scholarly journals Poor Physical Capacity in Bronchiectasis Patients Is Correlated with Poor Quality of Life

Author(s):  
Jarkko Mäntylä ◽  
Tanja Törölä ◽  
Witold Mazur ◽  
Paula Bergman ◽  
Paula Kauppi

Abstract BackgroundTo study the risk factors associated with quality of life (QoL) in a cohort of Finnish non-cystic fibrosis bronchiectasis (BE) patients. We aimed to evaluate which of the clinical characteristics were risk factors for poor quality of life, how patients with frequent exacerbations differed from those with only few exacerbations and if QoL symptom domains were correlated with dyspnoea or severity of BE.MethodsA cross-sectional study and part of the EMBARC study including questionnaire data and medical record data. Study participants were recruited between August 2016 and March 2018 from three different pulmonary clinics in Helsinki University Central Hospital (HUH) catchment area, Finland. The study included 95 adult patients with (mean age was 69 (SD± 13) years).A Finnish translation of the disease-specific quality of life-bronchiectasis (QoL-B) questionnaire was applied, and scores in the lowest quarter (25%) of the scale were considered to indicate poor QoL. The bronchiectasis severity index (BSI) and FACED (including FEV1, age, pulmonary bacterial colonization, affected lobes and dyspnoea) score were used. The severity of dyspnoea was examined using the modified Medical Research Council (mMRC) dyspnoea scale.ResultsAlmost all (82%) presented with chronic sputum production and exacerbations, with a median rate of 1.7 (SD ±1.6). Exacerbations (OR 1.7, p < 0.01), frequent exacerbations (OR 4.9, p < 0.01), high BSI score (OR 1.3, p < 0.01) and extensive disease (OR 3.7, p = 0.05) were predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in one second (FEV1) and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, whereas 11.6% were classified as severe according to the FACED score. The mMRC dyspnoea score (r = -0.57) and BSI (r = -0.60) were negatively correlated with physical domain in QoL-B questionnaire. ConclusionFrequent exacerbations, radiological disease severity and high BSI score were predictive of poor QoL. Reduced physical capacity was correlated with dyspnoea and severity of disease. Interventions to reduce bacterial colonisation and to maintain physical functioning should be used to minimize exacerbations and to improve quality of life in BE patients.Study registrationUniversity of Helsinki, faculty of medicine; 148/16.08.2017

2020 ◽  
Author(s):  
Jarkko Mäntylä ◽  
Witold Mazur ◽  
Tanja Törölä ◽  
Paula Bergman ◽  
Paula Kauppi

Abstract Background: Bronchiectasis (BE) is an increasing burden on healthcare systems, and there is an urgent need for improved treatments, better clinical care and for clinical and translational research on this condition. Reducing the number of exacerbations is one of the key goals in BE management. Patients who suffer from frequent exacerbations are likely to experience more exacerbations, which have negative effects on quality of life (QoL), healthcare utilisation and mortality. Thus, we aimed to investigate the risk factors associated with quality of life (QoL) in a cohort of Finnish non-cystic fibrosis BE patients.Methods: A cross-sectional study is part of the EMBARC. Recruitment occurred between August 2016 and March 2018 from three clinics in Helsinki University Central Hospital, Finland. The study included 95 adult patients (mean age was 69 (SD± 13) years). Seventy nine percent were women. A disease-specific quality of life-bronchiectasis (QoL-B) questionnaire was applied, and scores in the lowest quarter (24%) indicate poor QoL. The bronchiectasis severity index (BSI) and FACED score were used. The severity of dyspnoea was examined using the modified Medical Research Council (mMRC) dyspnoea scale. Results: Almost all (82%) presented with chronic sputum production and exacerbation, with a median rate of 1.7 (SD ±1.6). Exacerbations (OR 1.7), frequent exacerbations (OR 4.9, p < 0.01), high BSI score (OR 1.3, p < 0.01) and extensive disease (OR 3.7, p = 0.05) were predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in one second (FEV1) and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, whereas 11.6% were classified as severe according to the FACED score. The mMRC dyspnoea score (r = -0.57) and BSI (r = -0.60) were negatively correlated with physical domain in QoL-B questionnaire. Conclusion: Frequent exacerbations, radiological disease severity and high BSI score were predictive of poor QoL. Reduced physical capacity was correlated with dyspnoea and severity of disease. Interventions to reduce bacterial colonisation and to maintain physical functioning should be used to minimize exacerbations and to improve QoL.Study registration: University of Helsinki, faculty of medicine; 148/16.08.2017; Registered 16 August 2017; https://researchportal.helsinki.fi/


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joseph Obiri Asante ◽  
Meng Jie Li ◽  
Jing Liao ◽  
Yi Xiang Huang ◽  
Yuan Tao Hao

Abstract Background Healthcare workers are often exposed to stressful working conditions at work which affect their quality of life. The study investigated the relationship between psychosocial risk factors, stress, burnout, and quality of life among primary healthcare workers in general medical practice in Qingyuan and Chaozhou cities in Guangdong province. Method The cross-sectional study was conducted in 108 primary health facilities including 36 community health centers (CHCs) across two developing cities in Guangdong province. A total of 873 healthcare workers completed the questionnaires. Quality of life was evaluated using The World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and psychological risk factors were evaluated by the Copenhagen Psychosocial Questionnaire (COPSOQ). General quality of life and the quality of life domains were transformed into a score range from minimum 0 to 100 maximum. Higher scores indicated better quality of life and vice versa. Significant associations were verified using multiple regression analysis. Results Poor quality of life was observed in 74.6% of healthcare workers surveyed. General poor quality of life was significantly higher among workers who reported higher burnout (Beta = − 0.331, p < 0.001). In addition, workers with high levels of burnout, unmarried workers and female workers had a higher possibility of physical health. A greater risk of poor psychological health was observed among workers with high burnout, poor sense of community and those with lower educational levels. Workers who lacked social support, those with fewer possibilities for development had increased probability of poor quality of life in the social domain. Poor quality of life in the environmental domain was observed among workers who were dissatisfied with their jobs and workers with low salaries. Conclusions Primary healthcare workers in developing cities in China have a highly demanding and strained working environment and poor quality of life. Reducing job stress and improving work conditions may ultimately improve the well-being of primary healthcare workers.


2021 ◽  
Vol 4 (5) ◽  
pp. 20118-20131
Author(s):  
Elisa Maia Dos Santos ◽  
Grazielle Vilas Bôas Huguenin ◽  
Paulo Rogério Melo Rodrigues ◽  
Bernardete Weber ◽  
Annie Seixas Bello De Moreira

The Health-related quality of life (HRQoL) is an important measure of the health status of a population. It can be related to nutritional status and risk factors of cardiovascular disease.This study aimed to assess the quality of life and the association with nutritional status and other modifiable risk factors in patients with atherosclerotic disease.This is a cross-sectional study carried out in two public health centers in Rio de Janeiro, Brazil. A total of 273 participants with a documented history of atherosclerotic disease in the last ten years from their entry to the study. Quality of life (SF-36 questionnaire); physical activity; food intake (food frequency questionnaire), blood pressure; anthropometric and biochemical measures were assessed. Poor quality of life scores were identified, women had lower scores (p0.05) for all SF-36 domains. Obesity was associated with a decreased score of SF-36 physical and mental health domains. Sedentary lifestyle was associated with poorer quality of life in almost all domains assessed. The adoption of healthy weight and appropriate physical activity was associated with better quality of life in patients with atherosclerotic disease.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Meiling Xuan ◽  
Chuanjian Lu ◽  
Zehui He

Abstract Background Seborrheic dermatitis (SD) is a common, chronic, inflammatory skin disorder, yet few studies have reported its clinical characteristics, or addressed its effect on quality of life (QoL). This study assesses the clinical characteristics and QoL of SD patients in China. It also identifies the clinical, demographic and environmental factors that may influence QoL. Methods Three hundred twelve SD outpatients from 9 hospitals completed a survey. QoL was measured with the dermatology-specific instrument Skindex-29. We collected social demographic characteristics and disease severity, and conducted logistic regression to determine the factors associated with QoL impairment. Results 67.3% of the patients were females. The mean Skindex-29 overall score was 33.97 (SD = 20.55). The breakdown was 40.79 (SD = 24.24) for emotions, 32.83 (SD = 19.84) for symptoms and 28.3 (SD = 23.24) for functioning. 48.1% had severe emotional problems. Logistic regression analysis showed that BMI less than 25 (OR = 0.223; 95% CI: 0.072–0.692; P = 0.009), skin disease-related hospitalization (OR = 6.882; 95% CI:1.767–26.795; P = 0.005), environmental PM 10 levels above 120 μg/m3 (OR = 3.386; 95% CI: 1.253–9.15; P = 0.016) and severe disease conditions (OR = 4.438; 95% CI:1.26–15.626; P = 0.02) were risk factors for severe emotional impairment. Moreover, skin disease-related hospitalization (OR = 6.057; 95% CI:1.351–27.149; P = 0.019), environmental PM 10 levels between 70 and 120 μg/m3 (OR = 6.317; 94% CI: 1.704–23.42; P = 0.006), moderate (OR = 2.388; 95% CI: 1.272–4.487; P = 0.007) and severe disease conditions (OR = 5.732; 95% CI: 1.838–17.88; P = 0.003) were each risk factors for overall severe impairment. Conclusion In China, nearly half of SD patients had severely emotional problems. Disease severity, BMI, dermatologic hospitalization, and ambient PM 10 levels are each risk factors for QoL impairment in SD patients. These implications are alarming, and warrant public health attention in SD disease management.


2015 ◽  
pp. 50-58
Author(s):  
Thi Dung Nguyen ◽  
Tam Vo

Background: The patients on hemodialysis have a significantly decreased quality of life. One of many problems which reduce the quality of life and increase the mortality in these patients is osteoporosis and osteoporosis associated fractures. Objectives: To assess the bone density of those on hemodialysis by dual energy X ray absorptiometry and to examine the risk factors of bone density reduction in these patients. Patients and Method: This is a cross-sectional study, including 93 patients on chronic hemodialysis at the department of Hemodialysis at Cho Ray Hospital. Results: Mean bone densities at the region of interest (ROI) neck, trochanter, Ward triangle, intertrochanter and total neck are 0.603 ± 0.105; 0.583 ± 0.121; 0.811 ± 0.166; 0.489 ± 0.146; 0.723 ± 0.138 g/cm2 respectively. The prevalences of osteoporosis at those ROI are 39.8%, 15.1%; 28%; 38.7%; and 26.9% respectively. The prevalences of osteopenia at those ROI are 54.8%; 46.3%; 60.2%; 45.2% and 62.7% respectively. The prevalence of osteopososis in at least one ROI is 52.7% and the prevalence of osteopenia in at least one ROI is 47.3%. There are relations between the bone density at the neck and the gender of the patient and the albuminemia. Bone density at the trochanter is influenced by gender, albuminemia, calcemia and phosphoremia. Bone density at the intertrochanter is affected by the gender. Bone density at the Ward triangle is influenced by age and albuminemia. Total neck bone density is influenced by gender, albuminemia and phosphoremia. Conclusion: Osteoporosis in patients on chronic hemodialysis is an issue that requires our attention. There are many interventionable risk factors of bone density decrease in these patients. Key words: Osteoporosis, DEXA, chronic renal failure, chronic hemodialysis


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Jung Kim ◽  
Ji Won Park ◽  
Mi Ae Lee ◽  
Han-Ki Lim ◽  
Yoon-Hye Kwon ◽  
...  

AbstractTo identify low anterior resection syndrome (LARS) patterns and their associations with risk factors and quality of life (QOL). This cross-sectional study analyzed patients who underwent restorative anterior resection for left-sided colorectal cancer at Seoul National University Hospital, Seoul, Republic of Korea. We administered LARS questionnaires to assess bowel dysfunction and quality of life between April 2017 and November 2019. LARS patterns were classified based on factor analyses. Variable effects on LARS patterns were estimated using logistic regression analysis. The risk factors and quality of life associated with dominant LARS patterns were analyzed. Data of 283 patients with a median follow-up duration of 24 months were analyzed. Major LARS was observed in 123 (43.3%) patients. Radiotherapy (odds ratio [OR]: 2.851, 95% confidence interval [95% CI]: 2.504–43.958, p = 0.002), low anastomosis (OR: 10.492, 95% CI: 2.504–43.958, p = 0.001), and complications (OR: 2.163, 95% CI: 1.100–4.255, p = 0.025) were independently associated with major LARS. LARS was classified into incontinence- or frequency-dominant types. Risk factors for incontinence-dominant LARS were radiotherapy and complications, whereas those for frequency-dominant LARS included low tumor location. Patients with incontinence-dominant patterns showed lower emotional function, whereas those with frequency-dominant patterns showed lower global health QOL, lower emotional, cognitive, and social functions, and higher incidence of pain and diarrhea. Frequency-dominant LARS had a greater negative effect on QOL than incontinence-dominant LARS. These patterns could be used for preoperative prediction and postoperative treatment of LARS.


2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Alexandre Moura dos Santos ◽  
Rafael Giovani Misse ◽  
Isabela Bruna Pires Borges ◽  
Bruno Gualano ◽  
Alexandre Wagner Silva de Souza ◽  
...  

Abstract Background Modifiable cardiovascular risk factors (MCRFs), such as those related to aerobic capacity, muscle strength, physical activity, and body composition, have been poorly studied in Takayasu arteritis (TAK). Therefore, the aim of the study was to investigate MCRFs and their relationships with disease status and comorbidities among patients with TAK. Methods A multicenter cross-sectional study was conducted between 2019 and 2020, in which 20 adult women with TAK were compared with 16 healthy controls matched by gender, age, and body mass index. The following parameters were analyzed: aerobic capacity by cardiopulmonary test; muscle function by timed-stands test, timed up-and-go test, and handgrip test; muscle strength by one-repetition maximum test and handgrip test; body composition by densitometry; physical activity and metabolic equivalent by IPAQ, quality of life by HAQ and SF-36; disease activity by ITAS2010 and NIH score; and presence of comorbidities. Results Patients with TAK had a mean age of 41.5 (38.0–46.3) years, disease duration of 16.0 (9.5–20.0) years, and a mean BMI of 27.7±4.5 kg/m2. Three out of the 20 patients with TAK had active disease. Regarding comorbidities, 16 patients had systemic arterial hypertension, 11 had dyslipidemia, and two had type 2 diabetes mellitus, while the control group had no comorbidities. TAK had a significant reduction in aerobic capacity (absolute and relative VO2 peak), muscle strength in the lower limbs, increased visceral adipose tissue, waist-to-hip ratio, reduced walking capacity, decreased weekly metabolic equivalent, and quality of life (P< 0.05) as compared to controls. However, there were no correlations between these MCRFs parameters and disease activity. Conclusions TAK show impairment in MCRFs; therefore, strategies able to improve MCRF should be considered in this disease.


2013 ◽  
Vol 16 (1) ◽  
pp. 117-126 ◽  
Author(s):  
Mariana Martinez Orlando ◽  
Maria Stella Peccin da Silva ◽  
Império Lombardi Junior

INTRODUCTION: Ageing has become a huge public health challenge due to the need to find solutions for improving quality of life. OBJECTIVE: This study aimed to assess quality of life, muscle strength, balance and physical capacity among elderly practitioners and non-practitioners of physical activity. MATERIALS AND METHODS: An observational, cross-sectional study was carried out involving 74 elderly individuals in the city of Santos (state of São Paulo, Brazil), divided into two groups: practitioners and non-practitioners of physical activity. The International Physical Activity Questionnaire was used for the classification of the participants. The generic SF-36 questionnaire was used to assess quality of life. The Berg scale was used for the analysis of balance. Dynamometry was used for the muscle strength test. The six-minute walk test was used for the assessment of physical capacity. RESULTS: Significant differences were found between elderly practitioners and non-practitioners of physical activity regarding quality of life (p = 0.001), muscle strength (p = 0.001), balance (p = 0.001) and physical capacity (p = 0.001). The data also showed that aspects of quality of life were strongly correlated with physical capacity among the non-practitioners of physical activity (r = 0.741). CONCLUSION: Elderly individuals in the city of Santos (Brazil) who practice physical activity have better quality of life, muscle strength, physical capacity and balance in comparison to those who do not practice physical activity.


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