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Cumplido-Trasmonte C, Barquín-Santos E, Gor-García-Fogeda MD, Plaza-Flores A, García-Varela D, Ibáñez-Herrán L, González-Alted C, Díaz-Valles P, López-Pascua C, Castrillo-Calvillo A, Molina-Rueda F, Fernandez R, Garcia-Armada E. STELO: A New Modular Robotic Gait Device for Acquired Brain Injury-Exploring Its Usability. SENSORS (BASEL, SWITZERLAND) 2023; 24:198. [PMID: 38203060 PMCID: PMC10781374 DOI: 10.3390/s24010198] [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: 11/21/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
In recent years, the prevalence of acquired brain injury (ABI) has been on the rise, leading to impaired gait functionality in affected individuals. Traditional gait exoskeletons are typically rigid and bilateral and lack adaptability. To address this, the STELO, a pioneering modular gait-assistive device, was developed. This device can be externally configured with joint modules to cater to the diverse impairments of each patient, aiming to enhance adaptability and efficiency. This study aims to assess the safety and usability of the initial functional modular prototype, STELO, in a sample of 14 ABI-diagnosed participants. Adverse events, device adjustment assistance and time, and gait performance were evaluated during three sessions of device use. The results revealed that STELO was safe, with no serious adverse events reported. The need for assistance and time required for device adjustment decreased progressively over the sessions. Although there was no significant improvement in walking speed observed after three sessions of using STELO, participants and therapists reported satisfactory levels of comfort and usability in questionnaires. Overall, this study demonstrates that the STELO modular device offers a safe and adaptable solution for individuals with ABI, with positive user and therapist feedback.
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Affiliation(s)
- Carlos Cumplido-Trasmonte
- International Doctoral School, Rey Juan Carlos University, 28922 Madrid, Spain;
- Marsi Bionics SL, 28521 Madrid, Spain; (E.B.-S.); (A.P.-F.); (D.G.-V.); (L.I.-H.); (E.G.-A.)
| | - Eva Barquín-Santos
- Marsi Bionics SL, 28521 Madrid, Spain; (E.B.-S.); (A.P.-F.); (D.G.-V.); (L.I.-H.); (E.G.-A.)
| | - María Dolores Gor-García-Fogeda
- Marsi Bionics SL, 28521 Madrid, Spain; (E.B.-S.); (A.P.-F.); (D.G.-V.); (L.I.-H.); (E.G.-A.)
- Department of Physical Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Alberto Plaza-Flores
- Marsi Bionics SL, 28521 Madrid, Spain; (E.B.-S.); (A.P.-F.); (D.G.-V.); (L.I.-H.); (E.G.-A.)
| | - David García-Varela
- Marsi Bionics SL, 28521 Madrid, Spain; (E.B.-S.); (A.P.-F.); (D.G.-V.); (L.I.-H.); (E.G.-A.)
| | - Leticia Ibáñez-Herrán
- Marsi Bionics SL, 28521 Madrid, Spain; (E.B.-S.); (A.P.-F.); (D.G.-V.); (L.I.-H.); (E.G.-A.)
| | - Carlos González-Alted
- Spanish National Reference Centre for Brain Injury (CEADAC), 28034 Madrid, Spain; (C.G.-A.); (P.D.-V.)
| | - Paola Díaz-Valles
- Spanish National Reference Centre for Brain Injury (CEADAC), 28034 Madrid, Spain; (C.G.-A.); (P.D.-V.)
| | | | | | - Francisco Molina-Rueda
- Department of Physical Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Roemi Fernandez
- Centre for Automation and Robotics (CAR), CSIC-UPM, Ctra. Campo Real km 0.2–La Poveda-Arganda del Rey, 28500 Madrid, Spain
| | - Elena Garcia-Armada
- Marsi Bionics SL, 28521 Madrid, Spain; (E.B.-S.); (A.P.-F.); (D.G.-V.); (L.I.-H.); (E.G.-A.)
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2
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Bautista TG, Roman G, Khan M, Lee M, Sahbaz S, Duthely LM, Knippenberg A, Macias-Burgos MA, Davidson A, Scaramutti C, Gabrilove J, Pusek S, Mehta D, Bredella MA. What is well-being? A scoping review of the conceptual and operational definitions of occupational well-being. J Clin Transl Sci 2023; 7:e227. [PMID: 38028344 PMCID: PMC10643923 DOI: 10.1017/cts.2023.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Well-being is a multifaceted construct that is used across disciplines to portray a state of wellness, health, and happiness. While aspects of well-being seem universal, how it is depicted in the literature has substantial variation. The aim of this scoping review was to identify conceptual and operational definitions of well-being within the field of occupational health. Broad search terms were used related to well-being and scale/assessment. Inclusion criteria were (1) peer-reviewed articles, (2) published in English, (3) included a measure of well-being in the methods and results section of the article, and (4) empirical paper. The searches resulted in 4394 articles, 3733 articles were excluded by reading the abstract, 661 articles received a full review, and 273 articles were excluded after a full review, leaving 388 articles that met our inclusion criteria and were used to extract well-being assessment information. Many studies did not define well-being or link their conceptual definition to the operational assessment tool being used. There were 158 assessments of well-being represented across studies. Results highlight the lack of a consistent definitions of well-being and standardized measurements.
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Affiliation(s)
| | - Gretchen Roman
- University of Rochester Medical Center, Rochester, NY, USA
| | - Munziba Khan
- National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | - Michele Lee
- Northern Arizona University, Flagstaff, AZ, USA
| | | | | | | | | | | | | | | | - Susan Pusek
- University of North Carolina School of Medicine, St. Chapel Hill, NC, USA
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Hu M, Zhang B, Lin Y, Xu M, Zhu C. Trajectories of post-stroke quality of life and long-term prognosis: Results from an eleven-year prospective study. J Psychosom Res 2023; 173:111466. [PMID: 37647831 DOI: 10.1016/j.jpsychores.2023.111466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE The relationship between quality of life (QoL) and long-term prognosis in stroke patients is still unclear. We explored physical and mental QoL trajectories during the first six months after stroke and determined the associations between trajectories and long-term prognosis in patients with first-ever ischemic stroke. METHODS Included were 733 participants from a prospective study. QoL was assessed with the 12-item Short Form Survey (SF-12) at baseline, 3 and 6 months. Patients' prognoses (stroke recurrence and death) were identified from 2010 to 2021. The latent class growth model (LCGM) was used to identify distinct trajectories of physical and mental QoL measured over the first 6 months. We employed the Cox model or Fine-Gray model for prognoses to examine the associations between QoL trajectories and prognosis. RESULTS Five trajectories of physical QoL and five trajectories of mental QoL were identified. For physical QoL of the Poor-Improved, and Moderate-Impaired trajectory versus Moderate-Improved trajectory, the hazard ratio (HR) for death was 2.39 (1.14 to 5.02), and 2.03(0.93 to 4.44); the HR for recurrence was 1.56 (0.83 to 2.94) and 2.33 (1.28 to 4.24). For mental QoL of the Moderate-Impaired trajectory versus the Moderate-Improved trajectory, the HR for death was 2.48 (1.21 to 5.07). The results were robust in the sensitivity analysis. CONCLUSION QoL during the first six months after ischemic stroke can be categorized into distinct groups. Change in QoL was associated with long-term survival. Secondary prevention of recurrent strokes might rely more on improving patients' physical QoL.
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Affiliation(s)
- Meijing Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Baiyang Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yidie Lin
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Minghan Xu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.
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Lee YH, Ko LW, Hsu CY, Cheng YY. Therapeutic Effects of Robotic-Exoskeleton-Assisted Gait Rehabilitation and Predictive Factors of Significant Improvements in Stroke Patients: A Randomized Controlled Trial. Bioengineering (Basel) 2023; 10:bioengineering10050585. [PMID: 37237654 DOI: 10.3390/bioengineering10050585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/06/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Robotic-exoskeleton-assisted gait rehabilitation improves lower limb strength and functions in post-stroke patients. However, the predicting factors of significant improvement are unclear. We recruited 38 post-stroke hemiparetic patients whose stroke onsets were <6 months. They were randomly assigned to two groups: a control group receiving a regular rehabilitation program, and an experimental group receiving in addition a robotic exoskeletal rehabilitation component. After 4 weeks of training, both groups showed significant improvement in the strength and functions of their lower limbs, as well as health-related quality of life. However, the experimental group showed significantly better improvement in the following aspects: knee flexion torque at 60°/s, 6 min walk test distance, and the mental subdomain and the total score on a 12-item Short Form Survey (SF-12). Further logistic regression analyses showed that robotic training was the best predictor of a greater improvement in both the 6 min walk test and the total score on the SF-12. In conclusion, robotic-exoskeleton-assisted gait rehabilitation improved lower limb strength, motor performance, walking speed, and quality of life in these stroke patients.
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Affiliation(s)
- Yi-Heng Lee
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung City 40705, Taiwan
| | - Li-Wei Ko
- Department of Electronics and Electrical Engineering, Institute of Electrical and Control Engineering, Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B) in College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Chiann-Yi Hsu
- Biostatistics Task Force, Taichung Veterans General Hospital, Taichung City 40705, Taiwan
| | - Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung City 40705, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Intelligent Long Term Medical Care Research Center, Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City 40227, Taiwan
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Camarata MA, Ala A, Coskun AK, Deng Y, Embel VK, Gonzalez-Peralta R, Maciejewski KR, Patel A, Rubman S, To U, Tomlin R, Schilsky ML, Zimbrean PC. Major Depressive Disorder in an International Multisite Wilson Disease Registry. J Acad Consult Liaison Psychiatry 2023; 64:106-117. [PMID: 36521682 DOI: 10.1016/j.jaclp.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/13/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Psychiatric symptoms are frequently reported in Wilson disease (WD); however, systematic assessments with validated measures are lacking. OBJECTIVE We aim to report the prevalence and clinical correlates for major depressive disorder (MDD) as resulting from a multisite international WD registry. METHODS All patients enrolled in the WD registry received structured psychiatric evaluations (Mini International Neuropsychiatric Interview, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale, Perceived Stress Scale), laboratory tests, hepatology, and neurological assessments. We present the analysis of the data collected at enrollment for the first 3 years (N = 62). RESULTS Thirty-seven percent (23) had a lifetime history (MDD), and 6% (4) met the criteria for an active major depressive episode. Depression was self-reported in 30.51% (19) at WD diagnosis. Patients with MDD had worse mental health quality-of-life (QOL) scores (median 43 vs 53.6, P = 0.006), higher severe anxiety (13.04% vs 0), higher perceived stress (median 18 vs 9, P < 0.003), and higher levels of neuroticism (median 8 vs 5.0, P = 0.002). We found no significant difference in physical health QOL and severity of neurological or liver disease. There was no significant difference in copper parameters or liver tests in those with MDD and without. The limitations of our study consist of the small sample size, the cross-sectional report, and the lack of brain copper measurements. CONCLUSIONS Lifetime MDD is highly prevalent in WD and associated with worse mental health QOL. We did not find a significant association among liver disease, neurological disease laboratory tests, and MDD. Screening for depression should be considered in patients with WD.
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Affiliation(s)
- Michelle A Camarata
- Digestive Diseases, Transplantation and Immunology, Yale University, New Haven, CT; Gastroenterology and Hepatology, Royal Surrey County Hospital, Surrey, United Kingdom
| | - Aftab Ala
- Gastroenterology and Hepatology, Royal Surrey County Hospital, Surrey, United Kingdom; Department of Clinical and Experimental Medicine, University of Surrey, Surrey, United Kingdom; King's College Hospital, Institute of Liver Studies, London, United Kingdom
| | - Ayse K Coskun
- Digestive Diseases, Transplantation and Immunology, Yale University, New Haven, CT
| | - Yanhong Deng
- Yale Center for Analytical Sciences, Yale University, New Haven, CT
| | - Veysel K Embel
- Digestive Diseases, Transplantation and Immunology, Yale University, New Haven, CT
| | | | | | - Amar Patel
- Neurology, Yale University, New Haven, CT
| | | | - Uyen To
- Digestive Diseases, Transplantation and Immunology, Yale University, New Haven, CT
| | - Ricarda Tomlin
- Digestive Diseases, Transplantation and Immunology, Yale University, New Haven, CT
| | - Michael L Schilsky
- Digestive Diseases, Transplantation and Immunology, Yale University, New Haven, CT
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Is SF-12 a valid and reliable measurement of health-related quality of life among adults with Marfan syndrome? A confirmatory study. PLoS One 2021; 16:e0252864. [PMID: 34106976 PMCID: PMC8189474 DOI: 10.1371/journal.pone.0252864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 05/24/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction The structural validity and reliability of the Short-Form Health Survey 12 (SF-12) has not yet been tested in adults with the Marfan syndrome (MFS). This gap could undermine an evidence-grounded practice and research, especially considering that the need to assess health-related quality of life in patients with MFS has increased due to the improved life expectancy of these patients and the need to identify their determinants of quality of life. For this reason, this study aimed to confirm the dimensionality (structural validity) of the SF-12, its concurrent validity, and its reliability (internal consistency). Methods We performed a cross-sectional study in a convenience sample of 111 Italian adults with MFS, collecting anamnestic and socio-demographic information, the SF-12, and short-form Health Survey 36 (SF-36). A confirmatory factor analysis was performed to verify whether the items of SF-12 related to physical restrictions, physical functioning, and bodily pain were retained by the physical summary component of the SF-12. The items referred to the role limitations due to emotional issues, social functioning, and mental health were retained by the mental summary component (MCS12). SF-36 was used to assess the concurrent validity of SF-12, hypothesizing positive correlations among the equivalent summary scores. Results The two-factor structural solution resulted in fitting the sample statistics adequately. The internal consistency was adequate for the two factors. Furthermore, the physical and mental summary scores of the SF-36 were positively correlated with their equivalent summary scores derived from the SF-12. Conclusions This study confirmed the factor structure of the SF-12. Therefore, the use of SF-12 in clinical practice and research for assessing the health-related quality of life among adults with MFS is evidence-grounded. Future research is recommended to determine whether the SF-12 shows measurement invariance in different national contexts and determine eventual demographic variation in the SF-12 scores among patients with MFS.
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The Effect of Mental Health, Neurological Disease, and Liver Disease on Quality of Life in Patients With Wilson Disease. J Acad Consult Liaison Psychiatry 2021; 62:528-537. [PMID: 34044196 DOI: 10.1016/j.jaclp.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/03/2021] [Accepted: 04/10/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Wilson disease (WD) is a chronic disorder of copper metabolism which may affect patient's quality of life (QOL). OBJECTIVE Our aim was to assess the relationship between mental QOL (M-QOL) and physical QOL (P-QOL) and severity of the liver, neurological disease and mental health in patients with WD. METHODS At enrollment into our multisite international WD registry, adults (n = 62) were administered examinations assessing QOL (Short-Form 12-Item Health Survey), cognition, and mood. Patients also underwent hepatology and neurological assessments. RESULTS Patients had lower M-QOL than P-QOL scores, P = 0.0006. Patients with major depressive disorder (n = 22) had worse M-QOL scores, P = 0.0017 but not P-QOL. We found no association with impaired cognition (n = 37) and QOL. The P-QOL scores have a moderate negative association with neurological disease severity based on the Unified Wilson Disease Rating Scale score (total [r = -0.38, P < 0.003], part 2 [r = -0.50, P < 0.0001], and part 3 [r = -0.37, P = 0.004]). M-QOL was not associated with Unified Wilson Disease Rating Scale scores. Worse P-QOL, but not M-QOL, was found in higher cirrhosis severity indicated by Child-Pugh (r = -0.80, P = 0.002) and Model for End Stage Liver Disease scores (r = -0.64, P = 0.03). CONCLUSIONS M-QOL was associated with depression but not cognitive impairment, neurological disease, or liver disease severity, suggesting that mental health issues may affect overall QOL independent of the degree of liver or neurological disease. P-QOL was affected by the severity of neurological and liver disease but not mental health but also contributes to overall QOL in WD. An appreciation of the range of problems that affect QOL in adults with WD will help health care providers address issues that could improve overall well-being. The Short-Form 12-Item Health Survey may provide a useful instrument for QOL surveillance in WD.
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Lau JH, Abdin E, Vaingankar JA, Shafie S, Sambasivam R, Shahwan S, Thumboo J, Chong SA, Subramaniam M. Confirmatory factor analysis and measurement invariance of the English, Mandarin, and Malay versions of the SF-12v2 within a representative sample of the multi-ethnic Singapore population. Health Qual Life Outcomes 2021; 19:80. [PMID: 33691707 PMCID: PMC7944897 DOI: 10.1186/s12955-021-01709-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The Short Form Health Survey (SF-12v2) is an increasingly popular measure of health-related quality of life (HRQoL) in Singapore. In order to examine whether the SF-12v2 was appropriate for use in the population, the factor structure and validity of the English, Mandarin, and Malay versions were assessed in a representative sample of the general population of Singapore. METHODS 6126 respondents were recruited for the Singapore Mental Health Study 2016 (SMHS 2016), a cross-sectional and population-based survey. Confirmatory factor analyses (CFA) were conducted to examine the fit of a two-factor model for the SF-12v2 within a representative sample and amongst the different language (English, Mandarin, Malay) subgroups. Multiple-group CFAs (MGCFA) were conducted to test measurement invariance across the different languages, ethnicities, and chronic illnesses subgroups. CFA-generated latent factor scores (FSCORE command in MPlus) were also compared with the composite scores derived from the developer's scoring method via correlations. Sociodemographic correlates of the latent physical and mental health scores were explored. RESULTS CFA results within the full sample supported a two-factor model (RMSEA = 0.044; CFI = 0.991; TLI = 0.988; SRMR = 0.044) in which physical functioning, role physical, bodily pain and general health items loaded onto a latent physical health factor, while role emotional, mental health, social functioning, and vitality items loaded onto a latent mental health factor. Physical and mental health factors were allowed to correlate, unlike the developer's orthogonal scoring method. All standardized loadings were high and statistically significant. Both factors had high internal consistency. CFA within subsamples of English, Mandarin, and Malay languages indicated similar findings. MGCFA results indicate that measurement invariance held across the different languages, ethnicities, and those with and without chronic illnesses. CONCLUSION The present study identified a two-factor (physical and mental health) structure within the general population and amongst the three different languages and demonstrated the measurement invariance of SF-12v2 across different subgroups. Findings indicate that algorithm-derived PCS and MCS should be interpreted with caution as they may result in inaccurate conclusions regarding the relationships between HRQoL and its correlates. Future studies using the SF-12v2 within the general population of Singapore should consider utilizing the factor structure put forth in the present study to obtain more appropriate estimates of HRQoL.
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Affiliation(s)
- Jue Hua Lau
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, SingHealth, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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van der Meulen M, Zamanipoor Najafabadi AH, Lobatto DJ, Andela CD, Vliet Vlieland TPM, Pereira AM, van Furth WR, Biermasz NR. SF-12 or SF-36 in pituitary disease? Toward concise and comprehensive patient-reported outcomes measurements. Endocrine 2020; 70:123-133. [PMID: 32562182 PMCID: PMC7525280 DOI: 10.1007/s12020-020-02384-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Pituitary diseases severely affect patients' health-related quality of life (HRQoL). The most frequently used generic HRQoL questionnaire is the Short Form-36 (SF-36). The shorter 12-item version (SF-12) can improve efficiency of patient monitoring. This study aimed to determine whether SF-12 can replace SF-36 in pituitary care. METHODS In a longitudinal cohort study (August 2016 to December 2018) among 103 endoscopically operated adult pituitary tumor patients, physical and mental component scores (PCS and MCS) of SF-36 and SF-12 were measured preoperatively, and 6 weeks and 6 months postoperatively. Chronic care was assessed with a cross-sectional study (N = 431). Mean differences and agreement between SF-36 and SF-12 change in scores (preoperative vs. 6 months) were assessed with intraclass correlation coefficients (ICC) and limits of agreement, depicting 95% of individual patients. RESULTS In the longitudinal study, mean differences between change in SF-36 and SF-12 scores were 1.4 (PCS) and 0.4 (MCS) with fair agreement for PCS (ICC = 0.546) and substantial agreement for MCS (ICC = 0.931). For 95% of individual patients, the difference between change in SF-36 and SF-12 scores varied between -14.0 and 16.9 for PCS and between -7.8 and 8.7 for MCS. Cross-sectional results showed fair agreement for PCS (ICC = 0.597) and substantial agreement for MCS (ICC = 0.943). CONCLUSIONS On a group level, SF-12 can reliably reproduce MCS in pituitary patients, although PCS is less well correlated. However, individual differences between SF-36 and SF-12 can be large. For pituitary diseases, alternative strategies are needed for concise, but comprehensive patient-reported outcome measurement.
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Affiliation(s)
- Merel van der Meulen
- Department of Medicine, Division of Endocrinology, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands.
| | - Amir H Zamanipoor Najafabadi
- Department of Medicine, Division of Endocrinology, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
- University Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden/The Hague, The Netherlands
| | - Daniel J Lobatto
- Department of Medicine, Division of Endocrinology, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
- University Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden/The Hague, The Netherlands
| | - Cornelie D Andela
- Department of Medicine, Division of Endocrinology, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
| | - Thea P M Vliet Vlieland
- Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Alberto M Pereira
- Department of Medicine, Division of Endocrinology, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
| | - Wouter R van Furth
- University Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden/The Hague, The Netherlands
| | - Nienke R Biermasz
- Department of Medicine, Division of Endocrinology, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
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Jarosławski S, Jarosławska B, Błaszczyk B, Auqier P, Toumi M. Health-related quality of life of patients after ischaemic stroke treated in a provincial hospital in Poland. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2020; 8:1775933. [PMID: 32944198 PMCID: PMC7482738 DOI: 10.1080/20016689.2020.1775933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ischaemic stroke (IS) is a major cause of death and disability and affects the quality of life of patients. Previous studies focused on urban populations. OBJECTIVE To evaluate the health-related quality of life (QoL) of patients with history of IS and living in a rural area in Poland. PATIENTS Rural population of 172 patients discharged from a district hospital in Zakopane, Poland with a diagnosis of IS in the period from 01.01.2005 to 31.10.2006. INTERVENTION QoL was evaluated using the European Quality of Life Scale-5 Dimensions EQ-5D-3 L (EQ-5D) and the Short Form Health Survey - 12 version 2 (SF-12). RESULTS In the EQ-5D survey, 57.3% of patients had only some problems with mobility, 40.3% with usual activities, 63.2% with pain/discomfort, 59% with anxiety/depression, and 32.2% with self-care. In the SF-12 survey, both summary components (physical and psychological) were reduced compared to the population norm. CONCLUSION The quality of life in IS survivors is clearly reduced in the majority of domains assessed by the EQ-5D and SF-12 questionnaires. The most important factors affecting QoL were the functional state, depression and anxiety. A significant difference as compared to to urban and mixed populations was observed for a reduced SF-12 mental health component and for the EQ-5D visual analogue scale. We found no effect of gender, age or cognitive disorders on the outcomes of SF-12.
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Affiliation(s)
- Szymon Jarosławski
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | | | | | - Pascal Auqier
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | - Mondher Toumi
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
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Does Medication-Related Osteonecrosis of the Jaw Influence the Quality of Life of Cancer Patients? Biomedicines 2020; 8:biomedicines8040095. [PMID: 32344782 PMCID: PMC7235831 DOI: 10.3390/biomedicines8040095] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/13/2020] [Accepted: 04/23/2020] [Indexed: 01/11/2023] Open
Abstract
The aim of this study is to observe the influence of Medication-Related Osteonecrosis of the Jaw (MRONJ) on the physical and mental conditions of cancer patients using a Quality of Life (QoL) questionnaire during regular dental practice measures. Twenty cancer patients (8 males and 12 females) with established MRONJ were enrolled in the “MoMax” (Oral Medicine and Maxillofacial) project of the Department of Oral Sciences and Maxillofacial Surgery at “Sapienza” University of Rome, and were included in the study. The 12-item Short Form Survey was used to evaluate the QoL. Statistical analysis revealed a significant difference for Mental Component Summary (MCS) scores based on age (p = 0.018). The regression analysis revealed that the Physical Component Summary (PCS) scores were negatively influenced by the anti-resorptive medication duration (p = 0.031 and β = −1.137). No significant differences were observed with the other variables considered. The QoL of cancer patients is generally deteriorated and MRONJ may cause a further negative impact. This study highlights the possible need to include psychosocial and physical evaluations in the management process of MRONJ in cancer patients.
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Bazargan M, Cobb S, Castro Sandoval J, Assari S. Smoking Status and Well-Being of Underserved African American Older Adults. Behav Sci (Basel) 2020; 10:bs10040078. [PMID: 32326442 PMCID: PMC7226211 DOI: 10.3390/bs10040078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose: This study investigated the association between current and past cigarette smoking, with four domains of well-being, namely, physical quality of life, mental quality of life, depressive symptoms, and self-rated health status (SRH), among older African American adults who lived in economically impoverished areas of South Los Angles. Methods: This community-based cross-sectional study included a convenience sample of economically-disadvantaged African Americans adults (n = 740) who were 55 years old and older residing in South Los Angeles. We conducted in-depth face-to-face interviews to collect data on the socioeconomic status (level of education and fiscal pressures), demographic factors (age and gender), physical health (number of chronic medical conditions), smoking (never smokers (reference group), past smokers, and current smokers), and well-being (quality of life, depressive symptoms, and self-rated health). Linear regressions were used to analyze the data. Results: Over 21% reported that they are current smokers, compared with 31% who identified as former smokers. Almost 40% perceived the quality of their health status to be fair or poor. Compared with non-smokers, current cigarette smokers reported a worse physical quality of life, depressive symptoms, and self-rated health. Current smokers also reported a marginally worse mental quality of life. Past smoker status was inconsistently associated with worse well-being in some, but not all, indicators. The association between smoking status and worse well-being was independent of gender, socioeconomic status, and physical health status. Conclusion: Current smoking is associated with worse well-being of older African American adults in economically constrained urban settings. As the same pattern could not be found for former smokers, quitting smoking may be a strategy for economically-disadvantaged African American individuals to enhance their well-being. This provides additional support for programs that help African American individuals who are smokers to quit smoking, particularly in economically-disadvantaged urban areas.
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Affiliation(s)
- Mohsen Bazargan
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Sharon Cobb
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Jessica Castro Sandoval
- Department of Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Shervin Assari
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Correspondence:
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Shen CL, Wang S, Yang S, Tomison MD, Abbasi M, Hao L, Scott S, Khan MS, Romero AW, Felton CK, Mo H. A 12-week evaluation of annatto tocotrienol supplementation for postmenopausal women: safety, quality of life, body composition, physical activity, and nutrient intake. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:198. [PMID: 29954374 PMCID: PMC6022510 DOI: 10.1186/s12906-018-2263-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 06/21/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Evidence suggests that tocotrienols may benefit bone health in osteopenic women. However, their safety in this population has never been investigated. This study was to evaluate the safety of a 12-week supplementation of annato tocotrienol in postmenopausal osteopenic women, along with effects of the supplementation on quality of life, body composition, physical activity, and nutrient intake in this population. METHODS Eighty nine postmenopausal osteopenic women were randomly assigned to 3 treatment arms: (1) Placebo (430 mg olive oil/day), (2) Low tocotrientol (Low TT) (430 mg tocotrienol/day from DeltaGold 70 containing 300 mg tocotrienol) and (3) High tocotrienol (High TT) (860 mg tocotrienol/day from DeltaGold 70 containing 600 mg tocotrienol) for 12 weeks. DeltaGold 70 is an extract from annatto seed with 70% tocotrienol consisting of 90% delta-tocotrienol and 10% gamma-tocotrienol. Safety was examined by assessing liver enzymes (aspartate aminotransferase, alanine aminotransferase), alkaline phosphatase, bilirubin, kidney function (blood urea nitrogen and creatinine), electrolytes, glucose, protein, albumin, and globulin at 0, 6, and 12 weeks. Serum tocotrienol and tocopherol concentrations were assessed and pills counted at 0, 6, and 12 weeks. Quality of life, body composition, physical activity, and dietary macro- and micro-nutrient intake were evaluated at 0 and 12 weeks. A mixed model of repeated measures ANOVA was applied for analysis. RESULTS Eighty seven subjects completed the study. Tocotrienol supplementation did not affect liver or kidney function parameters throughout the study. No adverse event due to treatments was reported by the participants. Tocotrienol supplementation for 6 weeks significantly increased serum delta-tocotrienol level and this high concentration was sustained to the end of study. There was no difference in serum delta-tocotrienol levels between the Low TT and the High TT groups. No effects of tocotrienol supplementation were observed on quality of life, body composition, physical activity, and nutrient intake. CONCLUSIONS Annatto-derived tocotrienol up to 600 mg per day for 12 weeks appeared to be safe in postmenopausal osteopenic women, particularly in terms of liver and kidney functions. Tocotrienol supplementation for 12 weeks did not affect body composition, physical activity, quality of life, or intake of macro- and micro-nutrients in these subjects. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02058420 . TITLE Tocotrienols and bone health of postmenopausal women.
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Mestre TA, Carlozzi NE, Ho AK, Burgunder JM, Walker F, Davis AM, Busse M, Quinn L, Rodrigues FB, Sampaio C, Goetz CG, Cubo E, Martinez-Martin P, Stebbins GT. Quality of Life in Huntington's Disease: Critique and Recommendations for Measures Assessing Patient Health-Related Quality of Life and Caregiver Quality of Life. Mov Disord 2018; 33:742-749. [PMID: 29570848 DOI: 10.1002/mds.27317] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The compromise of quality of life in Huntington's disease is a major issue, both for individuals with the disease as well as for their caregivers. The International Parkinson and Movement Disorder Society commissioned a review of the use and clinimetric validation status of measures used in Huntington's disease to assess aspects related with quality of life and to make recommendations on their use following standardized criteria. We included both patient-centered measures (patient health-related quality-of-life measures) and caregiver-centered measures (caregiver quality-of-life measures). After conducting a systematic literature search, we included 12 measures of patient health-related quality of life and 2 measures of caregiver quality of life. Regarding patient-centered measures, the Medical Outcomes Study 36-Item Short-Form Health Survey is "recommended" as a generic assessment of health-related quality of life in patients with Huntington's disease. The 12-Item Short Form Health Survey, the Sickness Impact Profile, the 12-item World Health Organization Disability Assessment Schedule, and the Huntington's Disease Health-Related Quality of Life questionnaire are "suggested." No caregiver-centered quality-of-life measure obtained a "recommended" status. The Alzheimer's Carer's Quality of Life Inventory and the Huntington's Disease Quality of Life Battery for Carers are "suggested." Recognizing that the assessment of patient health-related quality of life can be challenging in Huntington's disease, as patients may lack insight and there is insufficient clinimetric testing of these scales, the committee concluded that further validation of currently available health-related quality-of-life measures should be undertaken, namely, those Huntington's disease-specific health-related quality-of-life measures that have recently been reported and used. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tiago A Mestre
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Institute, Ottawa, Canada
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Aileen K Ho
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Jean-Marc Burgunder
- Swiss HD Center, NeuroZentrumSiloah and Department of Neurology, University of Bern, Bern, Switzerland
| | - Francis Walker
- Department of Neurology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Aileen M Davis
- Krembil Research Institute, University Health Network and Institute of Health Policy, Management and Evaluation and Rehabilitation Institute, University of Toronto, Toronto, Canada
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Wales, UK
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Filipe B Rodrigues
- Huntington's Disease Centre, Institute of Neurology, University College London, London, UK.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | | | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Esther Cubo
- Department of Neurology, Hospital Universitário Hermanos Yagüe, Burgos, Spain
| | - Pablo Martinez-Martin
- National Center of Epidemiology and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Carlos III Institute of Health, Madrid, Spain
| | - Glenn T Stebbins
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Measurement Properties of the Scoliosis Research Society Outcomes Questionnaire in Adolescent Patients With Spondylolisthesis. Spine (Phila Pa 1976) 2017; 42:1316-1321. [PMID: 28146020 DOI: 10.1097/brs.0000000000002091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective validation of the Scoliosis Research Society Outcomes Questionnaire French-Canadian version (SRS-22fv) in adolescent patients with spondylolisthesis. OBJECTIVE To determine the measurement properties of the SRS-22fv. SUMMARY OF BACKGROUND DATA The SRS-22 is widely used for the assessment of health-related quality of life in adolescent idiopathic scoliosis (AIS) and other spinal deformities. Spondylolisthesis has an important effect on quality of life. The instrument was previously used in this population, although its measurement properties remained unknown. We aim to determine its reliability, factorial, concurrent validity, and its discriminant capacity in an adolescent spondylolisthesis population. METHODS The SRS-22fv was tested in 479 subjects (272 patients with spondylolisthesis, 143 with AIS, and 64 controls) at a single institution. Its reliability was measured using the coefficient of internal consistency, concurrent validity by the short form-12 (SF-12v2 French version) and discriminant validity using multivariate analysis of variance, analysis of covariance, and multivariate linear regression. RESULTS The SRS-22fv showed a good global internal consistency (spondylolisthesis: Cronbach α = 0.91, AIS: 0.86, and controls: 0.78) in all its domains for spondylolisthesis patients. It showed a factorial structure consistent with the original questionnaire, with 60% of explained variance under four factors. Moderate to high correlation coefficients were found for specifically corresponding domains between SRS-22fv and SF-12v2. Boys had higher scores than do girls, scores worsened with increasing age and body mass index. Analysis of covariance showed statistically significant differences between patients with spondylolisthesis, patients with AIS, and controls when controlling for age, sex, body mass index, pain, function, and self-image scores. In the spondylolisthesis group, scores on all domains and mean total scores were significantly lower in surgical candidates and in patients with high-grade spondylolisthesis. Low to moderate ceiling effects were shown in function (1.1%), self-image (10.7%), and pain (13.6%). CONCLUSION The SRS-22fv can discriminate between healthy and spondylolisthesis subjects. It can be used in spondylolisthesis patients to assess health-related quality of life. LEVEL OF EVIDENCE 4.
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Wan-Fei K, Hassan STS, Sann LM, Ismail SIF, Raman RA, Ibrahim F. Depression, anxiety and quality of life in stroke survivors and their family caregivers: A pilot study using an actor/partner interdependence model. Electron Physician 2017; 9:4924-4933. [PMID: 28979724 PMCID: PMC5614274 DOI: 10.19082/4924] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/28/2017] [Indexed: 12/02/2022] Open
Abstract
Background Depression and anxiety are common in stroke survivors as well as their family caregivers. However, it is not known whether each person’s emotional distress contributes to their partner’s quality of life (QOL). Objective This study aimed to examine the effect of depression and anxiety on QOL in stroke survivor-caregiver dyads using dyadic analysis technique - the Actor-Partner Interdependence Model (APIM). Methods This was a cross-sectional pilot study with a total of 30 participating dyads (30 stroke survivors and 30 family caregivers) from Hospital Rehabilitasi Cheras, Kuala Lumpur, Malaysia. This pilot study was conducted over a period of 3 months, between December 2014 and February 2015. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). QOL was assessed using the Short Form-12 Health Survey (SF-12). All analyses were carried out using IBM SPSS version 22. Dyadic data were analysed using multilevel modelling (MLM). Results Depression was uniquely associated with an individual’s own QOL. Survivors and caregivers with higher depression had poorer physical component summary (PCS) scores and mental component summary (MCS) scores. Stroke survivor’s depression exerted a significant actor effect on their PCS (b=−1.42, p=0.001) and MCS (b=−1.52, p<0.001). Caregiver’s depression exerted a significant actor effect on their PCS (b=−2.53, p<0.001) and MCS (b=−1.51, p=0.004). Caregivers’ anxiety negatively influenced their own MCS (b=−0.58, p=0.031). Furthermore, depression exerted a significant partner effect on PCS in stroke survivors (b=−1.19, p=0.003). Caregivers’ depression was also related to their stroke survivors’ poorer QOL, particularly PCS. Conclusion The findings suggest that depression affects the QOL of both stroke survivors and caregivers, not only emotionally but also physically. This dyadic study also has evidence pointing to depression in caregivers and its association with stroke survivors’ physical QOL.
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Affiliation(s)
- Khaw Wan-Fei
- M.Sc. of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor D.E., Malaysia
| | - Syed Tajuddin Syed Hassan
- Ph.D., in Ecology/Statistical Entomology, Professor, Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor D.E., Malaysia
| | - Lye Munn Sann
- MBBS, DrPH, Professor, Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor D.E., Malaysia
| | - Siti Irma Fadhilah Ismail
- Ph.D., in Epidemiology & Public Health, Lecturer, Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor D.E., Malaysia
| | - Rosna Abdul Raman
- MS of Health Sciences, Lecturer, Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor D.E., Malaysia
| | - Faisal Ibrahim
- MBBS, MPH, MPHM, Associate Professor, Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor D.E., Malaysia
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Dai R, Lam OLT, Lo ECM, Li LSW, McGrath C. Oral health-related quality of life in patients with stroke: a randomized clinical trial of oral hygiene care during outpatient rehabilitation. Sci Rep 2017; 7:7632. [PMID: 28794410 PMCID: PMC5550442 DOI: 10.1038/s41598-017-07666-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 06/28/2017] [Indexed: 11/22/2022] Open
Abstract
This study was to evaluate the effectiveness of oral hygiene care in improving oral health- and health-related quality of life (OHRQoL and HRQoL) among patients receiving outpatient stroke rehabilitation. Subjects were randomized to: (1) a conventional oral hygiene care programme (COHCP) comprising a manual toothbrush, and oral hygiene instruction, or (2) an advanced oral hygiene care programme (AOHCP) comprising a powered toothbrush, 0.2% chlorhexidine mouthrinse, and oral hygiene instruction. The interventional period lasted for 3 months, followed by a 3-month observational period. HRQoL was assessed by SF-12, and OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14), General Oral Health Assessment Index (GOHAI), and Oral Health Transitional Scale (OHTS). Participants in AOHCP group had significantly better OHRQoL at the end of clinical trial as assessed by OHTS (p < 0.01), and at the end of observational study as assessed by GOHAI (p < 0.05) than those in the COHCP. Participants in the AOHCP group had significantly better HRQoL as assessed by physical component summary score (PCS) the end of both 3 and 6 months (both p < 0.05). This study provided the evidence that the AOHCP was more effective than the COHCP within stroke rehabilitation in improving subjective health.
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Affiliation(s)
- Ruoxi Dai
- Department of Dental Public Health Faculty of Dentistry, The University of Hong Kong, 3/F Prince Philip Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong.,The Second People's Hospital of Hefei, 246 Heping Road, Hefei, Anhui, China
| | - Otto L T Lam
- Department of Prosthodontics, Faculty of Dentistry, The University of Hong Kong, 4/F Prince Philip Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Edward C M Lo
- Department of Dental Public Health Faculty of Dentistry, The University of Hong Kong, 3/F Prince Philip Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Leonard S W Li
- Department of Rehabilitation Medicine, Tung Wah Hospital, 12 Po Yan Street, Sheung Wan, Hong Kong, China
| | - Colman McGrath
- Department of Dental Public Health Faculty of Dentistry, The University of Hong Kong, 3/F Prince Philip Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong.
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Hagell P, Westergren A, Årestedt K. Beware of the origin of numbers: Standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations. Res Nurs Health 2017; 40:378-386. [DOI: 10.1002/nur.21806] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/16/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Hagell
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Albert Westergren
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences; Department of Research; Linnaeus University; Kalmar County Hospital; Kalmar Sweden
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
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Shen CL, Mo H, Yang S, Wang S, Felton CK, Tomison MD, Soelaiman IN. Safety and efficacy of tocotrienol supplementation for bone health in postmenopausal women: protocol for a dose-response double-blinded placebo-controlled randomised trial. BMJ Open 2016; 6:e012572. [PMID: 28011809 PMCID: PMC5223723 DOI: 10.1136/bmjopen-2016-012572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Osteoporosis is a major health concern in postmenopausal women, and oxidative stress contributes to the development of bone loss. Cellular studies and ovariectomised rat model mimicking bone loss in postmenopausal women show the bone-protective effect of tocotrienols (TTs) with antioxidant capability. We aim to access the safety and efficacy of TT consumption for bone health in postmenopausal women. METHODS AND ANALYSIS In this 12-week randomised double-blinded placebo-controlled trial for the effects of dietary TT supplementation in postmenopausal women, postmenopausal women aged 45 years and older with at least 1 year after menopause and bone mineral density T-score at the spine and/or hip 2.5 or more below the reference values will be randomly assigned to 3 daily supplements: (1) placebo group receiving 860 mg olive oil, (2) low TT group receiving 430 mg of 70% pure TTs (containing 300 mg TT) and (3) high TT group receiving 860 mg of 70% pure TTs (600 mg TT). The primary outcome measure will be urinary N-terminal telopeptide. The secondary outcome measures will be serum bone-specific alkaline phosphatase, receptor activator of nuclear factor-κB ligand, osteoprotegerin, urinary 8-hydroxy-2'-deoxyguanosine and quality of life. At 0, 6 and 12 weeks, the following will be assessed: (1) primary and secondary outcome measures; (2) serum TT and tocopherol concentrations; (3) physical activity and food frequency questionnaires. Liver function will be monitored every 6 weeks for safety. 'Intent-to-treat' principle will be employed for data analysis. A model of repeated measurements with random effect error terms will be applied. Analysis of covariance, χ2 analysis and regression will be used for comparisons. ETHICS AND DISSEMINATION This study was approved by the Bioethics Committee of the Texas Tech University Health Sciences Center. The findings of this trial will be submitted to a peer-reviewed journal in the areas of bone or nutrition and international conferences. TRIAL REGISTRATION NUMBER NCT02058420; results.
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Affiliation(s)
- Chwan-Li Shen
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Huanbiao Mo
- Department of Nutrition, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, Georgia, USA
| | - Shengping Yang
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Shu Wang
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Carol K Felton
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Michael D Tomison
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Schmieder RE, Jumar A, Fronk EM, Alexandre AF, Bramlage P. Quality of life and emotional impact of a fixed-dose combination of antihypertensive drugs in patients with uncontrolled hypertension. J Clin Hypertens (Greenwich) 2016; 19:126-134. [DOI: 10.1111/jch.12936] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 08/19/2016] [Accepted: 08/22/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Roland E. Schmieder
- Department for Nephrology and Hypertension; University Hospital Erlangen; Erlangen Germany
| | - Agnes Jumar
- Department for Nephrology and Hypertension; University Hospital Erlangen; Erlangen Germany
| | | | | | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine; Mahlow Germany
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Crichton SL, Bray BD, McKevitt C, Rudd AG, Wolfe CDA. Patient outcomes up to 15 years after stroke: survival, disability, quality of life, cognition and mental health. J Neurol Neurosurg Psychiatry 2016; 87:1091-8. [PMID: 27451353 DOI: 10.1136/jnnp-2016-313361] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/29/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND The global epidemiological shift of disease burden towards long-term conditions means understanding long-term outcomes of cardiovascular disease is increasingly important. More people are surviving stroke to experience its long-term consequences, but outcomes in people living more >10 years after stroke have not been described in detail. METHODS Data were collected for the population-based South London Stroke Register, with participants followed up annually until death. Outcomes were survival, disability, activity, cognitive impairment, quality of life, depression and anxiety. FINDINGS Of 2625 people having first-ever stroke, 262 (21%) survived to 15 years. By 15 years, 61% (95% CI 55% to 67%) of the survivors were male, with a median age of stroke onset of 58 years (IQR 48-66). 87% of the 15-year survivors were living at home and 33.8% (26.2% to 42.4%) had mild disability, 14.3% (9.2% to 21.4%) moderate disability and 15.0% (9.9% to 22.3%) severe disability. The prevalence of disability increased with time but 1 in 10 of the 15-year survivors had lived with moderate-severe disability since their stroke. At 15 years, the prevalence of cognitive impairment was 30.0% (19.5% to 43.1%), depression 39.1% (30.9% to 47.9%) and anxiety 34.9% (27.0% to 43.8%), and survivors reported greater loss of physical than mental quality of life. CONCLUSIONS One in five people live at least 15 years after a stroke and poor functional, cognitive and psychological outcomes affect a substantial proportion of these long-term survivors. As the global population of individuals with cardiovascular long-term conditions grows, research and health services will need to increasingly focus on preventing and managing the long-term consequences of stroke.
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Affiliation(s)
- Siobhan L Crichton
- Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Benjamin D Bray
- Farr Institute of Health Informatics, University College London, London, UK
| | - Christopher McKevitt
- Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Anthony G Rudd
- Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Charles D A Wolfe
- Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, London, UK
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Webster KE, Feller JA. Comparison of the short form-12 (SF-12) health status questionnaire with the SF-36 in patients with knee osteoarthritis who have replacement surgery. Knee Surg Sports Traumatol Arthrosc 2016; 24:2620-6. [PMID: 26821809 DOI: 10.1007/s00167-015-3904-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate whether the performance of the short form-12 (SF-12) health survey is comparable with the longer version SF-36 for measuring health-related quality of life over time in patients with knee osteoarthritis who have joint replacement surgery. METHODS Four hundred and seven patients with knee osteoarthritis completed the SF-36 before surgery and at a minimum of 12 months following knee replacement. SF-12 item responses were obtained from the responses given to the SF-36 questionnaire. Correlation coefficients were calculated between SF-12 and SF-36 physical component summary (PCS) and mental component summary (MCS) scores and the respective change in scores. Sensitivity to change was determined with the standardised response mean (SRM). RESULTS PCS and MCS scores were highly correlated between SF-12 and SF-36 versions for both preoperative and post-operative measures (r = 0.90-0.96, p < 0.0001). Change scores (post-operative-preoperative) were also highly correlated (PCS: r = 0.88, p < 0.001; MCS r = 0.93, p < 0.001). Sensitivity to change was large for the PCS scale (all SRMs >1.0). Correlations above 0.7 were found between change scores for each SF-36 and SF-12 subscale except General Health (r = 0.55). CONCLUSIONS The SF-12 summary measures and component scores replicate well with the SF-36 and show similar responsiveness to change. The SF-12 appears to be an adequate alternative for use in patients with knee osteoarthritis who undergo replacement surgery, and its brevity should be attractive for both clinicians and patients. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Kate E Webster
- School of Allied Health, College of Science, Health & Engineering, La Trobe University, Bundoora, Melbourne, VIC, 3086, Australia.
| | - Julian A Feller
- OrthoSport Victoria, Epworth HealthCare, Richmond, Australia
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Ng SSM, Fong SSM, Chan WLS, Hung BKY, Chung RKS, Chim THT, Kwong PWH, Liu TW, Tse MMY, Chung RCK. The sitting and rising test for assessing people with chronic stroke. J Phys Ther Sci 2016; 28:1701-8. [PMID: 27390398 PMCID: PMC4932039 DOI: 10.1589/jpts.28.1701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/15/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the inter-rater and test-retest reliability of the
sitting-rising test (SRT), the correlations of sitting-rising test scores with measures of
strength, balance, community integration and quality of life, as well as the cut-off score
which best discriminates people with chronic stroke from healthy older adults were
investigated. [Subjects and Methods] Subjects with chronic stroke (n=30) and healthy older
adults (n=30) were recruited. The study had a cross-sectional design, and was carried out
in a university rehabilitation laboratory. Sitting-rising test performance was scored on
two occasions. Other measurements included ankle dorsiflexor and plantarflexor strength,
the Fugl-Meyer assessment, the Berg Balance Scale, the timed up and go test, the five
times sit-to-stand test, the limits of stability test, and measures of quality of health
and community integration. [Results] Sitting-rising test scores demonstrated good to
excellent inter-rater and test-retest reliabilities (ICC=0.679 to 0.967). Sitting-rising
test scores correlated significantly with ankle strength, but not with other test results.
The sitting-rising test showed good sensitivity and specificity. A cut-off score of 7.8
best distinguished healthy older adults from stroke subjects. [Conclusions] The
sitting-rising test is a reliable and sensitive test for assessing the quality of sitting
and rising movements. Further studies with a larger sample are required to investigate the
test’s validity.
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Affiliation(s)
- Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Shirley S M Fong
- Institute of Human Performance, The University of Hong Kong, Hong Kong
| | - Wayne L S Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Ben K Y Hung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Ricci K S Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Tina H T Chim
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Patrick W H Kwong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Tai-Wa Liu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong; School of Science and Technology, The Open University of Hong Kong, Hong Kong
| | - Mimi M Y Tse
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Raymond C K Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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Franzén K, Blomqvist K, Saveman BI. Impact of Chronic Heart Failure on Elderly Persons' Daily Life: A Validation Study. Eur J Cardiovasc Nurs 2016; 5:137-45. [PMID: 16290116 DOI: 10.1016/j.ejcnurse.2005.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2005] [Revised: 08/26/2005] [Accepted: 09/27/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Knowledge about how elderly persons perceive the impact of chronic heart failure (CHF) on daily life is important when planning nursing care. For this purpose, disease specific instruments are needed. However, few instruments have been developed or tested specifically on elderly persons. AIM To validate a Swedish version of the Minnesota Living with Heart Failure Questionnaire (LHFQ) on elderly persons with CHF, and use it to describe the impact of CHF on daily life in the same population. METHODS The sample comprised of 357 persons, aged between 65 and 99, diagnosed with CHF. A questionnaire including background data, the LHFQ and the SF-12 was used. RESULTS A factor analysis resulted in four dimensions: physical, emotional, treatment and pleasure. LHFQ showed convergent validity and ability to discriminate between known groups. Cronbach's alpha for the total scale was 0.94. Impairments in the physical dimension were most common, especially fatigue (88%) and shortness of breath (87%). CONCLUSIONS The LHFQ showed satisfying psychometric properties in an elderly Swedish population with CHF and can, with minor alterations, be recommended for research and clinical use. The impact of chronic heart failure on daily life was mostly physical, but other impairments were also common.
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Affiliation(s)
- Kristofer Franzén
- Department of Nursing, Faculty of Medicine, Lund University, P.O. BOX 157, SE-221 00 Lund, Sweden.
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Franzén K, Saveman BI, Blomqvist K. Predictors for Health Related Quality of Life in Persons 65 Years or Older with Chronic Heart Failure. Eur J Cardiovasc Nurs 2016; 6:112-20. [PMID: 16859996 DOI: 10.1016/j.ejcnurse.2006.06.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 05/11/2006] [Accepted: 06/15/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND A main goal in nursing care of persons with chronic heart failure (HF) is to strengthen their health related quality of life (HRQoL). This presupposes knowledge about the relation between heart failure and HRQoL. Existing studies have shown incongruent results about whether HRQoL is affected differently depending on age or sex of elderly persons with chronic HF. AIM This study aimed to investigate if age, sex, disease severity, comorbidity and living conditions predict health related quality of life among persons 65 years or older with chronic HF. METHODS The study included a sample of 357 persons. HRQoL was measured by the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. Multiple regression analyses were performed to analyse the relation between the predictors and HRQoL. RESULTS The main finding was that self-rated disease severity was strongly associated with HRQoL, but also age, sex, diabetes and respiratory diseases was associated with some of the dimensions of HRQoL. CONCLUSIONS Interventions aimed at delaying the progress of the disease, assist persons' to cope with the disease and maintain the domains of HRQoL that are still feasible could be important to improve HRQoL in elderly persons with chronic HF.
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Affiliation(s)
- Kristofer Franzén
- Department of Nursing, Faculty of Medicine, Lund University, P.O. BOX 157, SE-221 00 Lund, Sweden.
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Bretz MN, Graves A, West A, Kiesz KC, Toth L, Welch M. Steps against recurrent stroke plus: patient transition program. J Neurosci Nurs 2016; 46:E3-13; quiz E1-2. [PMID: 24992152 DOI: 10.1097/jnn.0000000000000065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Stroke is a devastating health event that affects 800,000 people annually in the United States. Nearly 20% of strokes are recurrent strokes. Research shows that support after discharge from the hospital poststroke is frequently inadequate. The purpose of "Steps Against Recurrent Stroke (STARS) Plus: Patient Transition Program" was to design and deliver a program to facilitate optimal recovery for stroke survivors and prevent recurrent stroke. The program began at discharge from the hospital and continued through the first year of rehabilitation and recovery. Twelve hospitals participated; 261 patients enrolled, and contact was established with 193. Outcomes were gathered based on patient self-report of health status using the Short-Form Health Survey at 30, 90, 180, and 360 days. A dependent sample t test was completed comparing participants' 30- and 360-day follow-up scores. Results demonstrated an overall increase in subjective pain. A repeated multivariate analysis of variance was conducted to compare 30- and 360-day Short-Form Health Survey scores across age and subscales. Results revealed that those in the younger and older age groups reported poorer health outcomes. Findings demonstrate a reduction in rehospitalization after stroke, increased medication adherence, strong patient satisfaction, and significant differences in health-related outcome measures across age groups, suggesting that middle-aged stroke survivors experience better health outcomes than younger or older age groups. Future programs should consider targeting pain management in all ages and education targeted at younger and older age groups, because they reported poorer health outcomes. The findings from this program should contribute to the guidance and insight for others developing transitional interventions for stroke survivors.
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Affiliation(s)
- Miranda N Bretz
- Questions or comments about this article may be directed to Miranda N. Bretz, MA, at . She is a Research Analyst at National Stroke Association, Centennial, CO. Alex Graves, MS ANP, is the Clinical Director of Stroke Service at University of Colorado Hospital, Aurora, CO. Angie West, RN MSN CCRN CNRN, is the Program Director Neuroscience/Stroke at Memorial Stroke Center, Long Beach Memorial Hospital, Long Beach, CA. Karen C. Kiesz, RN MN CNRN, is the Stroke Program Manager at MultiCare Health System Caroline Administration, Tacoma, WA. Lynn Toth, RN MSN NP-C, is a Cardiovascular Medical Specialist at Beebe Medical Center, Lewes, DE. Marie Welch, RN MSN MS CRRN, is a Stroke Coordinator and Clinical Nurse Specialist at Vidant Health, Greenville, NC
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Loosman WL, Hoekstra T, van Dijk S, Terwee CB, Honig A, Siegert CEH, Dekker FW. Short-Form 12 or Short-Form 36 to measure quality-of-life changes in dialysis patients? Nephrol Dial Transplant 2015; 30:1170-6. [PMID: 25829325 DOI: 10.1093/ndt/gfv066] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 02/16/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Short-Form 36 (SF-36) is a self-report health-related quality-of-life (HRQOL) questionnaire, widely used in dialysis patients. It consists of physical and mental component scores (PCS/MCS), ranging from 0 to 100. To improve efficiency, the Short-Form 12 (SF-12) was developed to reproduce PCS and MCS. We assessed the ability of SF-12 versus SF-36 to detect change over time, and the association of SF-12 versus SF-36 with short-term and long-term mortality in dialysis patients. METHODS Patients were selected from the Netherlands Cooperative Study on the Adequacy of Dialysis (N = 1379), a prospective follow-up study among incident dialysis patients (62.1% HD) who completed SF-36 measurements every 6 months. Changes in scores of SF-12 versus SF-36 were compared with intra-class correlation coefficients (ICCs). Subsequently, Bland-Altman plots were used to assess limits of agreement. Relationship with mortality was assessed with Cox models with and without a time-dependent variable, adjusted for age, sex, ethnicity, comorbidity and dialysis modality at baseline. RESULTS ICC for change in scores was 0.90 for MCS and 0.84 for PCS. Mean difference was -0.1 and 0.2, respectively, and limits of agreement were -8.3 to 8.4 for MCS change in scores and -8.8 to 9.2 for PCS. Adjusted hazard ratio's for mortality per 5 units increment were 0.87 (95% CI: 0.84-0.91) for MCS12, 0.87 (95% CI: 0.84-0.90) for MCS36, 0.79 (95% CI: 0.76-0.83) for PCS12 and 0.75 (95% CI: 0.71-0.78) for PCS36. CONCLUSIONS SF-12 can be used to detect change in HRQOL in cohort studies on dialysis patients. SF-12 and SF-36 were similarly associated with short-term and long-term mortality. However, the wide limits of agreement indicate that SF-12 and SF-36 can give different scores on the individual level, suggesting that for individual purposes SF-36 instead of SF-12 should be used.
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Affiliation(s)
- Wim L Loosman
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
| | - Tiny Hoekstra
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sandra van Dijk
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health, Care Research VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan Honig
- Department of Psychiatry, Sint Lucas Andreas Hospital/VU University Medical Center, Amsterdam, The Netherlands
| | - Carl E H Siegert
- Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Abstract
BACKGROUND Patients with early-stage lung cancer often have comorbid illnesses and fear debility and death when contemplating surgery. However, data that compare physical function of patients who receive surgery with similar patients who do not are sparse. The authors report 1-year outcome results for surgical and nonsurgical patients in a prospective lung cancer cohort to address this gap. METHODS The authors enrolled 386 patients with early-stage lung cancer. A 106-item survey was completed at the time of enrollment including the Short-Form 12 (SF-12) Health Survey to assess functional status. Patients were followed for a year. Chart abstractions were obtained to determine comorbid illnesses and surgical status. Death was ascertained through vital records. The SF-12 was repeated 1 year after the enrollment. Regression models were constructed to identify predictors of 1-year mortality and decline in physical function. RESULTS Fifty-nine patients (15.3%) died before 1-year follow-up. Mortality in the surgical group was 10.8% compared with 22.8% in the nonsurgical group (P < 0.001). In regression analysis controlling for age and comorbidities, surgical treatment was associated with a reduction in 1-year mortality (odds ratio: 0.5 and 95% confidence interval: 0.3-1.0) but did not worsen physical function relative to the untreated group (average decrease in physical component score of SF-12 = 1.9 for surgery group and 2.5 for no surgery group, P = 0.66). CONCLUSIONS Functional decline between surgically treated and untreated patients did not differ. This result casts doubt on its value as a treatment determinant. Cancer mortality seems to be a more essential issue in treatment decisions.
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Lopez-Espuela F, Zamorano JDP, Ramírez-Moreno JM, Jiménez-Caballero PE, Portilla-Cuenca JC, Lavado-García JM, Casado-Naranjo I. Determinants of Quality of Life in Stroke Survivors After 6 Months, from a Comprehensive Stroke Unit. Biol Res Nurs 2014; 17:461-8. [DOI: 10.1177/1099800414553658] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: In the social model of stroke, health-related quality of life (HRQoL) is the result of interplay among stroke severity, social support, and health-promoting behaviors. Our objective was to identify determinants of HRQoL in stroke survivors. Methods: Ischemic stroke patients were evaluated at 6 months with the Short Form 12 Health Survey, including physical component survey (PCS) and mental health component survey (MCS) summary scores. Multivariate stepwise regression analyses determined independent predictors of scores. Models included age, gender, socioeconomic class, education, residential environment, social support, previous comorbidity (Charlson Index), previous stroke, side of stroke, National Institutes of Health Stroke Scale (NIHSS) score at admission, Barthel Index (BI) and modified Rankin Scale (mRS) scores at discharge, and length of stay. Results: A total of 131 patients participated (mean age 70.1, SD = 12.5; 62.6% males). In all, 33.6% had a BI score <90 and an mRS score >2 (poor outcome). The mean ( SD) PCS score was 39.46 (9.3) and mean ( SD) MCS score was 34.86 (10.1). Lower PCS score was associated with female sex (β = 0.204, p = .009), poor social support (β = −0.225, p = .003), and poor Charlson Index (β = −0.162, p = .032) and BI scores (β = 0.384, p < .0001). Lower MCS score was associated with female sex (β = 0.162, p = .062) and poor NIHSS (β = −0.265, p = .019) and BI scores (β = 0.203, p < .071). Conclusion: Stroke severity, disability, gender, social support, and previous stroke have significant impacts on the physical and mental domains of generic HRQoL.
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Affiliation(s)
- Fidel Lopez-Espuela
- Psychologist and Research Nurse, Stroke Unit, Hospital San Pedro de Alcantara, Caceres, Spain
| | | | | | | | - Juan Carlos Portilla-Cuenca
- Department of Neurology, Stroke Unit, Department of Neurology, Hospital San Pedro de Alcántara, Caceres, Spain
| | | | - Ignacio Casado-Naranjo
- Department of Neurology, Stroke Unit, Department of Neurology, Hospital San Pedro de Alcántara, Caceres, Spain
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Wolfe CDA, Rudd AG, McKevitt C. Modelling, evaluating and implementing cost-effective services to reduce the impact of stroke. PROGRAMME GRANTS FOR APPLIED RESEARCH 2014. [DOI: 10.3310/pgfar02020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BackgroundStroke is a leading cause of death and disability but there is little information on the longer-term needs of patients and those of different ethnic groups.ObjectivesTo estimate risk of stroke, longer-term needs and outcomes, risk of recurrence, trends and predictors of effective care, to model cost-effective configurations of care, to understand stakeholders’ perspectives of services and to develop proposals to underpin policy.DesignPopulation-based stroke register, univariate and multivariate analyses, Markov and discrete event simulation, and qualitative methods for stakeholder perspectives of care and outcome.SettingSouth London, UK, with modelling for estimates of cost-effectiveness.ParticipantsInner-city population of 271,817 with first stroke in lifetime between 1995 and 2012.Outcome measuresStroke incidence rates and trends, recurrence, survival, activities of daily living, anxiety, depression, quality of life, appropriateness and cost-effectiveness of care, and qualitative narratives of perspectives.Data sourcesSouth London Stroke Register (SLSR), qualitative data, group discussions.ResultsStroke incidence has decreased since 1995, particularly in the white population, but with a higher stroke risk in black groups. There are variations in risk factors and types of stroke between ethnic groups and a large number of strokes occurred in people with untreated risk factors with no improvement in detection observed over time. A total of 30% of survivors have a poor range of outcomes up to 10 years after stroke with differences in outcomes by sociodemographic group. Depression affects over half of all stroke patients and the prevalence of cognitive impairment remains 22%. Survival has improved significantly, particularly in the older black groups, and the cumulative risk of recurrence at 10 years is 24.5%. The proportion of patients receiving effective acute stroke care has significantly improved, yet inequalities of provision remain. Using register data, the National Audit Office (NAO) compared the levels of stroke care in the UK in 2010 with previous provision levels and demonstrated that improvements have been cost-effective. The treatment of, and productivity loss arising from, stroke results in total societal costs of £8.9B a year and 5% of UK NHS costs. Stroke unit care followed by early supported discharge is a cost-effective strategy, with the main gain being years of life saved. Half of stroke survivors report unmet long-term needs. Needs change over time, but may not be stroke specific. Analysis of patient journeys suggests that provision of care is also influenced by structural, social and personal characteristics.Conclusions/recommendationsThe SLSR has been a platform for a range of health services research activities of international relevance. The programme has produced data to inform policy and practice with estimates of need for stroke prevention and care services, identification of persistent sociodemographic inequalities in risk and care despite a reduction in stroke risk, quantification of the effectiveness and cost-effectiveness of care and development of models to simulate configurations of care. Stroke is a long-term condition with significant social impact and the data on need and economic modelling have been utilised by the Department of Health, the NAO and Healthcare for London to assess need and model cost-effective options for stroke care. Novel approaches are now required to ensure that such information is used effectively to improve population and patient outcomes.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and the Department of Health via the National Institute for Health Research Biomedical Research Centre award to Guy’s and St Thomas’ NHS Foundation Trust in partnership with King’s College London.
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Affiliation(s)
- Charles DA Wolfe
- Department of Primary Care and Public Health Sciences, Division of Health and Social Care Research, School of Medicine, King’s College London, London, UK
- National Institute for Health Research Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, London, UK
| | - Anthony G Rudd
- Department of Primary Care and Public Health Sciences, Division of Health and Social Care Research, School of Medicine, King’s College London, London, UK
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Christopher McKevitt
- Department of Primary Care and Public Health Sciences, Division of Health and Social Care Research, School of Medicine, King’s College London, London, UK
- National Institute for Health Research Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, London, UK
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Liang Y, Cao R. Is the health status of female victims poorer than males in the post-disaster reconstruction in China: a comparative study of data on male victims in the first survey and double tracking survey data. BMC Womens Health 2014; 14:18. [PMID: 24468297 PMCID: PMC3913328 DOI: 10.1186/1472-6874-14-18] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 01/22/2014] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The health of females is more at risk during disasters. Studies that focus on the comparison of males and time span are few. This article focuses on the health-related quality of life (HRQOL) of female victims in the post-disaster reconstruction in China. We aim to reduce gender health inequalities by comparing and analyzing gender differences in HRQOL. Moreover, we analyze the trends in HRQOL of female victims by using tracking data, and then provide reasonable suggestions to enhance the HRQOL. METHODS This article explores the HRQOL of women victims in the post-disaster reconstruction from two perspectives: a comparison between males and a time span of six-month intervals. We conducted the first survey, and the double tracking survey in 2013. This study uses data from half a year later sample surveys collected from five counties (Wenchuan, Qingchuan, Mianzhu, Lushan, and Dujiangyan) in Sichuan in 2013 (N = 2000). RESULTS (1) By calculating the Cronbach's alpha coefficients of the SF-12 scale, we found that that reliability of the scale and the internal consistency are good. (2) Using SF-12 instead of SF-36 to measure the HRQOL of survivors is feasible. (3) The ANOVA and non-parametric testing methods show that significant differences exist between the eight dimensions of HRQOL in different genders after the earthquake. (4) After six months, the HRQOL of female victims in the post-disaster reconstruction has also undergone a significant change. (5) Compared with male victims, we should give more attention to female victims' HRQOL issues in the post-disaster reconstruction in Sichuan. (6) The performances of victims in the post-disaster reconstruction in PCS and MCS affect each other. CONCLUSION We found that in terms of gender, the male and female victims' HRQOL after the disaster largely varied: (1) In general, significant difference exists between male and female victims in terms of HRQOL. The HRQOL of female victims is poorer than that of male victims. (2) The PCS and MCS of victims affect each other. However, for female victims, the degree of influence of MCS on PCS is larger than that in males. (3) The MCS of female victims is more vulnerable than that of male victims. In terms of time span, the following information was obtained: (1) after six months of rest, victims' HRQOL significantly improved. (2) At this stage, relative to the MCS, the PCS of females should be given more attention.
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Affiliation(s)
- Ying Liang
- Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, Nanjing 210023, People's Republic of China
| | - Runxia Cao
- School of Statistics and Mathematics, Zhejiang Gongshang University, Zhejiang 310018, People's Republic of China
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Asadi-Lari M, Gray D. Generic tools for measuring health-related quality of life in coronary artery disease. Expert Rev Pharmacoecon Outcomes Res 2014; 7:171-6. [DOI: 10.1586/14737167.7.2.171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Reliability and validity of the French-Canadian version of the scoliosis research society 22 questionnaire in France. Spine (Phila Pa 1976) 2014; 39:E26-34. [PMID: 24150431 DOI: 10.1097/brs.0000000000000080] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Outcome study to determine the internal consistency, reproducibility, and concurrent validity of the French-Canadian version of the Scoliosis Research Society 22 (SRS-22 fcv) patient questionnaire in France. OBJECTIVE To determine whether the SRS-22 fcv can be used in a population from France. SUMMARY OF BACKGROUND DATA The SRS-22 has been translated and validated in multiple countries, notably in the French-Canadian language in Quebec, Canada. Use of SRS-22 fcv seems appropriate for evaluating adolescent idiopathic scoliosis in France. However, French-Canadian French is noticeably different from the French spoken in France, and no study has investigated the use of a French-Canadian version of a health-quality questionnaire in another French population. METHODS The methods used for validating the SRS-22 fcv in Quebec were adopted for use with a group of 200 adolescents with idiopathic scoliosis and 60 healthy adolescents in France. Reliability and reproducibility were measured by the Cronbach α and intraclass correlation coefficient (ICC), construct validity by factorial analysis, concurrent validity by the Short-Form of the survey, and discriminant validity by analysis of variance and multivariate linear regression. RESULTS In France, the SRS-22 fcv showed good global internal consistency (Cronbach α = 0.87, intraclass correlation coefficient = 0.92), a coherent factorial structure, and high correlation coefficients between the SRS-22 fcv and Short-Form of the survey (P < 0.001). However, reliability and validity were slightly less than that for the instrument's original validation and the validation of the SRS-22 fcv in Quebec. These differences could be explained by language and cultural differences. CONCLUSION The SRS-22 fcv is relevant for use in France, but further development and validation of a specific French questionnaire remain necessary to improve the assessment of functional outcomes of adolescents with scoliosis in France. LEVEL OF EVIDENCE N/A.
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LANG SASKIA, BECKER RÜDIGER, WILKE STEFANIE, HARTMANN MECHTHILD, HERZOG WOLFGANG, LÖWE BERND. Anxiety Disorders in Patients with Implantable Cardioverter Defibrillators: Frequency, Course, Predictors, and Patients’ Requests for Treatment. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 37:35-47. [DOI: 10.1111/pace.12276] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/24/2013] [Accepted: 08/12/2013] [Indexed: 12/31/2022]
Affiliation(s)
- SASKIA LANG
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - RÜDIGER BECKER
- Department of Cardiology; University of Heidelberg; Heidelberg Germany
| | - STEFANIE WILKE
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - MECHTHILD HARTMANN
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - WOLFGANG HERZOG
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - BERND LÖWE
- Department of Psychosomatic Medicine and Psychotherapy; University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek; Hamburg Germany
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Chyu MC, Zhang Y, Brismée JM, Dagda RY, Chaung E, Von Bergen V, Doctolero S, Shen CL. Effects of martial arts exercise on body composition, serum biomarkers and quality of life in overweight/obese premenopausal women: a pilot study. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2013; 6:55-65. [PMID: 24665215 PMCID: PMC3941186 DOI: 10.4137/cmwh.s11997] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Various exercise interventions have been shown to benefit weight control and general health in different populations. However, very few studies have been conducted on martial arts exercise (MAE). The objective of this pilot study is to evaluate the efficacy of 12 weeks of MAE intervention on body composition, serum biomarkers and quality of life (QOL) in overweight/obese premenopausal women. We found that subjects in the MAE group did not lose body weight, while they significantly decreased fat-free mass and muscle mass as compared to those in the control group, who demonstrated an increase in these parameters. The MAE group demonstrated an increase in serum IGF-I concentration, but no change in others. MAE may be a feasible and effective approach to improve body composition and QOL in overweight/obese premenopausal women. Our study underscores the need for further studies using larger samples to establish possible benefits of MAE in various populations.
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Affiliation(s)
- Ming-Chien Chyu
- Graduate Healthcare Engineering, Whitacre College of Engineering, Texas Tech University, Lubbock, TX
| | - Yan Zhang
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Texas Tech University, Lubbock, TX
| | - Jean-Michel Brismée
- Department of Rehabilitation Science, Texas Tech University Health Sciences Center, Texas Tech University, Lubbock, TX
| | - Raul Y Dagda
- Department of Pathology, Texas Tech University Health Sciences Center, Texas Tech University, Lubbock, TX
| | - Eugene Chaung
- School of Medicine, Texas Tech University Health Sciences Center, Texas Tech University, Lubbock, TX
| | - Vera Von Bergen
- School of Medicine, Texas Tech University Health Sciences Center, Texas Tech University, Lubbock, TX
| | - Susan Doctolero
- Clinical Research Institute, Texas Tech University Health Sciences Center, Texas Tech University, Lubbock, TX
| | - Chwan-Li Shen
- Department of Pathology, Texas Tech University Health Sciences Center, Texas Tech University, Lubbock, TX
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Tjahjadi M, Heinen C, König R, Rickels E, Wirtz CR, Woischneck D, Kapapa T. Health-Related Quality of Life After Spontaneous Subarachnoid Hemorrhage Measured in a Recent Patient Population. World Neurosurg 2013; 79:296-307. [DOI: 10.1016/j.wneu.2012.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 01/29/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022]
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Kapapa T, Woischneck D, Tjahjadi M. Long-term health-related quality of life after spontaneous nontraumatic subarachnoid hemorrhage: self and proxy reports in a 10-year period. World Neurosurg 2012; 81:105-9. [PMID: 23046914 DOI: 10.1016/j.wneu.2012.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 03/27/2012] [Accepted: 10/02/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study sought to examine health-related quality of life several years after spontaneous nontraumatic subarachnoid hemorrhage. Recent studies report impairments to be improved as far as normal levels. We question such an improvement in our own patient population over a period of 10 years. METHODS The Medical Outcomes Study 36-Item and Medical Outcomes Study 12-Item Short-Form Health Surveys on health-related quality of life were used to question 236 patients and 235 proxies. The patients were assigned to 5 groups according to the time that had elapsed since their hemorrhage: 1 year N = 22, 2 years N = 36, 5 years N = 86, 8 years N = 61, and 10 years N = 31. Analyses of variance (ANOVA, Kruskal-Wallis) and correlation (Spearman, Kendall tau) were used in an exploratory approach. Significance was established as P ≤ 0.05. RESULTS Over a period of 10 years, health-related quality of life is found to be impaired, and is reported as such by the patients themselves and their proxies. Comparison of the mean values between the groups, ie, 1, 2, 5, and 10 years, revealed no significant differences in health-related quality of life. The calculations with a view to correlations between the group means and time since hemorrhage also produced only very weak correlations of no significance. CONCLUSIONS Health-related quality of life is impaired over a period of 10 years. Spontaneous nontraumatic subarachnoid hemorrhage should be regarded as a chronic cerebrovascular condition.
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Affiliation(s)
- Thomas Kapapa
- Universitätsklinikum Ulm, Neurochirurgische Klinik, Ulm, Germany.
| | | | - Martin Tjahjadi
- Universitätsklinikum Ulm, Neurochirurgische Klinik, Ulm, Germany
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Subjective cognitive-affective status following thalamic stroke. J Neurol 2012; 260:386-96. [DOI: 10.1007/s00415-012-6635-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/06/2012] [Accepted: 07/19/2012] [Indexed: 10/28/2022]
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Rachpukdee S, Howteerakul N, Suwannapong N, Tang-Aroonsin S. Quality of life of stroke survivors: a 3-month follow-up study. J Stroke Cerebrovasc Dis 2012; 22:e70-8. [PMID: 22749628 DOI: 10.1016/j.jstrokecerebrovasdis.2012.05.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 05/07/2012] [Accepted: 05/12/2012] [Indexed: 11/25/2022] Open
Abstract
The assessment of stroke survivors' quality of life (QoL) is essential for planning poststroke therapy strategies. This study aimed to assess, compare, and identify predictors of unsatisfactory QoL in different dimensions of stroke survivors at 1 month and 3 months poststroke. A total of 125 stroke survivors were recruited from 4 public hospitals under the auspices of the Department of Medical Services, Bangkok Metropolitan Administration, Thailand, and followed for 3 months. QoL was assessed using the self-administered SF-36 Health Survey, version 2.0. Six specific dimensions of QoL--physical function, role-physical, bodily pain, general health, vitality, and role-emotional--were significantly improved at 3 months poststroke; however, 2 dimensions--social function and mental health--were not. Multiple logistic regression analysis revealed that at 1 month poststroke, significant predictors of unsatisfactory QoL were being dependent (Barthel Index score <80), severe cognitive impairment (Canadian Neurological Scale score <7), right hemisphere lesions, being single or widowed, age ≥ 60 years, and being unemployed poststroke. At 3 months poststroke, significant predictors of unsatisfactory QoL were being dependent (Barthel Index score <80), severe cognitive impairment (Canadian Neurological Scale score <7), being single or widowed, being unemployed poststroke, and self-supporting/other support for treatment fees. This follow-up study demonstrated a significant improvement in QoL from 1 month to 3 months poststroke. Predictors of QoL varied both over time poststroke and over the specific dimensions of QoL being considered.
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Jakobsson U, Westergren A, Lindskov S, Hagell P. Construct validity of the SF-12 in three different samples. J Eval Clin Pract 2012; 18:560-6. [PMID: 21210901 DOI: 10.1111/j.1365-2753.2010.01623.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Studies have challenged the validity and underlying measurement model of the physical and mental component summary scores of the 36-item Short-Form Health Survey in, for example the elderly and people with neurological disorders. However, it is unclear to what extent these observations translate to physical and mental component summary scores derived from the 12-item short form (SF-12) of the 36-item Short-Form Health Survey. This study evaluated the construct validity of the SF-12 in elderly people and people with Parkinson's disease (PD) and stroke. METHODS SF-12 data from a general elderly (aged 75+) population (n = 4278), people with PD (n = 159) and stroke survivors (n = 89) were analysed regarding data quality, reliability (coefficient alpha) and internal construct validity. The latter was assessed through item-total correlations, exploratory and confirmatory factor analyses. RESULTS Completeness of data was high (93-98.8%) and reliability was acceptable (0.78-0.85). Item-total correlations argued against the suggested items-to-summary scores structure in all three samples. Exploratory factor analyses failed to support a two-dimensional item structure among elderly and stroke survivors, and cross-loadings of items were seen in all three samples. Confirmatory factor analyses showed lack of fit between empirical data and the proposed items-to-summary measures structure in all samples. CONCLUSIONS These observations challenge the validity and interpretability of SF-12 scores among the elderly, people with PD and stroke survivors. The standard orthogonally weighted SF-12 scoring algorithm is cautioned against. Instead, when the assumed two-dimensional structure is supported in the data, oblique scoring algorithms appear preferable. Failure to consider basic scoring assumptions may yield misleading results.
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Affiliation(s)
- Ulf Jakobsson
- Department of Health Sciences, Lund University, Lund, Sweden
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Alverson EM, Kessler TA. Relationships between lifestyle, health behaviors, and health status outcomes for underserved adults. ACTA ACUST UNITED AC 2012; 24:364-74. [PMID: 22672488 DOI: 10.1111/j.1745-7599.2012.00697.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine the relationships between lifestyle, health behaviors, and health status for underserved adults. DATA SOURCES A convenience sample of 84 adults responded to a questionnaire on lifestyle, health behaviors, health indices, and health status. Health status was measured by the 12-Item Short-Form Health Survey (SF-12). CONCLUSIONS The majority of the sample was white, female, ranged in age from 19 to 64 years, and had an annual income range of $0-$25,000. Lifestyle factors reported included smoking (44%), consuming alcohol (59%), using street drugs previously (43%), exercising regularly (45%), and having adequate sleep (M= 7.16 h). Sixty-five percent engaged in at least one screening behavior during the past 12 months and used at least one prescription medication. Data for health indices demonstrated subjects had at least one current symptom (89%), at least one current medical condition (72%), and a body mass index classified as overweight (48%). No significant relationships were found between lifestyle and health status. Findings indicated health indices rather than lifestyle were related to health status. IMPLICATIONS FOR PRACTICE Findings provided selective support for the links between lifestyle, health behaviors, and health status. Nurses can use the results as a basis for future assessments and interventions with underserved adults.
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Affiliation(s)
- Elise M Alverson
- College of Nursing, Valparaiso University, Valparaiso, IN 46383, USA.
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Årestedt K, Saveman BI, Johansson P, Blomqvist K. Social support and its association with health-related quality of life among older patients with chronic heart failure. Eur J Cardiovasc Nurs 2012; 12:69-77. [PMID: 22457369 DOI: 10.1177/1474515111432997] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social support is generally known to influence health-related quality of life (HRQoL), but this association is not well explored among older patients with chronic heart failure. AIMS (1) To describe social support in older patients with chronic heart failure in relation to gender. (2) To investigate if age, gender, cohabitation, perceived financial situation, and disease severity are associated with social support. (3) To investigate if social support is associated with HRQoL after controlling for age, gender, and disease severity. METHODS Data were collected in a sample of 349 patients (≥ 65 years) with chronic heart failure. Patients' HRQoL was measured with the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. The Interview Schedule for Social Interaction measured social support. Data were analysed with descriptive statistics, repeated-measure ANOVA, and multiple linear regression analyses with robust standard errors. RESULTS Social support was generally rated high, although being a man, living alone, perceiving a problematic financial situation, and high disease severity (NYHA) were associated with lower levels of social support. Age was not associated with social support. Social support was generally associated with HRQoL, in particular the emotional dimensions. CONCLUSION Taking social support into account when caring for older patients with heart failure can be of importance for improving or maintaining HRQoL.
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Bergman E, Malm D, Berterö C, Karlsson JE. Does one's sense of coherence change after an acute myocardial infarction?: A two-year longitudinal study in Sweden. Nurs Health Sci 2011; 13:156-63. [DOI: 10.1111/j.1442-2018.2011.00592.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wolfe CDA, Crichton SL, Heuschmann PU, McKevitt CJ, Toschke AM, Grieve AP, Rudd AG. Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register. PLoS Med 2011; 8:e1001033. [PMID: 21610863 PMCID: PMC3096613 DOI: 10.1371/journal.pmed.1001033] [Citation(s) in RCA: 156] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 04/07/2011] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Although stroke is acknowledged as a long-term condition, population estimates of outcomes longer term are lacking. Such estimates would be useful for planning health services and developing research that might ultimately improve outcomes. This burden of disease study provides population-based estimates of outcomes with a focus on disability, cognition, and psychological outcomes up to 10 y after initial stroke event in a multi-ethnic European population. METHODS AND FINDINGS Data were collected from the population-based South London Stroke Register, a prospective population-based register documenting all first in a lifetime strokes since 1 January 1995 in a multi-ethnic inner city population. The outcomes assessed are reported as estimates of need and included disability (Barthel Index <15), inactivity (Frenchay Activities Index <15), cognitive impairment (Abbreviated Mental Test < 8 or Mini-Mental State Exam <24), anxiety and depression (Hospital Anxiety and Depression Scale >10), and mental and physical domain scores of the Medical Outcomes Study 12-item short form (SF-12) health survey. Estimates were stratified by age, gender, and ethnicity, and age-adjusted using the standard European population. Plots of outcome estimates over time were constructed to examine temporal trends and sociodemographic differences. Between 1995 and 2006, 3,373 first-ever strokes were registered: 20%-30% of survivors had a poor outcome over 10 y of follow-up. The highest rate of disability was observed 7 d after stroke and remained at around 110 per 1,000 stroke survivors from 3 mo to 10 y. Rates of inactivity and cognitive impairment both declined up to 1 y (280/1,000 and 180/1,000 survivors, respectively); thereafter rates of inactivity remained stable till year eight, then increased, whereas rates of cognitive impairment fluctuated till year eight, then increased. Anxiety and depression showed some fluctuation over time, with a rate of 350 and 310 per 1,000 stroke survivors, respectively. SF-12 scores showed little variation from 3 mo to 10 y after stroke. Inactivity was higher in males at all time points, and in white compared to black stroke survivors, although black survivors reported better outcomes in the SF-12 physical domain. No other major differences were observed by gender or ethnicity. Increased age was associated with higher rates of disability, inactivity, and cognitive impairment. CONCLUSIONS Between 20% and 30% of stroke survivors have a poor range of outcomes up to 10 y after stroke. Such epidemiological data demonstrate the sociodemographic groups that are most affected longer term and should be used to develop longer term management strategies that reduce the significant poor outcomes of this group, for whom effective interventions are currently elusive. Please see later in the article for the Editors' Summary.
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Affiliation(s)
- Charles D A Wolfe
- Division of Health and Social Care Research, King's College London, London, United Kingdom.
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Gray RJ, Myint PK, Elender F, Barton G, Pfeil M, Price G, Wyatt N, Ravenhill G, Thomas E, Jagger J, Hursey A, Waterfield K, Hardy S. A Depression Recognition and Treatment package for families living with Stroke (DepReT-Stroke): study protocol for a randomised controlled trial. Trials 2011; 12:105. [PMID: 21529370 PMCID: PMC3096922 DOI: 10.1186/1745-6215-12-105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 04/30/2011] [Indexed: 11/28/2022] Open
Abstract
Background Depression occurs in up to 50% of patients after stroke and limits rehabilitation and recovery. Mood disorders are also highly prevalent in carers; their mental health intertwined with the physical and mental wellbeing of the person they are caring for. We argue that working with families, rather than patients alone may improve the treatment of depression in both patients and their carers enhancing the mental wellbeing and quality of life of both. Methods A single blind cluster randomised controlled trial to evaluate whether families after stroke who are treated with the Depression Recognition and Treatment package (DepReT-Stroke) in addition to treatment as usual (TAU) show improved mental well being compared to those families who receive only TAU. We aim to recruit one hundred and twenty-six families (63 in each group). The DepReT-Stroke intervention will help families to consider the various treatment options for depression, make choices about which are likely to fit best with their lives and support them in the use of self-help therapies (e.g. computerised Cognitive Behavioural Therapy or exercise). An essential component of the DepReT-Stroke package will be to help people adhere to their chosen treatment(s). The primary outcome will be the Mental Component Subscale of the SF-36 assessed at baseline and again six months post intervention. Effectiveness of the intervention will be determined using analysis of co-variance; comparing the mean change in MCS scores from baseline to six months follow-up adjusting for the clustering effects of baseline scores and family. An economic evaluation of the intervention will help us determine whether the intervention represents a cost-effective use of resources. Discussion Depression both for patients and their carers is common after stroke. Our Depression Recognition and Treatment package (DepReT-stroke) may help clinicians be more effective at detecting and managing a common co-morbidity that limits rehabilitation and recovery. Trial Registration ISRCTN: ISRCTN32451749 Research Ethics Committee Reference Number: 10/H0310/23 Grant Reference Number: (NIHR) PB-PG-0808-17056
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Affiliation(s)
- Richard J Gray
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK.
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Rehabilitation and Recovery of the Patient with Stroke. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10056-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Shen CL, Chyu MC, Pence BC, Yeh JK, Zhang Y, Felton CK, Doctolero S, Wang JS. Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: safety and quality of life report. Altern Ther Health Med 2010; 10:76. [PMID: 21143878 PMCID: PMC3014873 DOI: 10.1186/1472-6882-10-76] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 12/09/2010] [Indexed: 11/12/2022]
Abstract
Background Evidence suggests that both green tea polyphenols (GTP) and Tai Chi (TC) exercise may benefit bone health in osteopenic women. However, their safety in this population has never been systematically investigated. In particular, there have been hepatotoxicity concerns related to green tea extract. This study was to evaluate the safety of 24 weeks of GTP supplementation combined with TC exercise in postmenopausal osteopenic women, along with effects on quality of life in this population. Methods 171 postmenopausal women with osteopenia were randomly assigned to 4 treatment arms for 24 weeks: (1) Placebo (500 mg starch/day), (2) GTP (500 mg GTP/day), (3) Placebo + TC (placebo plus TC training at 60 min/session, 3 sessions/week), and (4) GTP + TC (GTP plus TC training). Safety was examined by assessing liver enzymes (aspartate aminotransferase, alanine aminotransferase), alkaline phosphatase, and total bilirubin at baseline and every 4 weeks. Kidney function (urea nitrogen and creatinine), calcium, and inorganic phosphorus were also assessed at the same times. Qualify of life using SF-36 questionnaire was evaluated at baseline, 12, and 24 weeks. A mixed model of repeated measures ANOVA was applied for analysis. Results 150 subjects completed the study (12% attrition rate). The compliance rates for study agents and TC exercise were 89% and 83%, respectively. Neither GTP supplementation nor TC exercise affected liver or kidney function parameters throughout the study. No adverse event due to study treatment was reported by the participants. TC exercise significantly improved the scores for role-emotional and mental health of subjects, while no effect on quality of life was observed due to GTP supplementation. Conclusions GTP at a dose of 500 mg/day and/or TC exercise at 3 hr/week for 24 weeks appear to be safe in postmenopausal osteopenic women, particularly in terms of liver and kidney functions. TC exercise for 24 weeks (3 hr/wk) significantly improved quality of life in terms of role-emotional and mental health in these subjects. ClinicalTrials.gov identifier: NCT00625391.
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Bramlage P, Wolf WP, Fronk EM, Stuhr T, Erdlenbruch W, Wasem J, Ketelhut R, Schmieder RE. Improving quality of life in hypertension management using a fixed-dose combination of olmesartan and amlodipine in primary care. Expert Opin Pharmacother 2010; 11:2779-90. [PMID: 20929435 DOI: 10.1517/14656566.2010.521499] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To assess quality of life (QoL) in unselected patients in primary care treated with a fixed-dose combination of olmesartan and amlodipine. Research design and methods. Multicenter, noninterventional, noncontrolled observational study in 8241 patients seen by 2187 physicians over 12 - 18 weeks. MAIN OUTCOME MEASURES Changes in QoL were assessed by using the Short Form 12 (SF-12) questionnaire completed by 5434 patients (65.9%) at baseline and 4924 patients (59.8%) at the follow-up visit. RESULTS Patients had a mean age of 62.8 ± 11.8 years (48.1% female), mean blood pressure [BP] at baseline was 161.8 ± 16.6/93.6 ± 10.2 mmHg and 74.8% had at least one co-morbid risk factor or condition. All 12 items of the SF-12 improved over the observational period (p < 0.0001) as did the physical (46.8 vs 40.4; p < 0.0001) and mental summary scores (52.4 vs 47.5; p < 0.0001). Correlations of changes in systolic and diastolic BP, pulse pressure and heart rate with scores were significant, although weak (maximum -0.2055 for physical health and changes in systolic blood pressure). CONCLUSIONS The fixed-dose combination of olmesartan and amlodipine significantly improves QoL in an unselected population of patients in primary-care practice. This might translate into improved patient compliance and improved long-term antihypertensive efficacy.
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Affiliation(s)
- Peter Bramlage
- Institute for Cardiovascular Pharmacology and Epidemiology, Mahlow, Germany.
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Chyu MC, James CR, Sawyer SF, Brismée JM, Xu KT, Poklikuha G, Dunn DM, Shen CL. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal women with osteopaenia: a randomized clinical study. Clin Rehabil 2010; 24:1080-90. [PMID: 20702512 DOI: 10.1177/0269215510375902] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE to evaluate the effects of tai chi exercise on risk factors for falls in postmenopausal women with osteopaenia through measurements of balance, gait, physical function and quality of life. DESIGN a randomized, controlled, single-blinded, 24-week trial with stratification by age and bone mass. SETTING general community. PARTICIPANTS Sixty-one independently living elderly females aged 65 years and older with low bone mass. INTERVENTIONS subjects were recruited and randomly assigned to 24 weeks of tai chi (60 minutes/session, three sessions/week, n = 30) or a control group (n = 31). OUTCOME MEASURES computerized dynamic posturography, gait, 'timed up and go', five-chair sit-to-stand and quality of life assessed at baseline, 12 and 24 weeks. RESULTS after 24 weeks, subjects in the tai chi group demonstrated an increase in stride width (P = 0.05) and improvement in general health (P = 0.008), vitality (P = 0.02) and bodily pain (P = 0.03) compared with those in the control group. There was no significant difference in balance parameters, 'timed up and go', five-chair sit-to-stand and other domains of quality of life. CONCLUSION tai chi exercise may reduce risk factors for falls by increasing the stride width, and may improve quality of life in terms of general health, vitality and bodily pain in postmenopausal women with osteopaenia.
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Affiliation(s)
- Ming-Chien Chyu
- Department of Mechanical Engineering, Texas Tech University and Department of Pathology, Texas, USA
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Five-year stability in associations of health-related quality of life measures in community-dwelling older adults: the Rancho Bernardo Study. Qual Life Res 2010; 19:1333-41. [PMID: 20652752 PMCID: PMC2963736 DOI: 10.1007/s11136-010-9700-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2010] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study examines the five-year stability of the association of SF-12 and SF-6D scores with scores on the longer SF-36 and its domains in community-dwelling older men and women. METHODS Participants were 653 men and 917 women aged 50 and older who completed mailed surveys of HRQOL (1995, 2000). SF-36 physical (PCS) and mental (MCS) component scores, domain scores; SF-12 PCS and MCS scores; and SF-6D scores were computed. RESULTS Average age in 1995 was 68.2 ± 10.7 for men and 69.8 ± 11.3 for women. In 1995 and 2000, men had significantly higher scores on all measures (P's < 0.001). Sex-specific Pearson correlations of SF-12 PCS and MCS scores with SF-36 PCS and MCS scores ranged from 0.91 to 0.97 (P's < 0.000). Health utility scores (SF-6D) were also associated with SF-36 PCS and MCS scores, but correlations were lower, ranging from 0.61 to 0.79 (P's < 0.000). Age-stratified comparisons of 5-year change scores for SF-36 PCS showed significant declines in physical health for both men and women within all four age-groups (50-59, 60-69, 70-79, 80+) with steepest declines in the oldest age-group (age 80+). Over time, mental health scores showed significant modest improvement in the younger age-groups but declines in men >70 and women >80 years. The SF-6D scores improved somewhat for the youngest men and women but mean change scores declined for the other age-groups. CONCLUSION Similar conclusions would result using either instrument SF-12 or SF-36. However, SF-6D and SF-36 assess, at least in part, different underlying aspects of HRQOL. Both age and sex impact HRQOL.
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