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2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 1-1
Author(s):  
Manali I. Patel ◽  
Sana Indravadan Khateeb ◽  
Ivana Krajcinovic ◽  
Deb Salava ◽  
Tumaini Coker

1 Background: Low-income and minority populations have disproportionately less activation in their cancer care, worse health-related quality of life (HrQOL), and greater acute care use than affluent and white populations. Community-based interventions are needed to improve patient experiences and quality of cancer care among these populations. We used community-based participatory methods to refine a previously tested intervention for use in Atlantic City NJ. The intervention, LEAPS, uses community health workers trained to activate patients to discuss advance care planning and their symptom burden with cancer clinicians and to connect patients with culturally-relevant community resources to overcome complications from social determinants of health. We conducted a randomized controlled trial of LEAPS in collaboration with a employer-union health fund. Members of the employer-union health fund with newly diagnosed with hematologic and solid tumor cancers were randomized to the 6-month intervention or to usual care. The objective was to determine if the intervention improved HrQOL at 4 months post-enrollment as compared to baseline more than usual care and secondarily the effect on change in patient activation at 4 months post-enrollment as compared to baseline and acute care use within 12 months post-enrollment. Methods: We conducted patient interviews to assess HrQOL and patient activation and obtained claims data for health care use. We used regression models to evaluate differences in health-related quality of life (validated Functional Assessment of Cancer Therapy-General) scores and patient activation (validated Patient Activation Measure) scores between groups over time and exact poisson regression adjusted for length of follow-up to compare emergency department and hospitalization utilization. Results: A total of 160 patients were consented and randomized into the study (80 intervention; 80 control). There were no differences in demographic or clinical factors across groups. The majority were non-white (74%), female (53%), mean age 57 years. The most common diagnoses were breast (31%) and lung (21%) cancer and the majority were diagnosed with stage 3 or 4 (63%). At 4 months, the intervention group had greater improvements in quality of life as compared to the control group (difference in difference: 9.56 p < 0.001), greater change in patient activation (difference in difference: 12.43 (p < 0.001)), and lower acute care use (hospital visits (1.10 (1.53) +/- 1.83 (1.31), p = 0.02) and emergency department use (1.2 (2.82) versus 3.47 (3.62) p = 0.03). Conclusions: Integration of community-based interventions into cancer care for low-income and minority populations may be a more effective and sustainable way to ensure equitable cancer care. Clinical trial information: NCT03699748.


Author(s):  
Tran Thu Ngan ◽  
Vu Quynh Mai ◽  
Hoang Van Minh ◽  
Michael Donnelly ◽  
Ciaran O’Neill

Abstract Purpose This study compared the health-related quality of life (HRQoL) of breast cancer (BC) patients, survivors, and age-matched women from the general population in Vietnam to address the paucity of HRQoL research and contribute to the robust assessment of BC screening and care in Vietnam. Methods The standardised EQ-5D-5L instrument was incorporated in an online survey and a hospital-based face-to-face survey, and together with data from the Vietnam EQ-5D-5L norms study. χ2 tests assessed EQ-5D health profile associations and a Tobit regression model investigated the association between overall health status (EQ-VAS/utility scores) and sociodemographic and clinical characteristics. Results A total of 309 participants (107 patients undergoing treatment and 202 survivors who had completed treatment) provided usable responses. The dimensions that affected mostly the HRQoL of women with BC were pain/discomfort and anxiety/depression. Current patients and survivors differed significantly regarding HRQoL dimensions of mobility, self-care, usual activities, and anxiety/depression. Their health utilities were 0.74 and 0.84, respectively, compared with 0.91 for age-matched Vietnamese women in the general population (p < 0.001). Treatment status (survivor vs patient), younger age, higher monthly household income, and higher education levels were associated with higher health utility. Conclusions The results point to unmet needs in mental health support and well-being and for attention to be given to the development of a biopsychosocial system of cancer diagnosis, treatment, and care. The results will also inform future assessments of the comparative value for money of interventions intended to impact on breast cancer in Vietnam.


2021 ◽  
Vol 10 (18) ◽  
pp. 4231
Author(s):  
Ji-Young Lee ◽  
Jin-Ho Kim ◽  
Tae-Yoon La ◽  
Jin-A Choi

Purpose: The aim of this study is to investigate the structure–function characteristics and vision-related quality of life (VR-QoL) in uveitic glaucoma (UG) compared with open-angle glaucoma (OAG). Method: The study included 69 patients with UG and 138 patients with primary open angle glaucoma, normal-tension glaucoma. A 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was used to evaluate the patients’ VR-QoL. The retinal nerve fiber layer thickness (RNFLT) was measured using optical coherence tomography, and the integrated visual field (IVF) was determined using the best location method. Results: There were no significant differences in the binocular IVF and mean deviation (MD) of the affected eye between the OAG and UG group, whereas the average RNFLT was significant thinner in the OAG group (p = 0.008). The patients with UG showed a significantly lower composite score and five subscales of the VFQ-25, compared with those with OAG (p < 0.05, for all, general linear model). Multivariate linear regression analyses showed that the composite score showed the strongest associations with the whole IVF (β = 1.240, p < 0.001) in the OAG group, whereas in the UG group, a significant association was seen only with the inferior VF of the affected eye (β = 0.596, p = 0.038). Conclusions: The eyes with UG exhibited distinctive structure–function characteristics and worse VR-QoL that differentiated them from OAG eyes.


2021 ◽  
Vol 34 (4) ◽  
pp. 420-429
Author(s):  
Jenna L. Shackleford ◽  
Regena Spratling ◽  
Susan J. Kelley

The purpose of this paper is to present a conceptual-theoretical-empirical model addressing variables associated with self-management of care and adherence to treatment and its relationship to health-related quality of life for adolescents with congenital heart disease. There is limited research on adolescents with congenital heart disease regarding the relationship between autonomy, relatedness, competence, self-management of care and adherence to treatment, and health-related quality of life. The proposed Health-Related Quality of Life and Transition of Adolescents With Congenital Heart Disease to Self-Manage in Adulthood model, adapted from the Self-Determination Theory, will help to better understand these relationships.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Hamid Reza Rostami ◽  
Malahat Akbarfahimi ◽  
Amin Ghaffari ◽  
Mohammad Kamali ◽  
Mehdi Rassafiani

Objective. This study is aimed at exploring the relationship between the work-related quality of life and job satisfaction among Iranian occupational therapists. Methods. In an analytical-descriptive, cross-sectional study, 322 occupational therapists were recruited through a convenient sampling. Inclusion criteria consisted of age between 22 and 50 years, at least one-year work experience, 24 hours of working per week as an occupational therapist, and membership of Iranian Occupation Therapy Association. After signing the informed consent and completing demographic information, each participant completed the Minnesota Satisfaction Questionnaire- Short Form (MSQ-SF) and work-related quality of life scale. Results. The highest quality of working life belonged to occupational therapists who were female, married, with an annual salary of more than 40000$ (compared to below 20000 $), and those with work experience between 5 and 12 years. There was a positive and significant relationship between work-related quality of life and job satisfaction. Work-related quality of life scores could significantly predict MSQ-SF scores ( β 1 = 0.54 , p < .001 ). Conclusions. The significantly positive relationship between work-related quality of life and job satisfaction suggests the importance of organizational programs for enhancing factors of work-related quality of life in order to improve job satisfaction and quality of life among Iranian occupational therapists.


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