Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

Mapping Intimacies ◽

10.21203/rs.2.17909/v2 ◽

2020 ◽

Author(s):

Austyn Snowden ◽

Jenny Young ◽

Jan Savinc

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Health Status ◽

Cancer Type ◽

Cancer Stage ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Background Optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, median 84 days later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models with heteroscedasticity-consistent standard errors. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. EQ-5D utility scores improved at follow-up by 0.121 [0.0891-0.153], p<.001, and VAS scores improved by 7.81 [5.88-9.74], p<.001. The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants had both a statistically significant and clinically meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants, this study has shown for the first time that it is possible to capture a clinically meaningful improvement as a function of reducing someone’s personally identified concerns

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Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

10.21203/rs.2.17909/v3 ◽

2020 ◽

Author(s):

Austyn Snowden ◽

Jenny Young ◽

Jan Savinc

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Health Status ◽

Cancer Type ◽

Cancer Stage ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Background: Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention.Method: Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, median 84 days later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models with heteroscedasticity-consistent standard errors. Results: Participants were White British with median age between 50-64 years. Cancer type and stage were varied. EQ-5D utility scores improved at follow-up by 0.121 [0.0891-0.153], p<.001, and VAS scores improved by 7.81 [5.88-9.74], p<.001. The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion: This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants had both a statistically significant and clinically meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants, this study has shown for the first time that it is possible to capture a clinically meaningful improvement as a function of reducing someone’s personally identified concerns.

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Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

10.21203/rs.2.17909/v1 ◽

2019 ◽

Author(s):

Austyn Snowden ◽

Jenny Young ◽

Jan Savinc

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Health Status ◽

Cancer Type ◽

Cancer Stage ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

Abstract Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.

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Body composition and changes in health-related quality of life in older age: a 10-year follow-up of the Helsinki Birth Cohort Study

Quality of Life Research ◽

10.1007/s11136-020-02453-1 ◽

2020 ◽

Vol 29 (8) ◽

pp. 2039-2050

Author(s):

Tuija M. Mikkola ◽

Hannu Kautiainen ◽

Mikaela B. von Bonsdorff ◽

Minna K. Salonen ◽

Niko Wasenius ◽

...

Keyword(s):

Quality Of Life ◽

Body Composition ◽

Cohort Study ◽

Birth Cohort ◽

Birth Cohort Study ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study

Quality of Life Research ◽

10.1007/s11136-015-1167-4 ◽

2015 ◽

Vol 25 (5) ◽

pp. 1285-1294 ◽

Cited By ~ 4

Author(s):

M. A. C. Van Son ◽

J. De Vries ◽

J. A. Roukema ◽

T. Gosens ◽

M. H. J. Verhofstad ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Lower Extremity ◽

Health Related Quality ◽

Follow Up Study ◽

Related Quality ◽

Health Related

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Gingivitis influences oral health-related quality of life in adolescents: findings from a cohort study

Revista Brasileira de Epidemiologia ◽

10.1590/1980-549720200051 ◽

2020 ◽

Vol 23 ◽

Author(s):

Fernanda Ruffo Ortiz ◽

Camila Silveira Sfreddo ◽

Ana Gabriela Maieron Coradini ◽

Maria Laura Braccini Fagundes ◽

Thiago Machado Ardenghi

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Oral Health ◽

Health Related Quality ◽

Periodontal Index ◽

Related Quality ◽

Health Related ◽

The Impact

ABSTRACT: Introduction: Oral health-related quality of life (OHRQoL) is affected by different clinical conditions. The aim of this study was to evaluate the impact of gingivitis on OHRQoL in adolescents. Methodology: This cohort study consisted of a random sample of 1,134 schoolchildren enrolled during 2012, in Santa Maria, Brazil. After two years, 743 adolescents were follow-up (response rate: 65.5%). Clinical, socioeconomic and OHRQoL data were collected. OHRQoL was assessed by the short Brazilian version of the Child Perceptions Questionnaire 11-14 (CPQ11-14), and gingival bleeding through Community Periodontal Index. Gingivitis was considered with the presence of 15% or more bleeding sites. Poisson regression models were used to evaluate the association between gingivitis and overall and domain-specific CPQ11-14 scores. Prevalence of gingivitis at baseline was considered the main predictor for the OHRQoL at follow-up. Results: Gingivitis at baseline was associated with higher overall CPQ 11-14 score (RR = 1.07; 95%CI 1.01 - 1.14), and emotional well-being (RR = 1.17; 95%CI 1.04 - 1.31), independently of other oral conditions and socioeconomic variables. Conclusions: The findings indicate that gingivitis negatively impacts the adolescents’ OHRQoL. Moreover, gender, maternal schooling and household income were also associated with OHRQoL.

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Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.26.2.e2119244.oar ◽

2021 ◽

Vol 26 (2) ◽

Author(s):

Jocelito TONDOLO JUNIOR ◽

Jessica Klöckner KNORST ◽

Gabriele Rissotto MENEGAZZO ◽

Bruno EMMANUELLI ◽

Thiago Machado ARDENGHI

Keyword(s):

Quality Of Life ◽

Early Childhood ◽

Cohort Study ◽

Oral Health ◽

Well Being ◽

Health Related Quality ◽

Related Quality ◽

Health Related

ABSTRACT Objective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. Results: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. Conclusion: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

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Health-related quality of life following adolescent sports-related concussion or fracture: a prospective cohort study

Journal of Neurosurgery Pediatrics ◽

10.3171/2018.8.peds18356 ◽

2019 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Kelly Russell ◽

Erin Selci ◽

Brian Black ◽

Michael J. Ellis

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Initial Assessment ◽

Health Related Quality ◽

Clinical Recovery ◽

Related Quality ◽

Health Related ◽

Time From Injury

OBJECTIVEThe longitudinal effects of sports-related concussion (SRC) in adolescents on health-related quality of life (HRQOL) remain poorly understood. Hence, the authors established two objectives of this study: 1) compare HRQOL outcomes among adolescents with an acute SRC or a sports-related extremity fracture (SREF) who were followed up until physician-documented clinical recovery; and 2) identify the clinical variables associated with worse HRQOL among adolescent SRC patients.METHODSThe authors conducted a prospective cohort study of adolescents with acute SRC and those with acute SREF who underwent clinical assessment and follow-up at tertiary subspecialty clinics. Longitudinal patient-reported HRQOL was measured at the time of initial assessment and at each follow-up appointment by using the adolescent version (age 13–18 years) of the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale and Cognitive Functioning Scale.RESULTSA total of 135 patients with SRC (60.0% male; mean age 14.7 years; time from injury to initial assessment 6 days) and 96 patients with SREF (59.4% male; mean age 14.1 years; time from injury to initial assessment 8 days) participated in the study. At the initial assessment, the SRC patients demonstrated significantly worse cognitive HRQOL and clinically meaningful impairments in school and overall HRQOL compared to the SREF patients. Clinical variables associated with a worse HRQOL among SRC patients differed by domain but were significantly affected by the patients’ initial symptom burden and the development of delayed physician-documented clinical recovery (> 28 days postinjury). No persistent impairments in HRQOL were observed among SRC patients who were followed up until physician-documented clinical recovery.CONCLUSIONSAdolescent SRC is associated with temporary impairments in HRQOL that have been shown to resolve in patients who are followed up until physician-documented clinical recovery. Future studies are needed to identify the clinicopathological features that are associated with impaired HRQOL and to assess whether the initiation of multidisciplinary, targeted rehabilitation strategies would lead to an improvement in HRQOL.

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