Effect of regional and systemic fluorinated pyrimidine chemotherapy on quality of life in colorectal liver metastasis patients.

1997 ◽  
Vol 15 (5) ◽  
pp. 2022-2029 ◽  
Author(s):  
S Earlam ◽  
C Glover ◽  
M Davies ◽  
C Fordy ◽  
T G Allen-Mersh
Keyword(s):  
Quality Of Life ◽  
Repeated Measures ◽  
Systemic Chemotherapy ◽  
Symptom Control ◽  
Full Blood Count ◽  
Similar Survival ◽  
Chemotherapy Patients ◽  
Hands And Feet ◽  
Sore Mouth

PURPOSE Since systemic and regional (HAI) fluorinated pyrimidine chemotherapies offer similar survival benefit in treatment of colorectal liver metastases (CLM), we sought to identify their impact on quality of life (QoL), which might be a useful indicator of treatment preference. METHODS We compared QoL in 135 CLM patients managed by symptom control (n = 49 patients), systemic fluorouracil (5FU)/folinic acid (n = 35), or hepatic arterial floxuridine (FUDR) (n = 51). Full blood count and liver function tests, World Health Organization (WHO) toxicity criteria, and QoL (Rotterdam Symptom Checklist [RSC], the Sickness Impact Profile [SIP], and the Hospital Anxiety and Depression scale [HAD]) were measured monthly in all patients. RESULTS The HAD anxiety score was significantly increased in symptom control compared with chemotherapy patients 1 month after randomization. There was a significant increase in RSC physical score (repeated measures, P = .05), and in scores for sore mouth (P < .01), dry mouth (P < .01), and tingling hands and feet (P < .01) in systemic chemotherapy compared with symptom control patients. Significant QoL differences (repeated measures and Mann-Whitney U [MWU]) between HAI and symptom control patients were not detected. Systemic chemotherapy patients lived for significantly longer (log-rank test, P < or = .0001) with abnormal HAD anxiety, RSC psychosocial, or RSC sore mouth scores compared with HAI patients, but there were no overall survival differences. CONCLUSION Randomization to symptom control only was associated with increased anxiety. QoL with systemic chemotherapy was impaired by side effects. HAI was associated with similar survival to systemic chemotherapy but with better sustained QoL.

scholarly journals Development and Evaluation of the Effectiveness of the Web-Based Education Program Among Cancer Patients Undergoing Treatment of Systemic Chemotherapy: A Randomised Controlled Trial

2021 ◽  
Author(s):  
Hicran Bektas ◽  
Hasan Senol Coskun ◽  
Fatma Arikan ◽  
Keziban Ozcan ◽  
Aysel Tekeli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Education Program ◽  
Systemic Chemotherapy ◽  
Symptom Control ◽  
Web Based ◽  
Expert Opinions ◽  
Web Based Education ◽  
The Web

Abstract Purpose This study aims to develop a web-based education program among cancer patients undergoing treatment of systemic chemotherapy and to evaluate the effect of the program on symptom control, quality of life, self-efficacy, and depression. Methods A web-based education program was prepared in line with patient needs, evidence-based guidelines, and expert opinions and tested with 10 cancer patients. A single-blind, randomised controlled study design was applied at a medical oncology unit of a university hospital. Pretests were applied to 60 cancer patients undergoing systemic chemotherapy, and the patients (intervention:30, control: 30) were randomized. The intervention group used the web-based education program for three months, and they were allowed to communicate with researchers 24/7 via the website. The effectiveness of the web-based education program at baseline and after 12 weeks was evaluated. The CONSORT 2010 guideline was performed. Results Expert opinions were found to be compatible with each other (Kendall's Wa = 0.233, p=0.008). The difference between symptom control (p=0.026) and quality of life (p=0.001) during the three-month follow-up of the groups were statistically significant, and there was no difference between the groups in terms of self-efficacy and depression levels (p˃0.05). Conclusion The web-based education program was found to be effective in remote symptom management and improving the quality of life of cancer patients. Trial registration www.clinicaltrials.gov , NCT05076916 (12 October 2021, retrospectively registered)

Impacts on Quality of Life with Escitalopram Monotherapy and Aripiprazole Augmentation in Patients with Major Depressive Disorder: A CAN-BIND Report

2021 ◽  
Author(s):  
Emma Morton ◽  
Venkat Bhat ◽  
Peter Giacobbe ◽  
Wendy Lou ◽  
Erin E. Michalak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Repeated Measures ◽  
Short Form ◽  
Treatment Phase ◽  
Major Depressive ◽  
Symptomatic Remission ◽  
Substantial Degree

Abstract Introduction Many individuals with major depressive disorder (MDD) do not respond to initial antidepressant monotherapy. Adjunctive aripiprazole is recommended for treatment non-response; however, the impacts on quality of life (QoL) for individuals who receive this second-line treatment strategy have not been described. Methods We evaluated secondary QoL outcomes in patients with MDD (n=179). After 8 weeks of escitalopram, non-responders (<50% decrease in clinician-rated depression) were treated with adjunctive aripiprazole for 8 weeks (n=97); responders continued escitalopram (n=82). A repeated-measures ANOVA evaluated change in Quality of Life Enjoyment and Satisfaction Short Form scores. QoL was described relative to normative benchmarks. Results Escitalopram responders experienced the most QoL improvements in the first treatment phase. For non-responders, QoL improved with a large effect during adjunctive aripiprazole treatment. At the endpoint, 47% of patients achieving symptomatic remission still had impaired QoL. Discussion Individuals who were treated with adjunctive aripiprazole after non-response to escitalopram experienced improved QoL, but a substantial degree of QoL impairment persisted. Since QoL deficits may predict MDD recurrence, attention to ways to support this outcome is required.

scholarly journals Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Leonice Fumiko Sato Kurebayashi ◽  
Ruth Natalia Teresa Turrini ◽  
Talita Pavarini Borges de Souza ◽  
Carolina Felicio Marques ◽  
Renata Tavares Franco Rodrigues ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Nursing Staff ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Cohen’S D ◽  
Pain Visual Analog Scale ◽  
Cohen's D

RESUMEN Objectives: to evaluate the effectiveness of the auricular protocol (APPA) in reducing pain and anxiety and improving the quality of life of the nursing staff of a hospital. Method: randomized clinical trial with an initial sample of 180 professionals divided into 4 groups Control (G1), Seed (G2), Needle (G3) and Tape (G4). The evaluation instruments were the State-Trait Anxiety Inventory, Pain Visual Analog Scale and Quality of Life instrument, applied at the start and after five and 10 sessions (five weeks). Descriptive statistics, analysis of variance (ANOVA) and Cohen's d Index were used in the analysis. Results: there was a statistical difference (p < 0.05) for anxiety according to the repeated measures ANOVA, with better results for the G3 in the final assessment (Cohen's d index 1.08/17% reduction). There was a reduction of pain of 36% in G3 and 24% in G2 and a 13% increase in the mental aspect of quality of life for the G3, although without statistical significance. Conclusion: the APPA protocol reduced the anxiety levels of nursing staff after 10 sessions. Further studies are, however, suggested with new populations and in different contexts so that the results can be confirmed. RBR-5pc43m.

scholarly journals Quality of Life and Hemodynamic Effects of Switching From Hemodialysis to Hemodiafiltration: A Canadian Controlled Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110577
Author(s):  
Isabelle Ethier ◽  
Immaculate Nevis ◽  
Rita S. Suri
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Repeated Measures ◽  
Recovery Time ◽  
Randomized Clinical Trials ◽  
Analysis Of Covariance ◽  
Intradialytic Hypotension ◽  
Laboratory Values

Background: Recent randomized clinical trials have demonstrated beneficial effects of hemodiafiltration (HDF) compared with hemodialysis (HD) on mortality and hemodynamic stability. Data on quality of life in HDF compared with HD is limited. Objective: This study aimed to determine whether patients receiving HD experience improvements in quality of life, hemodynamic and laboratory parameters after switching to HDF. Design: Observational controlled cohort study. Setting & Patients: Adult patients receiving maintenance dialysis were followed for 3 months both before and after transfer to a new unit, where they received HDF. Prior to transfer, control patients were already treated by HDF. Methods: Quality of life at baseline and follow-up was measured using the validated minutes to recovery (MR) question. Dialysis data were collected for 3 consecutive sessions monthly; laboratory values were collected monthly. Wilcoxon signed rank test and repeated measures analysis of covariance were used to evaluate pre/post transfer changes and quantile regression to identify predictors of change in recovery time. Results: Of 227 patients, 82 died, were transplanted, were hospitalized or did not transfer, leaving 123 subjects and 22 controls for analysis. MR did not improve with switching to HDF, although patients with MR > 60 min before transfer experienced a significant decrease in their MR, compared with controls. There was no improvement in intradialytic hypotension with HDF. There were no differences in laboratory values before vs after switch. Limitations: Nonrandomized single-center study, including only small numbers of patients and covering a short follow-up period; hemodynamic values only evaluated over 1 week per month; residual kidney function not recorded. Conclusions: In this Canadian experience of HDF, patients remained stable with respect to several laboratory and dialysis related parameters. Switch to HDF was associated with substantially reduced recovery time in patients with MR > 60 minutes at baseline.

scholarly journals Long-Term Patient Satisfaction and Quality of Life After Breast-Conserving Therapy: A Prospective Study Using the BREAST-Q

2021 ◽  
Author(s):  
Ilona Stolpner ◽  
Jörg Heil ◽  
Fabian Riedel ◽  
Markus Wallwiener ◽  
Benedikt Schäfgen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Patient Satisfaction ◽  
Repeated Measures ◽  
Aesthetic Surgery ◽  
Well Being ◽  
Breast Conserving Therapy ◽  
Patient Reported

Abstract Background Poor patient-reported satisfaction after breast-conserving therapy (BCT) has been associated with impaired health-related quality of life (HRQOL) and subsequent depression in retrospective analysis. This prospective cohort study aimed to assess the HRQOL of patients who have undergone BCT using the BREAST-Q, and to identify clinical risk factors for lower patient satisfaction. Methods Patients with primary breast cancer undergoing BCT were asked to complete the BREAST-Q preoperatively (T1) for baseline evaluation, then 3 to 4 weeks postoperatively (T2), and finally 1 year after surgery (T3). Clinicopathologic data were extracted from the patients’ charts. Repeated measures analysis of variance (ANOVA) was used to determine significant differences in mean satisfaction and well-being levels among the test intervals. Multiple linear regression was used to evaluate risk factors for lower satisfaction. Results The study enrolled 250 patients. The lowest baseline BREAST-Q score was reported for “satisfaction with breast” (mean, 61 ± 19), but this increased postoperatively (mean, 66 ± 18) and was maintained at the 1 year follow-up evaluation (mean, 67 ± 21). “Physical well-being” decreased from T1 (mean, 82 ± 17) to T2 (mean, 28 ± 13) and did not recover much by T3 (mean, 33 ± 13), being the lowest BREAST-Q score postoperatively and in the 1-year follow-up evaluation. In multiple regression, baseline psychosocial well-being, body mass index (BMI), and type of incision were risk factors for lower “satisfaction with breasts.” Conclusion Both the aesthetic/surgery-related and psychological aspects are equally important with regard to “satisfaction with breasts” after BCT. The data could serve as the benchmark for future studies.

scholarly journals Quality of Life and Symptom Control after Stent Placement or Surgical Palliation of Malignant Colorectal Obstruction

2010 ◽  
Vol 210 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Satish Nagula ◽  
Nicole Ishill ◽  
Carla Nash ◽  
Arnold J. Markowitz ◽  
Mark A. Schattner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stent Placement ◽  
Symptom Control ◽  
Colorectal Obstruction ◽  
Surgical Palliation
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