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BACKGROUND: Numerous military soldiers have lost limbs as a result of the Syrian War. While there are variations between trauma-related amputations in military and civilian populations, both scenarios result in life-changing injuries. OBJECTIVE: To explore the relationship between body image, self-esteem, and quality of life (QOL) domains following trauma-related major amputation. It will be the first study in Syria on the correlation between self-esteem and body image. It will help improve our quality of care to meet patient needs and increase well-being, which in turn will help to address body image, self-esteem, and QOL. METHOD: A cross-sectional study that recruited 235 soldiers with amputations in two centers and two military hospitals in Latakia and Tartous. Patients were given an 81-item questionnaire that included the Amputee Body-Image Scale (ABIS), the Rosenberg Self-esteem (RSE) scale, the WHOQOL-BREF questionnaire, and unidimensional pain measures. The ANOVA test, a student's t-test, multiple linear regression, internal consistency, and test-retest reliability were utilized for statistical analysis. RESULTS: There was a strong relationship between body image, self-esteem, and QOL, with the presence of body image concerns significantly associated with lower self-esteem scores and lower QOL scores (p=0.001). Patients with phantom pain sensation had significantly reduced self-esteem (p =0.001), greater body image concerns (p =0.001), and lower scores in all domains of QOL. We found that body image and self-esteem impacted the psychological, social, and environmental domains. After controlling for pain level and number of co-morbid conditions, body image and self-esteem did not predict WHOQOL-BREF scores, with the exception of the environmental domain, where no pain and low self-esteem predicted better environmental domain scores. CONCLUSION: Patients' body image and self-esteem were greatly impacted by lower-limb amputations. Additionally, phantom pain further impacted self-esteem, body image, and QOL. The image of the body had a profound effect on psychological, social, and environmental domains, and self-esteem was influenced by almost all aspects of QOL.
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Imagen Corporal , Calidad de Vida , Autoimagen , Humanos , Imagen Corporal/psicología , Calidad de Vida/psicología , Masculino , Estudios Transversales , Adulto , Siria , Femenino , Encuestas y Cuestionarios , Amputados/psicología , Personal Militar/psicologíaRESUMEN
Background Structural stigma and institutionalised discrimination towards people living with HIV remain pervasive in many settings. However, qualitative explorations of experiences of stigma, health and social service engagement, and quality of life among people living with HIV in Singapore remain under-researched. Methods Semi-structured interviews were conducted with 73 participants in Singapore. These included 56 people living with HIV (30 men who have sex with men, 23 heterosexual men, and 3 women) and 17 stakeholders including healthcare professionals and other allied workers. Interviews focused on participant perspectives or experiences of HIV diagnosis, navigating healthcare, attitudes towards HIV, and impact of HIV on relationships. Data were analysed through inductive thematic analysis. Results Our findings were framed within a minority stress model, highlighting the distal and proximal stressors relating to living with HIV. With regard to distal stressors, participants highlighted that they had experienced or were aware of institutionalised discrimination towards people living with HIV across various aspects of their lives. These included experiences - overt and covert - of discrimination in education, workplace, and healthcare settings. With regard to proximal stressors, participants highlighted the role of anticipated stigma and the stress of concealment. This included participants' fear of potential legal and/or social repercussions resulting from the disclosure of their HIV status, actions that they may not be able to anticipate and articulate. Although employers may not overtly discriminate, the fear of such anticipated discrimination influenced decisions to conceal HIV status in job applications and workplaces. This restricted agency for the people living with HIV in our study by affecting their regular medical follow-ups, socialising behaviours, and overall quality of life. Consequently, many participants felt that concealment of their status, and forgoing potential educational, employment, and even health opportunities, were the only ways of protecting themselves from such forms of stigma and discrimination. Conclusions This study found that anticipated stigma and discrimination diminished the quality of life of people living with HIV in Singapore. Implementing an anti-discrimination framework could address the unpredictability and alleviate the manifold unknowns of anticipated stigma.
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Miedo , Infecciones por VIH , Calidad de Vida , Estigma Social , Estrés Psicológico , Humanos , Masculino , Singapur , Infecciones por VIH/psicología , Femenino , Calidad de Vida/psicología , Adulto , Estrés Psicológico/psicología , Miedo/psicología , Persona de Mediana Edad , Investigación Cualitativa , Discriminación Social/psicologíaRESUMEN
OBJECTIVE: Analyze the influence of oral hygiene guidance for the maintenance of fixed partial dentures (FPD) and the influence of this treatment on the quality of life (QL) of rehabilitated patients. MATERIAL AND METHODS: The Simplified Oral Hygiene Index (OHI-S) and Bleeding on Probing Index (BOP) methods was employed to evaluate oral hygiene (OH), and the OHIP-14 questionnaire to assessment QL. The sample consisted of 33 patients (26 females and 7 males, mean age 51.53 years) in treatment with FPD. The OH and QL assessments were conducted in temporary FPD placing session and 30 days after definitive cementation. R e s u l t s: OHI-S and BOP showed increasing results (p <0.05) comparing initial and final assessments. There was a negative correlation between OHI-S and BOP, in both periods of analysis. The OHIP-14 showed a significant result according to the Likert scale scores, with an impact reduction from 9.33 to 0.57. CONCLUSIONS: It was concluded that FPD rehabilitations need of properly oral hygiene guidance, that could be influence on oral health status. In addition, the FPD rehabilitation improved the QL of the patients.
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Dentadura Parcial Fija , Salud Bucal , Higiene Bucal , Calidad de Vida , Humanos , Femenino , Calidad de Vida/psicología , Masculino , Persona de Mediana Edad , Adulto , Índice de Higiene Oral , Anciano , Encuestas y CuestionariosRESUMEN
BACKGROUND: N-methyl-D-aspartate-receptor (NMDAR) encephalitis is a rare neurological autoimmune disease with severe neuropsychiatric symptoms during the acute phase. Despite good functional neurological recovery, most patients continue to experience cognitive, psychiatric, psychological, and social impairments years after the acute phase. However, the precise nature and evolving patterns over time of these long-term consequences remain unclear, and their implications for the well-being and quality of life of predominantly young patients have yet to be thoroughly examined. METHODS: SAPIENCE is a European multi-center (n = 3) prospective observational cohort study studying the long-term cognitive, psychiatric, psychological, and social outcome in patients with NMDAR encephalitis. The study consists of three interconnected levels. Level 1 comprises a qualitative interview and focus groups with patients and their caregivers. Level 2 consists of a condensed form of the interview, standardized questionnaires, and a detailed neuropsychological examination of patients. Level 3 involves an online survey that will be open to patients world-wide and explores patient-reported outcomes (PROMs), and patient-reported experiences (PREMs) in association with clinical and cognitive outcomes. Levels 1 to 3 will progressively contribute developing of structured interviews, survey questions, and treatment guidelines by informing one another. DISCUSSION: SAPIENCE is an in-depth study of the long-term effects of NMDAR encephalitis and bridges the gap between standardized assessments and individual patient experiences, intending to improve patient care and to increase awareness of the psychosocial long-term consequences of the disease. Through collaboration of experts in clinical neurology and social and health psychology across Europe, SAPIENCE aims to create online assessment tools and formulate guidelines for patient-centered post-acute care that will help enhance the quality of life for patients and caregivers.
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Encefalitis Antirreceptor N-Metil-D-Aspartato , Humanos , Encefalitis Antirreceptor N-Metil-D-Aspartato/psicología , Encefalitis Antirreceptor N-Metil-D-Aspartato/complicaciones , Calidad de Vida/psicología , Estudios Prospectivos , Femenino , Estudios de Cohortes , Masculino , Europa (Continente)/epidemiología , Adulto , Pruebas Neuropsicológicas , Medición de Resultados Informados por el PacienteRESUMEN
AIM: This study aims to develop the Quality of Life in Pregnancy Scale (PREG-QOL) as a new instrument to evaluate the quality of life during pregnancy and test its psychometric properties. DESIGN: An instrument development study and psychometric testing of the content and construct validity, factor structure and reliability. METHODS: The study was conducted in three stages: (1) creating an item pool, (2) preliminary evaluation of items, and (3) refining the scale and evaluating psychometric properties. Instrument development guidelines were used to evaluate content validity, construct validity, internal consistency and stability of the instrument over time. Data to evaluate psychometric properties of the PREG-QOL were collected between April and August 2021. RESULTS: Items were developed using in-depth interviews with pregnant women and extensive literature review. Scale-content validity index was 0.98. Exploratory factor analysis revealed a 26-item instrument with 6 factors, which explained % 56.2 of variance. Confirmatory factor analysis (CFA) showed that factors 3 and 5 should be combined into the factor of physical domain since they included items about the same theme. Fit indices obtained by CFA were at sufficient levels. Parallel test method was employed to evaluate the correlation of the PREG-QOL with the SF-36. The findings indicated that the PREG-QOL had high internal inconsistency and stability over time. CONCLUSION: The PREG-QOL is a valid and reliable instrument in terms of its psychometric characteristics. The 26-item instrument was composed of the five factors of perception of general satisfaction, emotional domain, physical domain, health support systems and social domain. IMPACT: Displaying good psychometric properties, the PREG-QOL may be used to evaluate multiple dimensions of the quality of life during pregnancy.
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Psicometría , Calidad de Vida , Humanos , Femenino , Calidad de Vida/psicología , Embarazo , Adulto , Reproducibilidad de los Resultados , Encuestas y Cuestionarios/normas , Análisis Factorial , Mujeres Embarazadas/psicología , Adulto JovenRESUMEN
PURPOSE: This study aimed to develop a Quality of Life (QOL) assessment scale for older patients with Neuro-co-Cardiological Diseases (NCCD) and to evaluate the reliability and validity of the scale. METHOD: The study participants were derived from the Elderly Individuals with NCCD Registered Cohort Study (EINCCDRCS), a multicenter registry of patients with NCCD. The preliminary testing of the questionnaire was conducted among 10 older individuals aged 65 years and older who had NCCD and were recruited from the registry. Other patients who met the inclusion criteria participated in the field testing. After verifying the unidimensionality, local independence, and monotonicity assumptions of the scale, we employed the Rasch model within Item Response Theory framework to assess the quality of the scale through methods including internal consistency, criterion validity, Wright map, and item functioning differential. Subsequently, we assessed the construct validity of the scale by combining exploratory factor analysis with confirmatory factor analysis. RESULTS: Based on well-validated scales such as the short-form WHOQOL-OLD, HeartQOL, IQCODE, and SF-36, an original Neuro-co-Cardiological Diseases Quality of Life scale (NCCDQOL) was developed. 196 individuals from the EINCCDRCS were included in the study, with 10 participating in the preliminary testing and 186 in the field testing. Based on the results of the preliminary testing, the original questionnaire was refined through item deletion and adjustment, resulting in an 11-item NCCDQOL questionnaire. The Rasch analysis of the field testing data led to the removal of 21 misfitting individuals. The NCCDQOL demonstrated a four-category structure, achieved by combining two response categories. This structure aligned with the assumptions of unidimensionality, local independence, and monotonicity. The NCCDQOL also exhibited good validity and reliability. CONCLUSION: The revised NCCDQOL questionnaire demonstrated good reliability and validity in the Rasch model, indicating promising potential for clinical application.
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Calidad de Vida , Humanos , Calidad de Vida/psicología , Anciano , Masculino , Femenino , Encuestas y Cuestionarios/normas , Estudios de Cohortes , Anciano de 80 o más Años , Enfermedades del Sistema Nervioso/psicología , Enfermedades del Sistema Nervioso/diagnóstico , Cardiopatías/psicología , Cardiopatías/diagnóstico , Reproducibilidad de los Resultados , Sistema de Registros , ComorbilidadRESUMEN
BACKGROUND: Diabetes-specific quality of life (QoL) questionnaires are commonly used to assess the impact of diabetes and its management on an individual's quality of life. While several valid and reliable measures of diabetes-specific QoL exist, there is no consensus on which to use and in what setting. Furthermore, there is limited evidence of their acceptability to people with diabetes. Our aim was to explore perceptions of adults with type 1 diabetes (T1D) toward five diabetes-specific QoL measures. METHODS: Adults (aged 18 + years) with T1D living in Australia or the United Kingdom (UK) were eligible to take part in 'YourSAY: QoL', an online cross-sectional survey. Recruitment involved study promotion on diabetes-related websites and social media, as well as direct invitation of people with T1D via a hospital client list (UK only). In random order, participants completed five diabetes-specific QoL measures: Audit of Diabetes-Dependent Quality of Life (ADDQoL-19); Diabetes Care Profile: Social and Personal Factors subscale (DCP); DAWN Impact of Diabetes Profile (DIDP); Diabetes-Specific Quality of Life Scale: Burden Subscale (DSQoLS); Diabetes Quality of Life Questionnaire (Diabetes QOL-Q). They were invited to provide feedback on each questionnaire in the form of a brief free-text response. Responses were analysed using inductive, thematic template analysis. RESULTS: Of the N = 1,946 adults with T1D who completed the survey, 20% (UK: n = 216, Australia: n = 168) provided qualitative responses about ≥ 1 measure. All measures received both positive and negative feedback, across four themes: (1) clarity and ease of completion, e.g., difficulty isolating impact of diabetes, dislike of hypothetical questions, and preference for 'not applicable' response options; (2) relevance and comprehensiveness, e.g., inclusion of a wide range of aspects of life to improve personal relevance; (3) length and repetition, e.g., length to be balanced against respondent burden; (4) framing and tone, e.g., preference for respectful language and avoidance of extremes. CONCLUSIONS: These findings suggest opportunities to improve the relevance and acceptability of existing diabetes-specific QoL measures, and offer considerations for developing new measures, which need to be better informed by the preferences of people living with diabetes.
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Diabetes Mellitus Tipo 1 , Investigación Cualitativa , Calidad de Vida , Humanos , Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 1/terapia , Calidad de Vida/psicología , Masculino , Femenino , Adulto , Estudios Transversales , Encuestas y Cuestionarios , Persona de Mediana Edad , Australia , Reino Unido , Adulto Joven , Adolescente , Anciano , Percepción , PsicometríaRESUMEN
BACKGROUND: Health-related quality of life (HRQoL) reflects an individual's perception of their physical and mental health over time. Despite numerous studies linking physical activity to improved HRQoL, most rely on self-reported data, limiting the accuracy and generalizability of findings. This study leverages objective accelerometer data to explore the association between physical activity and HRQoL in Korean adults. OBJECTIVE: The objective of this study is to analyze the relationship between objectively measured physical activity using accelerometers and HRQoL among Korean adults, aiming to inform targeted interventions for enhancing HRQoL through physical activity. METHODS: This observational study included 1298 participants aged 19-64 years from the Korea National Health and Nutrition Examination Survey (KNHANES) VI, who wore an accelerometer for 7 consecutive days. HRQoL was assessed using the EQ-5D questionnaire, and physical activity was quantified as moderate-to-vigorous physical activity accelerometer-total (MVPA-AT) and accelerometer-bout (MVPA-AB). Data were analyzed using logistic regression to determine the odds ratio (ORs) for low HRQoL, adjusting for socioeconomic variables and mental health factors. RESULTS: Participants with higher HRQoL were younger, more likely to be male, single, highly educated, employed in white-collar jobs, and had higher household incomes. They also reported less stress and better subjective health status. The high HRQoL group had significantly more participants meeting MVPA-AB ≥600 metabolic equivalents (P<.01). Logistic regression showed that participants meeting MVPA-AB ≥600 metabolic equivalents had higher odds of high HRQoL (OR 1.55, 95% CI 1.11-2.17). Adjusted models showed consistent results, although the association weakened when adjusting for mental health factors (OR 1.45, 95% CI 1.01-2.09). CONCLUSIONS: The study demonstrates a significant association between HRQoL and moderate to vigorous physical activity sustained for at least 10 minutes, as measured by accelerometer. These findings support promoting physical activity, particularly sustained moderate to vigorous activity, to enhance HRQoL. Further interventional studies focusing on specific physical activity domains such as occupational, leisure-time, and commuting activities are warranted.
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Acelerometría , Ejercicio Físico , Encuestas Nutricionales , Calidad de Vida , Humanos , Masculino , República de Corea/epidemiología , Adulto , Calidad de Vida/psicología , Ejercicio Físico/psicología , Femenino , Persona de Mediana Edad , Adulto Joven , Encuestas y CuestionariosRESUMEN
Existing research supports the therapeutic value of hope in different therapies and for diverse patient groups. Patients who are socially inhibited tend to have a particularly difficult time in group therapy, and the experience of hope in that context may be especially poignant for them. The present study investigated the impact of hope on the outcome of a group-based treatment and whether this impact differed for patients depending on their level of social inhibition. The sample consisted of 49 consecutively admitted patients who completed treatment in an intensive, integrative group therapy program. Patients completed four self-report measures to assess hope, social inhibition, quality of life, and depression. Regression with moderation analysis was employed. The analyses revealed that social inhibition significantly moderated the impact of hope on treatment outcome, indicating that hope had a more pronounced effect among those patients with relatively higher levels of social inhibition.
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Esperanza , Psicoterapia de Grupo , Humanos , Psicoterapia de Grupo/métodos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Inhibición Psicológica , Calidad de Vida/psicología , Resultado del Tratamiento , Depresión/terapia , Depresión/psicologíaRESUMEN
Background: Cognitive impairment and dementia pose a significant challenge to the aging population, impacting the well-being, quality of life, and autonomy of affected individuals. As the population ages, this will place enormous strain on health care and economic systems. While computerized cognitive training programs have demonstrated some promise in addressing cognitive decline, adherence to these interventions can be challenging. Objective: The objective of this study is to improve the accuracy of predicting adherence lapses to ultimately develop tailored adherence support systems to promote engagement with cognitive training among older adults. Methods: Data from 2 previously conducted cognitive training intervention studies were used to forecast adherence levels among older participants. Deep convolutional neural networks were used to leverage their feature learning capabilities and predict adherence patterns based on past behavior. Domain adaptation (DA) was used to address the challenge of limited training data for each participant, by using data from other participants with similar playing patterns. Time series data were converted into image format using Gramian angular fields, to facilitate clustering of participants during DA. To the best of our knowledge, this is the first effort to use DA techniques to predict older adults' daily adherence to cognitive training programs. Results: Our results demonstrated the promise and potential of deep neural networks and DA for predicting adherence lapses. In all 3 studies, using 2 independent datasets, DA consistently produced the best accuracy values. Conclusions: Our findings highlight that deep learning and DA techniques can aid in the development of adherence support systems for computerized cognitive training, as well as for other interventions aimed at improving health, cognition, and well-being. These techniques can improve engagement and maximize the benefits of such interventions, ultimately enhancing the quality of life of individuals at risk for cognitive impairments. This research informs the development of more effective interventions, benefiting individuals and society by improving conditions associated with aging.
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Disfunción Cognitiva , Aprendizaje Profundo , Humanos , Anciano , Femenino , Masculino , Disfunción Cognitiva/psicología , Disfunción Cognitiva/terapia , Anciano de 80 o más Años , Cooperación del Paciente/psicología , Calidad de Vida/psicología , Entrenamiento CognitivoRESUMEN
AIM: To the determinants and the underlying mechanism of health literacy, social support, and resilience on the health-related quality of life (HRQoL) among older stroke survivors. DESIGN: A cross-sectional design was applied at four comprehensive hospitals in Chongqing via convenience sampling from January 2020 to June 2021. METHODS: Health literacy, social support, and resilience were designed as independent variables, and HRQoL was measured as a dependent variable. Structural equation modelling with the bootstrap method was used to test the hypotheses. RESULTS: The theoretically derived model exhibited a good fit (χ2/df ratio = 2.830, GFI = 0.987, CFI = 0.978, RMSEA = 0.066). Health literacy (ß = 0.12, p < 0.05) and social support (ß = 0.14, p < 0.05) directly affect HRQoL. Resilience (ß = 0.40, p < 0.01) also mediated the relationship between health literacy, social support, and HRQoL. The three variables explaining 29.0% of HRQoL variance. PATIENT OR PUBLIC CONTRIBUTION: There was no direct patient or public involvement in the design, conduct, or reporting of this study. Participants were recruited through convenience sampling from four comprehensive hospitals in Chongqing, and their perspectives or contributions were not explicitly sought. The study focused on examining the determinants and underlying mechanism of health literacy, social support, and resilience on the health-related quality of life among older stroke survivors. Nonetheless, the findings of this research may inform the development of interventions aimed at improving the health-related quality of life in post-stroke older patients.
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Alfabetización en Salud , Calidad de Vida , Resiliencia Psicológica , Apoyo Social , Accidente Cerebrovascular , Sobrevivientes , Humanos , Calidad de Vida/psicología , Femenino , Masculino , Anciano , Estudios Transversales , Accidente Cerebrovascular/psicología , Sobrevivientes/psicología , Análisis de Clases Latentes , Anciano de 80 o más Años , Encuestas y Cuestionarios , China , Persona de Mediana EdadRESUMEN
The study aimed to determine whether self-efficacy acts as a moderator between the severity of menopausal symptoms and life satisfaction. The research tools were: The Generalized Self-Efficacy Scale (GSES), The Satisfaction with Life Scale (SWLS) The Menopause - Specific Quality of Life (MENQOL), and a standardized questionnaire comprising questions on the participants' characteristics. 516 women using health care services who had menopausal symptoms took part in the study. Self-efficacy (GSES) (r = -0.176; p < 0.001) and life satisfaction (SWLS) (r = -0.106; p = 0.016) were negatively correlated with the severity of menopausal symptoms (MENQOL). The self-efficacy correlated positively with satisfaction with life (r = 0.278; p < 0.001). A low level of self-efficacy was associated with a significant and negative relationship between the severity of menopausal symptoms and satisfaction with life (p = 0.005), while at a high and moderate level of self-efficacy, the severity of menopausal symptoms was not associated with life satisfaction (p > 0.05). Self-efficacy moderates the relationship between the severity of menopausal symptoms and life satisfaction in menopausal women. The moderating function of self-efficacy is that, at its low level, an increase in the severity of menopausal symptoms reduces life satisfaction, while at medium and high levels, an increase in the severity of menopausal symptoms does not reduce life satisfaction.
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Menopausia , Satisfacción Personal , Calidad de Vida , Autoeficacia , Humanos , Femenino , Menopausia/psicología , Menopausia/fisiología , Persona de Mediana Edad , Calidad de Vida/psicología , Encuestas y Cuestionarios , Índice de Severidad de la Enfermedad , Adulto , AncianoRESUMEN
Background: While there are benefits to women entering the workforce, there are also drawbacks, such as stress, anxiety, and depression, which can lower quality of life. However, some research indicates that women's spiritual health may be a protective factor in these situations. This study is to explore the relationship between spiritual health and quality of life, stress, anxiety, and depression among a population of women working in health care centers, given the existence of such a relationship among women. Methods: In 2022, 500 women who worked in health centers in Izeh City, Iran, participated in this cross-sectional survey. The clustered census sampling approach was used for the sample. The research participants completed a 12-item quality of life questionnaire on spiritual health, stress, anxiety, and depression as part of the data gathering process. The data were examined using independent t tests, one-way variance, and Pearson correlation after being entered into SPSS-24. Results: Of the participants, 18% were single and 68% were married. In terms of depression, stress, and anxiety, the mean and standard deviation were 8.26 ± 5.78, 11.26 ± 4.89, and 7.91 ± 0.98, respectively. The quality of life had a mean and standard deviation of 30.82 ± 3.56. Women who were unmarried and had more work experience reported a considerably greater quality of life (p < 0.05). The findings indicated that stress and spiritual health (p = 0.001), anxiety and spiritual health (p = 0.032), and depression and spiritual health (p = 0.024) all had a significant and inverse association. Furthermore, a strong and positive correlation was found (p = 0.001) between spiritual health and quality of life. Conclusion: The study's conclusions demonstrated a clear link between spiritual health and life satisfaction, suggesting that working women's quality of life may be raised by treatments that support spiritual health. Furthermore, the findings demonstrated a significant inverse relationship between spiritual health and the psychological variables of stress, anxiety, and depression. This suggests that by understanding the factors influencing mental health and the role of spiritual health moderator, it may be possible to improve the psychological state of employed women.
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Ansiedad , Depresión , Calidad de Vida , Espiritualidad , Estrés Psicológico , Humanos , Femenino , Calidad de Vida/psicología , Irán , Estudios Transversales , Adulto , Depresión/psicología , Depresión/epidemiología , Estrés Psicológico/psicología , Ansiedad/psicología , Encuestas y Cuestionarios , Persona de Mediana Edad , Mujeres Trabajadoras/psicología , Mujeres Trabajadoras/estadística & datos numéricosRESUMEN
Heart failure is a complex clinical manifestation due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). Diastolic dysfunction of the LV plays an important role in worsening the quality of life (QoL) in heart failure patients. The aim of this study was to assess the relationship between the severity or grade of LV diastolic dysfunction and QoL in heart failure with reduced ejection fraction (HFrEF) patients. A retrospective cohort study was conducted at the Cardiac Center of H. Adam Malik Hospital, Medan, Indonesia, from January 2022 to December 2022. This study included inpatients and outpatients aged above 18 years who were diagnosed with HFrEF, identified by echocardiography with an ejection fraction of ≤40%. Echocardiography was performed to evaluate left ventricular diastolic dysfunction, and QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) 6-12 months after the severity of LV diastolic dysfunction was confirmed. The MLHFQ was classified into good and poor QoL. The severity of LV diastolic function was measured using the E/A ratio, mean E/e' ratio, tricuspid regurgitation velocity (TR Vmax), and left atrial volume index (LAVI), and was classified into grades I, II, and III. The relationships between the severity of diastolic dysfunction and other factors with QoL were measured using Chi-squared, Fisher's exact test, or Mann-Whitney test, as appropriate. A total of 96 patients were included in the study, of which 56 (58.3%) patients had grade I, 12 (12.5%) had grade II, and 28 (29.2%) patients had grade III of LV diastolic dysfunction. There were 77 (80.2%) and 19 (19.8%) patients with good and poor QoL, respectively. This study revealed a significant relationship between the severity of LV diastolic dysfunction and QoL in HFrEF patients with p=0.040. In conclusion, the degree of LV diastolic dysfunction is related to the QoL of HFrEF patients and therefore better comprehensive management strategies should be considered in HFrEF cases to address the impact of LV diastolic dysfunction on QoL.
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Ecocardiografía , Insuficiencia Cardíaca , Calidad de Vida , Volumen Sistólico , Disfunción Ventricular Izquierda , Humanos , Masculino , Calidad de Vida/psicología , Femenino , Disfunción Ventricular Izquierda/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Persona de Mediana Edad , Estudios Retrospectivos , Volumen Sistólico/fisiología , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/psicología , Insuficiencia Cardíaca/complicaciones , Anciano , Indonesia/epidemiología , Encuestas y Cuestionarios , Adulto , Índice de Severidad de la Enfermedad , Diástole/fisiologíaRESUMEN
Fall is the leading cause of disability and mortality due to unintentional injury in older adults. The aim of this study was to determine the prevalence and risk factors associated with knee pain, fear of falling, and quality of life among community-dwelling older adults in Northern Thailand. A cross-sectional study was conducted among older adults aged 60 and over. A total of 369 participants were enrolled from April to May 2024. Oxford knee score, a short version of the Falls Efficacy Scale International (FES-I) and World Health Organization quality of life-BREF-Thai, was measured. The results showed that the mean age was 69.4 years and 47 (12.7%) had a history of falls in the previous year. The prevalence of fear of falling was 39.3% for low, 22.5% for moderate, and 38.2% for high concern. Age, marital status, alcohol, history of falls, hypertension, arthritis, and osteoporosis were associated with fear of falling. After adjusting to age, gender, body mass index, education, marital status, smoking, alcohol, history of falls, and chronic disease, osteoarthritis of the knee was positively associated with increasing fear of falling (ß: 0.361; p<0.001), while quality of life was negatively associated with fear of falling (ß: -0.064; p<0.011). In conclusion, the identified determinants of fear of falling among the elderly indicated the need for fear of falling prevention programs targeting not only individual lifestyles but also chronic diseases. This study provides useful information that might help to develop and adopt effective policies for fear of falling control in Thailand.
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Accidentes por Caídas , Miedo , Vida Independiente , Calidad de Vida , Humanos , Accidentes por Caídas/prevención & control , Tailandia/epidemiología , Anciano , Masculino , Calidad de Vida/psicología , Femenino , Miedo/psicología , Estudios Transversales , Vida Independiente/psicología , Persona de Mediana Edad , Factores de Riesgo , Prevalencia , Anciano de 80 o más Años , Artralgia/psicología , Artralgia/epidemiologíaRESUMEN
Introduction: Neurofibromatosis type 1 (NF1) is a rare genetic disorder, with lack of evidence of disease burden in China. We aimed to describe the economic burden, health-related quality of life (HRQL), and caregiver burden of NF1 patients in China. Methods: We conducted an online cross-sectional survey employing the China Cloud Platform for Rare Diseases, with 223 caregivers of NF1 pediatric patients (patients under 18), and 226 adult patients. Economic burden was estimated using direct and indirect costs related to NF1 in 2021, and the Work Productivity and Activity Impairment Questionnaire: General Health V2.0 (WPAI-GH). HRQL measures included EQ-5D-Y proxy version and PedsQL™ 4.0 Generic Core Scales (PedsQL GCS) proxy version for pediatric patients, and EQ-5D-5L and PedsQL™ 3.0 Neurofibromatosis Module (PedsQL NFM) for adult patients. Caregiver burden was estimated by Zarit Burden Interview (ZBI). Results: For pediatric patients, the average direct cost in 2021 was CNY 33,614 (USD 4,879), and employed caregivers' annual productivity loss was 81 days. EQ-5D-Y utility was 0.880 ± 0.13 and VAS score was 75.38 ± 20.67, with 52.6% patients reporting having problems in "pain/discomfort" and 42.9% in "anxiety/depression." PedsQL GCS total score was 68.47 ± 19.42. ZBI score demonstrated that 39.5% of caregivers had moderate-to-severe or severe burden. For adult patients, average direct cost in 2021 was CNY 24,531 (USD 3,560). Patients in employment reported an absenteeism of 8.5% and presenteeism of 21.6% according to the results of WPAI-GH. EQ-5D-5L utility was 0.843 ± 0.17 and VAS score was 72.32 ± 23.49, with more than half of patients reporting having problems in "pain/discomfort" and "anxiety/depression" dimensions. PedsQL NFM total score was 68.40 ± 15.57. Conclusion: Both pediatric and adult NF1 patients in China had a wide-ranging economic burden and low HRQL, especially in the psychological dimension. Caregivers for NF1 pediatric patients experienced considerable caregiver burden. More attention and support from policymakers and stakeholders are required to relieve NF1 patients' and caregivers' distress.
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Carga del Cuidador , Costo de Enfermedad , Neurofibromatosis 1 , Calidad de Vida , Humanos , Calidad de Vida/psicología , China , Neurofibromatosis 1/psicología , Masculino , Femenino , Estudios Transversales , Adulto , Niño , Adolescente , Carga del Cuidador/psicología , Encuestas y Cuestionarios , Persona de Mediana Edad , Cuidadores/psicología , Cuidadores/estadística & datos numéricos , Cuidadores/economía , Adulto Joven , PreescolarRESUMEN
Objectives: This study aimed to determine the health-related quality of life (HRQoL) of adult Omani patients with sickle cell disease (SCD). The quality of life of these patients in Oman is unknown. Methods: This cross-sectional study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, from June to October 2022 and included patients with SCD. A validated Arabic version of the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL in 8 domains. Results: A total of 235 patients with SCD were included in this study, the majority of whom were female (74.9%) and between 18 and 35 years of age (64.6%). The lowest HRQoL was reported for the domain of role limitations due to physical health (median score = 25.0, interquartile range [IQR] = 35.0), while the highest was seen for role limitations due to emotional problems (median score = 66.7, IQR = 100.0). Frequent SCD-related emergency department visits/hospital admissions and the adverse effect of SCD on patients' social lives had a significant negative impact on SF-36 scores for all 8 HRQoL domains (P ≤0.05). Additionally, SCD's impact on academic performance and a history of having been bullied due to SCD had a significant negative impact on SF-36 scores for 7 domains (P ≤0.05). Conclusion: Omani adult patients with SCD reported relatively poor HRQoL in several domains, with various factors found to be significantly associated with this. Healthcare providers and policy makers should consider offering additional clinical, educational and financial support to these patients to enhance their HRQoL.
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Anemia de Células Falciformes , Hospitales Universitarios , Calidad de Vida , Humanos , Calidad de Vida/psicología , Anemia de Células Falciformes/psicología , Anemia de Células Falciformes/epidemiología , Omán/epidemiología , Masculino , Femenino , Adulto , Estudios Transversales , Adolescente , Hospitales Universitarios/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven , Persona de Mediana EdadRESUMEN
Aim: To study the longitudinal relationship between loneliness and quality of life (QoL) in adults to identify key mechanisms to better design future psychosocial interventions. Method: 13,222 participants from three consecutive waves of the Survey of Health, Ageing, and Retirement in Europe (SHARE), aged 65 or older, 56.3% women. They were analyzed using cross-lagged panel model (CLPM), random intercept cross-lagged panel model (RI-CLPM), and multi-group models disaggregated by gender. Results: The RI-CLPM provided a better fit than the CLPM. Both models showed the stability of QoL and loneliness. All autoregressive paths were significant, and a negative association between concurrent QoL and loneliness was observed across all waves. The CLPM supported a reciprocal relationship, while the RI-CLPM only confirmed the effects of loneliness on QoL. Women reported higher levels of loneliness and poorer QoL, but no gender differences were identified in the longitudinal association. Conclusions: Addressing loneliness in early stages could be a better preventive measure to promote quality of life in both genders.
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Soledad , Calidad de Vida , Humanos , Soledad/psicología , Calidad de Vida/psicología , Femenino , Masculino , Anciano , Estudios Longitudinales , Europa (Continente)/epidemiología , Anciano de 80 o más Años , Factores Sexuales , Envejecimiento/psicologíaRESUMEN
BACKGROUND: The main objective of this study was to examine the burden of schizophrenia, depression, Alzheimer's disease/dementia, and stroke on caregivers and non-caregivers in Japan. This study also aimed to provide a comparative landscape on the burden of caregiving for each disorder. METHODS: The Japan National Health and Wellness Survey database, 2016 and 2018 was used in this study. Health-related quality of life (HRQoL), work productivity, and health care utilization were assessed using a self-administered, Internet-based questionnaire. The burden of caregiving experienced by each group of caregivers was compared with background-matched non-caregivers (controls) as well as with caregivers of patients with each disorder. RESULTS: Caregivers of patients with schizophrenia, depression, Alzheimer's disease/dementia, or stroke had lower HRQoL, higher healthcare costs and work productivity impairment than non-caregivers. Furthermore, caregivers of patients with psychiatric disorders such as schizophrenia and depression had lower HRQoL and work productivity than caregivers of patients with Alzheimer's disease/dementia and stroke. In addition, according to the Caregiver Reaction Assessment (CRA), caregivers of patients with schizophrenia and depression were more inclined to perceive a loss in physical strength and financial burden to the same extent as their self-esteem. CONCLUSIONS: This study indicated a substantial caregiving burden among caregivers of patients with psychiatric and neurological diseases in Japan. The caregiver burden of psychiatric disorders (schizophrenia and depression) was greater than that of neurological disorders (Alzheimer's disease/dementia and stroke), suggesting a need to provide support to caregivers of patients with psychiatric disorders to be better able to care for their patients. TRIAL REGISTRATION: None.
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Cuidadores , Demencia , Calidad de Vida , Esquizofrenia , Accidente Cerebrovascular , Humanos , Calidad de Vida/psicología , Masculino , Japón , Femenino , Esquizofrenia/enfermería , Persona de Mediana Edad , Cuidadores/psicología , Adulto , Accidente Cerebrovascular/psicología , Accidente Cerebrovascular/enfermería , Accidente Cerebrovascular/economía , Demencia/enfermería , Demencia/psicología , Eficiencia , Anciano , Depresión/psicología , Costo de Enfermedad , Carga del Cuidador/psicología , Enfermedad de Alzheimer/psicología , Enfermedad de Alzheimer/enfermeríaRESUMEN
Importance: Robotic exoskeletons leverage technology that assists people with spinal cord injury (SCI) to walk. The efficacy of home and community exoskeletal use has not been studied in a randomized clinical trial (RCT). Objective: To examine whether use of a wheelchair plus an exoskeleton compared with use of only a wheelchair led to clinically meaningful net improvements in patient-reported outcomes for mental and physical health. Design, Setting, and Participants: This RCT of veterans with SCI was conducted at 15 Veterans Affairs medical centers in the US from September 6, 2016, to September 27, 2021. Data analysis was performed from March 10, 2022, to June 20, 2024. Interventions: Participants were randomized (1:1) to standard of care (SOC) wheelchair use or SOC plus at-will use of a US Food and Drug Administration (FDA)-cleared exoskeletal-assisted walking (EAW) device for 4 months in the home and community. Main Outcomes and Measures: Two primary outcomes were studied: 4.0-point or greater improvement in the mental component summary score on the Veterans RAND 36-Item Health Survey (MCS/VR-36) and 10% improvement in the total T score of the Spinal Cord Injury-Quality of Life (SCI-QOL) physical and medical health domain and reported as the proportion who achieved clinically meaningful changes. The primary outcomes were measured at baseline, post randomization after advanced EAW training sessions, and at 2 months and 4 months (primary end point) in the intervention period. Device usage, reasons for not using, and adverse events were collected. Results: A total of 161 veterans with SCI were randomized to the EAW (n = 78) or SOC (n = 83) group; 151 (94%) were male, the median age was 47 (IQR, 35-56) years, and median time since SCI was 7.3 (IQR, 0.5 to 46.5) years. The difference in proportion of successes between the EAW and SOC groups on the MCS/VR-36 (12 of 78 [15.4%] vs 14 of 83 [16.9%]; relative risk, 0.91; 95% CI, 0.45-1.85) and SCI-QOL physical and medical health domain (10 of 78 [12.8%] vs 11 of 83 [13.3%]; relative risk, 0.97; 95% CI, 0.44-2.15) was not statistically different. Device use was lower than expected (mean [SD] distance, 1.53 [0.02] miles per month), primarily due to the FDA-mandated companion being unavailable 43.9% of the time (177 of 403 instances). Two EAW-related foot fractures and 9 unrelated fractures (mostly during wheelchair transfers) were reported. Conclusions and Relevance: In this RCT of veterans with SCI, the lack of improved outcomes with EAW device use may have been related to the relatively low device usage. Solutions for companion requirements and user-friendly technological adaptations should be considered for improved personal use of these devices. Trial Registration: ClinicalTrials.gov Identifier: NCT02658656.