scholarly journals Online health examination as a tool to recognize chronic disease risk factors and change unhealthy lifestyle choices among the long-term unemployed: A protocol for the STAR Duodecim Health Check and coaching program validation study (Preprint)

2021 ◽  
Author(s):  
Henna Kuhlberg ◽  
Sari Kujala ◽  
Iiris Hörhammer ◽  
Tuomas Koskela
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Qualitative Data ◽  
Health Check ◽  
Health Centers ◽  
Health Examination ◽  
Lifestyle Choices ◽  
The Unemployed

BACKGROUND Long-term illnesses and multimorbidity have become more common, thus reducing quality of life and increasing the demand for healthcare services. Lifestyle choices and socioeconomic status have a significant impact on the expected onset of diseases, age of death, and risk factors concerning long-term illnesses and morbidity. STAR is an online health examination tool which, based on questions about health, characteristics, lifestyle, and quality of life, gives users a report that includes an evaluation of their life expectancy and an estimated risk for developing common long-term illnesses. OBJECTIVE The goals of this study: 1. To review the capacity of STAR to recognize morbidity risks in comparison to a traditional nurse-led health examination and patient-reported health challenges; 2. To evaluate the user experience and usability of STAR; 3. To assess the potential impact of STAR on the health confidence and motivation of patients to make healthier lifestyle choices. METHODS This validation study will be conducted among 100 long-term unemployed persons attending a health check for the unemployed. The participants will be recruited from three Finnish public health centers in Espoo, Helsinki, and Tampere. At the health centers, the participants will use STAR and attend a nurse’s health check. Surveys with multiple-choice and open-ended questions will be collected from the participants, the nurse, and a study assistant. The questionnaires include questions about the participant’s background and health challenges from the individual’s and the nurse’s point of view, as well as questions about how well the health challenges matched the STAR report. The questionnaires also gather data about the user’s experience, usability, and the participants’ confidence in managing their health. A study assistant will fill an observer’s form containing questions about use time and possible problems encountered while using STAR. A sample of the unemployed participants will be interviewed by phone afterwards to collect more qualitative data. For the quantitative data, descriptive statistics and a reliability analysis will be performed, and mean sum scores will be computed for the study variables. Thematic analysis of the qualitative data will be performed. This study was approved by the Ethics Committee of the Expert Responsibility Area of Tampere University Hospital in June 2020. ETL Code R20067. RESULTS The data collection will begin at the start of 2021. CONCLUSIONS Multi-method assessment of online health examinations can provide an understanding of how and for whom the tools may be effective and efficient. This study provides an understanding of the novel information provided by STAR, an online health examination, to the healthcare professional and the patient, the usability of the tool, and the potential of the tool to activate patients in the management of their own health.

The crystal arthropathies

2013 ◽  
Vol 6 (11) ◽  
pp. 681-687 ◽  
Author(s):  
Robert A Jones ◽  
Brian Quilty
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Inflammatory Arthritis ◽  
Term Treatment ◽  
Routine Practice ◽  
Treatment Goals ◽  
Crystal Arthropathies ◽  
Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

Characterization of Sepsis and Sepsis-Associated Encephalopathy

2017 ◽  
Vol 34 (11-12) ◽  
pp. 938-945 ◽  
Author(s):  
Qing Feng ◽  
Yu-Hang Ai ◽  
Hua Gong ◽  
Long Wu ◽  
Mei-Lin Ai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Risk Factor ◽  
Diagnostic Criteria ◽  
Mortality Rates ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Long Term Prognosis

Background: Sepsis and sepsis-associated encephalopathy (SAE) are common intensive care unit (ICU) diseases; the morbidity and mortality are high. The present study analyzed the sensitivity of different diagnostic criteria of sepsis 1.0 and 3.0, epidemiological characteristics of sepsis and SAE, and explored its risk factors for death, short-term, and long-term prognosis. Methods: The retrospective study included patients in ICU from January 2015 to June 2016. After excluding 58 patients, 175 were assigned to either an SAE or a non-SAE group (patients with sepsis but no encephalopathy). The sensitivity of the diagnostic criteria was compared between sepsis 1.0 and 3.0, respectively. Between-group differences in baseline data, Acute Physiology and Chronic Health Evaluation II score (APACHE II score), Sequential Organ Failure Assessment score (SOFA score), etiological data, biochemical indicators, and 28-day and 180-day mortality rates were analyzed. Survival outcomes and long-term prognosis were observed, and risk factors for death were analyzed through 180-day follow-up. Results: The sensitivity did not differ significantly between the diagnostic criteria of sepsis 1.0 and 3.0 ( P = .286). The 42.3% incidence of SAE presented a significantly high APACHE II and SOFA scores as well as 28-day mortality and 180-day mortality (all P < .001). The incidence of death was 37.1%. The multivariate stepwise regression analysis demonstrated that the risk of death in SAE group was significantly higher than the non-SAE group ( P < .001). Sepsis-associated encephalopathy is a risk factor for sepsis-related death (relative risk [RR] = 2.868; 95% confidence interval: 1.730-4.754; P < .001). Although males showed a significantly high rate of 28-day and 180-day mortality ( P = .035 and .045), it was not an independent risk factor for sepsis-related death ( P = .072). The long-term prognosis of patients with sepsis was poor with decreased quality of life. No significant difference was observed in prognosis between the SAE and non-SAE groups ( P > .05). Conclusion: Both diagnostic criteria cause misdiagnosis, and the sensitivity did not differ significantly. The incidence of SAE was high, and 28-day and 180-day mortality rates were significantly higher than those without SAE. Sepsis-associated encephalopathy is a risk factor for poor outcome. The overall long-term prognosis of patients with sepsis was poor, and the quality of life decreased.

Longitudinal Evaluation of Quality of Life and Fatigue In Hodgkin Lymphoma Patients

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 935-935
Author(s):  
Peter Borchmann ◽  
Horst Müller ◽  
Corinne Brillant ◽  
Karolin Behringer ◽  
Teresa Halbsguth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Reference Values ◽  
Longitudinal Evaluation ◽  
Severe Fatigue ◽  
Advanced Stages

Abstract Abstract 935 Background: Long term impairment of quality of life (QoL) and elevated fatigue levels in Hodgkin Lymphoma (HL) survivors have been reported. However, few longitudinal data and no conclusive knowledge on components and determinants of QoL exist so far. Therefore, the German Hodgkin Study Group (GHSG) assessed the patients` QoL within the prospectively randomized studies HD10-12 for a detailed longitudinal evaluation of QoL and fatigue. Methods: QoL was assessed with a psychometrically proven questionnaire (QLQ-S) which contains the EORTC QLQ-C30 among other scales and items. Patients answered the questionnaires before, during, and at the end of therapy and at regular follow-up visits. For all QLQ-C30 functional scales and fatigue, longitudinal courses up to 27 months from diagnosis are given with means and 95%-confidence intervals. Reference values from a German control population were used for interpretation of the results. Components and determinants of QoL were analyzed with special modeling software (MPlus) which allows for full information maximum likelihood estimation of multivariate longitudinal models in the presence of missing data. The predictive value of fatigue at baseline for progression free survival and overall survival was tested in Cox proportional hazards analyses together with other known risk factors. Results: 4,160 patients were included in HD10-12, and 3,208 are evaluable for this analysis (total of 15,722 assessments). Before therapy, HL patients had clearly poorer mean scores in each QoL scale when compared to the German reference population. All scales at baseline were negatively influenced by gender (females) and more advanced disease. Before therapy age ≥50 years was negatively related to physical functioning and cognitive functioning, but positively to social functioning. After a decrease of QoL during chemotherapy, all scales showed considerable improvement. However, usually long term QoL remained below normal reference values and this was most pronounced in patients ≥50 years of age and advanced stages. A QoL model with three factors (physical, mental, and social) showed very good fit (RMSEA<.05) and high stability of QoL already 12 months after diagnosis. No relevant effect of the type of treatment could be detected. Overall, 44.7% of patients never experienced severe fatigue ≥50 (relative scale from 0–100), and 17.4% had fatigue only temporarily during treatment, and 15.1% had severe fatigue before therapy which vanished after therapy. In addition, 6.8% of patients developed severe long term fatigue without being severely fatigued before, and 6% had permanently severe fatigue. Cox regression for overall survival revealed that severe fatigue at baseline is a significant, strong and independent risk factor for death from any cause (p<.05, HR= 1.5). Other significant risk factors for OS included age, infradiaphragmatic nodes, and large mediastinal mass. In contrast, gender, high ESR, extranodal involvement, B-symptoms, intermediate stages, advanced stages were not significant. Conclusion: This is the first detailed QoL and fatigue analysis in HL patients covering all stages of the disease before, during, and after therapy. QoL domains are clearly impaired before the onset of chemotherapy, but improve over time substantially. Baseline QoL is affected in considerable degree by tumor- and patient-specific characteristics. Importantly, type and intensity of HL treatment have no relevant negative impact on long term QoL or fatigue. The strong impact of severe fatigue at baseline on overall survival is currently analyzed in more detail and results will be presented. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Health-related quality of life of COVID-19 survivors at 6 months after hospital discharge: a cohort study

2021 ◽  
Author(s):  
MeiXuan Lin ◽  
Liqun Huang ◽  
Danwen Zheng ◽  
Linjie Zhang ◽  
Bing Feng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cognitive Function ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Abstract Background: COVID-19 is a multi-systemic disease that is highly contagious and pathogenic. The long-term consequences of it are not yet clear, as is whether society and life can return to a healthy state. Long-term assessment of their health-related quality of life (HRQoL) is essential. This study aimed to investigate HRQoL and its risk factors in COVID-19 survivors at a follow-up of 6-month. Methods: A multicenter cross-sectional survey was conducted among 192 COVID-19 patients with confirmed age ≥ 18 years who were discharged from various hospitals in Wuhan from January to April 2020. The demographic characteristics, clinical characteristics, and laboratory results of the study subjects were obtained from the hospital's medical records. Survivors' HRQoL was assessed using the Short Form 36 (SF-36), cognition was assessed using the ascertain dementia eight-item informant questionnaire (AD8), and survivors' pulmonary function were examined. All participants in this study completed the survey and testing at Hubei Provincial Hospital of Chinese and Western Medicine. SF-36 scores were compared with the Chinese norm, and logistic regression and multivariate analysis were used to investigate the factors affecting HRQoL in COVID-19 survivors. Results: SF-36 showed significant differences in HRQoL between COVID-19 survivors and the general Chinese population ( P< 0.05).Multiple linear regression demonstrated that age was negatively correlated with physical functioning (PF), role-physical limitation (RP) and social functioning (SF) ( P <0.05). Bodily pain (BP), vitality (VT), SF and role-emotional limitation (RE) were negatively correlated with females ( P <0.05). Length from discharge to follow‐up was positively correlated with PF and RP ( P <0.05). Abnormal cognitive function was negatively correlated with PF, RP, general health (GH), VT, SF, RE and mental health (MH) ( P <0.05). Abnormal Carbon Monoxide Diffusing Capacity (DLCO%<80%) was significantly negatively correlated with PF and SF ( P <0.05).In addition, there was a significant negative correlation between Coronary heart disease and RP, GH, VT and RE ( P <0.05).Logistic regression analysis demonstrated that age(OR 1.032) and AD8 scores (OR 1.203)were risk factors associated with a low physical component summary (PCS) score. Length from discharge to follow‐up (OR 0.971) was the protective factor for PCS score. Abnormal cognitive function (OR 1.543) was a significant determinant associated with a mental component summary (MCS)<50 in COVID-19 patients. Conclusions: The HRQoL of COVID-19 survivors remains to be improved at six-month follow-up. Future studies should track HRQoL in older adults, women, patients with abnormal DLCO, and abnormal cognitive function for a long time and provide them with rehabilitation advice and guidance.

scholarly journals Comprehensive and long-term surveys of COVID-19 sequelae in Japan, an ambidirectional multicentre cohort study: study protocol

2021 ◽  
Vol 8 (1) ◽  
pp. e001015
Author(s):  
Kensuke Nakagawara ◽  
Ho Namkoong ◽  
Hideki Terai ◽  
Katsunori Masaki ◽  
Takae Tanosaki ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Acute Phase ◽  
Large Scale ◽  
Significant Proportion ◽  
Society Meeting ◽  
Health Related ◽  
Socioeconomic Consequences

IntroductionThe rapid spread of COVID-19 posed a global burden. Substantial number of people died of the disease in the acute phase of infection. In addition, a significant proportion of patients have been reported to suffer from post-acute phase symptoms, sequelae of COVID-19, which may negatively influence the quality of daily living and/or socioeconomic circumstances of the patients. However, no previous study has comprehensively and objectively assessed the quality of life of patients by using existing international scales. Further, evidence of socioeconomic consequences among patients with COVID-19 is scarce. To address the multidimensional issues from sequelae of COVID-19, evidence from comprehensive surveys beyond clinical perspectives is critical that investigates health, and social determinants of disease progression as well as socioeconomic consequences at a large scale.Methods and analysisIn this study, we plan to conduct a nationwide and comprehensive survey for the sequelae of COVID-19 in a total of 1000 patients diagnosed at 27 hospitals throughout Japan. This study will evaluate not only the health-related status of patients from clinical perspectives but also the Health-related Quality of Life (HRQoL) scores, socioeconomic status and consequences to discuss the sequelae of the disease and the related risk factors. The primary endpoint is the frequency of long-term complications of COVID-19 infection. The secondary endpoints are risk factors for progression to sequelae of COVID-19 infection. The study will provide robust and important evidence as a resource to tackle the issues from the sequelae of COVID-19 from the multi-dimensional perspectives.Ethics and disseminationThis trial was approved by the Keio University School of Medicine Ethics Committee (20200243, UMIN000042299). The results of this study will be reported at a society meeting or published in a peer-reviewed journal.

scholarly journals Prediction of quality of life at long-term follow-up after Fontan operation by scoring risk factors.

1994 ◽  
Vol 58 (8) ◽  
pp. 646-652 ◽  
Author(s):  
PARK INSAM ◽  
MAKOTO NAKAZAWA ◽  
YASUHARU IMAI ◽  
KAZUO SAWATARI ◽  
KAZUO MOMMA
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Fontan Operation ◽  
Long Term Follow Up

scholarly journals Efficacy of optimal long-term management of multiple cardiovascular risk factors (CVD) on walking and quality of life in patients with peripheral artery disease (PAD): Protocol for randomized controlled trial

2012 ◽  
Vol 17 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Roberta K Oka ◽  
Michael S Conte ◽  
Christopher D Owens ◽  
Joseph Rapp ◽  
Gordon Fung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Controlled Trial ◽  
Cvd Risk Factors ◽  
Peripheral Artery ◽  
Cvd Risk ◽  
Randomized Controlled ◽  
Artery Disease

Peripheral artery disease (PAD) is an understudied chronic illness most prevalent in elderly individuals. PAD patients experience substantial walking impairment due to symptoms of limb ischemia that significantly diminishes quality of life (QOL). Cardiovascular disease (CVD) morbidity and mortality is increased in this population because of aggressive atherosclerosis resulting from untreated CVD risk factors. Despite current national guidelines recommending intensive CVD risk factor management for PAD patients, untreated CVD risk factors are common. Interventions that bridge this gap are imperative. The Vascular Insufficiency – Goals for Optimal Risk Reduction (VIGOR2) study is a randomized controlled trial (RCT) that examines the effectiveness of a long-term multifactor CVD risk reduction program on walking and quality of life in patients with PAD. The purpose of this article is to provide a detailed description of the design and methods of VIGOR2. Clinical Trial Registration – URL: http://clinicaltrials.gov/ct2/show/NCT00537225

scholarly journals Postpartum septic symphysitis, a rare condition with possible long-term consequences: a cohort study with long-term follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helen Elden ◽  
Monika Fagevik Olsen ◽  
Nasrin Farah Hussein ◽  
Lisa Wibeck Axelsson ◽  
Verena Sengpiel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Health Related Quality ◽  
Related Quality ◽  
Long Term Follow Up ◽  
Health Related ◽  
Long Term Consequences

Abstract Background Postpartum septic symphysitis (PPSS) is defined as acute onset of severe pain around the symphysis, restricted movement, fever, and elevated inflammatory parameters. It is a rare but serious condition requiring urgent diagnosis and treatment. The aim of this study was to describe the incidence, symptoms, diagnosis, treatment, and long-term follow-up of PPSS. Methods This follow-up study included 19 out of 21 women diagnosed with PPSS from 1989 to 2017 at one tertiary care hospital in Sweden. Clinical data were retrieved from hospital records and compared to those retrieved from a regional registry. Women completed a postal questionnaire, and those who reported lumbopelvic pain (LPP) were offered a clinical examination. Results 1) PPSS was diagnosed after a normal postpartum period of 24 to 50 h by blood tests (n = 19/19), ultrasonography (n = 9 /19), computer tomography (n = 8/19) or magnetic resonance imaging (n = 16/19) Treatment included aspiration of symphyseal abscesses, i.v. antibiotics and different physiotherapeutic interventions. Women with PPSS more frequently were primiparous (n = 14/19, p = 0.001), had an instrumental delivery (n = 14/19, p = 0.003), longer time of active labour (p = 0.01) and second stage of labour (p = 0.001) than women in the regional registry. 2) Ten out of 19 (52%) women reported LPP at follow-up. These women more often suffered impaired function related to LPP (Pelvic Girdle Questionnaire, 27 versus 0, p < 0.0001), a poorer health-related quality of life (EuroQol-5 dimensions p = 0.001 and EuroQol-visual analogue scale, 65 mm versus 84 mm, p = 0.022) and higher levels of anxiety and depression (Hospital Anxiety Depression Scale (HADS) HADS-Anxiety, 7 versus 2, p = 0.010; and HADS-Depression, 1 versus 0, p = 0.028) than women with no pain. 3). Of the eight women who were clinically assessed, one had lumbar pain and seven had pelvic girdle pain (PGP). Conclusions In the largest cohort of patients with PPSS to date, primiparas and women with instrumental vaginal delivery were overrepresented, indicating that first and complicated deliveries might be risk factors. Approximately half of the women reported PGP at follow-up, with considerable consequences affecting health-related quality of life and function decades after delivery. Prospective multicentre studies are needed to establish risk factors, long-term consequences, and adequate treatment for this rare pregnancy complication.

Health-Related Quality of Life (HRQL) in Adult Long-Term Hematopoietic Cell Transplant (HCT) Survivors: A Report from the Bone Marrow Transplant Survivor Study.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2254-2254
Author(s):  
Smita Bhatia ◽  
Liton Francisco ◽  
Andrea Carter ◽  
K. S. Baker ◽  
Stephen J. Forman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Health Insurance ◽  
Relative Risk ◽  
Return To Work ◽  
Household Income ◽  
P Value ◽  
Allogeneic Hct

Abstract We describe HRQL reported by adult survivors of autologous and allogeneic HCT and the risk factors associated with poor HRQL. Eligible subjects were individuals undergoing HCT at either City of Hope or the University of Minnesota between 1974 and 1998, and surviving two or more years after HCT. We analyzed the data from 1003 HCT survivors older than 21 years enrolled in a retrospective cohort study who had completed a validated City of Hope HCT-QOL tool. Of these, 54.5% were males, 80.2% were Caucasians, and 55% had received allogeneic HCT. The primary diagnoses included CML (n=233), AML (n=241), NHL (n=200), ALL (n=99), HD (n=88), and other (n=142). The median age at HCT was 35.4, median age at study participation: 43.4 years, and the median length of follow-up: 9.4 (2 to 28 years). Survivors’ responses were compared with those of the population norms in Physical, Psychological, Social and Spiritual domains, and overall quality of life (QOL). Poor QOL was defined as QOL scores less than two standard deviations below that reported for the tool norms. Using this definition, 9.2% of this cohort was identified to have poor overall QOL; 13.7% with poor Physical; 10% with poor Psychological; 6.7% with poor Social; and 4.3% with poor Spiritual well-being. Table below shows the results of the risk factors identified for poor QOL by multivariate analysis. Age, sex, type of HCT, and time since HCT were not associated with poor QOL. Thus, overall 9% of the long-term HCT survivors report poor overall QOL. Certain vulnerable sub-populations exist, specifically, low household income, difficulty in obtaining health insurance, inability to return to work, and the presence of pain and anxiety that impact upon the HRQL of this population, and require additional attention and possible intervention. Predictors of Poor Risk Factors for Poor QOL Overall QOL Physical Psychological Social Spiritual Relative Risk (p-value) Relative Risk (p-value) Relative Risk (p-value) Relative Risk (p-value) Relative Risk (p-value) Non-white race 2.1 (0.06) 2.4 (0.005) 1.6 (0.1) 2.0 (0.06) 0.5 (0.2) Inability to return to work 3.4 (0.003) 4.9 (<0.001) 3.6 (<0.001) 3.6 (0.002) 0.8 (0.7) Inability to return to school 2.4 (0.2) 4.6 (0.005) 5.2 (0.002) 1.1 (0.8) 0.9 (0.9) Difficulty in obtaining health insurance 1.7 (0.1) 1.9 (0.04) 0.9 (0.9) 3.6 (<0.001) 2.2 (0.05) Absence of health insurance 2.6 (0.05) 1.3 (0.6) 0.7 (0.5) 1.6 (0.4) 4.2 (0.005) Household income <$20k 3.0 (0.04) 0.9 (0.9) 4.4 (0.006) 2.2 (0.1) 3.1 (0.05) CGVHD 2.1 (0.02) 1.8 (0.02) 1.9 (0.04) 1.4 (0.3) 1.5 (0.3) Severe pain 8.8 (<0.001) 12.6 (<0.001) 2.4 (0.07) 5.4 (0.001) 2.8 (0.07) Severe anxiety 240.2 (<0.001) 5.3 (0.001) 60.2 (<0.001) 7.8 (<0.001) 19.7 (<0.001)

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