Differences in quality of life among older adults in Brazil according to smoking status and nicotine dependence

Exploring Unmet Needs in Prostate Cancer Care: A Cross-sectional Descriptive Study

Background and objective

Prostate cancer, the most common cancer among men worldwide, has significant impact on quality of life. Supportive care needs for those affected by prostate cancer are not well understood. This study aims to describe patient-reported unmet needs and explore supportive care priorities of men treated for prostate cancer.

Methods

A cross-sectional survey was distributed to all men who had accessed prostate cancer services (including surgical, radiation, and medical oncology treatment modalities) at a tertiary hospital. The survey included qualitative questions exploring patient experience and a validated patient-reported outcome measure (Supportive Care Needs Survey Short Form 34). Clinical information was collected. Analyses included, descriptive statistics, multivariate logistic regression models and qualitative analyses using a framework method.

Key findings and limitations

A total of 162 participants provided survey data. Domains about information, self-management, and sexual function were the highest ranked items with unmet needs. A qualitative analysis also identified "relationships", "information", and "the value of hindsight" constructs. Participants who identified three or more unmet needs expressed treatment regret (odds ratio 5.92, 1.98-22.23, p = 0.01).

Conclusions and clinical implications

Understanding the unmet needs of patients may better inform supportive care interventions that address what is important to patients. Importantly, participants valued relationships. There may be opportunities to better meet the needs of patients by improving access to information and self-management resources, particularly around sexuality. Further research is warranted.

Patient summary

Prostate cancer and its treatment impacts are not well understood. Prioritisation of relationships and improving access to information and self-management resources are important. Further attention to prostate cancer supportive care in clinical practice is needed.

Trends in physical activity research for breast cancer - A bibliometric analysis of the past ten years

Introduction

Cancer, particularly breast cancer, is a significant cause of death worldwide, and physical activity has been shown to reduce the risk of developing cancer and improve the prognosis of patients diagnosed with cancer. However, there is a lack of detailed analysis of publications related to physical activity in breast cancer patients, hindering the provision of strong evidence in this area.

Materials and methods

The Core Collection database of Web of Science (WoS) was used as the source of the bibliography, with a search conducted on October 16, 2023. The search strategy used the terms "Physical Activity" and "Breast Cancer" or "Lymphedema," identifying articles published between 2012 and 2022. The bibliometric analysis focused on three dimensions, including scientific production and delivery, scientific collaboration, and bibliometric evaluation at the individual level. We performed the data analysis with Bibiometrix, an open-source tool integrated with R that allows a complete analysis of the behavior of the scientific literature.

Results

A total of 979 publications related to physical activity o exercise in breast cancer (974 article, 1 data paper, 2 article early access y 2 proceedings paper), with an increasing trend in the number of articles published over the years. The most common research topics included "quality of life", "woman", "survivors", and the impact of physical activity on the risk of cancer recurrence. The United States was the most productive country in this area, and the Journal "Supportive Care in Cancer" was the most common journal to publish on this topic.

Conclusion

This bibliometric analysis provides insight into publication trends and common research topics in the area of physical activity and breast cancer. The results can be beneficial in guiding future physical rehabilitation research inquiries and providing information to funding agencies on areas of greatest research opportunities.

Social factors of health-related quality of life in older adults: a multivariable analysis

PURPOSE

The objective of the analysis was to examine the relationships between sociodemographic, socioeconomic, psychosocial, and behavioural factors and both physical and mental health-related quality of life (HRQOL) in older adults.

METHODS

The analysis was based on recent cross-sectional data of 1687 community residents from a whole population postal survey of German adults aged 65 years and older (33% response rate, 52% female, mean age 76 years). HRQOL was assessed using the 36-Item Short Form Survey (SF-36v2). For a differentiated analysis, hierarchical multiple linear regressions were performed.

RESULTS

An internal health locus of control, physical activity, social support, and income were positively associated with physical HRQOL (Adj. R2 = 0.34; p < 0.001) and mental HRQOL (Adj. R2 = 0.18; p < 0.001), whereas an external health locus of control and age were negatively associated with both. Alcohol use and educational level were positively associated only with physical HRQOL, whilst female gender was negatively associated only with mental HRQOL.

CONCLUSION

Sociodemographic, socioeconomic, psychosocial, and behavioural factors were associated with physical and mental HRQOL. These results highlight the importance of social factors in HRQOL and provide approaches for policy and practice to develop and implement tailored health interventions for older adults. Our findings may be transferable to municipalities in metropolitan areas of high-income European countries.

CLINICAL TRIAL REGISTRATION

Not applicable.

Knowledge, attitudes and practices of primary healthcare professionals regarding smoking and smoking cessation among the elderly in France

INTRODUCTION

Smoking remains a leading cause of preventable death in France, even among the elderly. Although smoking prevalence has decreased overall, it still affects a significant portion of older adults. This study investigates the knowledge, attitudes, and practices of primary healthcare professionals regarding smoking and smoking cessation among the elderly in France.

METHODS

A cross-sectional study involved 300 primary care professionals (general practitioners, pharmacists, nurses) in the Ile-de-France region. Data collection occurred via telephone interviews in September and October 2019. The study employed a questionnaire focusing on knowledge (10 questions), attitudes (12 statements), and clinical practices (7 questions) related to tobacco dependence in older adults. Responses were scored based on correctness for knowledge and appropriateness for attitudes and practices.

RESULTS

The surveyed professionals were predominantly female (57.7%), with a mean age of 53.0 years, and most were non-smokers or former smokers (85.3%). While 66.7% believed older smokers had lower cessation rates, only 64.3% knew it was safe to prescribe nicotine replacement therapy for the elderly. Attitude scores averaged 8.8/12, with pharmacists scoring highest (9.9) and nurses lowest (8.2). Practices scores averaged 2.8/7, with physicians scoring highest (3.8) and pharmacists lowest (1.9).

CONCLUSIONS

Primary healthcare professionals have a relatively good knowledge of the management of tobacco dependence in the elderly and consider it to be part of their mission. However, their confidence in their abilities needs to be strengthened, and many opportunities to counsel and assist this population to quit smoking are still being missed. Preventive approaches to older smokers are essential, in keeping with the concept that 'every contact with the healthcare system counts'. Improving practice will require education and training that will not only build knowledge but also change perceptions, leading to better attitudes and practices in the management of smoking cessation among older adults.

Psychological health of mothers and siblings of children with autism spectrum disorders during COVID-19 pandemic: new evidence in Italian families

BACKGROUND AND AIM

Psychological challenges are well recognized in families with a child with Autism Spectrum Disorders (ASD). Instead, less is known about the effects of traumatic scenarios, such as COVID-19, on the psychological health of these families. The main aim of this research was to study the psychological health of both mothers and typically developing (TD) siblings of children with ASD during the COVID-19 pandemic. Second, we investigated the relationship between the mothers' psychological resources and their children psychological well-being.

METHODS

The sample included 52 mothers and their children: 15 with one child with ASD and at least one TD child (aged 4-14) (ASD-siblings group) and 37 with one or more TD child (aged 4-14) (TD control group). The data were collected through an online platform; four standardized questionnaires (GAD-7, BDI-II, CD-RISC 25 and CBCL) were administered.

RESULTS

The analyses revealed more internalizing and total behavioral symptoms in the siblings of children with ASD, compared to TD control group. Regarding the mothers, we did not find differences in depression and anxious symptoms between the two groups. However, the results reported a lower level of resilience in the mothers of children with ASD relative to mothers of TD children. Finally, the psychological well-being of the TD children was associated with the level of mothers' anxiety only in the ASD-siblings group.

CONCLUSIONS

Overall, our data show that the COVID-19 outbreak may had been particularly challenging for families of children with ASD, and highlight the importance of intensifying psychological support to families.

Smoking status and its relationship with depression among the elderly population in Malaysia: Findings from the National Health and Morbidity Survey 2018

INTRODUCTION

Literature exploring smoking status and its association with depression among the elderly population using nationwide data in Malaysia is limited. Hence, a nationwide survey to determine the prevalence of smoking and depression among the elderly (aged ≥60 years) population was undertaken.

METHODS

This secondary dataset analysis used data from the National Health and Morbidity Survey (NHMS) 2018. Data from 3914 participants were collected on elderly health in the Malaysian population. Sociodemographic characteristics were recorded. Smoking status was grouped as current smokers, former smokers, and non-smokers. A validated Malay language version of the Geriatric Depression Scale (M-GDS-14) was used to screen for depression among the elderly.

RESULTS

There was a significant association between smoking status with location, gender, employment status, marital status, ethnicity, education level, income, and depression. Current smokers are significantly higher in rural than urban areas. Among depressed participants, 65.7%, 17.1% and 17.2% were non-smokers, former smokers and current smokers, respectively. Multiple logistic regression showed that single (unmarried/separated/ divorced/widowed) participants were more likely to be depressed compared to married participants (AOR=1.68; 95% CI: 1.16-2.43). Whilst unemployed participants were more likely to be depressed than those who were employed (AOR=1.72; 95% CI: 1.22-2.44). Other Bumiputras were more likely to have depression compared to Malay, Chinese and Indian participants. Participants without formal education were more likely to be depressed compared to those having tertiary education. These participants have a 2-fold increased risk of depression (AOR=2.13; 95% CI: 1.02-4.45). Participants whose monthly salaries were <2000 MYR (AOR=3.67; 95% CI: 1.84-7.31) and 1000-1999 MYR (AOR=2.71; 95% CI: 1.23-5.94) were more likely to have depression compared with those who had received ≥3000 MYR. Ever smokers were more likely to be depressed than non-smokers (AOR=1.68; 95% CI: 1.23-2.29).

CONCLUSIONS

Elderly Malaysians are indeed at risk of developing depression particularly if they had ever smoked. Public health awareness and campaigning are pertinent to disseminate these outcomes in order to spread the awareness associated with smoking-related depression.

Exploring food insecurity and multimorbidity in Indian socially disadvantaged people: cross-sectional findings from LASI, 2017-18

OBJECTIVES

The present study aimed to examine the association of multimorbidity status with food insecurity among disadvantaged groups such as Scheduled Castes (SCs), Scheduled Tribes (STs), and Other Backward Class (OBCs) in India.

METHOD

The data for this study was derived from the first wave of the Longitudinal Ageing Study in India (LASI),2017-18, focusing on 46,953 individuals aged 45 years and over who belong to SCs, STs, and OBCs groups. Food insecurity was measured based on the set of five questions developed by the Food and Nutrition Technical Assistance Program (FANTA). Bivariate analysis was performed to examine the prevalence of food insecurity by multimorbidity status along with socio-demographic and health-related factors. Multivariable logistic regression analysis and interaction models were used.

RESULTS

The overall prevalence of multimorbidity was about 16% of the study sample. The prevalence of food insecurity was higher among people with multimorbidity compared to those without multimorbidity. Unadjusted and adjusted models suggested that people with multimorbidity were more likely to be food insecure than people without multimorbidity. While middle-aged adults with multimorbidity and men with multimorbidity had a higher risk of food insecurity.

CONCLUSION

The findings of this study suggest an association between multimorbidity and food insecurity among socially disadvantaged people in India. Middle-aged adults experiencing food insecurity tend to reduce the quality of their diet and consume a few low-cost, nutritionally deficient meals to maintain caloric intake, putting them again at risk for several negative health outcomes. Therefore, strengthening disease management could reduce food insecurity in those facing multimorbidity.

Assessment of structural and cross-cultural validity of the Disabilities of the Arm, Shoulder and Hand questionnaire: a scoping review

Introduction

The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire is a patient-reported outcome measure (PROM) that has been translated and cross-culturally adapted to at least 50 languages. Since the measure was developed in 1996, many researchers have reported on the construct validity (including structural and cross-cultural validity) of this instrument following translation and cross-cultural adaptation. The aim of this scoping review was to identify the methods used for the psychometric evaluation of structural and cross-cultural validity of the DASH questionnaire.

Methods

The updated methodological guidance for the conduct of scoping reviews and the PRISMA Extension for scoping reviews checklist was utilised. EBSCOHost (Academic Search Premier, Africa Wide, CINAHL, E-Journals and Medline), PubMed and Google Scholar were searched for articles (published between 1996-2022) and considered against the eligibility criteria.

Results

The scoping review collated evidence across 50 articles (37 language versions) of the evaluation of structural and cross-cultural validity of the DASH questionnaire. Three articles conducted confirmatory factor analysis (CFA) to assess structural validity, and none performed Multiple Group Confirmatory Factor Analysis (MGCFA) to assess cross-cultural validity.

Conclusion

The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) taxonomy propose that structural validity is best evaluated through CFA, with prior evidence of dimensionality. Additionally, cross-cultural validity (measurement invariance) is to be evaluated through MGCFA. This review identified that CFA is utilised infrequently and that to date cross-cultural validity has not been appropriately assessed for translations of the DASH questionnaire.

A longitudinal assessment of posttraumatic stress symptoms and pain catastrophizing after injury

PURPOSE/OBJECTIVE

Identifying individuals with high levels of pain catastrophizing (PC) may inform early psychological interventions to prevent the transition from acute to chronic post-injury pain. We examined whether pre-and post-injury posttraumatic stress symptoms (PTSS) predict post-injury PC among emergency department (ED) patients following acute motor vehicle crash (MVC).

RESEARCH METHOD/DESIGN

This study represents secondary data analysis of a randomized clinical trial (NCT03247179) examining the efficacy of the PTSD Coach app on post-injury PTSS (PTSSpost). Among 63 injured ED patients (63% female; 57% non-White; average age = 37) with moderate pain (≥4 of 10), we assessed recall of pre-injury PTSS (PTSSrecall: stemming from preexisting exposures) and baseline PC within 24 hr post-MVC; PTSSpost stemming from the MVC was assessed 30-days later, and the outcome of PC was assessed at 90-days post-injury. We controlled for group assignment (intervention vs. control) in all analyses.

RESULTS

Results revealed that at baseline and 90-days, PC was higher among non-White versus White participants. After adjusting for relevant covariates, PTSSrecall uniquely predicted post-injury PC and each subscale of PC (helplessness, magnification, and rumination). Similarly, after controlling for PTSSrecall and relevant covariates, PTSSpost uniquely predicted total and subscale post-injury PC. Intervention group participants reported less rumination than control group participants.

CONCLUSIONS/IMPLICATIONS

These novel findings highlight that injured Black patients may be vulnerable to post-injury PC, and that both PTSSrecall and PTSSpost significantly predict post-injury PC. Brief PTSS assessment in the ED can identify high-risk patients who may benefit from early intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Learning and quality of life in undergraduate nursing students: An exploratory study in Chile during the COVID-19 pandemic

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a global pandemic that has modified all social and, especially, learning instances. The purpose of this study was to determine the perception of final-year nursing students at a university in southern Chile regarding the impact of the pandemic on their learning, and consequently on their quality of life, in the context of the COVID-19 pandemic.

MATERIALS AND METHODS

This is a qualitative study. The research was conducted on 14 nursing students who were selected from a university located in the province of Talca, Maule Region, Chile. Data collection was done through semi-structured interviews conducted during July and September 2021. The data were analyzed using the inductive logic of theoretical categorization; this process was assisted by the Nvivo 10 program.

RESULTS

Two mega categories were generated that accounted for the nursing students' experience during the COVID-19 pandemic: objective factors category and subjective factors category. Six subcategories were derived from these two categories: free time, social relationships, learning from practice, physical exercise, eating habits, and emotional state.

CONCLUSION

The research findings indicate that the students, in addition to feeling upset about not being able to do the internship, also feel that they have not been able to acquire all the knowledge necessary for their training and professional development, since the virtual classes fail to deliver adequate learning as they lack the practical component that is so important in their careers. This has repercussions in the physical, social, and psychological areas, affecting their quality of life.

Factors associated with a change in smoking habit during the first COVID-19 lockdown: an Italian cross-sectional study among ever-smokers

BACKGROUND

The COVID-19 pandemic and the lockdown period lasted from March to May 2020, resulted in a highly stressful situation yielding different negative health consequences, including the worsening of smoking habit.

METHODS

A web-based cross-sectional study on a convenient sample of 1013 Italian ever smokers aged 18 years or more was conducted. Data were derived from surveys compiled by three different groups of people: subjects belonging to Smoking Cessation Services, Healthcare Providers and Nursing Sciences' students. All institutions were from Northern Italy. The primary outcome self-reported worsening (relapse or increase) or improvement (quit or reduce) of smoking habit during lockdown period. Multiple unconditional (for worsening) and multinomial (for improving) logistic regressions were carried out.

RESULTS

Among 962 participants, 56.0% were ex-smokers. Overall, 13.2% of ex-smokers before lockdown reported relapsing and 32.7% of current smokers increasing cigarette intake. Among current smokers before lockdown, 10.1% quit smoking and 13.5% decreased cigarette intake. Out of 7 selected stressors related to COVID-19, four were significantly related to relapse (OR for the highest vs. the lowest tertile ranging between 2.24 and 3.62): fear of being infected and getting sick; fear of dying due to the virus; anxiety in listening to news of the epidemic; sense of powerlessness in protecting oneself from contagion. In addition to these stressors, even the other 3 stressors were related with increasing cigarette intensity (OR ranging between 1.90 and 4.18): sense of powerlessness in protecting loved ones from contagion; fear of losing loved ones due to virus; fear of infecting other.

CONCLUSION

The lockdown during the COVID-19 pandemic was associated with both self-reported relapse or increase smoking habit and also quitting or reduction of it.

The Association Between Smoking and Health-Related Quality of Life Among Chinese Individuals Aged 40 Years and Older: A Cross-Sectional Study

Objective

The purpose of this study was to investigate the association between smoking and health-related quality of life among Chinese individuals aged 40 years and older.

Method

Using a stratified multistage sampling method, data from 1,543 adults aged 40 years and older were obtained from a household survey conducted in eight provinces in China. The health-related quality of life was quantified based on the utility index obtained using a standardized instrument entitled “The European Five-Dimensional Health Scale (EQ-5D-5L).” Descriptive statistics were used to summarize the demographic characteristics and social factors of the sample according to smoking status. An instrumental variable (IV) probit model was used to estimate the association between smoking status and health-related quality of life.

Results

Of the 1,543 participants, 485 (31.43%) were smokers and 1,058 (68.57%) were non-smokers. Smoking was negatively associated with the probability of having a higher quality of life (p < 0.01). For smokers, the average probability of having a higher quality of life was 11.65% lower than when they did not smoke.

Conclusions

These findings suggest that smoking reduces health-related quality of life among Chinese individuals aged 40 years and older. Anti-smoking programs should consider this factor.

A head-to-head comparison of EQ-5D-5L and SF-6D in Dutch patients with fractures visiting a Fracture Liaison Service

AIMS

This study compared the psychometric properties of EQ-5D-5L and SF-6D to assess the interchangeability of both instruments in patients with a recent fracture presenting at a Fracture Liaison Service (FLS).

MATERIALS AND METHODS

Data from a prospective observational study in a Dutch FLS clinic were used. Over 3 years, subjects were interviewed at several time points using EQ-5D-5L and SF-36. Floor and ceiling effects were evaluated. Agreement was evaluated by intra-class correlation coefficients and visualized in Bland-Altman plots. Spearman's rank correlation coefficients were applied to assess convergent validity. Mann-Whitney U test or Kruskal-Wallis H test as well as effect size (ES) were used to explore known-groups validity. Responsiveness was explored using standardized response mean (SRM) and ES. For each measurement property, hypotheses on direction and magnitude of effects were formulated.

RESULTS

A total of 499 patients were included. EQ-5D-5L had a considerable ceiling effect in comparison to SF-6D (21 vs. 1.2%). Moderate agreement between the (UK and Dutch) EQ-5D-5L and SF-6D was identified with intra-class correlation coefficients of 0.625 and 0.654, respectively. Bland-Altman plots revealed proportional bias as the differences in utilities between two instruments were highly dependent on the health states. High correlation between instruments was found (UK: rho = 0.758; Dutch: rho = 0.763). EQ-5D-5L and SF-6D utilities showed high correlation with physical component score but low correlation with mental component score of SF-36. Both instruments showed moderate discrimination (ES > 0.5) for subgroup by baseline fracture type, and moderate responsiveness (SRM > 0.5) in patients that sustained a subsequent fracture.

CONCLUSION

Both EQ-5D-5L and SF-6D appeared to be valid utility instruments in patients with fractures attending the FLS. However, they cannot be used interchangeably given only moderate agreement was identified, and differences in utilities and ceiling effect were revealed. Comparable construct validity and responsiveness were indicated, and neither instrument was found to be clearly superior.

Trajectories of Health-Related Quality of Life, Health Literacy, and Self-Efficacy in Curatively-Treated Patients with Esophageal Cancer: A Longitudinal Single-Center Study in Italy

This prospective longitudinal study aimed to describe the trajectories of HRQoL, health literacy, and self-efficacy in patients with esophageal cancer, which have been thus far poorly described. Data were collected at baseline (preoperative phase) and in the postoperative period (two weeks, and one, two, and three months after esophagectomy). The study hypothesis was that health literacy and self-efficacy might predict better health status and quality of life over time. Forty-five patients were enrolled between 2018 and 2019. HRQoL, health literacy, and self-efficacy were assessed using validated scales. The ability to analyze information to exert greater control over life events critically (critical health literacy) (η²p = 0.660) and the individual's confidence in dealing with challenging tasks (self-efficacy) (η²p = 0.501) strongly predicted the scores of general health status over time. Overall, the functional status improved at 3 months after surgery, and this trend paralleled the decline of cancer-specific and surgery-related symptoms. In conclusion, researchers and clinicians should pay greater attention to optimizing baseline health literacy and self-efficacy levels. Future educational and motivational interventions should be further tested and possibly integrated into the prehabilitation programs.

Prevention Strategies of Alcohol and Substance Use Disorders in Older Adults

Older adults are increasingly engaging in unhealthy substance use. Owing to aging and comorbid medical conditions, older adults are at increased risk of adverse effects from alcohol, tobacco, and illicit drug use. Preventative measures, regular screening, and appropriate intervention can protect older adults from the negative outcomes of substance use and potentially improve their quality of life. This article reviews the latest trends of substance use in older adults, impact on health, and the best practice approaches for the clinical assessment of substance use disorders in this age group.

Tabagismo em idosos: Uma revisão integrativa

Introdução: o tabagismo é um grave problema de saúde pública em âmbito mundial que afeta a todas as faixas etárias, causando altas taxas de morbimortalidade evitáveis.Objetivo: descrever o que vem sendo publicado sobre o tabagismo na população idosa nos últimos cinco anos na esfera internacional.Metodologia: trata-se de uma revisão integrativa da literatura, onde foram realizadas buscas de artigos nas seguintes bases de dados: PUBMED/MEDLINE, BVS/LILACS, SCOPUS e SCIELO, utilizando os seguintes Descritores em Ciências da Saúde em inglês: “Tobacco Use Cessation” OR “Tobacco Use Disorder” AND “Health of the Elderly” OR “Aged” OR “Aged, 80 and over”. O recorte temporal foi de 2016 a 2020.Resultados: dos 1.642 trabalhos recuperados das bases, houve o afunilamento para um número total de 18 artigos, com a seguinte categorização: mortalidade e outros desfechos clínicos negativos (5); o tabagismo, as síndromes geriátricas e outras patologias (4); políticas públicas para o controle do tabaco (3); qualidade de vida e tabagismo (3); e fatores preditores para cessação tabágica (3).Conclusões: apenas um estudo selecionado foi realizado no Brasil, ressaltando a necessidade de mais estudos brasileiros envolvendo o tabagismo na população idosa objetivando uma melhor compreensão dos aspectos envolvidos e futuras capacitações e otimização de políticas públicas específicas.

Social Isolation Profiles and Older Adult Substance Use: A Latent Profile Analysis

OBJECTIVES

The aim of this study was to determine substance use among older adults based upon their social isolation and loneliness profiles.

METHODS

Data were derived from the New Jersey Older Adult Survey on Drug Use and Health (OASDUH). Latent profile Analysis (LPA) was used to determine the profiles of older adults (N = 801) based on five dimensions of social isolation and loneliness. Logistic and generalized ordered logistic regressions were conducted to assess the relationship between the latent profiles and substance use.

RESULTS

LPA identified five social isolation/loneliness profiles. The "connected and active" group had the lowest odds of cigarette use. The "alone but not lonely" group had the highest odds of cigarette use, alcohol use, and high-risk drinking. The "alone and lonely" group had the highest odds of non-medical drug use.

DISCUSSION

In working with older adults who are using substances, it is important to inquire about their social isolation and loneliness. Cognitive behavioral therapy for the "alone and lonely" group may be beneficial, as it has been deemed effective in reducing loneliness and enhancing social network.

Predictors of health-related quality of life among semi-precious stone mineworkers exposed to silica dust

OBJECTIVE

The study aimed to comparatively evaluate HRQOL in miners of semi-precious stones with and without silicosis, and determine the associated factors, as well as the performance of two different questionnaires in measuring HRQOL.

METHODS

In a cross-sectional study of 348 male miners (129 with silicosis) who underwent an interview and spirometry, HRQOL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and the Saint George's Respiratory Questionnaire (SGRQ).

RESULTS

Miners with silicosis were older, had less schooling, worked more hours daily, and had longer exposure to silica. They also had worse scores of QoL in both questionnaires. Respiratory symptoms and %FEV₁ were contributing factors for the models of total health and all the domains of the SGRQ, and 40% of the variability of the general health domain of WHOQOL-BREF was due to dyspnea, wheezing, %FEV₁, and pack-years of cigarette smoking. Respiratory symptoms, lung function, pack-years of cigarette smoking, years of education, and average monthly income were contributing factors for the models of the different domains of the WHOQOL-BREF.

CONCLUSIONS

Our study revealed impaired HRQOL in semi-precious stone miners evaluated using both questionnaire tools of SGRQ and WHOQOL-BREF, of which SGRQ had superior performance. Respiratory symptoms, functional impairment, and pack-years of cigarette smoking were the most important determinants of the workers' general HRQOL.

Mapping EORTC QLQ-C30 and FACT-G onto EQ-5D-5L index for patients with cancer

Background

To develop direct and indirect (response) mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy General (FACT-G) onto the EQ-5D-5L index.

Methods

We conducted the QOL-MAC study where EQ-5D-5L, EORTC QLQ-C30, and FACT-G were cross-sectionally evaluated in patients receiving drug treatment for solid tumors in Japan. We developed direct and indirect mapping algorithms using 7 regression methods. Direct mapping was based on the Japanese value set. We evaluated the predictive performances based on root mean squared error (RMSE), mean absolute error, and correlation between the observed and predicted EQ-5D-5L indexes.

Results

Based on data from 903 and 908 patients for EORTC QLQ-C30 and FACT-G, respectively, we recommend two-part beta regression for direct mapping and ordinal logistic regression for indirect mapping for both EORTC QLQ-C30 and FACT-G. Cross-validated RMSE were 0.101 in the two methods for EORTC QLQ-C30, whereas they were 0.121 in two-part beta regression and 0.120 in ordinal logistic regression for FACT-G. The mean EQ-5D-5L index and cumulative distribution function simulated from the recommended mapping algorithms generally matched with the observed ones except for very good health (both source measures) and poor health (only FACT-G).

Conclusions

The developed mapping algorithms can be used to generate the EQ-5D-5L index from EORTC QLQ-C30 or FACT-G in cost-effectiveness analyses, whose predictive performance would be similar to or better than those of previous algorithms.

Quality of Life Among Breast Cancer Patients Attending Hawassa University Comprehensive Specialized Hospital Cancer Treatment Center

BACKGROUND

Breast cancer affects the overall quality of life (QOL) among its survivors. Limited evidence is available about the QOL among cases. Therefore, this study was intended to assess the quality of life of breast cancer patients attending the cancer treatment center at Hawassa University Comprehensive Specialized Hospital, Hawassa, southern Ethiopia.

METHODS

An institution-based cross-sectional study was conducted among breast cancer patients attending cancer treatment at the Hawassa University Comprehensive Specialized Hospital between April and June, 2019. All breast cancer patients attending treatment the center were included in the study by universal sampling. Data were collected using a structured questionnaire containing demographic data, patient clinical factors and Quality of Life Instrument (WHOQOL)-BREF version 3.0. The collected data were entered into EpiData software version 3.1 and analyzed using SPSS Version 20.0. Descriptive statistics were presented in tables.

RESULTS

A total of 259 respondents with a mean age of (SD) 44.89 (12.56) participated in study. The mean score of overall global health scale was 75.3 (SD±17.1) with the mean health satisfaction was 12.43 (SD±3.98). The highest mean score was observed in environmental domain, 93.31 (SD±19.76), despite social domain being very low, 36.69 (SD±7.62). Most of the participants were highly satisfied with the health care service that was provided, with a mean score of 16.1 (SD±3.1). In contrast, the majority of study participants were disappointed with the need for any medical treatment, body appearance, luxurious activities, and sexual life, with mean scores of 8.93 (SD±3.68), 8.74 (SD±4.26), 9.1 (SD±4.22), and 8.1 (SD±4.14), respectively.

CONCLUSION

Breast cancer patients in southern Ethiopia suffered from poor social and psychological support that, in turn, highly affected their life value. Therefore, due attention should be given to enhance social and psychological support for breast cancer patients as a whole.

Smoking Status and Well-Being of Underserved African American Older Adults

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.