ПОКАЗНИКИ ЯКОСТІ ЖИТТЯ ОСІБ, ЩО ДОГЛЯДАЮТЬ ЗА ПАЦІЄНТАМИ З ДЕМЕНЦІЄЮ

Dementia is associated with decreased memory, impaired thinking, behavior and ability to perform daily functions. This condition mainly affects the elderly and is one of the main causes of disability. Dementia affects not only patients, their families and caregivers, but society as a whole. The number of people with dementia is on the rise worldwide, and prognosis generally indicates a significant increase in overall prevalence associated with population aging. A large number of patients with dementia are at home, where their family members perform the function of caring for them. With the progression of the disease, patients lose the ability to care for themselves on their own, so the question of outside care arises for their relatives. The aim of this study is to analyze the quality of life indicators in persons performing the function of caring for patients with dementia. It has been found that almost 80% of patients with dementia are cared for by their relatives. Caregivers are at risk of depression, anxiety and psychological stress. In this study, the authors identified factors influencing the mental health of caregivers, among which the degree of dementia and the patient's ability to perform daily activities were significant. In caregivers with a low level of mental tension, manifestations of social maladaptation were less common. Depending on the level of psychological stress, individuals with a high level of tension had lower indicators of quality of life on the scales "physical functioning" (p=0.003), "role functioning due to physical condition" (p<0.001), "social functioning" (p=0.04), "role functioning due to emotional state" (p=0.003), "mental health" (p=0,004). For this category of people, it is recommended to use counseling, psycho-educational activities aimed at understanding the improvement of quality of life.

Rebamipid in real clinical practice: quality of life and safety of use

The aim of the study was to assess the tolerability and impact on the quality of life of pharmacotherapy for gastric ulcer, erosive gastritis using regimens including rebamipide. The quality of life of patients was assessed using the SF-36 questionnaire. Pharmacotherapy of gastric ulcer with the inclusion of rebamipide as part of the conventional treatment regimen provides data comparable to the healthy group on the scales of physical functioning, role functioning due to physical condition, pain intensity, general health, and vital activity. The results of our own research and data from literary sources indicate that rebamipide is a drug with a confident evidence base, good tolerance and safety of use.

Exploring the Outcomes That Matter Most to Young People Treated for Chronic Pain: A Qualitative Study

Global and national policies state that all children and young people should be part of decision making and that outcomes that matter to them should take priority, yet patient-centred outcomes have been identified as a gap in the paediatric chronic pain literature. This study gave youths experiencing chronic pain a platform to have their views heard. Using novel methods, twenty-one young people, aged 11 to 18 years old, completed a semi-structured interview in which they constructed a timeline drawing to symbolise their treatment. They identified when aspects of their life changed (outcomes) and described the importance of these changes. Thematic analysis identified four themes that emerged at different stages of the treatment: “perfect storm”; “turning points”; “disconnect”; and; “free”. “Turning points” were points in time when the narrative of the young person took a turn in a different direction. At these points, the outcomes important to them also changed. Youths initially prioritised outcomes related to pain, then during treatment the focus became their emotional functioning, with role functioning and “going out” becoming the focus at the end. The stage of treatment as perceived by the young person impacted which outcomes mattered most.

Innate Immunity Stimulation During COVID-19 Pandemic: Challenge

AIM: We report an open spontaneous anecdotical retrospective survey of Corynebacterium parvum administration to 4000 fragile immune-depressed and multimorbid patients treated with a killed C. parvum strain to enhance the innate immunity integrating the adaptative immune response for a long standing antinfectious resistance. METHODS: 4000 patients (1900 men and 2100 women) with mild, moderate or chronic disease, appealing to our Second Opinion Medical Consultation Network, signed an informed consent and were injected subcutaneously with C.parvum. The treatment was followed up at 6 months after therapy, filling the short form of the medical outcome health survey questionnaire (SF-36), directly by the patients or its parents and monitoring the health regularly via telemedicine (Skype, WhatsApp, mail, etc) or physician’s visit.RESULTS: The main efficacy endpoints, as assessed by the SF-36 questionnaire, are significant improvements in the mental and physical role functioning score (p< 0.02), in general health, in social role functioning (p < 0.02), vitality (p < 0.03), and a significant reduction in bodily pain (p< 0.03). There was a quick (48-72 hours) symptoms improvement and/or complete regression of the herpetic eruptions observed in 1000 affected patients and of herpetic neuralgia (reduced in 80% of cases), also full recovery or frequency reduction (30%) of recurrent cystitis and prostatitis in 120 affected patients, and last, but not least, a life quality improvement in 100 oncologic patients of overall 200 cases. A significant increase in the lymphocyte count (p<0.01), mainly Helper and Killer lymphocytes, was noted after 6 months by Parvulan injection vs. the baseline.The asymptomatic SARS-CoV-2 patients, incidentally, enrolled in our survey, were tested at sixth months for antibodies against SARS-CoV-2 and 14 patients occurred high level of SARS-CoV-2 antibodies. The incubating Covid infections in the Parvulan injected patients even if rail and multi-morbid recovered in a short term (48-96 hours) and with benign clinical course, usually no need of further drugs administration except for the variants, which lasted on average one week and required some antipyretics, and low dose steroid for a few days.CONCLUSIONS: Our results confirm that C.parvum is quite safe and effective to support immune-compromised patients when epidemic or pandemic events rise the life risk and any kind of infections and complications rate.Further double-blind placebo evidence-based studies are urgently required, and our numerically substantial not sponsored spontaneous observation aims exclusively to promote further evidence based double blind institutional studies.

The Use of Complementary and Alternative Medicine in Thai Gynecologic Oncology Patients: Influencing Factors

Background. To determine the factors influencing the use of complementary and alternative medicine (CAM) in gynecologic cancer patients and the prevalence and pattern of CAM use. Methods. This was a cross-sectional study of 370 gynecologic cancer patients conducted at the outpatient clinic, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. After obtaining informed consent, participants were asked to complete a standardized questionnaire including sociodemographic and clinical characteristics, detail of CAM use, attitude of CAM use, and quality of life using EORTC-QLQ-C30. Results. The prevalence of CAM use was 25.13%. The most common type was herbal medicine (55.90%). The participants who resided or had a birthplace in rural areas presented with a higher proportion of CAM use than those in urban areas ( P = 0.470 and P = 0.004 , respectively). Participants who received multiple modalities of cancer treatment reported a significantly higher proportion of CAM use ( P = 0.024 ). Most CAM users agreed that the CAM could be used in combination with standard treatment, and some rather disagreed that CAM could interrupt the treatment effect of the conventional treatment. CAM users had significantly higher role functioning in quality-of-life scores. Conclusion. Factors influencing CAM use in gynecologic cancer patients were rural area birthplace or residency, receiving multiple modalities of cancer treatment, having positive attitude toward CAM use. CAM users had better performance in role functioning in the quality-of-life score. Therefore, gynecologic oncologists should pay attention to these factors in order to communicate with gynecologic cancer patients about CAM use.

Real-World Health-Related Quality of Life in Patients with Diffuse Large B-Cell Lymphoma: Comparisons with Reference Populations and By Line of Therapy

Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin's lymphoma (NHL) constituting 30-58% of all NHL (Tilly et al, 2015; Thieblemont et al, 2020). Treatment can include intensive multiagent chemotherapy and other novel therapies which carries risk for toxicities. Despite this, we lack data comprehensively depicting the quality of life of real-world patients with DLBCL, particularly in the modern era with novel therapies. Therefore, we aimed to compare Quality of Life (QoL) to reference populations and assess real-world DLBCL patients across multiple countries and lines of therapy. Methods: Real-world data were drawn from the Adelphi DLBCL Disease Specific Programme™ (DSP), a point-in-time survey of hematologists, hemato-oncologists, oncologists and their patients with DLBCL conducted in France (FR), Germany (DE), Italy (IT), Spain (SP), the United Kingdom (UK) and the United States of America (US) between Jan-May 2021. Patients were asked to voluntarily complete a patient self-completion form (PSC) capturing demographics and QoL data through the use of patient-reported outcome instruments: the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30), EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L), EQ-5D-5L Visual Analogue Scale and Work Productivity and Activity Impairment questionnaire. Bivariate analysis was conducted to compare all cancer and NHL-specific reference values from the EORTC QLQ-C30 manual (Scott et al, 2008) to DLBCL DSP data, and to review QoL across lines of therapy, defined as first line and second line (1L+2L) and third line and above (3L+). Statistical significance level was set at p&lt;.05. If functional scores were lower, when compared to reference values, within the DSP, this was indicative of a worse QoL in patients with DLBCL. For symptomatic scores the opposite was true; should the DSP value be higher, this was indicative of a worse QoL in patients with DLBCL. Results: Data analysis was conducted on 441 patients with DLBCL who completed a PSC (FR: n=80, DE: n=150, IT: n=54, SP: n=43, UK: n=34, US: n=80); at data collection, mean (standard deviation) age was 64.6 (12.39) years, 36% of patients were female, 19% working full- or part-time and 80% were relapsed/refractory, 29% were 3L+. 8%, 24%, 28% and 40% were at Ann Arbor disease stage I, II, III and IV respectively at the time of data collection. When comparing DLBCL DSP values to EORTC QLQ-C30 all cancer reference values for functional scores (Table 1), global health status, physical functioning, role functioning, emotional functioning, cognitive functioning and social functioning were significantly worse than all cancer reference values. In terms of symptoms, DSP values for fatigue, nausea and vomiting, dyspnea, appetite loss and diarrhea were significantly worse than all cancer reference values (Table 2). Results were mixed when comparing with EORTC QLQ-C30 NHL-specific reference values (Table 1) for functional scores; global health status was significantly worse for the DLBCL DSP population, whilst role functioning, cognitive functioning and social functioning were significantly better than NHL reference values. Significantly worse symptom scores were observed in the DLBCL DSP population (Table 2) for nausea and vomiting, pain, dyspnea and diarrhea when compared with the reference values. Functioning scores were significantly worse in 3L+ patients vs 1L+2L for global health status, physical functioning, role functioning, cognitive functioning and social functioning (Table 3). Fatigue, dyspnea and diarrhea symptomatic scores were significantly worse in 3L+ vs 1L+2L patients. Symptom burden was high across all lines of therapy (Table 4). Conclusion: Real-world patients with DLBCL demonstrated significantly worse QoL when compared with a general cancer reference population with respect to all functional scores, as well as fatigue, nausea and vomiting, dyspnea, appetite loss and diarrhea, underscoring the high symptom burden experienced by patients with DLBCL. Patients with DLBCL on 3L+ had significantly worse QoL than those on earlier lines of therapy with respect to global health status, physical functioning, role functioning, cognitive functioning and social functioning, fatigue, dyspnea and diarrhea indicating an unmet need in novel treatment options to help improve QoL in later lines. Figure 1 Figure 1. Disclosures Ma: Regeneron Pharmaceuticals Inc.: Current Employment, Current holder of individual stocks in a privately-held company. Quek: Regeneron Pharmaceuticals Inc.: Current Employment, Current holder of individual stocks in a privately-held company.

Assessment of Quality of Life in Chinese Patients with Chronic Lymphocytic Leukemia

Background: Despite the changing landscape of treatment of chronic lymphoma leukemia (CLL) and in contrast to the large number of quality of life (QoL) and psychosocial studies in patients with solid tumors, relatively few studies have reported QoL in patients with CLL. This study aims to assess depression, anxiety, stress and QoL in a Chinese CLL cohort. Patients and Methods: Taking advantage of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 accompanying CLL-specific module QLQ-CLL17 questionnaire and DASS-21 questionnaire, a total of 50 Chinese patients with CLL completed self-reported questionnaires from December 2019 to July 2021, assessing the level of depression, anxiety, stress and QoL. Results: Among the 50 CLL patients, 34 patients were male. The median age was 57 (22-77) years old. 66% of the patients were uncertain about the staging of the disease. 36% of the patients were uncertain about therapeutic implications of CLL. According to EORTC QLQ-C30, patients had low level of physical functioning, role functioning, emotional functioning, cognitive functioning and social functioning were 80%, 32%, 68%, 66%, 64%, respectively. Patients in active-treatment group had significantly lower level of physical function than "watch and wait" group (90% vs. 65%, P=0.03). The proportion of patients with cognitive problems was significantly higher in female patients than in male patients (93.8% vs. 52.9%, P=0.004). According to QLQ-CLL17, patients with symptom burden, physical condition and worries about health were 94% (47/50), 86% (43/50), 98% (48/50). Patients under 60 years old had higher scores for worries about health than patients older than 60. According to DASS-21 questionnaire, 86% of the patients had depression symptomatic scores (mild grade: 2%, medium grade: 52%, severe grade: 20%, very severe grade: 12%). 84% of the patients had anxiety symptomatic scores ( mild grade: 6%, medium grade: 14%, severe grade: 30%, very severe grade: 34%). 64% of the patients had stress symptomatic scores ( mild grade: 18%, medium grade: 22%, severe grade: 16%, very severe grade: 8%). And these psychosocial issues had no significant correlation with gender, age, household income and treatment . The same questionnaires were completed by 5 patients for the second time after median 8（2-18）months. Compared to the initial assessment, they scored significantly worse on the emotional scales (P=0.0237). No significant difference regarding physical functioning, role functioning, cognitive functioning and social functioning were observed between the former and the latter. Conclusions: The majority of CLL patients had impaired QoL and psychosocial issues. Active-treatment patients had worse physical condition than "watch and wait" patients. Male patients had better cognitive functioning. Younger patients had more worries about health than the elderly. Greater efforts should be made in management of CLL patients. Disclosures No relevant conflicts of interest to declare.

Gender features of the life quality of preschool children living in Dushanbe

Aim. To assess the parameters and gender characteristics of the life quality of preschool children and the influence of a complex of factors on them.Material and methods. A study of the quality of life of 354 children was carried out. Ther were divided into two subgroups - younger (3-4 years old, 97 children) and senior preschool age (5-7 years old, 257 children). The PedsQL ™ 4.0 questionnaire was used to assess the QoL of children.Results and discussion. It was found that with age, the parameters of QOL increase on the scale of “emotional functioning”, and on the scale of “functioning in kindergarten” - decreases. The children of 5-7 years old themselves rated such aspects of QOL as emotional and role functioning significantly higher. Gender differences had specificitiesthe QOL of boys in the younger preschool group was higher in terms of emotional functioning. According to children, differences were established on the scale of “social functioning”, where this indicator was significantly higher in girls. The interrelation of various risk factors on the QOL indicators of children has proved to be valid.Conclusion. The results of the survey showed that parents tend to assess the QOL of their children in this age category somewhat lower than the children themselves. The results once again confirm the influence of various medical and social factors on the QOL of children.

Detailed clinical phenotyping and generalisability in prognostic models of functioning in at-risk populations

Summary Personalised prediction of functional outcomes is a promising approach for targeted early intervention in psychiatry. However, generalisability and resource efficiency of such prognostic models represent challenges. In the PRONIA study (German Clinical Trials Register: DRKS00005042), we demonstrate excellent generalisability of prognostic models in individuals at clinical high-risk for psychosis or with recent-onset depression, and substantial contributions of detailed clinical phenotyping, particularly to the prediction of role functioning. These results indicate that it is possible that functioning prediction models based only on clinical data could be effectively applied in diverse healthcare settings, so that neuroimaging data may not be needed at early assessment stages.

Assessment of a Healthy Lifestyle and Quality of Life of Men and Women in Modern Society Based on SF-36

Quality of life (QL) is defined as the subjective perception of one’s own well-being in a socio-cultural context, the satisfaction of one’s desires and the achievement of an ideal level of well-being. Quality of life is related to health (HRQOL), refers to the functioning and well-being in the physical, mental and social dimensions of life. Research purpose: to analyze the main factors of quality of life of male and female population in modern Ukrainian society. Material and Methods. 482 men and women aged 20-60 took part in sociological research. The following research methods were used to solve the problemsset in the work: analysis and processing of special literature and data from the Internet; pedagogical observation; questionnaires (SF36); methods of mathematical statistics. Results. The results of their own research show that the male population had a better quality of life on all scales of the SF-36 questionnaire compared to women (p <0.05). Respondents under the age of 20-29 had indicators of quality of life above average on the scales of physical and role physical functioning; pain in this age group did not have a significant impact on quality of life. The general state of health was assessed above the average level by respondents aged 20-29 and 30-39, regardless of gender, they were characterized by high scales of social activity and viability. Conclusions. It is established that the indicator General health is a system-forming factor of quality of life for men and women in terms of the number of correlations. The obtained results allowed to determine the expediency and speed of implementation of preventive measures for men and women depending on the content of certain scales. Decreased overall health (GH) in men and women after the age of 50 significantly affects their quality of life, as evidenced by the large number of significant correlation coefficients. In women over 50 years of age, there is a sharp decrease in RP (role functioning due to physical condition) to 46 points, vital activity (VT) to 50 points, role functioning (due to emotional state) (RE) to 53 points. In men at this age, role functioning increases to 90 points, and social functioning (SF) to 89 points, which may indicate an uneven distribution of family and social functions in the lives of people of different sexes, overloading women with household chores, which prevents them from spending free time, affects the emotional state.