A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with cp-BPPV: A randomised controlled trial in primary care.

Abstract Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability. Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men ( P <0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus ( P =0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration : ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

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Impact of Epley manoeuvre on self-perceived disability: A randomised controlled trial in primary care

10.21203/rs.3.rs-36678/v1 ◽

2020 ◽

Author(s):

Ricard Carrillo Muñoz ◽

Jose Luis Ballve Moreno ◽

Ivan Villar Balboa ◽

Yolanda Rando Matos ◽

Oriol Cunillera Puertolas ◽

...

Keyword(s):

Primary Care ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Controlled Clinical Trial ◽

Double Blind ◽

Perceived Disability ◽

Randomised Controlled ◽

The Impact

Abstract Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability.Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men (P<0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus (P=0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

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Early detection of anaemia in primary care with haemoglobinometry: ANHEMOG clinical trial protocol

BMC Family Practice ◽

10.1186/s12875-021-01548-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Boris Trenado Luengo ◽

Rosa García-Sierra ◽

Maria Asunción Wilke Trinxant ◽

Esther Díaz Mondelo ◽

Ramon Miralles Baseda ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Chronic Diseases ◽

Response Times ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Monthly Basis ◽

The Impact

Abstract Background Detecting, treating and monitoring anaemia has a functional, social and economic impact on patients’ quality of life and the health system, since inadequate monitoring can lead to more accident & emergency visits and hospitalizations. The aim of this study is to evaluate the impact in the patient clinical outcomes of using haemoglobinometry to early detect anaemia in patients with chronic anaemia in primary care. Methods Randomized controlled trial Capillary haemoglobin will be measured using a haemoglobinometer on a monthly basis in the intervention group. In the control group, the protocol currently in force at the primary care centre will be followed and venous haemoglobin will be measured. Any cases of anaemia detected in either group will be referred to the transfusion circuit of the reference hospital. Discusion The results will shed light on the impact of the intervention on the volume of hospitalizations and accident & emergency (A&E) visits due to anaemia, as well as patients’ quality of life. Chronic and repeated bouts of anaemia are detected late, thus leading to decompensation in chronic diseases and, in turn, more A&E visits and hospitalizations. The intervention should improve these outcomes since treatment could be performed without delay. Improving response times would decrease decompensation in chronic diseases, as well as A&E visits and hospitalizations, and improve quality of life. The primary care nurse case manager will perform the intervention, which should improve existing fragmentation between different care levels. Trial registration NCT04757909. Registered 17 February 2021. Retrospectively registered.

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Using Telemedicine to Improve the Quality of Life of Parents of Infants With CHD Surgery After Discharge

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzab133 ◽

2021 ◽

Author(s):

Qi-Liang Zhang ◽

Yu-Qing Lei ◽

Jian-Feng Liu ◽

Hua Cao ◽

Qiang Chen

Keyword(s):

Quality Of Life ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Intervention Group ◽

Control Group ◽

Educational Levels ◽

Education Levels

Abstract Background The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease surgery after discharge. Methods A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with congenital heart disease surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. Results One month after discharge, the SAS and SDS scores of parents in the intervention group were significantly lower than those in the control group (P<0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at one month after discharge (P<0.05), while the scores of parents in the control group were similar at one month after discharge (P>0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P<0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P<0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P>0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents’ educational levels were, the higher their SAS and SDS scores were (P<0.05). One month after discharge, in the control group, the lower the parents’ education levels were, the higher their SAS and SDS scores (P<0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the WHOQOL-BREF scale showed that the scores of the physiological, psychological, social and environmental fields at one month after discharge in the intervention group were significantly higher than those in the control group (P<0.05). Conclusion Providing health education and medical support to the parents of infants with congenital heart disease surgery after discharge via telemedicine can effectively relieve the parents’ anxiety and depression and improve their quality of life.

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Impact of a Postoperative Intervention Educational Program on the Quality of Life of Patients with Hip Fracture: A Randomized, Open-Label Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249327 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9327

Author(s):

Francisco Javier Amarilla-Donoso ◽

Raúl Roncero-Martín ◽

Jesus Lavado-García ◽

María de la Luz Canal-Macías ◽

María Pedrera-Canal ◽

...

Keyword(s):

Quality Of Life ◽

Hip Fracture ◽

Social Functioning ◽

Educational Program ◽

Bodily Pain ◽

Intervention Group ◽

Control Group ◽

Controlled Clinical Trial ◽

The Impact

The objective of this study was to determine the impact of a postoperative educational intervention program on the health-related quality of life (HRQoL) of patients with hip fracture using a controlled clinical trial in a randomized, multicenter study. In total, 102 patients (45.5%) from trauma units at the two University Hospitals of the province of Cáceres received the educational program, whereas 122 (54.5%) did not. Patients were consecutively included in either an intervention or a control group. Patients from the intervention group received an educational program during admission and the postoperative period. Patients from the control group did not receive any educational program. These patients were managed according to routine protocols. The patients were predominantly female (76.3%), aged 84.6 years (SD 6.1). All dimensions in both groups at 12 months showed a significant decrease with respect to baseline, except for bodily pain in both groups (p = 0.447; p = 0.827) and social functioning in the intervention group (p = 0.268). Patients receiving the educational program showed higher levels in the dimensions of the Mental Component Summary (MCS-12) (p = 0.043), vitality (p = 0.010), and social functioning (p < 0.001), as well as in the dimensions of the SF-12 health survey questionnaire of HRQoL 12 months after surgery. In conclusion, our study of the intervention group showed that there were significant improvements in MCS-12, vitality, and social function dimensions compared to the control group.

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A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP), Improves Quality of Life

Canadian Respiratory Journal ◽

10.1155/2010/327650 ◽

2010 ◽

Vol 17 (2) ◽

pp. 67-73 ◽

Cited By ~ 27

Author(s):

Shawna L McGhan ◽

Eric Wong ◽

Heather M Sharpe ◽

Patrick A Hessel ◽

Puish Mandhane ◽

...

Keyword(s):

Quality Of Life ◽

Usual Care ◽

Education Program ◽

Intervention Group ◽

Asthma Management ◽

Control Group ◽

Asthma Education ◽

Children With Asthma

BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.OBJECTIVE: To assess the feasibility and impact of ‘Roaring Adventures of Puff’ (RAP), a six-week childhood asthma education program administered by health professionals in schools.METHODS: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.RESULTS: The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent’s perceived understanding and ability to cope with and control asthma, and overall quality of life (P<0.05). On follow-up, doctor visits were reduced in the control group.CONCLUSION: A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

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CT of the coronary arteries in patients with non-coronary chest pain. An educational intervention aimed at improving reliance and reducing episodes of recurring chest pain

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.221 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

I Krohn ◽

CB Rygh ◽

TM Norekvaal

Keyword(s):

Quality Of Life ◽

Chest Pain ◽

False Negative ◽

Intervention Group ◽

Control Group ◽

Ct Examination ◽

Examination Result ◽

Low Probability

Abstract Funding Acknowledgements Type of funding sources: None. Background Chest pain is a symptom closely linked to coronary disease (CAD) and a common complaint in the general practitioner’s office. Nevertheless, most of these complaints are benign and of non-coronary origin. Computed Tomography (CT) is the main diagnostic tool to investigate the coronary arteries, an examination with a low probability of false-negative result (<1%). Despite negative findings of CAD, this patient group still experience higher degree of morbidity and anxiety and decreased quality of life when compared to a population without chest pain. Purpose To determine the effect of an intervention for reliance in the CT-examination and recurring chest pain in patients with non-coronary chest pain in follow-up after one month. Methods Patients with chest pain, but with normal CT-findings, i.e. no CAD, were randomised into two groups. The intervention group received extended information about the examination, such as the reliability of the result due to CTs low probability of false-negative result and also the great prognostic value it provides. The examination result was then conveyed to the patient. The control group received standard care; i.e no extended information was given and the examination result was obtained from their general practitioner after one week. The effect of the intervention was measured with a specific question regarding reliance in the CT-examination and the Seattle Angina Questionnaire (SAQ) at follow-up after one month. Results The study included 92 patients; follow-up response rate was 80%. Of the participants were 63 females (68%), and the mean age was 51 years. Analysis showed that the intervention group had significantly higher reliance in the CT-examination (p = 0.016) and significantly reduced incidences of chest pain (p = 0.042) when compared to the control group at 1-month follow-up (Figure 1). Conclusion This intervention demonstrates that relatively simple actions may have a great impact on patient care. Providing patients with extended information and an early communication of CT results have a positive effect on reliance and chest pain after one month. Such an effect may lead to lower morbidity, less anxiety and a higher quality of life in this group. Further examinations after six or twelve months might provide additional knowledge of the long-term effect of the performed intervention. Abstract Figure 1

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The Effect of Solution-Focused Counseling on Violence Rate and Quality of Life of Pregnant Women at Risk of Domestic Violence: A randomized Controlled Trial

10.21203/rs.3.rs-34762/v1 ◽

2020 ◽

Author(s):

Sepideh Din Mohammadi ◽

Mohsen Dadashi ◽

Elahe Ahmadnia ◽

leila Janani ◽

Roghieh Kharaghani

Keyword(s):

Quality Of Life ◽

At Risk ◽

Domestic Violence ◽

Pregnant Women ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Solution Focused

Abstract Background: Domestic violence is considered as one of the most common social problems, which can affect the quality of life of women. The problem of preventing and controlling this problem, especially during pregnancy, is one of the basic challenges of health systems. The aim of this study was to determine the effect of counseling based on conflict solution on the rate of violence and quality of life of pregnant women at risk of domestic violence. Methods: This study was a randomized controlled trial on 90 pregnant women, who were selected from maternity wards in health center number three in Zanjan city. Women who had inclusion criteria based on the domestic violence conflict tactics scale (CTS-2) selected with convenience sampling and randomly divided into two groups of intervention (45 people) and control (45 people) with a blocked randomization method. The intervention group received six counseling sessions with a solution-focused approach and the control group received no intervention. Study tool included demographic and reproductive questionnaires CTS- 2 and short form health survey (SF-36); which completed at baseline and six weeks follow-up in both groups. The results were analyzed by nonparametric ANCOVA using SPSS and R soft wares.Results: The results showed that there was a significant difference in the physical violence (P=0.001), psychological violence (P=0.001), and sexual violence (P=0.001) in the intervention group compared to the control group at six weeks follow- up. There were significant improvements in negotiation scores in the intervention group (P˂0.001). Moreover, there were significant differences in the quality of life scores (P=0.001), vitality (p=0.003), psychological health (p=0.004), bodily pain (p=0.014), physical functioning (p=0.023), and social functioning (p=0.019) between the two groups at the follow- up period.Conclusion: According to the result, individual counseling based on a solution-based approach reduces the amount of domestic violence and increases the quality of life of pregnant women at risk of violence.Trial registration: Iranian Registry of Clinical Trials IRCT2017040628352N4. Date of registration: August 20th 2017.

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Effects of Out-of-Hospital Continuous Nursing on Postoperative Breast Cancer Patients by Medical Big Data

Journal of Healthcare Engineering ◽

10.1155/2022/9506915 ◽

2022 ◽

Vol 2022 ◽

pp. 1-14

Author(s):

Peijuan He ◽

Bing Zhang ◽

Songna Shen

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Communication System ◽

Intervention Group ◽

Control Group ◽

Apriori Algorithm ◽

Breast Cancer Patients ◽

Medical Communication

This study aimed to explore the application value of the intelligent medical communication system based on the Apriori algorithm and cloud follow-up platform in out-of-hospital continuous nursing of breast cancer patients. In this study, the Apriori algorithm is optimized by Amazon Web Services (AWS) and graphics processing unit (GPU) to improve its data mining speed. At the same time, a cloud follow-up platform-based intelligent mobile medical communication system is established, which includes the log-in, my workstation, patient records, follow-up center, satisfaction management, propaganda and education center, SMS platform, and appointment management module. The subjects are divided into the control group (routine telephone follow-up, 163) and the intervention group (continuous nursing intervention, 216) according to different nursing methods. The cloud follow-up platform-based intelligent medical communication system is used to analyze patients’ compliance, quality of life before and after nursing, function limitation of affected limb, and nursing satisfaction under different nursing methods. The running time of Apriori algorithm is proportional to the data amount and inversely proportional to the number of nodes in the cluster. Compared with the control group, there are statistical differences in the proportion of complete compliance data, the proportion of poor compliance data, and the proportion of total compliance in the intervention group ( P < 0.05 ). After the intervention, the scores of the quality of life in the two groups are statistically different from those before treatment ( P < 0.05 ), and the scores of the quality of life in the intervention group were higher than those in the control group ( P < 0.05 ). The proportion of patients with limited and severely limited functional activity of the affected limb in the intervention group is significantly lower than that in the control group ( P < 0.05 ). The satisfaction rate of postoperative nursing in the intervention group is significantly higher than that in the control group ( P < 0.001 ), and the proportion of basically satisfied and dissatisfied patients in the control group was higher than that in the intervention group ( P < 0.05 ).

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The Atrial Fibrillation Health Literacy Information Technology Trial: Pilot Trial of a Mobile Health App for Atrial Fibrillation (Preprint)

10.2196/preprints.17162 ◽

2019 ◽

Author(s):

Emily Guhl ◽

Andrew D Althouse ◽

Alexandra M Pusateri ◽

Everlyne Kimani ◽

Michael K Paasche-Orlow ◽

...

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Pilot Trial ◽

Intervention Group ◽

Mean Difference ◽

Control Group ◽

Relational Agent ◽

Rhythm Monitoring

BACKGROUND Atrial fibrillation (AF) is a common arrhythmia that adversely affects health-related quality of life (HRQoL). We conducted a pilot trial of individuals with AF using a smartphone to provide a relational agent as well as rhythm monitoring. We employed our pilot to measure acceptability and adherence and to assess its effectiveness in improving HRQoL and adherence. OBJECTIVE This study aims to measure acceptability and adherence and to assess its effectiveness to improve HRQoL and adherence. METHODS Participants were recruited from ambulatory clinics and randomized to a 30-day intervention or usual care. We collected baseline characteristics and conducted baseline and 30-day assessments of HRQoL using the Atrial Fibrillation Effect on Quality of Life (AFEQT) measure and self-reported adherence to anticoagulation. The intervention consisted of a smartphone-based relational agent, which simulates face-to-face counseling and delivered content on AF education, adherence, and symptom monitoring with prompted rhythm monitoring. We compared differences in AFEQT and adherence at 30 days, adjusted for baseline values. We quantified participants’ use and acceptability of the intervention. RESULTS A total of 120 participants were recruited and randomized (59 to control and 61 to intervention) to the pilot trial (mean age 72.1 years, SD 9.10; 62/120, 51.7% women). The control group had a 95% follow-up, and the intervention group had a 93% follow-up. The intervention group demonstrated significantly higher improvement in total AFEQT scores (adjusted mean difference 4.5; 95% CI 0.6-8.3; P=.03) and in daily activity (adjusted mean difference 7.1; 95% CI 1.8-12.4; P=.009) compared with the control between baseline and 30 days. The intervention group showed significantly improved self-reported adherence to anticoagulation therapy at 30 days (intervention 3.5%; control 23.2%; adjusted difference 16.6%; 95% CI 2.8%-30.4%; P<.001). Qualitative assessments of acceptability identified that participants found the relational agent useful, informative, and trustworthy. CONCLUSIONS Individuals randomized to a 30-day smartphone intervention with a relational agent and rhythm monitoring showed significant improvement in HRQoL and adherence. Participants had favorable acceptability of the intervention with both objective use and qualitative assessments of acceptability.

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Nutritional Intervention to Prevent Weight Gain in Patients Commenced on Olanzapine: A Randomizedcontrolled Trial

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2005.01607.x ◽

2005 ◽

Vol 39 (6) ◽

pp. 479-486 ◽

Cited By ~ 2

Author(s):

Sherryn Evans ◽

Richard Newton ◽

Sally Higgins

Keyword(s):

Quality Of Life ◽

Body Image ◽

Weight Gain ◽

Treatment Group ◽

Nutrition Education ◽

Intervention Group ◽

Control Group ◽

Average Weight ◽

The Impact

Objective: Olanzapine is the most commonly prescribed atypical antipsychotic medication in Australia. Research repor ts an average weight gain of between 4.5 and 7 kg in the 3 months following its commencement. Trying to minimize this weight gain in a population with an already high prevalence of obesity, mor tality and morbidity is of clinical and social importance. This randomized controlled trial investigated the impact of individual nutrition education provided by a dietitian on weight gain in the 3 and 6 months following the commencement of olanzapine. Method: Fifty-one individuals (29 females, 22 males) who had star ted on olanzapine in the previous 3 months (mean length of 27 days 20) were recruited through Peninsula Health Psychiatric Services and were randomly assigned to either the intervention (n = 29) or the control group (n = 22). Individuals in the intervention group received six 1 hour nutrition education sessions over a 3-month period. Weight, waist circumference, body mass index (BMI) and qualitative measures of exercise levels, quality of life, health and body image were collected at baselineat 3 and 6 months. Results: After 3 months, the control group had gained significantly more weight than the treatment group (6.0 kg vs 2.0 kg, p≤0.002). Weight gain of more than 7% of initial weight occurred in 64% of the control group compared to 13% of the treatment group. The control group's BMI increased significantly more than the treatment group's (2 kg/m2 vs 0.7 kg/m2, p ≤0.03). The treatment group reported significantly greater improvements in moderate exercise levels, quality of life, health and body image compared to the controls. At 6 months, the control group continued to show significantly more weight gain since baseline than the treatment group (9.9 kg vs 2.0 kg, p≤0.013) and consequently had significantly greater increases in BMI (3.2 kg/m2vs 0.8 kg/m2, p ≤0.017). Conclusion: Individualnutritional intervention provided bya dietitian is highly successful at preventing olanzapine-induced weight gain.

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