Psychometric Validation of the German Translation of the Quality of Life Questionnaire-Bronchiectasis (QOL-B)—Data from the German Bronchiectasis Registry PROGNOSIS

Patients with bronchiectasis feature considerable symptom burden and reduced health-related quality of life (QOL). We provide the psychometric validation of the German translation of the disease-specific Quality of Life Questionnaire-Bronchiectasis (QOL-B), version 3.1, using baseline data of adults consecutively enrolled into the prospective German bronchiectasis registry PROGNOSIS. Overall, 904 patients with evaluable QOL-B scores were included. We observed no relevant floor or ceiling effects. Internal consistency was good to excellent (Cronbach’s α ≥0.73 for each scale). QOL-B scales discriminated between patients based on prior pulmonary exacerbations and hospitalizations, breathlessness, bronchiectasis severity index, lung function, sputum volume, Pseudomonas aeruginosa status and the need for regular pharmacotherapy, except for Social Functioning, Vitality and Emotional Functioning scales. We observed moderate to strong convergence between several measures of disease severity and QOL-B scales, except for Social and Emotional Functioning. Two-week test-retest reliability was good, with intraclass correlation coefficients ≥0.84 for each scale. Minimal clinical important difference ranged between 8.5 for the Respiratory Symptoms and 14.1 points for the Social Functioning scale. Overall, the German translation of the QOL-B, version 3.1, has good validity and test-retest reliability among a nationally representative adult bronchiectasis cohort. However, responsiveness of QOL-B scales require further investigation during registry follow-up.

Validation of Acromegaly Quality of Life Questionnaire (AcroQol) for the Iranian Population

Background Acromegaly is a chronic disease seriously impacting the patients' quality of life. This study aimed to validate the Acromegaly Quality of Life Questionnaire (AcroQoL) for the Persian-speaking population. Methods This cross-sectional study recruited 73 Iranian patients with a confirmed diagnosis of acromegaly. The content validity of the scales was evaluated by an expert panel of eight endocrinologists. Construct validity was assessed by using confirmatory factor analysis. Internal consistency was assessed on the basis of Cronbach’s alpha, and a goodness-of-fit (GoF) index was calculated to display whether the model fitted the data. Results The content validity index (CVI) and content validity ratio (CVR) yielded values of 0.85 and 0.80, respectively. The average variance extracted (AVE) from physical and psychological dimensions was 0.520 and 0.462, respectively, exceeding the minimum criterion of 0.40. Cronbach’s alpha for physical and psychological dimensions equaled 0.868 and 0.866, respectively, indicating the adequate internal consistency of multiple items for each construct. The subscales’ R square and path coefficient were greater than the recommended threshold (physical dimension: 0.778, psychological dimension: 0.873), demonstrating the suitability of this criterion. Finally, the GoF value of 0.29 indicated the model's moderate fit. Conclusions The findings revealed that the Persian version of AcroQoL is of adequate validity and reliability for evaluating the quality of life of Iranian people with acromegaly.

Influência dos Cânceres Gástrico e Hematológico na Qualidade de Vida e na Funcionalidade de Pacientes Oncológicos

Introdução: O câncer é uma doença complexa, sendo a segunda maior causa de morte no Brasil e no mundo, com uma média de 9,8 milhões de óbitos ao ano. Objetivo: Verificar a influência do tipo de câncer, gástrico ou hematológico, na qualidade de vida e na funcionalidade dos indivíduos. Método: Trata-se de um estudo clínico, transversal, analítico e de abordagem quantitativa. Utilizaram-se na coleta de dados uma ficha com dados demográficos, antropométricos, habituais e da doença, o Quality of Life Questionnaire-Core30 da European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) e a Escala de Performance de Karnofsky (KPS). Resultados: Foram avaliados 29 pacientes no total; destes, 19 pacientes com câncer hematológico (Grupo A) e dez com câncer gástrico (Grupo B). A correlação entre idade, EORTC QLQ-C30 e KPS foi positiva entre a idade e os sintomas (r=,571, p=0,011) e a idade e a somatória total do EORTC QLQ-C30 (r=,548, p=0,015); e negativa entre a KPS e os sintomas (r=-,495, p=0,031) e a KPS e a somatória total do EORTC QLQ-C30 (r=,-580, p=0,009) no grupo A. No grupo B, não foi observada nenhuma correlação entre essas variáveis. Conclusão: Pacientes com câncer hematológico e câncer gástrico apresentam redução da qualidade de vida, sendo observada uma diminuição da funcionalidade nos pacientes com câncer hematológico quando comparado ao câncer gástrico. A redução da função nesses indivíduos pode estar diretamente relacionada com a idade e os sintomas físicos apresentados.

QUALIDADE DE VIDA RELACIONADA À SAÚDE DE MULHERES IDOSAS EM TRATAMENTO DE CÂNCER DE MAMA

OBJETIVO: AVALIAR A QUALIDADE DE VIDA RELACIONADA À SAÚDE DE MULHERES IDOSAS EM TRATAMENTO DE CÂNCER DE MAMA. MÉTODO: ESTUDO TRANSVERSAL, DESCRITIVO, COM ABORDAGEM QUANTITATIVA, REALIZADO COM 57 MULHERES IDOSAS EM TRATAMENTO DE CÂNCER DE MAMA. A COLETA DE DADOS OCORREU DURANTE OS MESES DE JUNHO A NOVEMBRO DE 2019, POR MEIO DE UM INSTRUMENTO SEMIESTRUTURADO PARA OBTENÇÃO DE DADOS SOCIODEMOGRÁFICOS E CLÍNICOS E OS QUESTIONÁRIOS EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER QUALITY OF LIFE QUESTIONNAIRE “CORE” 30 E QUALITY OF LIFE QUESTIONNAIRE – BREAST CANCER 23. OS DADOS FORAM ANALISADOS DE FORMA DESCRITIVA COM O AUXÍLIO DO STATISTICAL PACKAGE FOR THE SOCIAL SCIENCE FOR WINDOWS, VERSÃO 22.0. O PROJETO FOI APROVADO PELO COMITÊ DE ÉTICA EM PESQUISA SOB PARECER Nº 3.293.768. RESULTADOS: NA QUALIDADE DE VIDA GERAL, OBSERVOU-SE QUE AS IDOSAS APRESENTARAM BOA MÉDIA NA ESCALA DE SAÚDE GLOBAL E RAZOÁVEL NA ESCALA FUNCIONAL, DESTACANDO-SE A FUNÇÃO SOCIAL. JÁ A ESCALA DE SINTOMAS APRESENTOU MÉDIA BAIXA, DESTACANDO-SE A DIFICULDADE FINANCEIRA, INSÔNIA, FADIGA E DOR. NO QUESTIONÁRIO ESPECÍFICO, A ESCALA FUNCIONAL APRESENTOU MAIOR MÉDIA, COM DESTAQUE POSITIVO PARA A IMAGEM CORPORAL. NA ESCALA DE SINTOMAS, OS EFEITOS COLATERAIS E OS SINTOMAS DA MAMA FORAM OS QUE MAIS CONTRIBUÍRAM PARA A DETERIORAÇÃO DA QUALIDADE DE VIDA. CONCLUSÃO: A QUALIDADE DE VIDA GLOBAL APRESENTOU-SE BOA, NO ENTANTO, A MESMA SOFRE IMPACTOS DEVIDO AOS EFEITOS COLATERAIS AO TRATAMENTO.

Validation of the food allergy independent measure and the EuroPrevall food allergy quality of life questionnaire for children 8–12 years translated into Spanish

Background: Different questionnaires have been developed to measure quality of life (QoL) in patients with food allergy. Our aim was to validate a Spanish translation of the Food Allergy Independent Measure (FAIM) and the EuroPrevall Food Allergy Quality of Life Questionnaire—Child Form (FAQLQ-CF) for children aged 8–12 years.Methods: Sixty children with a diagnosis of IgE-mediated allergy to food completed the questionnaires. The internal consistency was evaluated with Cronbach’s alpha. The correlation of FAQLQ-CF with FAIM was assessed to test construct validity. We compared both values with the diagnosis of anaphylaxis to evaluate discriminant validity.Results: Cronbach’s alpha was in the range of 0.654–0.863 for the four domains of FAQLQ-CF and 0.779 for FAIM. There were no criteria to remove questions from the questionnaires. Significant correlations could be found between FAQLQ-CF and the number of offending foods and the impact on social life (all r > 0.33, P < 0.01), and between FAIM and anaphylaxis.Conclusions: The Spanish translation of FAQLQ-CF showed acceptable internal consistency, good construct validity, and capacity to discriminate patients depending on the number of foods to avoid and the impact on social life. FAIM showed good discriminant capacity for anaphylaxis.

Yoga Versus Physical Therapy In Multiple Sclerosis: Randomized Controlled Trial

Background. Yoga originated in the territory of modern India more than 3000 years ago and uses techniques for working with the musculoskeletal system, cardiorespiratory system and attention. Currently, the effectiveness and safety of yoga in patients with various neurological disorders, including MS, is of interest to many scientists and clinicians. The main aim of this study is to examine the effect of yoga on symptoms and quality of life in patients with MS versus physical therapy (exercise therapy) and no exercise.Methods. The patients were randomly assigned to 3 groups (yoga, PT, or waiting list), patients from the waiting list had an opportunity to enter the yoga program after the end of the trial period. After 12 weeks of regular exercises (or absence of them), the effect of yoga and PT on the functional status and quality of life of patients were evaluated. The MS treatment was a part of routine practice, as prescribed by the treating neurologist. The data was collected during the patients’ two visits to the study center - before the start of the study and at the end of the 12-week period. The in-person examination included a doctor's assessment of the EDSS, the SF-36 quality of life questionnaire, the fatigue scale, the Berg balance scale, the 6-minute walking test.Results. A total of 36 patients finished the clinical study: 30 women and 6 men. There was no statistically significant difference between the groups in terms of improvement in MS symptoms as measured by the balance, walking test and fatigue scales. However, in the analysis of the 8 criteria of SF-36 quality-of-life questionnaire the covariation analysis statistically significant differences were found in favor of the yoga group in terms of physical functioning (PF) (p=0.003), life activity (VT) (p<0.001), mental health (MH) (p=013), social functioning (SF) (p=0.028). Conclusions. Thus, regular yoga classes under the guidance of qualified staff are a promising method of non-drug rehabilitation of patients with MS with motor disorders. More research is needed to examine the impact of yoga on clinical patient improvement and quality of life indicators.Trial registration. ISRCTN15486200 https://doi.org/10.1186/ISRCTN15486200

Relaxamento Guiado como Prática Integrativa para Mulheres Submetidas à Radioterapia

Introdução: O câncer de mama ocupa uma das primeiras posições das neoplasias malignas em mulheres. Entre os tipos de tratamento, está a radioterapia que, apesar de ser um método seguro, traz diversos efeitos colaterais que prejudicam a qualidade de vida relacionada à saúde. Objetivo: Avaliar o efeito da prática integrativa e complementar de relaxamento com visualização guiada na melhora da qualidade de vida relacionada à saúde de mulheres com câncer de mama submetidas à radioterapia. Método: Pesquisa quantitativa, quase-experimental, do tipo pré e pós-teste, realizada com 25 mulheres com câncer de mama submetidas à radioterapia em um Centro de Oncologia do Sul de Minas Gerais, entre julho de 2019 a março de 2020. Foram coletados dados sobre aspectos sociodemográficos e clínicos, e utilizado o instrumento Quality of Life Questionnaire-Core 30 da European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) para avaliação da qualidade de vida, aplicado em três momentos do tratamento. As seções de relaxamento foram aplicadas três vezes na semana durante todo o tratamento radioterápico. Resultados: A maioria das pacientes se encontrava na faixa etária de 41-60 anos, com nível médio de escolaridade, aposentadas, católicas, brancas, casadas e em estadiamento IIA. Os escores relacionados às escalas funcionais apresentaram melhora ao longo do tratamento. Para a escala de sintomas, os prevalentes foram insônia, constipação e fadiga. Conclusão: A prática de relaxamento foi eficaz na melhora dos domínios da qualidade de vida relacionada à saúde, sendo uma prática de baixo custo que pode ser aplicada por profissionais treinados.

Revision and Validation of the Chinese Version of the McGill Quality of Life Questionnaire for ICU End-of-Life Patients

Background Hospice care for end-of-life patients in the ICU should focus on quality of life. Currently, there are no specific quality-of-life measures for ICU end-of-life patients in China. Objective The aim of this study was to revise and culturally adapt the Taiwanese version of the McGill Quality of Life Questionnaire (MQOL-Taiwan) and to test its reliability and validity to provide an effective instrument for assessing the quality of life of ICU patients at the end of life. Methods The revision and cultural adaptation of the MQOL-Taiwan were performed to develop a Chinese version of the McGill Quality of Life Questionnaire for ICU end-of-life patients (MQOL-ICU). A total of 156 ICU doctors, 286 ICU nurses and 120 ICU family members of end-of-life patients were surveyed with the revised scale to evaluate the quality of life of ICU patients at the end of life. The content validity, construct validity, and internal consistency of the scale were measured after the revision. Results The Chinese version of the MQOL-ICU scale was formed based on the MQOL-Taiwan scale, which includes 8 items. For the Chinese version of the MQOL-ICU, the item-content validity index (I-CVI) ranged from 0.789 to 0.905, and the average scale-level content validity index (S-CVI/Ave) was 0.845. After exploratory factor analysis, the Kaiser-Meyer-Olkin (KMO) value was 0.700, and 3 dominant factors were extracted: physical and psychological symptoms, existential well-being, and support. In addition, 70.385% of the total variance was explained. The internal consistency (Cronbach's α) coefficient of the whole MQOL-ICU was 0.804, and the coefficients for the 3 domains ranged from 0.779 to 0.833. Conclusion The Chinese version of the MQOL-ICU showed good reliability and validity, and it can be used to assess the quality of life of ICU patients at the end of life.

Assessment of Quality of Life in Patients with Medication-Related Osteonecrosis of the Jaw Following Reconstructive and Restorative Surgery

Recently, numerous articles have been published describing atypical lesions of the jaw bones related to treatment with medications based on phosphorus or analogs of its compounds, particularly bisphosphonates. Goal: To conduct a comparative analysis of the quality of life after radical surgery of the jaw in patients with medication-related osteonecrosis. A total of 82 patients were interviewed, of which 39 (47.6%) patients were in the control group (conservative treatment) and 43 (52.4%) patients in the main group had radical surgical treatment. The mean age of patients in both groups was 66.8 ± 10.03 years. Treatment of patients in the control group in terms of conventional conservative protocol included the local application of 0.05% chlorhexidine solution 1–2 times a day, antibacterial therapy (clindamycin—150 mg 4 times daily for 7 days) and NSAIDs (nimesulide). Patients in the main group (n = 43) underwent segmental resection of the jaw. Thirty days and then 6 months after the treatment, all patients were asked to assess the intensity of pain using a numerical scale, where 0 = no pain, 5 = moderate pain and 10 = the most severe pain imaginable, and to fill in the SF-36 Quality of Life Questionnaire. Results: An analysis of the results obtained with the Numeric Pain Rating Scale demonstrated that the mean pain intensity before treatment was 8.9 points in the control group, and 9.7 in the main group. These values were indicative of “unbearable pain.” After treatment (30 days), the pain score in the control group decreased and amounted to 4.1, which is evidence of the persistence of “moderate pain” in patients. In patients who underwent segmental jaw resection, the mean pain intensity was 0.5. There was no relationship with gender, but there was a direct relationship between the intensity of the pain and the stage of the process (CI = 95%). The SF-36 quality of life questionnaire showed that in the control group, who were treated conservatively, bodily pain (BoP) decreased from a score of 91.2 to 34.3, and the mental health score increased from 34.2 before treatment to 36.3 after treatment, which indicates the persistence of discomfort. The remaining parameters improved after treatment, but no complete recovery was achieved. Before radical surgery, the main group of patients also had a high level of bodily pain (95.2), but after surgery this decreased to 12.4. The remaining parameters also showed a significant difference before and after radical surgery, indicating a positive trend. Radical surgery allows us to improve the quality of life of patients, thereby confirming that surgical volume is a secondary aspect if there is no relapse after the treatment.

Mepolizumab Is an Effective Option in Severe Eosinophilic Asthma Regardless of Baseline Features: Single-Center Real-Life Data

<b><i>Background:</i></b> Mepolizumab has been approved as a treatment option for severe eosinophilic asthma (SEA) patients in our country. We aimed to evaluate the clinical and functional efficacy of mepolizumab in this group of patients in real life as well as the response rates to mepolizumab and the possible factors affecting the response. <b><i>Methods:</i></b> The study was a retrospective chart review of patients with SEA treated with mepolizumab. The data were collected at baseline, and at the 6th and 12th month. <b><i>Results:</i></b> A total of 62 patients (41F/21M) with a mean age of 44.41 ± 13.24 years were included in the study. They had poor symptom control with a mean asthma control test (ACT) score of 16.61 ± 5.59, frequent exacerbations with a mean of 3.4 ± 3.7 in the previous 12 months, and 80.6% required daily oral corticosteroid (OCS) with a median dosage of 8 mg/day as methylprednisolone. The ACT score increased to 22.47 ± 3.18 and 22.03 ± 4.31, respectively, and blood eosinophil count decreased from 1,146/μL to 89/μL and 85/μL at the 6th and 12th month, respectively. The mean FEV1 at baseline was 2.102 L there was an increase of 0.373 L at 6th month and 0.596 L at 12th month. The percentage of regular users of OCS decreased to 66.0% at 6th month with a median dosage of 4 mg and 52.6% at 12th month with a median dosage of 2 mg. Mepolizumab reduced the rate of exacerbations compared with the previous year from a mean of 3.40 to 0.15 at 6th month and 0.36 at 12th month. There was a significant improvement in Asthma Quality of Life Questionnaire (AQLQ), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Sino-nasal Outcome Test (SNOT-22) scores at both of time points. The rate of responders and super-responders at 6th month was 60% and 28%, respectively, and consequently, the overall response rate was 88%. At the 12th month, the super-responder rate increased to 44.7% as well as the overall response to 89.4%. The only difference between the nonresponders, responders, and super-responders at the 6th and 12th month was whether regular daily OCS was used pre-mepolizumab. All nonresponders at both 6th and 12th month were using OCS regularly, whereas most of super-responder used the OCS only during exacerbations. <b><i>Conclusion:</i></b> Mepolizumab effectively reduced asthma exacerbations, steroid requirement, blood eosinophil counts and improved asthma control, pulmonary function, sinonasal symptoms and quality of life. Our data suggest that mepolizumab would be effective in selected patients in real-life settings.