽  
Catherine M. Edgar ◽  
...  

Background:Cross-sectional research has demonstrated poorer function and health-related quality of life (HRQOL) in those with multiple sclerosis (MS) but less is known about change over time. The goals of this study were to measure change in HRQOL and identify factors associated with change.Methods:HRQOL was assessed at baseline and annually over two subsequent years using the Multiple Sclerosis Quality of Life Inventory. Function was assessed using the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite. Annualized rate of change was calculated for all twenty outcomes. Mixed effects modeling (univariate followed by multivariate) was used to examine the associations among patient characteristics and the age- and sex-adjusted Physical Component Summary (PCS) and Mental Component Summary (MCS) at study initiation and over the two years of follow-up.Results:Of 300 participants, 288 (96%) provided at least one assessment and are included in this analysis. Although 14 of the 20 outcomes showed a mean decline, only two (SF-36 physical function, p=0.018 and the EDSS, p<0.001) were statistically significant. The SF-36 social function showed a significant improvement (p=0.031). Only two variables were significantly associated with a decreased rate of decline or improvement over two years, including being female (PCS, p=0.001) and use of visiting nurse services (MCS, p<0.001).Conclusions:HRQOL is relatively stable over two years of follow-up, particularly for mentally-oriented outcomes. Further research with a longer period of follow-up is needed to provide additional insight into factors associated with change in HRQOL in patients with MS.


2020 ◽  
Author(s):  
ming zhang ◽  
Lin Fan ◽  
Meibian Zhang ◽  
Baofeng Liu ◽  
Qiang Zeng

Abstract Background p -Phenylenediamine (PPD) is a common component of hair dye, indicating the clinical characteristics of skin contact allergy and asthma with impaired pulmonary function. Howerver the adverse effects of PPD occupational exposure was rarely mentioned. The purpose of this study was to explore the PPD-induced pulmonary function, pruritus and health-related quality of life (HRQOL) of industrial workers of hair dye. Methods We recruited 124 workers from a hair dye manufacturer exposed to PPD. Individual PPD exposure and pulmonary function of workers were measured. The quality of life and subjective pruritus of workers was also assessed by SF-36 and VAS of pruritus, respectively. Results In the high PPD-exposed group, FVC% (percentage of forced vital capacity) was higher, while FEV1/FVC% (ratio percentage of forced expiratory volume) was lower than that in the low PPD-exposed group ( P <0.05). In terms of the HRQOL, the scores of mental health and vitality of the high PPD-exposed group were the lowest of all groups ( P <0.05), while the score of VAS was significantly higher than that of other two groups ( P <0.001). PPD levels were negatively correlated with vitality and mental health ( P <0.01). Higher PPD exposure level was correlated with a significantly higher VAS level (OR 9.394; 95%CI: 1.710, 51.622; P =0.010). The structural equation model provided a good fit to the data (χ2/df =1.607, GFI =0.901, AGFI =0.934, RMSEA =0.007, IFI =0.977, CFI =0.960, PGFI =0.615). And showed that PPD exposed level have positive effects on VAS level (β = 0.213, P <0.001). Then PPD exposed level partly via lack total score of SF-36 (β = -0.465, P =0.002); on negative effects on VAR level (β = -0.110, P <0.001). Conclusion Occupational PPD exposure might be associated with pulmonary function impairment, poor HRQOL, and subjective pruritus of workers.


2012 ◽  
Vol 20 (2) ◽  
pp. 346-353 ◽  
Author(s):  
Lígia da Silva Leroy ◽  
Maria Helena Baena de Moraes Lopes

This case-control study evaluated whether UI in the puerperium compromises the health-related quality of life (HRQoL) and if so, in which aspects. The study included 344 women (77 case group and 267 control group) up to 90 days postpartum, who were attended the Obstetrics Outpatient Clinic of a public teaching hospital, for the postpartum follow up consultation. A socio-demographic and clinical data questionnaire formulated and validated for the study, the International Consultation on Incontinence Questionnaire - Short-Form (ICIQ-SF), the King's Health Questionnaire (KHQ) and the Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36), were applied. The mean score of the ICIQ-SF was 13.9 (SD: 3.7). The case group presented high mean scores in the domains Impact of the Incontinence, Emotions, Daily Activity Limitations and Physical Limitations, of the KHQ. The groups differed significantly in the domains Physical Aspects, Pain, General Health Status, Vitality, Social Aspects and Mental Health of the SF-36. It is concluded that UI significantly affects the physical and mental health of puerperae.


2009 ◽  
Vol 15 (11) ◽  
pp. 1339-1346 ◽  
Author(s):  
Ilaria Casetta ◽  
Trond Riise ◽  
Monica Wamme Nortvedt ◽  
Nicola Tiberio Economou ◽  
Riccardo De Gennaro ◽  
...  

Women have about twice the risk of developing multiple sclerosis (MS) compared with men, a ratio that seems to be increasing. Most studies show that female patients seem to have a more favourable outcome of the disease. We studied the gender-specific impact of MS on health-related quality of life. We surveyed the population prevalence of MS patients in Ferrara, Italy. Data were extracted from the MS registry of the study area. Health-related quality of life was assessed using the MSQOL54 questionnaire. We analysed 370 patients (105 men and 265 women). They had worse scores than the general population in all health-related quality of life dimensions, ranging from 2.5 standard deviations (SD) lower for physical functioning to less than 0.5 standard deviations for mental health. Health-related quality of life scores were inversely correlated with disability scores. The impact of disability on health-related quality of life was higher for men than women regarding physical functioning (p < 0.01), vitality (p < 0.001), social functioning (p < 0.001), emotional wellbeing (p < 0.05) and mental health (p < 0.01). For scales reflecting mental health, a marked reduction with increasing disability was seen for men, while a linear reduction in the range of Expanded Disability Status Scale score 0—5 was reported for women, followed by no clear decrease for higher scores. We conclude that MS affects health-related quality of life in all of its dimensions. The impact of disability seems to be stronger among men, in particular for scales related to mental well-being. This could indicate that interventions should to be gender specific in order to better meet patients’ needs.


2015 ◽  
Vol 24 (2) ◽  
pp. 199-207
Author(s):  
Md Azharul Islam ◽  
Mst Adiba Akter

This study explored health related quality of life (HRQoL) of substance users (SUs) in Bangladesh in comparison with healthy control groups (CGs). Additionally, role of self esteem and sex on HRQoL was investigated. A trained assistant counselling psychologist measured HRQoL and self‐esteem of 120 SUs and 120 CGs using SF‐36 questionnaire and Rosenberg Self Esteem scale, respectively. SUs were mostly male (79.2%) from middle socioeconomic class (94%). SUs scored poorer in all domains of SF‐36 than the CGs. The magnitude of the effect size was largest for the role physical (effect size = –0.79), general mental health (effect size = –0.76) and social functioning (effect size = –0.73) subscale. Overall mental health was lower than physical health (effect size = –0.897). Males in both groups were better in four sub‐scales while females reported less role limitation due to physical and emotional problems. Self esteem moderated HRQoL of both group with slightly higher magnitude for SUs. HRQoL of SU of Bangladesh was lower than the study population. Dhaka Univ. J. Biol. Sci. 24(2): 199-207, 2015 (July)


Medicina ◽  
2008 ◽  
Vol 44 (3) ◽  
pp. 240 ◽  
Author(s):  
Jurgita Andruškienė ◽  
Giedrius Varoneckas ◽  
Arvydas Martinkėnas ◽  
Vilius Grabauskas

Objective. The aim of the study was to establish factors associated with poor sleep and to assess the relationship between self-evaluated sleep quality and health-related quality of life. Material and methods. Sleep complaints were evaluated using Basic Nordic Sleep Questionnaire, and health-related quality of life was assessed by SF-36. Subjective data about sleep quality were obtained from 1602 randomly selected persons: 600 males and 1002 females, aged 35–74 years. SF-36 was filled in by 1016 persons: 379 males and 637 females. Health status was evaluated by Perceived Health Questionnaire. The odds ratios of poor sleep were calculated using binary logistic regression analysis. Results. Among males poor self-evaluated health, frequent stress events, regular nighttime awakenings, and sleep latency period longer than 15 min in workdays were significant predictors of poor sleep. Among females, duration of sleep shorter than 7 h, frequent stress events, poor self-evaluated health, sleep latency period longer than 15 min in workdays, and regular nighttime awakenings predicted poor sleep. Poor sleepers, as compared with good ones, had poorer healthrelated quality of life. Conclusions. Poor perceived health, frequent stress events, regular nighttime awakenings, and sleep latency period longer than 15 min were indicated as significant predictors of poor sleep. Poor sleep worsened health-related quality of life in all domains of SF-36.


2019 ◽  
Vol 26 (8) ◽  
pp. 955-963 ◽  
Author(s):  
Rafael Arroyo ◽  
Denise P Bury ◽  
Jennifer D Guo ◽  
David H Margolin ◽  
Maria Melanson ◽  
...  

Background: In CARE-MS II (Comparison of Alemtuzumab and Rebif® Efficacy in Multiple Sclerosis; NCT00548405), alemtuzumab (12 mg/day; baseline: 5 days; 12 months later: 3 days) significantly improved health-related quality of life (HRQL) outcomes versus subcutaneous interferon beta-1a (SC IFNB-1a) in relapsing-remitting multiple sclerosis (RRMS) patients over 2 years. Patients completing CARE-MS II could enter a 4-year extension study (NCT00930553). Objective: The aim of this study is to assess 6-year HRQL outcomes in alemtuzumab-treated CARE-MS II patients, including those with highly active disease (HAD). Methods: During extension, patients could receive additional alemtuzumab for clinical/magnetic resonance imaging (MRI) activity or other disease-modifying therapies per investigator’s discretion. Assessments include Functional Assessment of Multiple Sclerosis (FAMS), 36-Item Short-Form Health Survey (SF-36), and EQ-5D visual analog scale (EQ-VAS). Results: Alemtuzumab-treated patients improved or stabilized all HRQL measures over 6 years with significant improvements from baseline at all time points on EQ-VAS and for up to 5 years on FAMS, SF-36 MCS, and SF-36 PCS. Alemtuzumab-treated patients with HAD showed significant improvements versus baseline at Year 2 on all HRQL measures, and significant improvements versus SC IFNB-1a on SF-36 PCS and EQ-VAS; however, the improvements did not reach the threshold for clinical relevance. Conclusion: Alemtuzumab-treated CARE-MS II patients improved or stabilized HRQL versus baseline over 6 years. This is the first study to show long-term HRQL benefits in patients with HAD.


Sign in / Sign up

Export Citation Format

Share Document