scholarly journals The effects of therapeutic group singing on voice, cough and quality of life in parkinson’s disease

2021 ◽  
Vol 6 (2) ◽  
pp. 79-88
Author(s):  
Cecilia Brooks ◽  
Danielle Porter ◽  
Daniel Furnas ◽  
Judith Maige Wingate
Keyword(s):  
Quality Of Life ◽  
Repeated Measures ◽  
Outpatient Setting ◽  
Small Sample ◽  
Speaking Rate ◽  
Post Intervention ◽  
Main Effect ◽  
Pitch Level ◽  
Potential Improvement

Purpose: To examine the effect of a group therapeutic singing intervention on voice, cough, and quality of life in persons with Parkinson Disease (PD) in a community-based outpatient setting using a repeated measures design.Methods: 19 volunteer participants with PD completed the study. Ten participants participated in the intervention and nine served voluntarily as controls. Participants completed one hour group singing sessions over 12 weeks led by a music therapist. Sessions consisted of 30 min of high intensity vocal exercise and 15 to 20 minutes of group singing. Data on phonation, speech, cough, and quality of life were collected pre-intervention and one week post intervention with final data collection 12 weeks post-intervention.Results: No significant change in voice measures although 50% of participants showed improvement. A main effect was found for breathiness (p=0.023), appropriate pitch level (p=0.037) and speaking rate (p=0.009). No main effect for cough but pairwise comparisons were nearly significant pre to post intervention (p=0.053) and pre-intervention to final follow up (p=0.023). No main effect found for QOL but singing participants demonstrated better QOL scores than controls.Conclusions: Results from this small sample suggest that there are some speech benefits from singing intervention as well as potential improvement in cough for airway clearance. Additional study is needed to confirm these results.

Improving Sleep among Adults with Multiple Sclerosis using Mindfulness plus Sleep Education

2020 ◽  
pp. 019394592094740
Author(s):  
Rebecca A. Lorenz ◽  
Samantha Auerbach ◽  
Patricia Nisbet ◽  
Loralee Sessanna ◽  
Nouf Alanazi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Repeated Measures ◽  
Group Analysis ◽  
Sleep Time ◽  
Medium Effect ◽  
Post Intervention ◽  
Sleep Education ◽  
Health Quality ◽  
Health Quality Of Life

We explored the feasibility of a mindfulness plus sleep education intervention, SleepWell!, delivered via videoconference compared to onsite among adults with MS. A non-randomized wait-list control design was used. Participants wore actigraphy watches and kept sleep diaries for seven days pre- and post intervention. Questionnaires were completed pre-intervention, post-intervention, and three months post-intervention. One group was conducted onsite. Three groups participated via videoconference. Attrition among videoconference groups was 23% compared to 57% in the onsite group. Within group analysis showed moderate-to-large effect sizes on sleep efficiency (d=0.78) and total sleep time (d=0.54) in the videoconference groups. One-way repeated measures ANOVA post-hoc analysis suggested small-to-medium effect over three months on sleep quality (ηp2 =0.28), physical health quality of life (ηp2 =0.42), mental health quality of life (ηp2 =0.13), and mindfulness (ηp2 =0.29). Results indicate feasibility of providing our intervention via videoconferencing. Preliminary analysis suggests that SleepWell! improves sleep and mindfulness among adults with MS.

Abstract 14563: Improving Monitoring Outcomes and Quality of Life for Heart Failure Patients in Telehomecare Program

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Valeria E Rac ◽  
Yeva Sahakyan ◽  
Nida Shahid ◽  
Aleksandra Stanimirovic ◽  
Iris Fan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Blood Pressure ◽  
Weight Gain ◽  
Repeated Measures ◽  
Linear Mixed Model ◽  
Small Sample ◽  
Daily Weight Gain ◽  
Heart Failure Patients

Introduction: Introduced in 2007 by the Ontario Telemedicine Network, the Telehomecare program provides monitoring of patient’s parameters and coaching sessions. There is an inconclusive data on the association of participation and patient-level outcomes. Hypothesis: We hypothesized that blood pressure (BP), daily weight fluctuation and quality of life would improve among heart failure patients participating in the Telehomecare. Methods: We applied a time series study design to analyze patients’ blood pressure and weight, transmitted via telemonitoring devices on a daily basis. Longitudinal surveys were conducted on a small sample of prospectively enrolled patients (n=22) to assess quality of life using EQ-5D and SF-12 over the three-month period. Daily weight gain was defined as an increase of ≥2 lbs between two consecutive measurements. The data for the period of July 2012 to March 2015 was analysed by repeated measures with generalized linear mixed model procedures in SAS. Results: Overall 1354 patients with heart failure (52% women) were enrolled with average age of 76.3±11.1. During the first month of enrolment, one third of the patients (n=433) had elevated BP with a monthly average systolic BP of 150.3±9.6 mm Hg and diastolic BP of 76.7±12.8, in comparison with adequately controlled (n=921) patients, who had an average systolic BP of 118.8±13.5 mm Hg and diastolic BP of 66.4±9.6 mm Hg. Over the seven month period, we found significant reduction in systolic (by 11.0 mm Hg; 95% CI 9.3-12.7) and diastolic BP (by 6.0 mm Hg; 95% CI 4.9-7.3) among patients who had elevated values at baseline, adjusted for age and gender. During the first month of enrolment, weight gain of ≥2 lbs was registered for 8% of days. The likelihood of daily weight gain slightly declined over the seven month period (OR 0.86. 95% CI 0.75-0.98). Physical and mental component scores of SF-12 and EQ 5D’s index score did not improve significantly except for EQ 5D visual analogue scale scores. Conclusion: In conclusion, changes observed in the patient monitoring parameters over time pointed out that hypertensive patients might benefit the most from the Telehomecare. The survey evaluations failed to detect any significant impact of the Telehomecare on the patients’ quality of life.

Managing Cancer as a Family Disease - Feasibility, Satisfaction and Family Functioning after Short-Time Counselling for Families with Parental Cancer

2021 ◽  
pp. 106648072110524
Author(s):  
Verena Ehrbar ◽  
Salomé Roos ◽  
Anna Denzinger ◽  
Martina Barbara Bingisser ◽  
Sandra Scherer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Family Communication ◽  
Family Members ◽  
Small Sample ◽  
Anxiety And Depression ◽  
Parental Cancer ◽  
Short Term ◽  
Post Intervention ◽  
Counselling Intervention

Background: Parental cancer affects not only the patient, but all family members. Access to psychological support for the entire family is highly relevant, but still scarce. The aim of the present research project was to develop, implement, and evaluate the effectiveness of a short-term counselling intervention for families with parental cancer. Methods: The short-term counselling intervention consisted of six sessions and was developed based on pre-existing evaluated concepts. All participating family members had to complete questionnaires prior and post-intervention. These questionnaires investigated changes in family communication and satisfaction levels, parental anxiety and depression levels, parental partnership quality and self-assessed quality of life of children and adolescents. Furthermore, feasibility of and satisfaction with the intervention was assessed. Results: Acceptability of short-term counselling was high in participating families, although feasibility was limited with regard to the final inclusion rate (n  =  10). Comparison of pre and post intervention measures showed a significant increase in family communication and satisfaction levels. Anxiety and depression levels were low, quality of parental partnership within the normal range, and quality of life reported from children was high. These scores remained stable from pre to post intervention. Conclusions: The counselling intervention most likely had positive effects in all family members with either stabilizing or increasing all measured outcomes. Although interpretation of the results is limited due to the small sample size, we believe that integrated in clinical routine of adult care of a hospital, this additional offer might be a valuable benefice to cancer patients and their families. Clinical Trial Registration Number: NCT03097458 (clinicaltrials.gov)

A Pilot Study of a Mindfulness-Based Art Therapy Intervention in Outpatients With Cancer

2018 ◽  
Vol 35 (9) ◽  
pp. 1195-1200 ◽  
Author(s):  
Salimah H. Meghani ◽  
Caroline Peterson ◽  
Donna H. Kaiser ◽  
Joseph Rhodes ◽  
Hengyi Rao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Art Therapy ◽  
Repeated Measures ◽  
Meaning Making ◽  
Well Being ◽  
Post Intervention ◽  
Related Quality ◽  
Quality Health ◽  
Health Related

Background: Patients with cancer frequently experience physical and psychological distress that can worsen their quality of life. Objectives: We assessed the outcomes of an 8-week mindfulness-based art therapy (MBAT) intervention, Walkabout: Looking In, Looking Out, on symptoms, sleep quality, health-related quality of life, sense of coherence (SOC), and spirituality in outpatients with cancer. Methods: A 1-group, pre–post intervention design with repeated measures at baseline, week 4, and week 8. Results: Despite a small pilot sample (n = 18), we found large effect sizes and statistically significant improvements from week 1 to week 8 in depression, the comprehensibility subscale of the SOC, and each subscale of spirituality, that is, peace, meaning, and faith. There were no significant changes in physical functioning, pain, sleep, tiredness, drowsiness, nausea, and appetite. Conclusions: The MBAT intervention, Walkabout, seems to meet key palliative care goals including improvement in emotional well-being, comprehensibility, and meaning making among outpatients with cancer.

scholarly journals SWE and SMI ultrasound techniques for monitoring needling treatment of ankylosing spondylitis: study protocol for a single-blinded randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mengyu Wang ◽  
Wen Fu ◽  
Lingcui Meng ◽  
Jia Liu ◽  
Lihua Wu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Ankylosing Spondylitis ◽  
Outcome Measures ◽  
Healthy Subjects ◽  
Acupuncture Group ◽  
Musculoskeletal Ultrasound ◽  
Sham Control ◽  
Post Intervention

Abstract Background Ankylosing spondylitis (AS) is a high-incidence disease in young men that interferes with patients’ physical and mental wellbeing and overall quality of life (QoL). It is often accompanied by arthralgia, stiffness, and limited lumbar flexibility. Acupuncture is safe and effective for reducing the symptoms of AS, but the underlying mechanisms by which it does so are not fully understood. Therefore, to objectively assess acupuncture efficacy, which is critical for patients making informed decisions about appropriate treatments, we will use shear-wave elastography (SWE) and superb microvascular imaging (SMI) ultrasound techniques to evaluate elasticity of lumbar paraspinal muscles and blood flow to the sacroiliac joint (SIJ) in AS. Methods We will recruit a total of 60 participants diagnosed with AS and 30 healthy subjects. Participants will be randomly allocated 1:1 to either an acupuncture group or a sham control acupuncture group. Primary-outcome measures will be musculoskeletal ultrasound, Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Metrology Index (BASMI), and the Visual Analogue Scale (VAS) for pain. Secondary outcome measures will be the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), and Fatigue Scale-14 (FS-14). We will monitor the effect of acupuncture or sham acupuncture on blood flow and SIJ inflammation using SMI, lumbar-muscle stiffness using SWE and the lumbar paraspinal-muscle cross-sectional area (CSA) using a two-dimensional (2D) grayscale imaging. QoL, physical function, and fatigue will be assessed using an evaluation scale or questionnaire developed for this study, with outcomes measured by the ASQoL, BASMI, BASDAI, BASFI, and FS-14. Healthy subjects will not receive acupuncture but undergo only musculoskeletal ultrasound at baseline. Acupuncture and sham control acupuncture interventions will be conducted for 30 min, 2–3 times/week for 12 weeks. Musculoskeletal ultrasound will be conducted at baseline and post-intervention, while other outcomes will be measured at baseline, 6 weeks, and post-intervention. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Discussion The results of this single-blinded, randomized trial with sham controls could help demonstrate the efficacy of acupuncture and clarify whether musculoskeletal ultrasound could be used to evaluate AS. Trial registration ClinicalTrials.gov ChiCTR2000031476. Registered 3 April 2020.

Association between multimodality measures of aortic stenosis severity and quality-of-life improvement outcomes after transcatheter aortic valve replacement

2021 ◽  
Author(s):  
Michael A Catalano ◽  
Shahryar G Saba ◽  
Bruce Rutkin ◽  
Greg Maurer ◽  
Jacinda Berg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Computed Tomography ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Multivariable Analysis ◽  
Calcium Score ◽  
Post Intervention ◽  
Transcatheter Aortic Valve

Abstract Aims Up to 40% of patients with aortic stenosis (AS) present with discordant grading of AS severity based on common transthoracic echocardiography (TTE) measures. Our aim was to evaluate the utility of TTE and multi-detector computed tomography (MDCT) measures in predicting symptomatic improvement in patients with AS undergoing transcatheter aortic valve replacement (TAVR). Methods and results A retrospective review of 201 TAVR patients from January 2017 to November 2018 was performed. Pre- and post-intervention quality-of-life was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Pre-intervention measures including dimensionless index (DI), stroke volume index (SVI), mean transaortic gradient, peak transaortic velocity, indexed aortic valve area (AVA), aortic valve calcium score, and AVA based on hybrid MDCT-Doppler calculations were obtained and correlated with change in KCCQ-12 at 30-day follow-up. Among the 201 patients studied, median KCCQ-12 improved from 54.2 pre-intervention to 85.9 post-intervention. In multivariable analysis, patients with a mean gradient >40 mmHg experienced significantly greater improvement in KCCQ-12 at follow-up than those with mean gradient ≤40 mmHg (28.1 vs. 16.4, P = 0.015). Patients with MDCT-Doppler-calculated AVA of ≤1.2 cm2 had greater improvements in KCCQ-12 scores than those with computed tomography-measured AVA of >1.2 cm2 (23.4 vs. 14.1, P = 0.049) on univariate but not multivariable analysis. No association was detected between DI, SVI, peak velocity, calcium score, or AVA index and change in KCCQ-12. Conclusion Mean transaortic gradient is predictive of improvement in quality-of-life after TAVR. This measure of AS severity may warrant greater relative consideration when selecting the appropriateness of patients for TAVR.

scholarly journals The effects of intensive home treatment on self-efficacy in patients recovering from a psychiatric crisis

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ansam Barakat ◽  
Matthijs Blankers ◽  
Jurgen E Cornelis ◽  
Nick M Lommerse ◽  
Aartjan T F Beekman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Self Efficacy ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Small Sample ◽  
Home Treatment ◽  
Differential Effects ◽  
Psychiatric Crisis

Abstract Background This study evaluated whether providing intensive home treatment (IHT) to patients experiencing a psychiatric crisis has more effect on self-efficacy when compared to care as usual (CAU). Self-efficacy is a psychological concept closely related to one of the aims of IHT. Additionally, differential effects on self-efficacy among patients with different mental disorders and associations between self-efficacy and symptomatic recovery or quality of life were examined. Methods Data stem from a Zelen double consent randomised controlled trial (RCT), which assesses the effects of IHT compared to CAU on patients who experienced a psychiatric crisis. Data were collected at baseline, 6 and 26 weeks follow-up. Self-efficacy was measured using the Mental Health Confidence Scale. The 5-dimensional EuroQol instrument and the Brief Psychiatric Rating Scale (BPRS) were used to measure quality of life and symptomatic recovery, respectively. We used linear mixed modelling to estimate the associations with self-efficacy. Results Data of 142 participants were used. Overall, no difference between IHT and CAU was found with respect to self-efficacy (B = − 0.08, SE = 0.15, p = 0.57), and self-efficacy did not change over the period of 26 weeks (B = − 0.01, SE = 0.12, t (103.95) = − 0.06, p = 0.95). However, differential effects on self-efficacy over time were found for patients with different mental disorders (F(8, 219.33) = 3.75, p < 0.001). Additionally, self-efficacy was strongly associated with symptomatic recovery (total BPRS B = − 0.10, SE = 0.02, p < 0.00) and quality of life (B = 0.14, SE = 0.01, p < 0.001). Conclusions Although self-efficacy was associated with symptomatic recovery and quality of life, IHT does not have a supplementary effect on self-efficacy when compared to CAU. This result raises the question whether, and how, crisis care could be adapted to enhance self-efficacy, keeping in mind the development of self-efficacy in depressive, bipolar, personality, and schizophrenia spectrum and other psychotic disorders. The findings should be considered with some caution. This study lacked sufficient power to test small changes in self-efficacy and some mental disorders had a small sample size. Trial registration This trial is registered at Trialregister.nl, number NL6020.

scholarly journals There and back again: analyzing the effect of outpatient readmission on the quality of life of patients attending a rheumatology clinic

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110348
Author(s):  
Alfredo Madrid-García ◽  
Isabel Montuenga-Fernández ◽  
Judit Font-Urgelles ◽  
Leticia León-Mateos ◽  
Esperanza Pato ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Outpatient Clinic ◽  
Outpatient Setting ◽  
P Value ◽  
Marginal Effect ◽  
Rheumatology Clinic ◽  
Related Quality ◽  
Health Related ◽  
San Carlos

Aims: The aim of this study was to assess the effect of “outpatient readmissions” on the health-related quality of life (HR-QoL) of outpatients from a rheumatology clinic, meaning the effect of the patient’s return to the outpatient clinic after having received care and been discharged. Methods: We conducted an observational longitudinal retrospective study, with patients selected from the Hospital Clínico San Carlos Musculoskeletal cohort, based on having received at least one discharge from the outpatient clinic and having returned (readmission) at least once after the discharge. The main outcomes were the patients’ baseline HR-QoL (measured on the first visit of each episode) and the ΔHR-QoL (difference between the HR-QoL in the last and the first visit of each episode). Successive episodes of admission and readmission were chronologically ordered, paired and analyzed using nested linear mixed models, nested by patients and by admission–readmission tandem. We carried out bivariable and multivariable analyses to assess the effect of demographic, clinical, treatment and comorbidity-related variables in both main outcomes. Results: For the first main outcome, 5887 patients (13,772 episodes) were analyzed. Based on the multivariable level, readmission showed no significant marginal effect on the baseline HR-QoL ( p-value = 0.17). Conversely, when analyzing the ΔHR-QoL, we did observe a negative and significant marginal effect ( p-value = 0.028), meaning that readmission was associated with a lower gain in the HR-QoL during the follow-up, compared with the previous episode. Conclusion: In the outpatient setting, readmission exerts a deleterious effect in patients undergoing this process. Identification of outpatients more likely to be readmitted could increase the value of the care provided.

scholarly journals Quality of life in primary sclerosing cholangitis: a systematic review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Elena Marcus ◽  
Paddy Stone ◽  
Anna-Maria Krooupa ◽  
Douglas Thorburn ◽  
Bella Vivat
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Research ◽  
Disease Progression ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Small Sample ◽  
Limited Evidence ◽  
Research Studies

Abstract Background Primary sclerosing cholangitis (PSC) is a rare bile duct and liver disease which can considerably impact quality of life (QoL). As part of a project developing a measure of QoL for people with PSC, we conducted a systematic review with four review questions. The first of these questions overlaps with a recently published systematic review, so this paper reports on the last three of our initial four questions: (A) How does QoL in PSC compare with other groups?, (B) Which attributes/factors are associated with impaired QoL in PSC?, (C) Which interventions are effective in improving QoL in people with PSC?. Methods We systematically searched five databases from inception to 1 November 2020 and assessed the methodological quality of included studies using standard checklists. Results We identified 28 studies: 17 for (A), ten for (B), and nine for (C). Limited evidence was found for all review questions, with few studies included in each comparison, and small sample sizes. The limited evidence available indicated poorer QoL for people with PSC compared with healthy controls, but findings were mixed for comparisons with the general population. QoL outcomes in PSC were comparable to other chronic conditions. Itch, pain, jaundice, severity of inflammatory bowel disease, liver cirrhosis, and large-duct PSC were all associated with impaired QoL. No associations were found between QoL and PSC severity measured with surrogate markers of disease progression or one of three prognostic scoring systems. No interventions were found to improve QoL outcomes. Conclusion The limited findings from included studies suggest that markers of disease progression used in clinical trials may not reflect the experiences of people with PSC. This highlights the importance for clinical research studies to assess QoL alongside clinical and laboratory-based outcomes. A valid and responsive PSC-specific measure of QoL, to adequately capture all issues of importance to people with PSC, would therefore be helpful for clinical research studies.

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.

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