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Zou D, Liu Y, Gong Y, Zhang X, Liu J, Shen J. Self-Efficacy's Mediating Role in the Relationship Between Self-Perceived Burden and Health-Related Quality of Life Among Older-Adult Inpatients in China: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:2157-2163. [PMID: 38736537 PMCID: PMC11088387 DOI: 10.2147/jmdh.s460151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose This study investigated the current state of self-efficacy and the association between self-perceived burden (SPB) and health-related quality of life (HRQoL) among Chinese older-adult inpatients. Methods A cross-sectional study was conducted using convenience sampling to survey Chinese older-adult inpatients. Data regarding demographic characteristics, self-efficacy, SPB, and HRQoL were collected. Pearson's correlation analysis was used to examine the correlations among the research variables. SPSS® Statistics V26.0, and SPSS® PROCESS Macro Model 4 were used to analyze the available data. The bootstrap method was used to analyze the mediating role of self-efficacy. Results Survey participants included 514 older-adult inpatients, with a mean age of 72.28±5.58 years. Self-efficacy (r=0.471, p<0.01) was positively correlated with HRQoL, whereas self-efficacy (r=-0.891, p<0.01) and HRQoL (r=-0.516, p<0.01) were negatively correlated with SPB. The mediating effect analysis revealed that self-efficacy either completely or partially mediated the effect of SPB on HRQoL, with the indirect effect accounting for 30.2% of the total. Conclusion This study provides a mediating model suggesting that SPB exerts both direct and indirect effects on the HRQoL of older-adult inpatients through self-efficacy.
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Affiliation(s)
- Dongmei Zou
- Department of Cardiovascular Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde city), Changde, People’s Republic of China
| | - Yanqiong Liu
- Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Youwen Gong
- Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Xueqing Zhang
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jieqiong Liu
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jinhua Shen
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
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Economidou EC, Angastiniotis M, Avraam D, Soteriades ES, Eleftheriou A. Addressing Thalassaemia Management from Patients' Perspectives: An International Collaborative Assessment. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:650. [PMID: 38674296 PMCID: PMC11052322 DOI: 10.3390/medicina60040650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: The effective management of chronic diseases, particularly hereditary and rare diseases and thalassaemia, is an important indicator of the quality of healthcare systems. We aimed to assess healthcare services in different countries for thalassaemia patients by using publicly available health indicators and by surveying thalassaemia patients and their caregivers. Materials and Methods: We reviewed official worldwide databases from the WHO, World Bank, and scientific resources, and we used a structured patient-tailored self-completed questionnaire to survey thalassaemia patients and their caregivers in 2023. Results: A total of 2082 participants were surveyed (mean age, 27 years; males, 42%). About 1 in 4 respondents did not complete high-school education, while 24% had a bachelor's degree. About a third of respondents were married and were in either full- or part-time employment. The vast majority (~80%) had initiated transfusion therapy between 1 and 4 years of age. Only 42% reported no delays in receiving blood transfusion, while 47% reported occasional delays and 8% serious delays. About half of patients reported being very satisfied (11%) or satisfied (38%) with the quality of services provided, while 1 in 3 patients reported being unsatisfied or very unsatisfied, and that their access to treatment was difficult or very difficult due to traveling expenses and the high cost of treatment. Conclusions: Important improvements in the care of thalassaemia patients have been documented during the past few decades. Nevertheless, additional focus is required through national healthcare systems to effectively address the many unmet needs revealed by our recent survey, as well as to achieve satisfactory patient outcomes.
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Affiliation(s)
| | | | - Demetris Avraam
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool L69 3BX, UK;
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, 33 Giannou Kranidioti Ave., 2220 Nicosia, Cyprus
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Fianza PI, Rahmawati A, Wijaya I, Oehadian A, Prasetya D, Vidyaniati P, Harti GF, Fadjari TH, Panigoro R. Gender Disparities in Psychological Disturbances and Quality of Life Among Adolescent and Adult Patients with Thalassemia: A Review. J Multidiscip Healthc 2024; 17:1663-1669. [PMID: 38646018 PMCID: PMC11032664 DOI: 10.2147/jmdh.s444592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 04/23/2024] Open
Abstract
Thalassemia is a chronic disease caused by impaired globin chain synthesis, leading to ineffective erythropoiesis, hemolysis, and chronic anemia. The treatment of patients with thalassemia, including blood transfusion combined with chelation therapy has progressed and improved their survival and prognosis. However, thalassemia-related psychological problems and impaired health-related quality of life (QoL) challenges still exist. Gender is one of the factors that has been suggested, to contribute to the disparities in psychological outcomes. This review article examined the evidence for gender differences in psychological disturbances and QoL in adolescent and adult patients with thalassemia. A non-systematic search of the literature was conducted in PubMed and Google Scholar for English full-text available from 2013 to 2023. We identified 23 studies with a sample size ≥ 100 that examined gender disparities in anxiety, depression, and QoL in adolescent and adult patients with thalassemia (mean prevalence of female = 53.1%; mean age = 28 years). Our review shows that there are gender disparities in psychological distress and QoL in adolescent and adult patients with thalassemia. Statistically significant gender differences were demonstrated in 62% of the psychological and QoL outcomes from 16 studies. Female patients had a higher prevalence of anxiety, depression, and poorer QoL in some studies. However, further studies with sufficient power and design are necessary to confirm the existence of gender disparities in psychological disturbances and QoL outcomes.
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Affiliation(s)
- Pandji Irani Fianza
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Anita Rahmawati
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Indra Wijaya
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Amaylia Oehadian
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Dimmy Prasetya
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Putri Vidyaniati
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Gusti Fungani Harti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Trinugroho Heri Fadjari
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Ramdan Panigoro
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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Klonizakis P, Roy N, Papatsouma I, Mainou M, Christodoulou I, Pantelidou D, Kokkota S, Diamantidis M, Kourakli A, Lazaris V, Andriopoulos D, Tsapas A, Klaassen RJ, Vlachaki E. A Cross-Sectional, Multicentric, Disease-Specific, Health-Related Quality of Life Study in Greek Transfusion Dependent Thalassemia Patients. Healthcare (Basel) 2024; 12:524. [PMID: 38470634 PMCID: PMC10931193 DOI: 10.3390/healthcare12050524] [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: 12/08/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
The assessment of health-related quality of life (HRQoL) in thalassemia offers a holistic approach to the disease and facilitates better communication between physicians and patients. This study aimed to evaluate the HRQoL of transfusion-dependent thalassemia (TDT) patients in Greece. This was a multicentric, cross-sectional study conducted in 2017 involving 283 adult TDT patients. All participants completed a set of two QoL questionnaires, the generic SF-36v2 and the disease-specific TranQol. Demographic and clinical characteristics were used to predefine patient subgroups. Significant factors identified in the univariate analysis were entered into a multivariate analysis to assess their effect on HRQoL. The SF-36 scores of TDT patients were consistently lower compared to the general population in Greece. The mean summary score of TranQol was relatively high (71 ± 14%), exceeding levels observed in national surveys in other countries. Employment emerged as the most significant independent factor associated with better HRQoL, whereas age had the most significant negative effect. This study represents the first comprehensive QoL assessment of a representative sample of the TDT population in Greece. The implementation of TranQol allowed for the quantification of HRQoL in Greece, establishing a baseline for future follow-up, and identifying more vulnerable patient subgroups.
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Affiliation(s)
- Philippos Klonizakis
- Adults Thalassemia Unit-2nd Department of Internal Medicine, Aristotle University, Hippokration General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (M.M.); (I.C.); (E.V.)
| | - Noémi Roy
- Department of Haematology, Oxford University Hospitals, NHS Foundation Trust, Oxford OX3 0AG, UK;
| | - Ioanna Papatsouma
- Department of Mathematics, Imperial College London, London SW7 2BP, UK;
| | - Maria Mainou
- Adults Thalassemia Unit-2nd Department of Internal Medicine, Aristotle University, Hippokration General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (M.M.); (I.C.); (E.V.)
| | - Ioanna Christodoulou
- Adults Thalassemia Unit-2nd Department of Internal Medicine, Aristotle University, Hippokration General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (M.M.); (I.C.); (E.V.)
| | - Despina Pantelidou
- Thalassemia Unit, AHEPA General Hospital of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.K.)
| | - Smaro Kokkota
- Thalassemia Unit, AHEPA General Hospital of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.K.)
| | - Michael Diamantidis
- Thalassemia and Sickle Cell Disease Unit, General Hospital of Larissa, 41110 Larissa, Greece;
| | - Alexandra Kourakli
- Thalassemia and Hemoglobinopathies Center, University Hospital of Patras, 26504 Patras, Greece; (A.K.); (V.L.)
| | - Vasileios Lazaris
- Thalassemia and Hemoglobinopathies Center, University Hospital of Patras, 26504 Patras, Greece; (A.K.); (V.L.)
| | - Dimitrios Andriopoulos
- Haemato-Oncology Department, Royal Marsden Hospital NHS Foundation Trust, London SW3 6JJ, UK;
| | - Apostolos Tsapas
- 2nd Department of Internal Medicine, Aristotle University, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
| | - Robert J. Klaassen
- Department of Pediatrics, Division of Hematology/Oncology, University of Ottawa, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada;
| | - Efthymia Vlachaki
- Adults Thalassemia Unit-2nd Department of Internal Medicine, Aristotle University, Hippokration General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (M.M.); (I.C.); (E.V.)
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Shah R, Badawy SM. Health-related quality of life with standard and curative therapies in thalassemia: A narrative literature review. Ann N Y Acad Sci 2024; 1532:50-62. [PMID: 38270933 PMCID: PMC10923063 DOI: 10.1111/nyas.15100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Health-related quality of life (HRQOL) is a patient-reported outcome that assesses the impact of a disease or illness on different domains of a patient's life. Different general and disease-specific measures can be used to evaluate HRQOL. This article aimed to summarize the evidence for HRQOL among patients with transfusion-dependent (TDT) and non-transfusion-dependent thalassemia (NTDT). We included HRQOL data related to standard therapy with blood transfusions, iron chelation, and/or luspatercept in TDT and NTDT, as well as curative therapies for TDT, including hematopoietic stem cell transplant (HSCT) and gene therapy. Patients with thalassemia had worse HRQOL scores compared to the general population, and chronic pain was seen to increase in frequency and severity over time with age. NTDT patients reported worse physical health and functioning, mental health, general health, and vitality than TDT patients. However, TDT patients reported worse pain, change in health, and social support than NTDT. Most therapies improved overall HRQOL among thalassemia patients. Deferasirox, an oral iron chelator, was associated with more HRQOL benefits compared to deferoxamine, an intravenous iron chelator. Luspatercept showed clinically meaningful improvement in physical functioning among TDT and NTDT. Furthermore, HSCT and gene therapy were associated with better physical, emotional, and mental domains scores.
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Affiliation(s)
- Richa Shah
- Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sherif M. Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Hematology, Oncology, and Stem Cell Transplant, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
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