Impact of invasive bladder cancer and orthotopic urinary diversion on general health-related quality of life: An SF-36 survey

Introduction: Cardiac rehabilitation (CR) is an evidence-based program to improve secondary prevention outcomes for patients with cardiovascular disease (CVD). Lower health-related quality of life is a known risk factor for worse CVD outcomes. We examined the effects of a patient-driven appointment-based CR program on health-related quality of life. Methods: We utilized data from the Yale New-Haven Health (YNHH) CR program over a 6-year period (2012-2017). Data was collected on patient demographics, clinical characteristics and socioeconomic status. The Medical Outcome Short-Form General Health Survey (SF-36) was used to measure general health status. We evaluated SF-36 score changes pre and post CR with paired T-tests and conducted logistic regression analysis to examine predictors of improvements in health-related quality of life. Results: Over the 6-year study period, a total of 2,135 patients (27.9% women, mean age 65±12 years) were enrolled in the CR program. Patients demonstrated significant improvements in both the SF-36 physical, mental and health transition components (P<0.001) (Table) . In particular, patients had significant improvement in the social functioning domain (measures limitations patients see in their ability to participate in social activities due to physical/emotional issues), with an increase of 23.3 points out of 100. Physician-reported patient stress and/or depression on intake medical exam were significant negative predictors for improvement in the total SF-36 score (OR 0.23, 95% CI 0.08-0.80, P=0.021), with the effect driven largely by its impact on the physical component of SF-36 (OR 0.27, 95% CI 0.09-0.83, P=0.022). Conclusion: We demonstrated that a novel appointment-based CR program produced improvements in patient-reported health-related quality of life. Appointment-based CR could be a viable alternative for patients who prefer more scheduling flexibility, to optimize health status improvement and CVD outcomes.

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Health related quality of life of survivors of trauma six months after discharge

South African Journal of Physiotherapy ◽

10.4102/sajp.v69i1.366 ◽

2013 ◽

Vol 69 (1) ◽

Cited By ~ 4

Author(s):

J. Schneiderman ◽

H. Van Aswegen ◽

P. Becker

Keyword(s):

Quality Of Life ◽

Physical Function ◽

General Health ◽

Mental Component Summary Score ◽

Trauma Survivors ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related

To investigate the health-related quality of life (HRQOL) of survivors of major trauma at six months following discharge, using two popular HRQOL tools. A cross-sectional study was done on adult trauma survivors in Johannesburg. Subjects completed the EQ-5D and SF-36 HRQOL questionnaires. Additional demographic and clinical data were collected. The majority of subjects reported some problems in usual activities and pain/discomfort as measured with the EQ-5D at six months. The mean EQ-5D VAS was 68 (±26.1). lowest scores were reported in the role physical (44.6 ± 41.6) and role emotional (44.1 ± 45.4) domains of the SF-36. mean SF-36 physical component summary (PCS) score (62.1 ± 27.8) was higher than mental component summary score (58.7 ±20.1). EQ-5D VAS was found to be moderately correlated with age (r=-0.4; p=0.05). A negative correlation was found between SF-36 physical function score and ICU length of stay (LOS), hospital LOS and age (r=-0.4 (p=0.03), -0.4 (p=0.03) and -0.6 (p=0.00) respectively). Statistical significance was observed in the correlation between age and SF-36 general health domain (r=-0.4; p=0.02) as well as age and PCS score (r=-0.5; p=0.01). Trauma survivors in Johannesburg experience limitations in specific emotional and physical domains of HRQOL at six months after discharge. Age was associated with the level of self-rated health as well as limitations in general health and physical function. ICU and hospital LOS were associated with limitations in physical function. There is a need for physical and psychological rehabilitation after discharge from trauma intensive care.

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Abstract 2090: Health Related Quality of Life Outcomes of Therapeutic Life Style Modification Program for Women with Metabolic Syndrome

Circulation ◽

10.1161/circ.118.suppl_18.s_667-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Eui Geum Oh ◽

Soo Hyun Kim ◽

So Yeon Bang ◽

Sa Saeng Hyun ◽

Yong Kwan Jeon ◽

...

Keyword(s):

Quality Of Life ◽

Metabolic Syndrome ◽

General Health ◽

Control Group ◽

Health Related Quality ◽

Point Change ◽

Sf 36 ◽

Related Quality ◽

Health Related

Background: The metabolic syndrome (MetS), with associated increased CHD risk, is highly prevalent among postmenopausal women in Korea. Although therapeutic lifestyle modification (TLM) has been recommended as a cornerstone therapy, studies investigating the effects of TLM on health related quality of life (HRQOL) are limited. Purpose : This study was to evaluate HRQOL outcomes of a six-month TLM in Korean women with Mets. Methods: A randomized controlled design was used. Fifty four women (mean age of 63.2 y) with Mets were recruited from community health centers and randomly assigned to the intervention (N=31) or control (N=23) groups. The subjects in the intervention group participated in a supervised weekly TLM session for six months. The TLM program was consisted of health monitoring, education, aerobic exercise (40-min/session, 200 Kcal/day), and a low calorie diet with low carbohydrate (≈1300Kcal/d). Those in the control group received a booklet about MetS and were instructed to maintain their usual diet and activities. HRQOL was measured using the MOS SF-36 at before, during (month 3), completion (month 6), and after completion of the TLM program (month 12). Mixed-model repeated measures ANCOVA was used to evaluate HRQOL outcomes. Results : There were significant group by time interactions for general health ( P = .043) and vitality ( P = .012). Both general health (mean 23-point change) and vitality scores (mean 16-point change) greatly improved in the treatment group over 6 months of TLM, compared with control group. However, the improvement of the general health and vitality in the experimental group was not sustained at month 12. There were significant treatment main effects (all P < .05) for the remaining SF-36 subscale scores. Conclusion : A systematic TLM program may be effective strategy for improving HRQOL in postmenopausal women with MetS.

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Relation Between Clinical Oral Health Status, Oral Health Related Quality of Life, Denture Material Type and Self-perceived General Health, in a General Population

Revista de Chimie ◽

10.37358/rc.19.9.7541 ◽

2019 ◽

Vol 70 (9) ◽

pp. 3315-3324

Author(s):

Alexandru Gratian Grecu ◽

Andra Elena Aungurencei ◽

Dan Lucian Dumitrascu

Keyword(s):

Quality Of Life ◽

Oral Health ◽

General Health ◽

Oral Health Status ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

The Mean

The purpose of the current study was to assess the oral health related quality of life (OHRQoL), general health related quality of life (HRQoL), clinical oral and denture status, as well as their interrelation, within a hospitalized general population. The Romanian versions of the Oral Health Impact Profile-49 (OHIP-49Ro), SF-36 questionnaires, together with an additional set of oral health assessment questions, were administered under the interview format to 170 patients, hospitalized in the Second Medical Clinic of Internal Medicine, Cluj-Napoca, Romania. The patients also underwent clinical examination, based on which the DMFT was calculated. Denture status, was as well, registered, together with the denture material. Each patient provided informed consent, prior to any examination. Questionnaire scores were calculated and used for the univariate descriptive statistics, reflecting oral health, OHRQoL and HRQoL sample tendencies. Successively, multiple regression analysis was applied, with the purpose of investigating the relationship between: the clinical oral health status, OHRQoL and HRQoL. In the first model, OHRQoL, while in the second model the dependent variable was represented by the HRQoL, each having a set of established predictors. Additionally, for denture wearing patients, OHRQoL variations in respect to the denture material were assessed, using one-way ANOVA. The mean OHIP-49Ro overall score was 31.90. The mean SF-36 subscales score was 60.66. The mean DMFT score was 18.47. For both regression analyses, all the regression models were significant. For the first model, the predictors accounted for 48.5% of variance in OHRQoL. For the second model, the highest percent of variance, explained by the predictors, was registered for the Mental Health subscale (22.8%). DMFT, as a clinical measure, was a statistically significant predictor rather for the perception in general health. However, OHRQoL was a good predictor for HRQoL, as an integrated part of it. Moreover, the one-way ANOVA indicated statistically significant differences in OHRQoL perception, in respect to the denture material F(2, 82) = 3.253, p = 0.044. The current study indicated complex relations between the patients� clinical status, the OHRQoL and HRQoL. The clinical determinants presented direct impact on both OHRQoL and HRQoL. More balanced HRQoL scores suggested that patients focused more on the perception of general health outcomes.

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HEALTH RELATED QUALITY OF LIFE AFTER RADICAL CYSTECTOMY AND URINARY DIVERSION FOR BLADDER CANCER: A SYSTEMATIC REVIEW AND CRITICAL ANALYSIS OF THE LITERATURE

The Journal of Urology ◽

10.1097/01.ju.0000149080.82697.65 ◽

2005 ◽

Vol 173 (4) ◽

pp. 1318-1322 ◽

Cited By ~ 150

Author(s):

MICHAEL P. PORTER ◽

DAVID F. PENSON

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Bladder Cancer ◽

Radical Cystectomy ◽

Urinary Diversion ◽

Critical Analysis ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Health-Related Quality of Life after Cystectomy and Urinary Diversion for Bladder Cancer

Advances in Urology ◽

10.1155/2011/715892 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 17

Author(s):

Cheryl Shih ◽

Michael P. Porter

Keyword(s):

Quality Of Life ◽

Bladder Cancer ◽

Urinary Diversion ◽

Future Research ◽

Complication Rates ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

With multiple options for urinary diversion after radical cystectomy for bladder cancer that have comparable cancer control and complication rates, health-related quality of life (HRQOL) has become an important consideration. This article reviews the methods for defining HRQOL, the challenges in measuring HRQOL in bladder cancer, and the literature comparing HRQOL after various methods of urinary diversion. Recent contributions include the validation of HRQOL instruments specific to bladder cancer and the publication of several prospective studies measuring HRQOL outcomes after cystectomy and urinary diversion. There is no convincing evidence from existing literature that any particular method of urinary diversion offers superior HRQOL outcomes. Rather, there is growing evidence that good HRQOL can be achieved with patient education and consideration of each patient's clinical and psychosocial situation. Future research should utilize the validated bladder cancer specific HRQOL instruments and perhaps explore the impact of preoperative counseling on postoperative HRQOL.

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Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2016-1896 ◽

2016 ◽

Vol 101 (8) ◽

pp. 2966-2974 ◽

Cited By ~ 46

Author(s):

Anuja Dokras ◽

David B. Sarwer ◽

Kelly C. Allison ◽

Lauren Milman ◽

Penny M. Kris-Etherton ◽

...

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Anxiety Disorders ◽

General Health ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

The Impact

Context: Polycystic ovary syndrome (PCOS) is associated with reduced health-related quality of life (HRQOL) and increased prevalence of depressive and anxiety disorders. The impact of PCOS-specific treatments on these co-morbidities is unclear. Objective: To assess the impact of weight loss and decreasing hyperandrogenism on HRQOL and mood and anxiety disorders in women with PCOS. Design/Setting/Participants: A secondary analysis of a randomized controlled trial (OWL-PCOS) of preconception treatment conducted at two academic centers in women (age, 18–40 years; body mass index, 27–42 kg/m2) with PCOS defined by Rotterdam criteria. Intervention: Continuous oral contraceptive pill (OCP) or intensive lifestyle intervention or the combination (Combined) for 16 weeks. Main Outcome Measure(s): Changes in HRQOL assessed by PCOSQ and SF-36 and prevalence of depression and anxiety disorder assessed by PRIME-MD PHQ. Results: The lowest scores were noted on the general health domain of the SF-36 and the weight and infertility domains on the PCOSQ. All three interventions resulted in significant improvement in the general health score on the SF-36. Both the OCP and Combined groups showed improvements in all domains of the PCOSQ (P < .01) compared to baseline scores. The Combined group had significant improvements in the weight, body hair, and infertility domains compared to a single treatment group (P < .05). In a linear regression model, change in weight correlated with improvements in the weight domain (P < .001) and physical well-being (P < .02), change in T correlated with improvements in the hair domain (P < .001), and change in both weight and T correlated with the infertility (P < .001) and menstrual domains (P < .05). Conclusions: Both weight loss and OCP use result in significant improvements in several physical and mental domains related to quality of life, depressive symptoms, and anxiety disorders, and combined therapies offer further benefits in overweight/obese women with PCOS.

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Evaluation of health-related quality of life in patients with Cushing's syndrome with a new questionnaire

Acta Endocrinologica ◽

10.1530/eje-07-0762 ◽

2008 ◽

Vol 158 (5) ◽

pp. 623-630 ◽

Cited By ~ 130

Author(s):

S M Webb ◽

X Badia ◽

M J Barahona ◽

A Colao ◽

C J Strasburger ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Health Status ◽

General Health ◽

Health Related Quality ◽

General Health Status ◽

Sf 36 ◽

Related Quality ◽

Health Related

Chronic exposure to hypercortisolism has significant impact on patient's health and health-related quality of life (HRQoL), as demonstrated with generic questionnaires. We have developed a disease-generated questionnaire to evaluate HRQoL in patients with Cushing's syndrome (CS; CushingQoL).ObjectiveValidate the CushingQoL questionnaire in patients with CS in clinical practice conditions.DesignObservational, international, cross-sectional study.MethodsA total of 125 patients were recruited by 14 investigators from Spain, France, Germany, The Netherlands, and Italy over a 2-month period. Clinical and hormonal data were collected and correlated with results of the generic short form 36 (SF-36) questionnaire, a question on self-perceived general health status and the CushingQoL score.ResultsA total of 107 patients were pituitary-dependent and 18 adrenal-dependent CS; 104 (83%) were females, mean age 45 years (range 20–73 years); 39 (31%) were currently hypercortisolemic; and 47 (38%) adrenal insufficient. In clinical practice, CushingQoL was feasible (117; 94% of patients fully responded to the questionnaire in a mean time of 4 min), reliable (Crohnbach's α=0.87), and valid (factorial analysis demonstrated unidimensionality and Rasch analysis lead to a final version with 12 items). A significant (P<0.001) correlation was observed between CushingQoL score and patients self-perceived general health status and dimensions of SF-36 (Pearson's correlation coefficient ≥0.597). Patients with current hypercortisolism scored worse (lower) than those without (44±22 vs 56±21, P=0.004). Linear regression analysis identified female gender and hypercortisolism as significant predictors for worse QoL.ConclusionCushingQoL is useful to evaluate HRQoL in patients with CS and correlates with clinical parameters.

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