scholarly journals Quality of Life, Sexual Functioning, and Physical Functioning Following Perineal Reconstruction with the Lotus Petal Flap

2020 ◽  
Vol 27 (13) ◽  
pp. 5279-5285
Author(s):  
Joke Hellinga ◽  
Martin W. Stenekes ◽  
Paul M. N. Werker ◽  
Moniek Janse ◽  
Joke Fleer ◽  
...  

Abstract Background Lotus petal flaps (LPF) may be used for the reconstruction of extralevator abdominoperineal defects that cannot be closed primarily. Limited data are available on how perineal reconstruction with the LPF impacts on patients’ quality of life (QoL), sexual functioning, and physical functioning. Methods A cross-sectional study was performed following perineal reconstruction with the LPF. The QoL of patients having undergone LPF reconstruction was compared with a control group in which perineal defects were closed without flaps. Sexual and physical functioning (presence of perineal herniation and range of motion [ROM] of the hip joints) could only be evaluated in the LPF group. Psychometrically sound questionnaires were used. Physical functioning was evaluated subjectively with binary questions and objectively by physical examination. Results Of the 23 patients asked to participate, 15 (65%) completed the questionnaires and 11 (47%) underwent physical examination. In the control group, 16 patients were included. There were no significant differences in QoL between the LPF and control groups. Within the LPF group, 33% of patients were sexually active postoperatively compared with 87% preoperatively. No perineal herniation was found. The ROM of the hip joints was bilaterally smaller compared with the generally accepted values. Conclusions Conclusions should be made with care given the small sample size. Despite a supposedly larger resection area in the LPF group, QoL was comparable in both groups. Nonetheless, reconstruction seemed to affect sexual function and physical function, not hampering overall satisfaction.

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Jayati Vohra ◽  
Kushal Madan ◽  
Manish Sharma ◽  
J.P.S Sawhney

Objectives: To study the effect of four weeks of aerobic exercise training, on sleep quality and quality of life parameters like anxiety, depression and physical functioning in Post Myocardial Infarction (MI) patients. Methods: ST elevated MI patients (n=21, <65years age) were voluntarily divided into 2 groups, control group (n=11) and exercising group (n=10). The patients in experimental group followed an exercise program of 3 sessions per week for 4 weeks. The subjective quality of life, anxiety and depression levels were assessed by the SF 36 questionnaire and Hospital Anxiety & Depression Scale (HAD scale) and the sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality and short sleep duration was defined as PSQI > 5 and total sleep time <6hrs. respectively. After 4 weeks of the program the questionnaires were repeated for all 21 patients. Wilcoxon rank order test and Student T test were used. P<0.05 was considered statistically significant Results: Intergroup analysis showed statically significant reduction in anxiety score (9vs0.5) and depression score (3vs0) in exercise group as compared to control group respectively. As compared to control group, exercise group also showed statistically significant improvement in the quality of life parameter score [physical functioning (750vs1000), role functioning physical (0vs400) & emotional (0vs300), energy level (215vs400), emotional well-being (400vs500), social functioning (120vs200), general health (230vs462.5) & health changes (50vs100)]. Intra group analysis also showed significant changes only in exercise group. After 4 weeks of exercise training, PSQI score improved in the experimental group from 9.5±4.11 to 1.13±0.35 (p=0.00029) indicating better sleep quality and duration. While it remained comparable to the baseline values in the control group i.e. from 9.9±4.70 to 10.33±3.87 (p value= 0.514). Conclusion: Four weeks of exercise program improves the quality & duration of sleep and quality of life in MI patients after 2 weeks of index event.


2001 ◽  
Vol 19 (3) ◽  
pp. 657-665 ◽  
Author(s):  
Roanne Segal ◽  
William Evans ◽  
Darren Johnson ◽  
Julie Smith ◽  
Sal Colletta ◽  
...  

PURPOSE: Self-directed and supervised exercise were compared with usual care in a clinical trial designed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer. PATIENTS AND METHODS: One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life, aerobic capacity, and body weight. Participants were randomly allocated to one of three intervention groups: usual care (control group), self-directed exercise, or supervised exercise. Quality of life, aerobic capacity, and body weight measures were repeated at 26 weeks. The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks. RESULTS: Physical functioning in the control group decreased by 4.1 points, whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups, respectively (P = .04). Post hoc analysis showed a moderately large (and clinically important) difference between the self-directed and control groups (9.8 points; P = .01) and a more modest difference between the supervised and control groups (6.3 points; P = .09). No significant differences between groups were observed for changes in quality of life scores. In a secondary analysis of participants stratified by type of adjuvant therapy, supervised exercise improved aerobic capacity (+3.5 mL/kg/min; P = .01) and reduced body weight (−4.8 kg; P < .05) compared with usual care only in participants not receiving chemotherapy. CONCLUSION: Physical exercise can blunt some of the negative side effects of breast cancer treatment, including reduced physical functioning. Self-directed exercise is an effective way to improve physical functioning compared with usual care. In participants not receiving chemotherapy, supervised exercise may increase aerobic capacity and reduce body weight compared with usual care.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21607-e21607 ◽  
Author(s):  
Michal Chovanec ◽  
Lucia Vasilkova ◽  
Lucia Setteyova ◽  
Katarina Rejlekova ◽  
Jana Obertova ◽  
...  

e21607 Background: Testicular cancer (GCT) survivors are at risk for different types of late treatment sequelae. This study aimed to evaluate long-term quality of life (QOL), sexual (SexF) and cognitive functioning (CogF) issues resulting from cisplatin-based chemotherapy. Methods: QoL, SexF and CogF data were prospectively collected in 83 GCT survivors with median 9 year follow-up (range 5-32). The chemotherapy group (CTG) consisted of 53 and 18 patients receiving a cisplatin cumulative dose of ≤ 400mg/m2 (LCD) and > 400mg/m2 (HCD), respectively. The control group (CG) included 12 patients treated with orchiectomy (6 pts) and adjuvant radiotherapy (6 pts). Data were collected using EORTC QLQ-C30, QLQ-TC26, FACT-Cog and sexual functioning questionnaires and analyzed according to the scoring guidelines. Results:The CTG survivors had significantly (all p < 0.05) more limitations while working or doing daily activities (37% vs 8%), needed to rest more often (61% vs 33%) and feared the disease relapse more often (73% vs 50%) compared to the CG. A subscale for family problems within QLQ-TC26 have shown higher impairment in the CTG vs. CG (mean score ± SEM: 54.2 ± 26.7 vs. 38.8. ± 7.3, P < 0.05). Cognitive abilities were perceived better in CG vs. CTG (mean score 24.5 ± 1.8 vs. 20.5 ± 0.7, P < 0.05). The CG surivors had higher education level and fathered more children compared to the CTG. The CTG felt more unsettled than the CG (all P < 0.05), however the impact of perceived cognitive impairment on their lives did not significantly differ ( P = 0.4). Patients who received HCD have suffered from dyspnea more often than patients treated with LCD (mean dyspnea subscale score ± SEM: 22.2 ± 4.4 vs 8.9 ± 2.6, P < 0.05). The HCD group also reported more difficulties to concentrate while watching television/reading newspaper and struggled to name things during conversation compared with the LCD group ( P < 0.05 for both). No impairment in sexual functioning was reported. Conclusions: Our study shows thatGCT survivors cured with cisplatin-based chemotherapy suffered from QoL issues and their perception of cognitive abilities was altered. The HCD of cisplatin further impaired several QoL and cognitive aspects.


2018 ◽  
Author(s):  
Julián Olalla ◽  
Jose María García de Lomas ◽  
Efrén Márquez ◽  
Francisco Jesús González ◽  
Alfonso Del Arco ◽  
...  

BACKGROUND New technologies can promote knowledge of HIV infection among patients suffering from this disease. Older patients with HIV infection represent an increasingly large group that could benefit from the use of specific apps. OBJECTIVE The aim of the study was to observe the acceptability and use of a mobile app on HIV infection in patients at least 60 years old and offer them the possibility of anonymously establishing contact with their peers. METHODS A series of clinical and psychosocial parameters were studied in 30 HIV-infected patients of over 60 years. The patients must be at least 60 years old, with a follow-up in the outpatient clinic for at least 1 year and without pathologies that limit his or her life expectancy to less than a year. They must know how to read and write. To be part of the group assigned to the app, they had to have their own smartphone and confirm that they were connected to the internet from that device. Overall, 15 of them were randomized to use an app and 15 were in the control group. All tests were repeated after 6 months. RESULTS The median age of patients was 66.5 years. Among them, 29 patients had an undetectable viral load at baseline. The median number of comorbid diseases was 2. Overall, 11 of them lived with their partners and 19 lived alone. They spent an average of 5 hours a day sitting down, and 56% (17/30) of them referred high physical activity. They scored 4 out of 5 for general quality of life perception. Moreover, 80% (24/30) presented high adherence to their treatment, and the average number of concomitant medications was 5. In the 6-min walking test, they covered a distance of 400 meters, and 3 of them desaturated during the test. The 15 patients made frequent use of the app, with 2407 sessions and an average of 7 min and 56 seconds time of use with a total of 13,143 screen views. During the 6 months of the trial, 3 non-AIDS events took place. There were no significant modifications to body mass index, blood pressure measurements, lipid profile, or immuno-virology information data. There were no differences in the questionnaire scores for perception of quality of life, confessed physical activity, or antiretroviral treatment (ART) and non-ART treatment adherence. CONCLUSIONS Significant differences between studied parameters were not objectified in these patients, possibly because this trial has significant limitations, such as a small sample size and only a brief follow-up period. However, patients did use the app frequently, making this a possible intervention to be proposed in future subsequent studies.


Author(s):  
K. V. Duve

The analysis of data from a number of scientific sources shows that even those patients, with favorable outcomes after suffering from aneurysmal subarachnoid hemorrhage (aSAH), may often experience a decline in quality of life (QoL), both at the physical and psychosocial levels. The influence of functional dependence on the patient’s quality of life remains controversial, because among the number of patients, who save the ability of self-care, there exists a part of those, who are not able to return to their previous lifestyle, kind of activity, they have difficulties in their relationships and emotional disorders. The aim of study was to assess the quality of life of patients in recovery and residual periods of aSAH. Material and methods. We examined 114 patients (64.91 % - males, 35.09 % - females). The patients’ quality of life was studied by using the questionnaire SF-36. The control group consisted of 20 healthy participants, matched by age and gender. Results. The significant decrease in QoL of patients was observed in all scales, with the exception of physical functioning, vital activity and social functioning. It should be noted, that "mental health" scale rates correlated with the level of anxiety (r = -0,55) and depression (r = -0,61). In the different age groups, the QoL indicators were almost identical, with the exception of "physical functioning" component, because older patients received a lower score for this scale (p<0.01). Patients with a moderate level of disability were observed with a decline in all QoL categories of the scale SF-36. Patients, who were totally independent, had also a significant decline in all QoL scale components, with the exception of physical functioning. Conclusions. We found the decrease in QoL of patients in recovery and residual periods of aSAH, which does not depend on one’s level of functional dependence. The influence of anxiety (r = -0,55) and depression (r = -0,61) on the subscale "mental health" was established.


2021 ◽  
Vol 11 (2) ◽  
pp. 86-93
Author(s):  
Jasna Veljkovic ◽  
◽  
Dragomir Davidovic ◽  
Ivana Leposavic ◽  
Maja Davidovic ◽  
...  

The aim of this a quasi-experimental study is to test the changes in the Quality of Life of chronic mental disorders (schizophrenia) treated with psychodrama. Total sample consisted of 60 subjects, aged 21-38. From these, 30 subjects were in the experimental group, while 30 subjects were in the control group. All subjects were previously psychologically tested, as well as basic demographic data has been taken. The instrument we used was Life Quality Scale in Schizophrenia (21 items form). Qualitative and quantitative analysis of the obtained data indicates a statistically significant improvement of social and communicative abilities of participants of experimental groups, better impulse control and activation in the work area. The disadvantage of this research is: the small sample. Future examination is needed, as well as a more advanced data processing methodology.


2021 ◽  
Author(s):  
Laura Krieger

The number of older adults living in collective dwellings is increasing. It is important to research effective strategies to maintain and enhance quality of life for older adults living in collective dwellings. Meaningful leisure, such as the ability to travel, is associated with increases in quality of life for older adults. Unfortunately, many older adults, especially those living in collective dwellings, face barriers to travel. Virtual reality (VR) may help older adults living in collective dwellings overcome barriers to travel. The present study examined whether older adults living in collective dwellings tolerated and enjoyed immersive VR, and whether six weeks of virtual tourism affected their quality of life, social engagement, and loneliness. Fourteen older adults living in retirement homes in Toronto participated in this study. Results suggested that participants tolerated immersive VR without experiencing cybersickness, and that they were happier, more excited, and less anxious immediately following VR exposure. Levels of social engagement increased following the six-week virtual tourism program. These quantitative findings were further supported by qualitative interviews. No changes in quality of life or loneliness were found. Limitations include a lack of a control group and small sample size. Addressing these limitations will help to isolate the effects of the virtual tourism program on indices of well-being.


2018 ◽  
Vol 36 (8) ◽  
pp. 749-756 ◽  
Author(s):  
Mary Jane Esplen ◽  
Jiahui Wong ◽  
Ellen Warner ◽  
Brenda Toner

Purpose This study aimed to test a group psychosocial intervention focused on improving disturbances of body image (BI), sexual functioning, and quality of life in breast cancer (BC) survivors. Methods A prospective, randomized controlled trial was conducted to assess the efficacy of an 8-week group intervention in women after BC treatment. The manual-based intervention combined two powerful ingredients: expressive guided-imagery exercises integrated within a model of group-therapy principles. The intervention facilitates exploration of identity, the development of new self-schemas, and personal growth. In addition, the intervention included an educational component on the social and cultural factors affecting women’s self-esteem and BI. The control condition included standard care plus educational reading materials. One hundred ninety-four BC survivors who had expressed concerns about negative BI and/or difficulties with sexual functioning participated in the study; 131 were randomly assigned to the intervention, and 63 were assigned to the control condition. Participants were followed for 1 year. Results Women in the intervention group reported significantly less concern/distress about body appearance ( P < .01), decreased body stigma ( P < .01), and lower level of BC−related concerns ( P < .01), compared with women in the control group. BC-related quality of life was also better in the intervention group compared with the control group at the 1-year follow-up ( P < .01). There was no statistically significant group difference in sexual functioning. Conclusion Restoring Body Image After Cancer (ReBIC), a group intervention using guided imagery within a group-therapy approach, is an effective method for addressing BI-related concerns and quality of life post-BC. The manual-based intervention can be easily adapted to both cancer centers and primary care settings.


Author(s):  
K. V. Duve

The analysis of data from a number of scientific sources shows that even those patients, with favorable outcomes after suffering from aneurysmal subarachnoid hemorrhage (aSAH), may often experience a decline in quality of life (QoL), both at the physical and psychosocial levels. The influence of functional dependence on the patient’s quality of life remains controversial, because among the number of patients, who save the ability of self-care, there exists a part of those, who are not able to return to their previous lifestyle, kind of activity, they have difficulties in their relationships and emotional disorders. The aim of study was to assess the quality of life of patients in recovery and residual periods of aSAH. Material and methods. We examined 114 patients (64.91 % - males, 35.09 % - females). The patients’ quality of life was studied by using the questionnaire SF-36. The control group consisted of 20 healthy participants, matched by age and gender. Results. The significant decrease in QoL of patients was observed in all scales, with the exception of physical functioning, vital activity and social functioning. It should be noted, that "mental health" scale rates correlated with the level of anxiety (r = -0,55) and depression (r = -0,61). In the different age groups, the QoL indicators were almost identical, with the exception of "physical functioning" component, because older patients received a lower score for this scale (p<0.01). Patients with a moderate level of disability were observed with a decline in all QoL categories of the scale SF-36. Patients, who were totally independent, had also a significant decline in all QoL scale components, with the exception of physical functioning. Conclusions. We found the decrease in QoL of patients in recovery and residual periods of aSAH, which does not depend on one’s level of functional dependence. The influence of anxiety (r = -0,55) and depression (r = -0,61) on the subscale "mental health" was established.


Author(s):  
Shefaly Shorey ◽  
Ee Heok Kua ◽  
Wilson Tam ◽  
Valerie Chan ◽  
Yong Shian Goh ◽  
...  

In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.


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