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Chugh Y, Katoch S, Sharma D, Bahuguna P, Duseja A, Kaur M, Dhiman RK, Prinja S. Health-Related Quality of Life Among Liver Disorder Patients in Northern India. Indian J Community Med 2022; 47:76-81. [PMID: 35368487 PMCID: PMC8971888 DOI: 10.4103/ijcm.ijcm_1033_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/29/2021] [Indexed: 11/26/2022] Open
Abstract
Objective: The present study aims to determine the health-related quality of life (HRQoL) among liver disorder patients being treated in tertiary care hospital in north India and exploration of factors affecting HRQoL. Methodology: The HRQoL was assessed among 230 patients visiting either the outpatient department (OPD) or those admitted in high dependency unit (HDU) or liver intensive care unit (ICU) using direct measuring tools such as Euro QoL five-dimension questionnaire (EQ-5D) and EQ visual analog scale. Multivariate regression was used to explore the factors influencing HRQoL. Results: Mean EQ-5D scores among chronic hepatitis and compensated cirrhosis patients were 0.639 ± 0.062 and 0.562 ± 0.048, respectively. Among those who were admitted in the ICU or HDU, mean EQ-5D score was 0.295 ± 0.031. At discharge, this score improved significantly to 0.445 ± 0.055 (P < 0.001). The multivariate results implied that HRQoL was significantly better among patients with lower literacy level (P = 0.018) and those treated in OPD settings (P < 0.001). Conclusion: HRQoL is impaired among patients suffering from liver disorders specifically those admitted in ICU. Further, there is a need to generate more evidence to explore the impact of determinants and treatment-associated costs on the HRQoL.
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Affiliation(s)
- Yashika Chugh
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Swati Katoch
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepshikha Sharma
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Bahuguna
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manmeet Kaur
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha Krishan Dhiman
- Department of Hepatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Al-Marzouki AF, Alrefaie NI, Aljohani NA, Alandanusi RA, Alghamdi AA, Radhwi OO. The Prevalence of Depression and Anxiety Among Sickle Cell Disease Patients in King Abdulaziz University Hospital. Cureus 2021; 13:e18374. [PMID: 34646713 PMCID: PMC8479852 DOI: 10.7759/cureus.18374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/09/2022] Open
Abstract
Background Sickle cell disease (SCD) is a recessive hereditary condition. The physical changes caused by SCD affect the quality of life (QoL) by negatively impacting psychological aspects. Objective This study aimed to assess the prevalence of depression and anxiety in SCD patients based on different sociodemographic characteristics in Jeddah, Saudi Arabia. Method A cross-sectional study was conducted at King Abdulaziz University Hospital (KAUH) in Jeddah from 13 July to 30 August 2021. The included patients were 18 years of age and above and affected with sickle cell disease. Medical staff interviewed the patients and filled the Patient Health Questionnaire (PHQ)-9 and General Anxiety Disorder (GAD)-7. Result One hundred nineteen (119) patients were included in this study. The median age of participants was 32 and mostly male (n=72, 60.5%). The rate of depression was 45.4%. On the other hand, the rate of anxiety was 22.7%. The median of the PHQ-9 score was 8±8 while the median of the GAD-7 score was 5±8. Moreover, the study showed that anxiety and depression in relation to sociodemographics were higher in the patient age groups of 30-34 years old, male, single, unemployed, and with higher education. There was a significant association between depression rate and the two variables: patient employment status (49.3%; p=0.047) and a family history of SCD (51%). Conclusion Depression in patients with sickle cell disease is prevalent and correlated to demographic and social factors.
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Affiliation(s)
| | - Norah I Alrefaie
- Hematology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Nora A Aljohani
- Hematology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | | | | | - Osman O Radhwi
- Hematology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
- Hematology, King Fahd Medical Research Center (KFMRC), Jeddah, SAU
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Vieira DA, da Cunha LR, da Silva CB, Almeida MTB, Gomes AD, de Faria CLL, Teixeira R, Neves FS, Rocha GA, de Melo FF, de Magalhães Queiroz DM, Silva LD. The combined polymorphisms of interleukin-6-174GG genotype and interleukin-10 ATA haplotype are associated with a poor quality of life in patients with chronic hepatitis C. Qual Life Res 2019; 28:1531-1542. [PMID: 30734130 DOI: 10.1007/s11136-019-02129-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Chronic hepatitis C (CHC) is associated with a decreased health-related quality of life (HRQOL). More recent studies have pointed toward a genetic basis of patient-reported quality of life outcomes. Taking into account that the influence of single-nucleotide polymorphisms (SNPs) on the HRQOL of CHC patients has not been studied, we investigated the combined IL10-1082G/A, - 819C/T, and - 592C/A SNPs, and IL6-174G/C SNP. We also evaluated the association between demographic, clinical, psychiatric, virological, and genetic variables with domains and summaries of HRQOL in CHC patients. METHODS 132 consecutive CHC patients and 98 controls underwent psychiatric evaluation by using the Mini International Neuropsychiatric Interview. HRQOL was assessed by a generic questionnaire, the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and by the specific Liver Disease Quality of Life Questionnaire (LDQOL). IL6 and IL10 polymorphisms were evaluated by Taqman SNP genotyping assay. Multivariate analysis was used to evaluate the associations. RESULTS Major depressive disorder was associated with lower SF-36 and LDQOL scores in seven and ten domains, respectively. Diabetes and hypertension were also associated with reduced HRQOL. CHC patients carrying the combination of IL10 ATA haplotype/IL6-GG genotype had lower scores in the SF-36-physical functioning domain, and reduced scores in the LDQOL effects of liver disease on activities of daily living, quality of social interaction, and sexual function domains than the non-carriers of the combined haplotype/genotype. CONCLUSION This is the first study to demonstrate that combined IL6 high-producer GG genotype and IL10 low-producer ATA haplotype is associated with poorer HRQOL in CHC patients.
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Affiliation(s)
- Diego Alves Vieira
- Faculdade de Medicina, Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Universidade Federal de Minas Gerais (UFMG), Av Alfredo Balena 190 s/216, Belo Horizonte, Minas Gerais, 30130-100, Brazil.,Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Luciana Rodrigues da Cunha
- Faculdade de Medicina, Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Universidade Federal de Minas Gerais (UFMG), Av Alfredo Balena 190 s/216, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Cliviany Borges da Silva
- Faculdade de Medicina, Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Universidade Federal de Minas Gerais (UFMG), Av Alfredo Balena 190 s/216, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Maria Thereza Bastos Almeida
- Medical undergraduate student, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Adriana Dias Gomes
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - César Lúcio Lopes de Faria
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rosângela Teixeira
- Faculdade de Medicina, Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Universidade Federal de Minas Gerais (UFMG), Av Alfredo Balena 190 s/216, Belo Horizonte, Minas Gerais, 30130-100, Brazil.,Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30130-100, Brazil
| | - Fernando Silva Neves
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Gifone Aguiar Rocha
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fabrício Freire de Melo
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Luciana Diniz Silva
- Faculdade de Medicina, Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Universidade Federal de Minas Gerais (UFMG), Av Alfredo Balena 190 s/216, Belo Horizonte, Minas Gerais, 30130-100, Brazil. .,Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30130-100, Brazil.
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Adzika VA, Glozah FN, Ayim-Aboagye D, Ahorlu CSK. Socio-demographic characteristics and psychosocial consequences of sickle cell disease: the case of patients in a public hospital in Ghana. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:4. [PMID: 28143586 PMCID: PMC5282775 DOI: 10.1186/s41043-017-0081-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 01/20/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is of major public health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Ghana. The objective of this study was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. METHODS A cross-sectional research design was used that involved the completion of questionnaires on socio-demographic characteristics, quality of life, coping mechanisms, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. RESULTS Results showed that majority of the patients were single, female, less than 39 years old and had attained secondary school level of education or less. Also, patients were more satisfied by the presence of love, friends and relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having faith in God was the most frequently reported mechanisms for coping with an unbearable SCD attacks. Results of multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. CONCLUSIONS It is recommended that a holistic intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.
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Affiliation(s)
- Vincent A Adzika
- Department of Psychology, Regent University College, Accra, Ghana.
| | | | | | - Collins S K Ahorlu
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Nakamura PM, Teixeira IP, Smirmaul BPC, Sebastião E, Papini CB, Gobbi S, Kokubun E. Health related quality of life is differently associated with leisure-time physical activity intensities according to gender: a cross-sectional approach. Health Qual Life Outcomes 2014; 12:98. [PMID: 25135321 PMCID: PMC4262226 DOI: 10.1186/1477-7525-12-98] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 05/09/2014] [Indexed: 11/28/2022] Open
Abstract
Background Several studies have demonstrated a positive association between physical activity (PA) and health-related quality of life (HRQL). However, studies have suggested that this association depends both on the PA intensity and the domain of HRQL evaluated. This study aimed to explore the association between physical, mental and overall HRQL with recommended levels of PA. PA levels were divided into moderate and vigorous intensity leisure-time PA and total leisure-time PA. Methods The study included 1001 adults, 582 women (46 ± 17 years) and 419 men (43 ± 16 years), residents in Rio Claro-SP, Brazil. All participants completed the SF-36 questionnaire to assess HRQL and the long version of the International Physical Activity Questionnaire (IPAQ) to assess level and intensities of leisure-time PA. Total leisure-time PA at moderate intensity was classified as: less than 9 min/week, 10-149 min/week, 150-299 min/week and 300 min/week or more. Total leisure-time PA at vigorous intensity was classified as: less than 9 min/week, 10 to 74.9 min/week, 75-149 min/week and 150 min/week or more. Multiple linear regression was performed in STATA version 12.0. Results Among women, moderate intensity and total leisure-time PA were associated with physical health. Among men, moderate and vigorous intensity and total leisure-time PA were associated with physical health and overall HRQL. Furthermore, moderate intensity and total leisure-time PA were associated with mental health in men. However, vigorous intensity PA was not associated with mental health for this group. Conclusion The different domains of HRQL were associated with different levels and intensities of PA in leisure-time according to gender of adults. These findings indicate the complexity and importance of evaluating the HRQL stratified by gender and consider the different levels and intensities of PA.
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Affiliation(s)
- Priscila Missaki Nakamura
- Department of Physical Education, Physical Activity, Health and Sport Laboratory (NAFES)-São Paulo State University, Rio Claro, SP, Brazil.
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ul Haq N, Hassali MA, Shafie AA, Saleem F, Aljadhey H. A cross sectional assessment of health related quality of life among patients with Hepatitis-B in Pakistan. Health Qual Life Outcomes 2012; 10:91. [PMID: 22866752 PMCID: PMC3480955 DOI: 10.1186/1477-7525-10-91] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 08/01/2012] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The study aims to assess Health Related Quality of Life (HRQoL) among Hepatitis B (HB) patients and to identify significant predictors of the HRQoL in HB patients of Quetta, Pakistan. METHODS A cross sectional study by adopting European Quality of Life scale (EQ-5D) for the assessment of HRQoL was conducted. All registered HB patients attending two public hospitals in Quetta, Pakistan were approached for study. Descriptive statistics were used to describe demographic and disease related characteristics of the patients. HRQoL was scored using values adapted from the United Kingdom general population survey. EQ-5D scale scores were compared with Mann-Whitney and Kruskal-Wallis test. Standard multiple regression analysis was performed to identify predictors of HRQoL. All analyses were performed using SPSS v 16.0. RESULTS Three hundred and ninety HB patients were enrolled in the study. Majority of the participants (n = 126, 32.3%) were categorized in the age group of 18-27 years (36.07 ± 9.23). HRQoL was measured as poor in the current study patients (0.3498 ± 0.31785). The multivariate analysis revealed a significant model (F(10, 380) = 40.04, P < 0.001, adjusted r(2) = 0.401). Educational level (β = 0.399, p = 0.025) emerged as a positive predictor of HRQoL. Age, gender, occupation, income and locality were not predictive of better quality of life in HB patients. CONCLUSIONS Hepatitis B has an adverse affect on patients' well-being and over all HRQoL. The study findings implicate the need of health promotion among HB patients. Improving the educational status and imparting disease related information for the local population can results in better control and management of HB.
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Affiliation(s)
- Noman ul Haq
- Department of Pharmacy, University of Baluchistan, Quetta, Pakistan/Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Asrul A Shafie
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Fahad Saleem
- Department of Pharmacy, University of Baluchistan, Quetta, Pakistan/Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Hisham Aljadhey
- College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Pucci GCMF, Rech CR, Fermino RC, Reis RS. Association between physical activity and quality of life in adults. Rev Saude Publica 2012; 46:166-79. [PMID: 22249758 DOI: 10.1590/s0034-89102012000100021] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 08/22/2011] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To summarize and analyze evidences of the association between physical activity and quality of life. METHODS Systematic literature review in three electronic databases -PubMed, Lilacs and SciELO- using the following descriptors: "physical activity," "motor activity," "exercise," "walking," "running," "physical fitness," "sport," "life style," "quality of life," "WHOQOL" and "SF." There were selected 38 studies published between 1980 and 2010 that used any instrument to measure physical activity and any version of the Medical Outcomes Study 36-Item Short-Form Health Survey or the World Health Organization Quality of Life to assess quality of life. RESULTS Most studies reviewed were cross-sectional (68%), 18% experimental, 8% prospective follow-up cohort and 5% mixed-design (cross-sectional and longitudinal). The most widely used questionnaire to assess quality of life was SF-36 (71%), and physical activity was self-reported in 82% of the studies reviewed. Higher level of physical activity was associated with better perception of quality of life in the elderly, apparently healthy adults and individuals with different clinical conditions. CONCLUSIONS There is a positive association between physical activity and quality of life that varies according to the domain analyzed.
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Affiliation(s)
- Gabrielle Cristine Moura Fernandes Pucci
- Grupo de Pesquisa em Atividade Física e Qualidade de Vida, Centro de Ciências Biológicas e da Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
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Quality of life and physical activity among adults: population-based study in Brazilian adults. Qual Life Res 2012; 21:1537-43. [PMID: 22362520 DOI: 10.1007/s11136-011-0083-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To analyze the association between leisure-time physical activity (PA) (walking, moderate- and vigorous-intensity activities) and transport (active commuting) with quality of life (QoL) domains (physical, social relations, environmental and psychological). METHODS Participants were 1,461 adults (18-65 years) living in the city of Curitiba, Brazil. QoL was assessed using the abbreviated WHOQoL questionnaire and PA through the IPAQ long version. Multiple linear regression models were used to analyze the relationship between PA types (walking, moderate and vigorous) and domains (leisure and transport) with QoL domains. RESULTS Walking for leisure was positively associated with social relations (β = 1.5; P = 0.011) and environment (β = 3.3; P = 0.015) domains among men and with physical (β = 3.2; P = 0.04), environment (β = 4.1; P = 0.011) and psychological (β = 3.2; P = 0.009) domains among women. Moderate intensity PA was associated with all but the physical QoL domain among women. Among men, this association was observed only between insufficient levels of PA and the physical domain of QoL (β = 3.0; P = 0.016). Vigorous PA was associated with social relations (β = 3.4; P = 0.034) and psychological (β = 4.2; P = 0.009) QoL domains. Transport PA was only associated with the physical QoL domain in men (β = 3.1; P = 0.042). CONCLUSION There is a positive relationship between PA and QoL, though this association varies according to the type and intensity of PA and differs across QoL domains. Unlike transport PA, leisure-time PA shows consistent association with QoL.
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McKenna O, Cunningham C, Blake C. Socio-demographic and clinical features of Irish iatrogenic hepatitis C patients: a cross-sectional survey. BMC Public Health 2009; 9:323. [PMID: 19735567 PMCID: PMC2761402 DOI: 10.1186/1471-2458-9-323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 09/07/2009] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A discrete sub-group of iatrogenically-acquired hepatitis C virus (HCV)-infected individuals exists in the Irish population on whom limited current research data is available. The aim of this study was to establish a current profile of the socio-demographic and clinical characteristics of the Irish iatrogenic hepatitis C population and to determine factors predicting symptoms experienced. METHODS An anonymous, national, cross-sectional survey was conducted to explore this populations' self-reported health and social attributes. Data were collected on 290 respondents. RESULTS Mean time since infection was 26 years. Eighty-four percent (n = 237) of respondents were female (mean age = 55.9 +/- 9.6 years). Hepatic and extra-hepatic symptoms were common (62% and 99% respectively). Fatigue and pain were frequent complaints while 89% reported diagnosed co-morbid disease. On logistic regression, female gender, age and co-morbid disease emerged as independent predictors of self-reported symptoms. CONCLUSION This study describes the current status of the iatrogenically infected patient cohort in Ireland, adding to existing knowledge regarding the clinical course and consequences of HCV infection. Changing healthcare needs were shown by comparison with earlier surveys in this same population, in terms of disease progression, development of co-morbid disease and ageing.
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Affiliation(s)
- Olivia McKenna
- UCD School of Physiotherapy and Performance Science, University College Dublin, Belfield, Dublin 4, Ireland.
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Kwan JW, Cronkite RC, Yiu A, Goldstein MK, Kazis L, Cheung RC. The impact of chronic hepatitis C and co-morbid illnesses on health-related quality of life. Qual Life Res 2008; 17:715-24. [PMID: 18427949 DOI: 10.1007/s11136-008-9344-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2007] [Accepted: 04/01/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Determine the relative impact of chronic hepatitis C (CHC) and co-morbid illnesses on health-related quality of life (HRQoL) in 3023 randomly selected veterans with known hepatitis C virus antibody (anti-HCV) status who previously completed a veteran-specific HRQoL questionnaire (SF-36V). METHODS Multiple regression analyses were performed to measure the relative contribution of anti-HCV status, four demographic variables, and ten common medical and six psychiatric co-morbidities to HRQoL between 303 anti-HCV(+) and 2720 anti-HCV(-) patients. RESULTS Anti-HCV(+) veterans were younger, reported a lower HRQoL on seven of eight 36-Item Short Form Health Survey for Veterans (SF-36V) subscales (P < or = 0.001) and the mental component summary (MCS) scale (P < 0.001). The ten medical and six psychiatric co-morbidities had variable impact on predicting lower HRQoL in both groups. After adjusting for demographic variables and co-morbid illnesses, we found that anti-HCV(+) patients reported a significantly lower MCS score (P < 0.001) and a trend toward a lower physical component summary (PCS) score (P < 0.07) compared to anti-HCV(-) veterans. Among the anti-HCV(+) veterans, co-morbid medical illnesses contributed to impaired PCS but not to MCS. CONCLUSIONS Veterans with CHC were younger than HCV(-) veterans and hence less likely to have other co-morbid medical illnesses. Medical co-morbidities seen in those veterans with CHC contribute to impaired PCS but not MCS. Anti-HCV(+) status negatively affects HRQoL, particularly MCS, independently of medical and psychiatric co-morbidities.
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Affiliation(s)
- Jeffrey W Kwan
- Division of Gastroenterology and Hepatology, Department of Medicine, VA Palo Alto Health Care System, (154C), 3801 Miranda Avenue, Palo Alto, CA 94304, USA
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Abstract
OBJECTIVE Depression and anxiety are common in sickle cell disease (SCD) but relatively little is known about their impact on SCD adults. This study measured prevalence of depression and anxiety in SCD adults, and their effects on crisis and noncrisis pain, quality-of-life, opioid usage, and healthcare utilization. METHODS The Pain in Sickle Cell Epidemiology Study is a prospective cohort study in 308 SCD adults. Baseline variables included demographics, genotype, laboratory data, health-related quality-of-life, depression, and anxiety. Subjects completed daily diaries for up to 6 months, reporting sickle cell pain intensity, distress, interference, whether they were in a sickle cell crisis, as well as health care and opioid utilization. RESULTS Two hundred thirty-two subjects who completed at least 1 month of diaries were studied; 27.6% were depressed and 6.5% had any anxiety disorder. Depressed subjects had pain on significantly more days than nondepressed subjects (mean pain days 71.1% versus 49.6%, p < .001). When in pain on noncrisis days, depressed subjects had higher mean pain, distress from pain, and interference from pain. Both depressed and anxious subjects had poorer functioning on all eight SF-36 subscales, even after controlling for demographics, hemoglobin type, and pain. The anxious subjects had more pain, distress from pain, and interference from pain, both on noncrisis pain days and on crisis days, and used opioids more often. CONCLUSIONS Depression and anxiety predicted more daily pain and poorer physical and mental quality-of-life in adults with SCD, and accounted for more of the variance in all domains of quality-of-life than hemoglobin type.
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Kuppermann M, Learman LA, Schembri M, Gregorich S, Jacoby A, Jackson RA, Gates E, Wassel-Fyr C, Lewis J, Washington AE. Effect of Noncancerous Pelvic Problems on Health-Related Quality of Life and Sexual Functioning. Obstet Gynecol 2007; 110:633-42. [PMID: 17766611 DOI: 10.1097/01.aog.0000279153.56275.b5] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effect of abnormal uterine bleeding and pelvic pain and pressure on health-related quality of life and sexual functioning and assess treatment satisfaction. METHODS This is a cross-sectional study of 1,493 sociodemographically diverse women who were seeking care for noncancerous pelvic problems and who had not undergone hysterectomy. Participants were asked about symptoms, attitudes, health-related quality of life, sexual functioning, and treatment satisfaction. Preference for current health was measured using the time tradeoff metric, which asked respondents to estimate the number of years of life they would be willing to trade off to not have a uterine condition. Multivariable logistic regression was used to identify determinants of treatment satisfaction. RESULTS Most (82.7%) participants reported a complete lack of or only partial symptom resolution, and 42.3% reported that their pelvic problems interfered with their ability to have and enjoy sex. Mean Short Form-12 Physical (43-49) and Mental (41-44) Component Summary scores were substantially lower than population norms for women aged 40-49 years. Mean current health time tradeoff scores ranged from 0.78 to 0.88. Satisfaction with Western medicines ranged from 31.3% (progestin intrauterine device) to 58.2% (opiates) and with uterine-preserving surgery from 20.0% (dilation and curettage) to 51.0% (myomectomy); 27.7 % of the women who used acupuncture were satisfied. Participants with lower educational attainment, greater symptom resolution, and less interference of pelvic problems with sex were more likely to be satisfied. CONCLUSION Noncancerous pelvic problems are associated with serious decrements in health-related quality of life and sexual functioning and low rates of treatment satisfaction. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Miriam Kuppermann
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California 94143-0856, USA.
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