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Li Z, Wang X, Ying Y, Li X, Zhu W, Meng C, Han G, Liu J, Wang J, Huang Y, Yang K, Zhang P, Zhu H, Guan H, Li X, Zhou L. Health-related quality of life (HRQoL), anxiety and depression in patients with ureteral stricture: a multi-institutional study. World J Urol 2023; 41:275-281. [PMID: 36469114 DOI: 10.1007/s00345-022-04227-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate health-related quality of life (HRQoL), anxiety and depression levels in patients with ureteral stricture (US) and to further investigate factors independently affecting this. METHODS We prospectively recruited a cohort of 275 consecutive patients with US between June 2020 and April 2021. The participants were required to provide complete sociodemographic, clinical and pathologic information. All patients were administered questionnaires to evaluate HRQoL, anxiety and depression. Multivariate linear regression analyses were performed to assess the contribution of covariates on HRQoL, anxiety and depression. RESULTS Patients with US, particularly iatrogenic US, scored significantly lower than the Chinese general population in all domains of the SF-36 (all p < 0.001), except SF. Increased age, female and high education attainment were independently associated with poor HRQoL. Interestingly, iatrogenic US, nephrostomy tube placement, urinary symptoms, high anxiety and depression level independently predicted poor HRQoL. Furthermore, the percentages of anxiety and depression cases in patients with US were 31.3% and 20.7%, respectively. Iatrogenic US and urinary symptoms, specifically waist discomfort, were the strongest predictors of increased levels of anxiety and depression. CONCLUSION Patients with US exhibited poor quality of life and emotional status. Various factors independently predicted worse HRQoL and emotion, which provide potential targets for medical, lifestyle-related, psychological interventions.
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Affiliation(s)
- Zhihua Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.,Department of Nursing, Peking University First Hospital, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Xiang Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Yicen Ying
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Xinfei Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Weijie Zhu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Chang Meng
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Guanpeng Han
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jing Liu
- Department of Urology, Beijing Jiangong Hospital, No. 6 Rufuli St, Xicheng District, Beijing, 100034, China
| | - Jie Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Yanbo Huang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.,Department of Nursing, Peking University First Hospital, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Peng Zhang
- Department of Urology, Emergency General Hospital, No. 29 Xibahenanli St, Chaoyang District, Beijing, 100020, China
| | - Hongjian Zhu
- Department of Urology, Beijing Jiangong Hospital, No. 6 Rufuli St, Xicheng District, Beijing, 100034, China
| | - Hua Guan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.,Department of Nursing, Peking University First Hospital, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
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Raveendran L, Koyle M, Bagli D, Twardowski K, Cicci N, Ronen GM, Sawin KJ, Szymanski KM. Integrative review and evaluation of quality of life related instruments in pediatric urology. J Pediatr Urol 2021; 17:443.e1-443.e14. [PMID: 33832872 DOI: 10.1016/j.jpurol.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION While most paediatric urologists consider patients' quality of life (QOL) important, few actually measure this outcome. Our goal was to assess instruments used in the pediatric urology QOL literature, specifically looking at whether they captured QOL. METHODS We searched MEDLINE and EMBASE for articles with a self-described primary outcome of measuring QOL. All validated QOL instruments in the papers were analyzed by QOL instrument content experts. Instruments were classified as focusing on: Functioning or QOL (Table). The term Functioning focuses on performing activities. QOL captures person's perceptions about their position in life, informed by circumstances, functioning and conditions. QOL instruments were further subdivided into generic QOL, health-related QOL (HRQOL) and disease-specific HRQOL. Only direct patient self-reported QOL instruments were then assessed, since they are the most clinically useful, reliably assessing patients' own perception of their QOL. RESULTS Forty-three publications met inclusion criteria (published 1999-2019). Most common conditions included urinary incontinence (16, 37.2%) and kidney transplantation (12, 27.9%). Overall, 22 unique instruments purporting to measure QOL were identified. Looking at the concepts measured by each instrument, nine instruments (40.9%) assessed Functioning. Nine instruments (40.9%) measured a combination of Functioning and QOL. Only the remaining 4 instruments (18.2%) assessed strictly QOL. The 13 instruments assessing any QOL focused on generic QOL (n = 4), HRQOL (n = 3) and disease-specific HRQOL (n = 6). Of the subset of four instruments assessing strictly QOL, and not Functioning, all had patient self-reported versions available: two generic QOL instruments (KINDL, KIDSCREEN), one generic HRQOL (DISABKIDS), and one disease-specific HRQOL (QUALAS). Thirteen of 43 studies (30.2%) employed more than one instrument. Thirty-eight studies (88.4%) used an instrument measuring Functioning, with 19 (44.1%) measuring only Functioning, not QOL at all. Twenty-four studies (55.8%) used an instrument measuring actual QOL, although 17 (39.5%) used a combined Functioning/QOL instrument. Only nine (20.9%) used a strictly QOL instrument (strictly HRQOL instruments: 4.7%). DISCUSSION We present encouraging evidence of sustained interest in QOL research in pediatric urology and identify areas needing improvement. Selecting appropriate QOL tools requires a working knowledge of their various underlying meanings and purposes. Whether it adequately assess QOL must be considered. We discuss strengths and weaknesses of instruments and a practical approach to QOL instrument selection. CONCLUSION Much of pediatric urology is grounded in improving QOL. Unfortunately, most studies published to date focus on Functioning, rather than young people's perception-based QOL. Future QOL studies should ideally employ validated instruments capturing patient-reported QOL.
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Affiliation(s)
- Lucshman Raveendran
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Martin Koyle
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Darius Bagli
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kornelia Twardowski
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicolas Cicci
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gabriel M Ronen
- Division of Pediatric Neurology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Kathleen J Sawin
- Department of Nursing Research and Evidence-Based Practice, Children's Hospital of Wisconsin, Milwaukee, WI, College of Nursing, University of Wisconsin-Milwaukee, USA
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA.
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Panek W, Janczak D, Panek M, Szydełko U, Chrzan R, Chabowski M, Szydełko T. Quality of Life of Patients After Laparoscopic Pyeloplasty Due to Ureteropelvic Junction Obstruction: A Long-Term Observation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1335:45-51. [PMID: 33713327 DOI: 10.1007/5584_2020_616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study aims to define the quality of life (QoL) of patients who had undergone laparoscopic pyeloplasty due to ureteropelvic junction obstruction. The QoL was investigated in 26 patients after pyeloplasty, on average, at a 7.5-year follow-up. The operation was performed in a single center between 2002 and 2009 and its effectiveness was confirmed by diuretic renography. The QoL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Additionally, we used an own questionnaire, created for this study, specifically assessing the health-related quality of life after pyeloplasty. Overall, 96% of patients were satisfied with the surgical procedure and all would agree to have another pyeloplasty procedure if needed. In one case, dissatisfaction was caused by persisting postoperative pain. All patients but one, dissatisfied due to persisting pain, reported that the postoperative pain intensity was not a problem that would impact the QoL or professional activity. We conclude that laparoscopic pyeloplasty did not adversely affect the patients' QoL, which might stem from beneficial functional outcomes making the patients satisfied with treatment results.
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Affiliation(s)
- Wojciech Panek
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland.,Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Dawid Janczak
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland.,Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Panek
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland
| | - Urszula Szydełko
- Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Chrzan
- Department of Pediatric Urology, Collegium Medicum of the Jagiellonian University, Cracow, Poland
| | - Mariusz Chabowski
- Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland. .,Department of Surgery, Fourth Military Teaching Hospital, Wroclaw, Poland.
| | - Tomasz Szydełko
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland.,Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
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Franciosi JP, Hommel KA, DeBrosse CW, Greenberg AB, Greenler AJ, Abonia JP, Rothenberg ME, Varni JW. Development of a validated patient-reported symptom metric for pediatric eosinophilic esophagitis: qualitative methods. BMC Gastroenterol 2011; 11:126. [PMID: 22099448 PMCID: PMC3228698 DOI: 10.1186/1471-230x-11-126] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 11/18/2011] [Indexed: 11/10/2022] Open
Abstract
Background Previous attempts to measure symptoms in pediatric Eosinophilic Esophagitis (EoE) have not fully included patients and parents in the item development process. We sought to identify and validate key patient self-reported and parent proxy-reported outcomes (PROs) specific to EoE. Methods We developed methodology for focus and cognitive interviews based on the Food and Drug Administration (FDA) guidelines for PROs, the validated generic PedsQL™ guidelines, and the consolidated criteria for reporting qualitative research (COREQ). Both child (ages 8-12 and 13-18) and parent-proxy (ages 2-4, 5-7, 8-12, and 13-18) interviews were conducted. Results We conducted 75 interviews to construct the new instrument. Items were identified and developed from individual focus interviews, followed by cognitive interviews for face and content validation. Initial domains of symptom frequency and severity were developed, and open-ended questions were used to generate specific items during the focus interviews. Once developed, the instrument construct, instructions, timeframe, scoring, and specific items were systematically reviewed with a separate group of patients and their parents during the cognitive interviews. Conclusions To capture the full impact of pediatric EoE, both histologic findings and PROs need to be included as equally important outcome measures. We have developed the face and content validated Pediatric Eosinophilic Esophagitis Symptom Score (PEESS™ v2.0). The PEESS™ v2.0 metric is now undergoing multisite national field testing as the next iterative instrument development phase.
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Affiliation(s)
- James P Franciosi
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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Yao DF, Weinberg AC, Penna FJ, Huang L, Freilich DA, Minnillo BJ, Shoag J, Retik AB, Nguyen HT. Quality of life in children with vesicoureteral reflux as perceived by children and parents. J Pediatr Urol 2011; 7:261-5. [PMID: 21527212 DOI: 10.1016/j.jpurol.2011.02.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Significant research has been dedicated to the management of vesicoureteral reflux (VUR). However, few studies have been published to evaluate the impact of this disease on quality of life. The aim of this study was a prospective examination of the health-related quality of life (HRQoL) in children with VUR who have either been treated medically (antibiotics or surveillance) or by ureteral reimplant (UR) using a validated patient satisfaction survey. MATERIALS AND METHODS A prospective, longitudinal study was conducted using a validated HRQoL questionnaire, the Pediatric Quality of Life Inventory (PedsQL™ 4.0 Generic Core). 353 children or parents of children with VUR, age 2-18 years, completed the survey. Statistical analysis was performed with significance set at p-value ≤ 0.05. RESULTS Children and parents of children with VUR did not score lower on total or subscale domains of HRQoL when compared to a historical healthy control. On univariate analysis, patients who underwent UR scored lower on total as well as physical, social, and school subscale HRQoL domains, compared to patients managed medically. When controlling for gender, ethnicity, age, reflux grade, and antibiotic use, there was no difference in total HRQoL between patients who underwent UR compared to those managed medically. CONCLUSIONS In terms of HRQoL, VUR is a benign clinical entity and neither antibiotic use nor UR is associated with lower HRQoL. Disease-specific quality of life surveys are needed to accurately evaluate patient and parent satisfaction in the management of VUR.
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Affiliation(s)
- David F Yao
- Department of Urology, Children's Hospital, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
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