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Black CJ, Ng CE, Goodoory VC, Ford AC. Novel Symptom Subgroups in Individuals With Irritable Bowel Syndrome Predict Disease Impact and Burden. Clin Gastroenterol Hepatol 2024; 22:386-396.e10. [PMID: 36858142 DOI: 10.1016/j.cgh.2023.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND & AIMS Current classification systems based on bowel habit fail to capture the multidimensional nature of irritable bowel syndrome (IBS). We previously derived and validated a classification system, using latent class analysis, incorporating factors beyond bowel habit. We applied this in another cohort of people with IBS to assess its ability to capture the impact of IBS on the individual, the health care system, and society. METHODS We collected demographic, symptom, and psychological health data from adults in the community self-identifying as having IBS, and meeting Rome IV criteria. We applied our latent class analysis model to identify the 7 subgroups (clusters) described previously, based on overall gastrointestinal symptom severity and psychological burden. We assessed quality of life, health care costs (£1 = $1.20), employment status, annual income, work productivity, and ability to perform work duties in each cluster. RESULTS Of 1278 responders, 752 (58.8%) met Rome IV criteria. The 7-cluster model fit the data well. The patients in the 4 clusters with the highest psychological burden, and particularly those in cluster 6 with high overall gastrointestinal symptom severity and high psychological burden, showed lower educational levels, higher gastrointestinal symptom-specific anxiety, were more likely to have consulted a gastroenterologist, and used more drugs for IBS. IBS-related and generic quality of life were impaired significantly in these 4 clusters and significantly fewer individuals reported earning ≥£30,000 per year. Productivity and the ability to work, manage at home, engage in social and private leisure activities, and maintain close relationships all were impacted significantly, and IBS-related health care costs over the previous 12 months were highest in these 4 clusters. In those in cluster 6, costs were more than £1000 per person per year. CONCLUSIONS Our clusters identify groups of individuals with significant impairments in quality of life, earning potential, and ability to work and function socially, who are high utilizers of health care.
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Affiliation(s)
- Christopher J Black
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom
| | - Cho-Ee Ng
- Department of Gastroenterology, County Durham and Darlington National Health Service Foundation Trust, Durham, United Kingdom
| | - Vivek C Goodoory
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom.
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Derrett S, Owen HE, Barson D, Maclennan B, Samaranayaka A, Harcombe H, Wyeth EH. New Zealand's Prospective Outcomes of Injury Study-10 years on (POIS-10): descriptive outcomes to 12 years post-injury. Inj Prev 2024:ip-2023-045058. [PMID: 38195656 DOI: 10.1136/ip-2023-045058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND The 'Prospective Outcomes of Injury Study-10 years on' (POIS-10) aims to contribute to improving long-term disability, health and well-being outcomes for injured New Zealanders. This brief report describes recruitment, characteristics and key outcomes to 12 years post-injury. METHODS Between 2007 and 2009, the study recruited 2856 people, including 566 Māori, from New Zealand's Accident Compensation Corporation's entitlement claims register. People experienced a range of injury types, causes and settings; 25% had been hospitalised for their injury. POIS-10 data were primarily collected via interviewer-administered structured questionnaires. RESULTS Of the original participants, 2068 (92%) were eligible for follow-up in POIS-10. Of these, 1543 (75%) people participated between March 2020 and July 2021, including 240 Māori. Half of the participants (n=757; 50%) reported ongoing problems attributed to their injury 12 years earlier. Most reported difficulties with items assessing disability (WHO Disability Assessment Schedule II). For health-related quality of life (HRQoL), measured using the EQ-5D-5L, the prevalence of problems was higher 12 years post-injury compared with 12 months post-injury for four of five dimensions. Importantly, the prevalence of problems did not reduce to pre-injury levels for any HRQoL dimension. DISCUSSION POIS-10 highlights the importance of early post-injury interventions to improve health, disability and well-being outcomes of injured New Zealanders.
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Affiliation(s)
- Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | - Helen E Owen
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | - David Barson
- Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Brett Maclennan
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | | | - Helen Harcombe
- Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Emma H Wyeth
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
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Zuo K, Sun Z, Wen K. Study on the impact and clinical effect of high-quality nursing intervention on the quality of life of elderly cataract patients. Pak J Med Sci 2024; 40:499-504. [PMID: 38356798 PMCID: PMC10862453 DOI: 10.12669/pjms.40.3.7526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/20/2023] [Accepted: 11/14/2023] [Indexed: 02/16/2024] Open
Abstract
Objective To evaluate the impact and clinical effect of high-quality nursing intervention on the quality of life of elderly cataract patients and its clinical effect. Methods This is a clinical comparative study. One hundred and twenty elderly cataract patients admitted to Tianjin Medical University Eye Hospital for surgical treatment were recruited and randomly divided into two groups: the control and experimental group, with 60 cases in each group from January 15, 2021 to January 15, 2022. Patients in the control group were given conventional nursing care in the perioperative period, while those in the experimental group were given high-quality nursing intervention in the perioperative period. The differences in anxiety (SAS) scores, depression (SDS) scores, intraocular pressure (IOP) recovery, the incidence of surgical complications and satisfaction before and after treatment between the two groups were compared and analyzed. Results No statistically significant difference was observed between the two groups in physical functioning, psychological functioning, social functioning and material life status scores before intervention(P>0.05). After the intervention, the above indicators improved significantly in the experimental group compared to the control group, with statistically significant differences (P=0.00). Moreover, SAS and SDS decreased significantly in the experimental group compared to the control group, with statistically significant differences(P=0.00). Conclusions High-quality nursing intervention improves various benefits in the treatment of elderly cataract patients, such as effectively reducing intraocular pressure, ameliorating patients' quality of life, lowering the incidence of postoperative complications, and improving patient satisfaction.
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Affiliation(s)
- Kunkun Zuo
- Kunkun Zuo, Ambulatory Surgery Center One, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Zhaoqing Sun
- Zhaoqing Sun, Ambulatory Surgery Center One, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Kai Wen
- Kai Wen, Ambulatory Surgery Center One, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
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Ergun O, Yildirim O, Bozyel I, Kaymak I, Gokcen D, Sennaroglu L. The hidden cochlear implant. J Laryngol Otol 2023; 137:1207-1214. [PMID: 36751901 DOI: 10.1017/s0022215123000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The hidden cochlear implant concept has two data transmission methods: Bluetooth low energy and transtympanic optical data transfer systems. This study aimed to present the hidden cochlear implant and compare the test results with the existing fully implanted cochlear implant. METHOD The Bluetooth low energy module was implanted into the implant bed. For the transtympanic optical data transfer tests, a receiver was passed through the posterior tympanotomy, and the transmitter was placed in the ear canal. RESULTS The Bluetooth low energy module range was 5.2-17.5 m. Transtympanic optical data transfer reached a rate of 1 Mbit/s and had 99.22 per cent accuracy. Despite various obstacles, the accuracy of the transtympanic optical data transfer was more than 99 per cent with a 250 Kbit/s rate. The average power consumption was 310 mW for the implanted Bluetooth low energy module and 41 mW for the transtympanic optical data transfer receiver. CONCLUSION Bluetooth low energy is suitable to be used transcutaneously. Transtympanic optical data transfer is an effective and promising technology. Hidden use cochlear implants aim to have the aesthetics of a fully implantable cochlear implant with higher reliability and a magnet-free design with smart device integration.
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Affiliation(s)
- O Ergun
- Department of Otorhinolaryngology Head and Neck Surgery, Baskent University Hospital, Ankara, Turkey
| | - O Yildirim
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Hacettepe University, Ankara, Turkey
| | - I Bozyel
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Hacettepe University, Ankara, Turkey
| | - I Kaymak
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Hacettepe University, Ankara, Turkey
| | - D Gokcen
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Hacettepe University, Ankara, Turkey
| | - L Sennaroglu
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Mirza B, Marouf A, Abi Sheffah F, Marghlani O, Heaphy J, Alherabi A, Zawawi F, Alnoury I, Al-Khatib T. Factors influencing quality of life in children with tracheostomy with emphasis on home care visits: a multi-centre investigation. J Laryngol Otol 2023; 137:1102-1109. [PMID: 36089743 DOI: 10.1017/s002221512200202x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Only a few studies have assessed the quality of life in children with tracheostomies. This study aimed to evaluate the quality of life and the factors influencing it in these children. METHOD This cross-sectional, two-centre study was conducted on paediatric patients living in the community with a tracheostomy by using the Pediatric Quality of Life Inventory. Clinical and demographic information of patients, as well as parents' socioeconomic factors, were obtained. RESULTS A total of 53 patients met our inclusion criteria, and their parents agreed to participate. The mean age of patients was 6.85 years, and 21 patients were ventilator-dependent. The total paediatric health-related quality of life score was 59.28, and the family impact score was 68.49. In non-ventilator-dependent patients, multivariate analyses indicated that social functioning and health-related quality of life were negatively affected by the duration of tracheostomy. The Quality of Life of ventilator-dependent patients was influenced by care visits and the presence of pulmonary co-morbidities. CONCLUSION Children with tracheostomies have a lower quality of life than healthy children do. Routine care visits by a respiratory therapist and nurses yielded significantly improved quality of life in ventilator-dependent children.
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Affiliation(s)
- B Mirza
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah
| | - A Marouf
- Department of Surgery, Otolaryngology - Head and Neck Surgery Section, King Faisal Specialist Hospital and Research Centre, Jeddah
| | - F Abi Sheffah
- Department of Surgery, Otolaryngology - Head and Neck Surgery Section, King Faisal Specialist Hospital and Research Centre, Jeddah
| | - O Marghlani
- Department of Surgery, Otolaryngology - Head and Neck Surgery Section, King Faisal Specialist Hospital and Research Centre, Jeddah
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - J Heaphy
- Department of Surgery, Otolaryngology - Head and Neck Surgery Section, King Faisal Specialist Hospital and Research Centre, Jeddah
| | - A Alherabi
- Department of Surgery, Otolaryngology - Head and Neck Surgery Section, King Faisal Specialist Hospital and Research Centre, Jeddah
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - F Zawawi
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah
| | - I Alnoury
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah
| | - T Al-Khatib
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah
- Department of Surgery, Otolaryngology - Head and Neck Surgery Section, King Faisal Specialist Hospital and Research Centre, Jeddah
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Restrepo S, Rojas S, Sanabria A. Satisfaction With Head and Neck Scar Appearance in Latin American Patients: A Cross-Sectional Study. Eplasty 2023; 23:e56. [PMID: 37743968 PMCID: PMC10517663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Background Surgical scars have been related to poor quality of life, and this is important for head and neck scars. There is a paucity of data about the effect of scars on appearance in Latin American patients. The objective of this study was to describe the self-assessment of patient scars using the Patient Scar Assessment Questionnaire (PSAQ). Methods This is a cross-sectional study. The validated Spanish version of the PSAQ was used. Adult patients who underwent elective head and neck surgery were included. Demographic and clinical data were obtained from clinical charts. Univariate and multivariate analysis using a forward logistic regression was planned to assess the weight of specific subscale items on the overall subscale score for appearance and satisfaction with appearance. Results 180 patients were recruited. A total of 144 (80%) patients were female, and the most frequent type of surgery was thyroidectomy. The global appearance, the global scar consciousness and the global scar appearance satisfaction was classified as excellent/good in 72.2%, 93.9% and 87.8% of patients, respectively. The multivariate analysis showed that color (OR 5.9, 95% CI 1.7-20.8), width (OR 58.9, [4.3-807.6]), and flatness (OR 5.7, [1.3-23.6]) were the items statistically associated with a regular/bad result in the appearance subscale. Conclusions There is a high level of satisfaction with head and neck scar appearance, and these data should be used to assess the impact of surgical interventions on cosmesis. The intrinsic characteristics of scars are the most relevant for defining scar satisfaction.
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Affiliation(s)
- Santiago Restrepo
- Department of Surgery, Universidad de Antioquia School of Medicine, Medellin, Colombia
| | - Santiago Rojas
- Department of Surgery, Universidad de Antioquia School of Medicine, Medellin, Colombia
| | - Alvaro Sanabria
- Department of Surgery, Universidad de Antioquia School of Medicine, Medellin, Colombia
- Head and Neck Service, Fundación Colombiana de Cancerología- Clínica Vida, Medellín, Colombia
- Centro de Excelencia en Enfermedades de Cabeza y Cuello, CEXCA, Medellín, Colombia
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Singh AK, J F N, Sharma NK, Anandkumar J, Mishra N, Pandey A. Bipaddled Pectoralis Major Myocutaneous Flap in Complex Oral Cancer Defects- A Single Center Experience with Quality of Life Assessment. Indian J Otolaryngol Head Neck Surg 2023; 75:641-648. [PMID: 37274991 PMCID: PMC10235259 DOI: 10.1007/s12070-022-03324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Advanced stage malignancies of oral cavity commonly result in complex full thickness defects with subsequent functional and aesthetic loss. Through this article we describe our center's experience in reconstruction of such defects with bipaddled pectoralis myocutaneous (PMMC) flap through an immediate, single-staged procedure. Materials And Methods The study included a total of 54 patients who underwent composite resection and neck dissection followed by reconstruction of the defect with bipaddled PMMC flap. All patients were followed up post-operatively for 1 year and were monitored for flap and donor site related complications. Using University of Washington Quality of life v4 questionnaire (UW-QOL4), we assessed the QOL of 54 patients. The mean scores were compared to other similar studies. Results: The overall complication rate was 66.6%, whereas, 33.3% patients had no complications. The most common complication was wound dehiscence seen in 31.5% of cases in the recipient site and 12.9% in the donor site. Other complications were seroma, hematoma, plate exposure, orocutaneous fistula etc. Around 73.7% patients reported a good, very good or outstanding overall quality of life in the post-operative period. The mean composite QOL score was 65.84. Our study showed comparable domains of pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function and taste with other similar studies. Conclusion: Bipaddled PMMC flap proves to be a considerable alternative for microvascular free flaps in reconstruction of full-thickness defects of oral cavity owing to its reliable blood supply, accessibility, easier harvesting technique, cost effectiveness, high success rate and acceptable quality of life. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03324-6.
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Affiliation(s)
- Akhilesh Kumar Singh
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Neville J F
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Naresh Kumar Sharma
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Janani Anandkumar
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Nitesh Mishra
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Arun Pandey
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
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Beutter CNL, Werner P, Sigle S, Martens UM, Fegeler C. Assessing Quality of Life Using FHIR - How to Combine Patient Reported Outcome with Patient Generated Data for Better Compliance. Stud Health Technol Inform 2023; 302:135-136. [PMID: 37203628 DOI: 10.3233/shti230083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Quality of life (QoL) is affected by environmental influences and varies between patients. A combined measurement through Patient Reported Outcomes (PROs) and Patient Generated Data (PGD) may enhance the detection of QoL impairments by a longitudinal survey. Leveraging different approaches of QoL measurement techniques, the challenge is to combine data in a standardized, interoperable way. We developed an app (Lion-App) to semantically annotate data from sensor systems as well as PROs to be merged in an overall analysis of QoL. A FHIR implementation guide was defined for a standardized assessment. To access sensor data the interfaces of Apple Health or Google Fit are used instead of integrating various provider directly into the system. Since QoL cannot be collected exclusively via sensor values, a combination of PROs and PGD is necessary. PGD enable a progression of QoL which offers more insight into personal limitations whereas PROs give insight about personal burden. The use of FHIR enables structured exchange of data while personalized analyses might improve therapy and outcome.
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Affiliation(s)
| | | | | | - Uwe Marc Martens
- MOLIT Institute gGmbH, Heilbronn, Germany
- SLK Kliniken GmbH, Heilbronn, Germany
| | - Christian Fegeler
- MOLIT Institute gGmbH, Heilbronn, Germany
- University of applied Science Heilbronn, Heilbronn, Germany
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Abstract
BACKGROUND Necrotising otitis externa is a serious infective condition. Patients are typically frail, diagnostic delay is common and severe pain is a key feature. This study aimed to qualitatively analyse patient-centred data to identify key themes in the patient's experience. METHODS Open-ended questionnaires were sent to 28 patients. Responses were qualitatively analysed using a grounded theory approach. Iterative cycles were used to develop codes using a constant comparison technique. Emerging categories were refined to identify core themes. RESULTS Four main themes emerged: severe pain, mental health, quality of life and diagnostic delays. CONCLUSION This is the first study to explore patients' perspectives in necrotising otitis externa. It indicates a need to raise awareness of necrotising otitis externa, and to improve symptom management, pain control and quality of life. This valuable information can be used to identify research priorities, guide service improvements, improve clinical care and feed into the development of a Core Outcome Set for necrotising otitis externa.
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Affiliation(s)
- E Owen
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R Abrar
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - E Stapleton
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
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de Cates C, Jashek-Ahmed F, Bohara RB, Salter C, Youngs R. How chronic ear disease affects quality of life: a qualitative research study in Nepal. J Laryngol Otol 2023; 137:390-397. [PMID: 35485736 DOI: 10.1017/s0022215122001050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Hearing loss is the third leading cause globally for 'years lived with disability'. The majority of those affected live in low and middle-income countries. METHOD This study used qualitative research methods to explore the impact of chronic ear disease on quality of life in Nepal. Twenty face-to-face semi-structured interviews were conducted during a visiting ear camp at the Britain Nepal Otology Service Ear Care Centre in Nepal. Interviews were recorded, transcribed and translated with thematic content analysis performed manually by two researchers. RESULTS Chronic ear disease has a significant impact on social interactions, emotional well-being and functionality. Barriers to surgery are cost, accessibility, reputation, gender and fear of complications. CONCLUSION This study provided valuable new insight into patient perspectives on living with chronic ear disease in Nepal. Patients with chronic ear disease experience discrimination and stigmatisation across all levels of personal, family and social life, with their function across all domains being directly limited by symptoms.
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Affiliation(s)
- C de Cates
- Department of Otolaryngology, Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, UK
| | - F Jashek-Ahmed
- West Middlesex Hospital, Chelsea & Westminster NHS Foundation Trust, London, UK
| | - R B Bohara
- Britain Nepal Otology Service Ear Care Centre, Nepalgunj, Nepal
| | - C Salter
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - R Youngs
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
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Yousefi S, Ahangar H, Bahrami M, Kamalinejad M, Yaghoubi A, Azizi H. Effectiveness of "Centaurea behen" root on quality of life in patients with systolic heart failure: A randomized clinical trial. J Cardiovasc Thorac Res 2023; 15:22-29. [PMID: 37342665 PMCID: PMC10278197 DOI: 10.34172/jcvtr.2023.31619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/10/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction: The effect of Centaurea behen (Cb) on patients with systolic heart failure is not known academically. This study was conducted to evaluate the effect of Cb on improving the quality of life (QoL) and echocardiographic and biochemical blood parameters in patients with systolic heart failure. Methods: This study was a parallel double-blind, placebo-controlled randomized trial of 60 patients with systolic heart failure, was conducted from May 2018 up to August 2019. Intervention group received 150 mg twice daily Cb capsules for two months + Guideline directed medical therapy (GDMT), and control group received GDMT + placebo capsules for two months. The main aim of the present study were to assess the QoL based on the 6-minute walk test (6MWT) and the Minnesota living with heart failure questionnaire (MLHFQ). Independent T-test, paired T-test, and ANOVA were used for the analysis. Results: At the beginning of the present study there were no significant differences between study groups in terms of QoL and clinical results. After treatment, the average values of QoL based on MLHFQ and 6MWT instruments were significantly improved 15.5 and 36.18, respectively (P<0.05). Conclusion: Based on the MLHFQ, and 6MWT tests, the consumption of Centaurea behen root extract was associated with significant improvement in the quality of life of patients with systolic heart failure.
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Affiliation(s)
- Saeid Yousefi
- Department of Iranian Traditional Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hassan Ahangar
- Department of Cardiology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Bahrami
- Department of Iranian Traditional Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohammad Kamalinejad
- Department of Pharmacognosy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Yaghoubi
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Azizi
- Research Center of Psychiatry and Behavirol Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Tengku S, Lohi I, Connelly A, Slaven E, Sloane K, Herity K, McBlain L, Douglas CM, Montgomery J. Late-onset swallowing outcomes post-treatment for head and neck cancer in a UK-based population. J Laryngol Otol 2023; 137:293-300. [PMID: 35317872 DOI: 10.1017/S0022215122000834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Adverse swallowing outcomes following head and neck squamous cell carcinoma treatment in the context of late-onset post-radiotherapy changes can occur more than five years post-treatment. METHODS A retrospective study was conducted utilising patient records from March 2013 to April 2015. Patients were categorised into 'swallow dysfunction' and 'normal swallow' groups. Quality of life was investigated using the MD Anderson Dysphagia Inventory and EuroQol questionnaires. RESULTS Swallow dysfunction was seen in 77 (51 per cent) of 152 patients. Twenty-eight patients (36 per cent) in the swallow dysfunction group reported symptoms in year five. Swallow dysfunction was associated with stage IV head and neck squamous cell carcinoma (p < 0.001) and radiotherapy (p < 0.001). MD Anderson Dysphagia Inventory global scores showed significant differences between swallow dysfunction and normal swallow groups (p = 0.01), and radiotherapy and surgery groups (p = 0.03), but there were no significant differences between these groups in terms of MD Anderson Dysphagia Inventory composite or EuroQol five-dimensions instrument scores. CONCLUSION One-third of head and neck squamous cell carcinoma survivors with swallow dysfunction still show symptoms at more than five years post-surgery, a point at which they are typically discharged.
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Casanovas-Marsal JO, Morales Hijazo L, Grima Campos L, Calvo Sanz V, Fernández Castro B, González de la Cuesta D. [Peripheral neuropathy, onycholysis and health-related quality of life in womens with breast cancer treated with taxanes. Prospective longitudinal study.]. Rev Esp Salud Publica 2023; 97:e202302008. [PMID: 36755503 PMCID: PMC10558105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVE Peripheral neuropathy and onycholysis are adverse events produced by taxanes in breast cancer that persist even after the end of treatment and negatively influence quality of life. The objectives of the study were to describe these side effects and the degree of involvement and relating them to the drug doses received. METHODS Prospective, cross-sectional study of in 50 womens dignosed of breast cancer, treated with docetaxel and paclitaxel in Hospital Universitario Miguel Servet in Zaragoza (Aragón, Spain). CTCAE v.5.0 scale and Semes Weinsten test were used to evaluate peripheral neuropathy and onycholysis. ECOG scale was performed to measure the health-related quality of life. Study variables were evaluated before-during treatment and 1 and 6 months after finish treatment. Statistical analysis was performed using Jamovi 1.2®. For the relationship of the qualitative variables, the chi-square, Fisher's exact test, Mc's test were used. Nemar and the Odds Ratio test. Effects were considered significant if p<0.05. RESULTS 43 subjects were included. During treatment the 9.8 presented motor neuropathy and 12.2% sensitive neuropathy, 37.2% onycholisis in upper extremities and 39.5% in lower extremities (χ2=11.3; p<0.001 / χ2=13.0; p<0.001) and 38.1% a health related quality of live limited in excessive activities (χ2=10.3; p=0.001). Post-treatment evaluation the 20.9% presented motor neuropathy and 32.6% sensitive neuropathy (χ2=3.57; p=0.059 / χ2=6.23; p=0.013), the 86% onycholisis in upper extremities and lower extremities (χ2=6.07; p=0.048 / χ2=10.1; p=0.006) and 58.5% a health related quality of live limited in excessive activities (χ2=8.47; p=0.014). 6 month later, the initials parameters were not recuperated. CONCLUSIONS Taxanes have a negative impact on the health-related quality of life in patients, even 6 months after finishing treatment due to the peripheral neuropathy and onycholysis that they cause.
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Affiliation(s)
| | - Lorena Morales Hijazo
- Enfermera, Hospital de Día de Oncología, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón. Zaragoza. España
| | - Laura Grima Campos
- Enfermera, Hospital de Día de Oncología, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón. Zaragoza. España
| | - Vanesa Calvo Sanz
- Enfermera, Hospital de Día de Oncología, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón. Zaragoza. España
| | - Belén Fernández Castro
- Enfermera, Supervisora Hospital de Día de Oncología, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón. Zaragoza. España
| | - Delia González de la Cuesta
- Enfermera, Supervisora de área investigación e innovación, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón. Zaragoza. España
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Sunderland M, Matthews C, Waterhouse D, Shetty S, Morton RP. Unmet needs, quality of life and psychological distress: insights regarding head and neck cancer patients in a rural setting. J Laryngol Otol 2023; 137:89-95. [PMID: 36128616 DOI: 10.1017/S0022215121001699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE This study aimed to evaluate the perceived quality of life, unmet needs and psychological distress in patients with head and neck cancer in a rural setting in New Zealand. METHOD Patients presenting with head and neck cancer in Northland, New Zealand, were asked to complete questionnaires on quality of life, unmet needs, and anxiety or depression together with a free-text option. RESULTS About one quarter of respondents (27 per cent) scored high in the anxiety and depression scale, with corresponding diminished quality of life scores and increased needs. Over half of respondents (54 per cent) found it challenging to travel for treatment. Financial difficulties were encountered more frequently with indigenous patients. Rurality alone does not lead to significant differences in quality of life or needs. CONCLUSION After treatment for head and neck cancer, it is important to monitor and manage patients' psychological distress and ease of access to health services to improve quality of life.
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Hendriksma M, Heijnen BJ, Verbist BM, de Jong MA, Langeveld APM, van Benthem PPG, Sjögren EV. Long-term functional outcomes in tumour stage T(2) glottic carcinoma after radiotherapy. J Laryngol Otol 2022;:1-6. [PMID: 35871793 DOI: 10.1017/S0022215122001682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate the long-term functional outcomes in patients who received primary radiotherapy for tumour-node stage T2N0 glottic carcinoma, stratified for tumour extension. METHODS A cross-sectional study was performed on patients who were treated with radiotherapy for T2N0 glottic carcinoma. Four questionnaires were used to measure different aspects of functional outcome. In addition, objective evaluation and perceptual analysis were performed. RESULTS Fourteen patients were included in this study. The median time between the start of radiotherapy and assessment was 42 months (range, 26-143 months). Patients reported high-level functioning, with low symptom scores and good swallowing function, and showed a median dysphonia grade of 1.5. The median Voice Handicap Index-30 score was 17.5. CONCLUSION Patients with T2N0 glottic carcinoma treated with radiotherapy had good long-term quality of life, with low symptom scores, good swallowing functioning and slightly elevated voice outcome parameters.
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Younossi ZM, Stepanova M, Taub RA, Barbone JM, Harrison SA. Hepatic Fat Reduction Due to Resmetirom in Patients With Nonalcoholic Steatohepatitis Is Associated With Improvement of Quality of Life. Clin Gastroenterol Hepatol 2022; 20:1354-1361.e7. [PMID: 34329774 DOI: 10.1016/j.cgh.2021.07.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/06/2021] [Accepted: 07/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Nonalcoholic steatohepatitis (NASH) is a chronic liver disease associated with adverse clinical outcomes and impaired health-related quality of life (HRQL). METHODS Patients with biopsy-proven non-cirrhotic NASH with hepatic fat fraction of ≥10% by magnetic resonance imaging-proton density fat fraction were enrolled in a phase 2, multicenter, double-blind, randomized, placebo-controlled study of resmetirom. HRQL was assessed using Short Form-36 throughout 36 weeks of treatment. RESULTS One hundred twenty-five NASH patients were enrolled (50 ± 11 years old, 50% male, 94% white, body mass index 35 ± 6 kg/m2, 39% with diabetes mellitus). Of these, 84 patients received 80 mg of resmetirom daily, and 41 received placebo. At baseline, HRQL scores were not different from general population norms (Physical Component Summary [PCS] 47.9 ± 9.3 vs 50, Mental Component Summary 50.4 ± 10.0 vs 50; all P > .05). By treatment week 12, patients who received resmetirom experienced improvement of Bodily Pain and Short Form-6D utility scores (P < .05); no HRQL improvement was noted in placebo (all P > .05). Improvement in PCS continued up to week 36 of treatment with resmetirom, again with no improvement in placebo group (all P > .05). Adjusted for the baseline score and clinicodemographic confounders, meeting the endpoint of a decrease in proton density fat fraction of ≥30% by week 12 (met by 54 of 116 treatment completers; 47 of 54 on resmetirom) was independently associated with greater improvements in Physical Functioning and PCS scores at week 36 (P < .05). Patients with improvement in NASH and fibrosis on liver biopsy also showed improvement in components of HRQL. CONCLUSIONS Patients with NASH treated who improved their hepatic fat fraction and/or Nonalcoholic Fatty Liver Disease Activity Score on serial liver biopsy experienced improvement of HRQL. Further studies are needed to confirm long-term sustainability of that improvement. CLINICALTRIALS gov #NCT02912260.
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Affiliation(s)
- Zobair M Younossi
- Center for Liver Disease, Department of Medicine, Inova Health System, Falls Church, Virginia.
| | - Maria Stepanova
- Center for Outcomes Research in Liver Diseases, Washington, District of Columbia
| | | | | | - Stephen A Harrison
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Pinnacle Clinical Research, San Antonio, Texas
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Goverover Y, Kim G, Chen MH, Volebel GT, Rosenfeld M, Botticello A, DeLuca J, Genova HM. The impact of the COVID-19 pandemic on engagement in activities of daily living in persons with acquired brain injury. Brain Inj 2022; 36:183-190. [PMID: 35213287 DOI: 10.1080/02699052.2022.2043441] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PRIMARY OBJECTIVES This study examined (a) the impact of coronavirus disease-2019 (COVID-19) pandemic on engagement in activity participation in persons with acquired brain injury (ABI); and (b) whether changes in activity participation during the pandemic were associated participants' health-related quality of life (HRQoL). RESEARCH DESIGN Exploratory online survey study. METHODS Eighty-seven respondents with ABI and 98 healthy adults (HA) participated in this study. Engagement in activity participation during COVID-19 was calculated as a percentage of the activities participants performed before the pandemic. MAIN RESULTS Participants with ABI modified their activities less than HA in order to maintain level of engagement in activity participation. They stopped performing more activities during the pandemic compared to HA and compared to their pre-pandemic engagement. Both groups continued to do similar percentage of activities without modifications compared to before the pandemic. Better HRQoL in both groups was predicted by a larger percentage of activities continued and fewer activities stopped. CONCLUSION Results emphasize the importance of addressing activity participation changes during situations where there are disruptions of the individual's habits and routines in order to minimize negative consequences of such changes.
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Affiliation(s)
- Yael Goverover
- Department of Occupational Therapy, New York University, New York, USA.,Neuropsychology,Kessler Foundation, East Hanover, New Jersey, USA
| | - Grace Kim
- Department of Occupational Therapy, New York University, New York, USA
| | - Michelle H Chen
- Neuropsychology,Kessler Foundation, East Hanover, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, New Jersey, USA
| | - Gerald T Volebel
- Department of Occupational Therapy, New York University, New York, USA.,Center of Health and Rehabilitation Research University, New York University, New York
| | - Meirav Rosenfeld
- Department of Occupational Therapy, New York University, New York, USA
| | - Amanda Botticello
- Neuropsychology,Kessler Foundation, East Hanover, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, New Jersey, USA
| | - John DeLuca
- Neuropsychology,Kessler Foundation, East Hanover, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, New Jersey, USA
| | - Helen M Genova
- Neuropsychology,Kessler Foundation, East Hanover, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, New Jersey, USA
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Saniasiaya J, Prepageran N. Impact of olfactory dysfunction on quality of life in coronavirus disease 2019 patients: a systematic review. J Laryngol Otol 2021; 135:947-52. [PMID: 34425929 DOI: 10.1017/S0022215121002279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To outline the impact on quality of life in coronavirus disease 2019 patients with olfactory dysfunction. METHODS Five databases were searched for articles referring to the impact on quality of life in coronavirus disease 2019 patients with olfactory dysfunction. The search was conducted for the period from November 2019 to April 2021. The search was conducted over one month (May 2021). RESULTS Four studies that met the objective were included. Altogether, there were 1045 patients. Various questionnaires were used to assess quality of life. Overall, the quality of life deficit affected 67.7 per cent of patients. Quality of life domains investigated include overall quality of life (four studies), food and taste dysfunction (two studies), mental health (two studies), cognitive function (one study), functional outcome (one study) and safety domains (one study). CONCLUSION Quality of life deficit was reported to be 67.7 per cent among coronavirus disease 2019 patients with olfactory dysfunction. The high prevalence of persistent olfactory dysfunction prompts more serious research, as the long-standing consequences of olfactory dysfunction are detrimental.
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Abrar R, Bruce IA, O'Driscoll M, Freeman S, de Estibariz UM, Stapleton E. Impact on patients of the coronovirus disease 2019 pandemic and postponement of cochlear implant surgery: a qualitative study. J Laryngol Otol 2021; 135:918-25. [PMID: 34404494 DOI: 10.1017/S002221512100219X] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to explore the impact of the coronavirus disease 2019 pandemic and postponement of elective surgical procedures for profoundly deaf patients awaiting cochlear implantation. METHOD Open-ended questionnaires were sent to all adult patients awaiting cochlear implantation surgery. Qualitative analysis was performed using a grounded theory approach. RESULTS Participants described a primarily negative impact on wellbeing from the surgery delay, expressing feelings of isolation or loneliness. Low mood, depression or hopelessness were commonly expressed by elderly participants; frustration and anxiety were described by young adults. Participants described a negative impact on their general daily life, describing difficulties communicating with facemasks and struggles with reliance on telephone communication because of social distancing. Despite these significant psychosocial challenges, only a minority described adaptive coping strategies. DISCUSSION Profoundly deaf patients may be at greater psychosocial risk because of unique challenges from their hearing disability. Our findings can be used to develop evidence-driven strategies to improve communication, wellbeing and quality of life.
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20
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Subramaniam N, Luu E, Asher R, Oates J, Clark JR, Low TH. The impact of radical parotidectomy with immediate facial nerve reconstruction: a quality-of-life measure. J Laryngol Otol 2021; 135:804-9. [PMID: 34315553 DOI: 10.1017/S0022215121001857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Immediate facial nerve reconstruction is the standard of care following radical parotidectomy; however, quality of life comparisons with those undergoing limited superficial parotidectomy without facial nerve sacrifice is lacking. METHOD Patients who underwent parotidectomy were contacted to determine quality of life using the University of Washington Quality of Life and Parotidectomy Specific Quality of Life questionnaires. A total of 29 patients (15 in the radical parotidectomy and 14 in the limited superficial parotidectomy groups) completed and returned questionnaires. RESULTS Using the University of Washington Quality of Life Questionnaire, similar quality of life was noted in both groups, with the radical parotidectomy group having significantly worse speech and taste scores. Using the Parotidectomy Specific Quality of Life Questionnaire, the radical parotidectomy group reported significantly worse speech, eye symptoms and eating issues. CONCLUSION Those undergoing radical parotidectomy with reconstruction had comparable overall quality of life with the limited superficial parotidectomy group. The Parotidectomy Specific Quality of Life Questionnaire better identified subtle quality of life complaints. Eye and oral symptoms remain problematic, necessitating better rehabilitation and more focused reconstructive efforts.
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21
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Costa JR, Castro A, Lino J, Soares T, Almeida E Sousa C. External auditory canal exostoses: long-term surgical satisfaction and its relationship with surgical complications. J Laryngol Otol 2021; 135:684-90. [PMID: 34342559 DOI: 10.1017/S0022215121001547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The main purpose of the present study was to evaluate whether complications related to surgery for exostoses are associated with a decrease in patients' quality of life. METHODS This was a retrospective study for which the following information was collected: sex, age, pre- and post-operative symptoms, pre- and post-operative audiological evaluation results, surgical approach, instruments used, complications, and Glasgow Benefit Inventory score. RESULTS The study included 67 patients (94 ears). The three main complaints reported were wax retention, otitis externa and hearing loss. Surgical complications occurred in 14.9 per cent of patients. Patients experienced a significant benefit from surgery, especially in relation to somatic state, with a global Glasgow Benefit Inventory score of + 44.3. No significant difference was found between the global Glasgow Benefit Inventory changes and surgery-related complications (p = 0.093). CONCLUSION After surgery for exostoses, the vast majority of patients showed improvement. Complications related to surgery in general do not seem to influence patients' satisfaction with surgery.
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22
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Madadkar Dehkordi S, Okhovat F, Karimiankakolaki Z. Designing a Clinical Trial Protocol about the Impact of Family-Based Multimedia Education Based on Telephone Tracking (Tele Nursing) to Improve the Quality of Life and Self-Efficacy in Patients with Myocardial Infarction. Int J Surg Protoc 2021; 25:92-97. [PMID: 34113746 PMCID: PMC8162287 DOI: 10.29337/ijsp.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Provision of education to a person with myocardial infarction and an active family member, who takes care of the patient can prevent or delay the onset of the disease. Telephone tracking is a very useful and inexpensive way to assess the patients’ needs and help them with their care problems. This clinical trial (interventional) protocol was conducted over the impact of family-based multimedia education based on the telephone tracking (tele-nursing) to improve the quality of life and self-efficacy in patients with myocardial infarction. Methods: Two phases are identified to design this study; the first phase includes designing a curriculum by investigating various studies and the panel of experts’ opinions. This phase will be conducted in the form of multimedia training and telephone contact. Multimedia training (including audio, video, image, and animation) over the patients’ lifestyle, nutrition, and care will be conducted through a one-day workshop in 2-3 hours for patients and one of their active family members. The active family member is defined as the primary caregiver, who spends more time with the patient. The educational course will be conducted at a coordinated date and time in the ward where the patients are hospitalized. The researcher will make telephone calls as the educational intervention and continue the follow-ups once a week for one month. The second phase of the intervention will contain a pre/post-test design along with application of Minnesota quality of life and Scherer general self-efficacy standard questionnaires in the intervention (with training) and control (without training) groups. The target participants will include all patients (and their active family members) admitted to CCUs of hospitals affiliated to Shahrekord University of Medical Sciences. Discussion: The present study provides useful data for designing a family-based multimedia educational intervention using the telephone-tracking method (tele-nursing) to improve the quality of life and self-efficacy in patients with myocardial infarction. It can also reduce their medical and treatment costs. The strategies of this program could be important and cost effective, and therefore we hope that the success of such a program is a step forward in improving cardiovascular patient’s health status. Highlights
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Affiliation(s)
| | - Forogh Okhovat
- Department of Nursing, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Zohreh Karimiankakolaki
- Ph.D Health Education and Promotion, Department of Health, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
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Mishra AK, Mallick A, Galagali JR, Gupta A, Sethi A, Ghotra A. Mastoid cavity obliteration using bone pâté versus bioactive glass granules in the management of chronic otitis media (squamous disease): a prospective comparative study. J Laryngol Otol 2021; 135:492-500. [PMID: 33975661 DOI: 10.1017/S0022215121001195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the efficacy of bone pâté versus bioactive glass in mastoid obliteration. METHOD This randomised parallel groups study was conducted at a tertiary care centre between September 2017 and August 2019. Sixty-eight patients, 33 males and 35 females, aged 12-56 years, randomly underwent single-stage canal wall down mastoidectomy with mastoid obliteration using either bone pâté (n = 35) or bioactive glass (n = 33), and were evaluated 12 months after the operation. RESULTS A dry epithelised cavity (Merchant's grade 0 or 1) was achieved in 65 patients (95.59 per cent). Three patients (4.41 per cent) showed recidivism. The mean air-bone gap decreased to 16.80 ± 4.23 dB from 35.10 ± 5.21 dB pre-operatively. The mean Glasgow Benefit Inventory score was 30.02 ± 8.23. There was no significant difference between the two groups in these outcomes. However, the duration of surgery was shorter in the bioactive glass group (156.87 ± 7.83 vs 162.28 ± 8.74 minutes; p = 0.01). CONCLUSION The efficacy of both materials was comparable.
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Mateos-Serrano B, García-López I, Toledano A, Gavilán J. Subjective voice analysis in patients with muscular tension dysphonia: comparison between clinician and patient evaluation. J Laryngol Otol 2021; 135:458-63. [PMID: 33906703 DOI: 10.1017/S0022215121001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study evaluated the correlation between patient and clinician subjective voice analysis in a group of patients suffering from muscular tension dysphonia. This disease does not usually present with organic lesions, and voice analysis is crucial to evaluate it. METHODS A retrospective study with 75 patients was performed. Correlation between grade, roughness, breathiness, asthenia and strain scale and voice handicap index-10 was analysed. Any possible influence of the type of muscular tension dysphonia on these two scales was studied. RESULTS There are only a few studies that correlate voice handicap index-10 and the grade, roughness, breathiness, asthenia and strain scale; however, none of them are specific for patients suffering from muscular tension dysphonia. A moderate correlation (r = 0.56) was found. No influence of muscular tension dysphonia type on voice handicap index-10 score was found, but muscular tension dysphonia type 4 had worse grade, roughness, breathiness, asthenia and strain scale scores than other muscular tension dysphonia types. This could be explained if muscular tension dysphonia type 4 is considered to be the most severe form of this disease. CONCLUSION The use of assessment scales based on the opinion of both the clinician and patient must be considered as complementary clinical tools in order to perform a complete assessment of dysphonia.
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Meghji S, Collett A, Nunney I, Prinsley P, Hanif J. Do patients report quality of life improvements after fitting of their unilateral bone conducting hearing implant? J Laryngol Otol 2021; 135:130-3. [PMID: 33531092 DOI: 10.1017/S0022215121000074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The audiological benefits of a bone conducting hearing implant are well documented; however, there is a paucity of literature comparing pre- and post-operative quality of life benefits. This study assessed the quality of life status before and after the device is implanted. METHODS A prospective study was conducted of all adult bone conducting hearing implants inserted in a teaching hospital between 2012 and 2017. All patients completed the Glasgow Health Status Inventory, a validated quality of life questionnaire, before and three to six months after implantation. RESULTS Sixty-two patients received a unilateral bone conducting hearing implant. All scores except the social score improved post-operatively. The paired t-test showed that the differences in the means for the Glasgow Health Status Inventory total, general and physical scores were statistically significant at the 5 per cent level (p < 0.0001). CONCLUSION This study, one of the few to assess quality of life pre- and post-implantation, showed a vast improvement in patients' perceived quality of life from the pre- to the post-operative phase.
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Chen B, Luo Z, Feng X, Pan K, Liu Q, Yang Y. Effect of high-quality care on limb function recovery and quality of life after osteoporotic hip fracture surgery in the elderly. J Musculoskelet Neuronal Interact 2021; 21:272-278. [PMID: 34059572 PMCID: PMC8185254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the effect of high-quality care on limb function recovery and quality of life (QOL) after osteoporotic hip fracture (OHF) surgery in the elderly. METHODS 116 elderly patients with OHF enrolled in our hospital from January 2017 to December 2019 were assigned into observation group (high-quality care, n=58) and control group (routine care, n=58). After one month of intervention, Harris Hip Score (HHS) and Barthel Index (BI) were used to evaluating limb function and self-care ability, pain intensity numerical rating scale (PINRS) for pain assessment, self-rating anxiety scale (SAS), and self-rating depression scale (SDS) for emotion assessment. Besides, postsurgical complications, QOL and patient satisfaction were examined. RESULTS HHS and BI were higher in observation group (P<0.05); PINRS, SAS and SDS were lower in observation group (P<0.05); incidence of postsurgical complications in the observation group was significantly lower than that in the control group (P<0.05); QOL and patient satisfaction in the observation group were higher than those in the control group (P<0.05). CONCLUSION High-quality care promotes the recovery of limb function, the QOL and the satisfaction of elderly patients.
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Affiliation(s)
- Biying Chen
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Zhen Luo
- Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Xiaolei Feng
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Kaixia Pan
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Qiuqin Liu
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Yexiang Yang
- Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China,Corresponding author: Yexiang Yang, Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, No.600 Tianhe Road, Tianhe District, Guangzhou 510630, Guangdong Province, P.R. China E-mail:
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Tutuncu M, Ertem DH, Soysal A. Prevalence And Impact Of Myofascial Pain Syndrome In Relapsing-Remitting Multiple Sclerosis And The Effects Of Local Anesthetic Injections For Short-Term Treatment. Mult Scler Relat Disord 2020; 46:102528. [PMID: 33022587 DOI: 10.1016/j.msard.2020.102528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/13/2020] [Accepted: 09/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies have suggested that patients with multiple sclerosis (MS) who have comorbid musculoskeletal disorders have a lower quality of life. However, there is limited data on the relationship between myofascial pain syndromes (MFPS) and MS. The aim of the study to investigate the frequency and impact of MFPS in patients with MS, to evaluate the effect of local anesthetic injections for short-term treatment. METHOD Three hundred ninety-eight patients with MS patients were evaluated during the study period. Patients meeting the inclusion criteria investigated for MFPS. Patients with active myofascial trigger points received local anesthetics blocks monthly and attended at least 4 follow-up appointments. Multiple Sclerosis Quality of Life Instrument 54 (MSQO-54), Beck Depression Scale, The Numeric Pain Rating Scale (NPRS), Fatigue Severity Scale, and Fatigue Impact Scale were administered before and after injections. The primary outcome was a 50 % reduction in pain intensity. RESULTS One hundred thirty-seven patients with relapsing remitting MS (RRMS) met the inclusion criteria. MFPS was present in 70 of 137 (51.9 %) patients. Thirty-one patients participated; however, 25 patients completed the study. From 3-months post injections, a significant decrease in NPRS was found (p<0.001); in addition, the scores of MSQO-54 have significantly increased and the scores of fatigue impact and severity tests were decreased (p<0.001). No serious complications were noted. CONCLUSION The results of this study support that MFPS can be experienced in patients with RRMS. Local anesthetic injections for trigger points may be an effective, tolerable, and inexpensive treatment for this patient group and contribute to significant reductions in pain severity scores and increase the quality of life.
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Affiliation(s)
- Mesude Tutuncu
- University Of Health Sciences İstanbul Bakırköy Prof. Dr. Mazhar Osman Psychıatrıc Traınıng And Research Hospıtal, Department of Neurology, Istanbul, Turkey.
| | - Devrimsel Harika Ertem
- University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Department of Pain Management, Istanbul, Turkey.
| | - Aysun Soysal
- University Of Health Sciences İstanbul Bakırköy Prof. Dr. Mazhar Osman Psychıatrıc Traınıng And Research Hospıtal, Department of Neurology, Istanbul, Turkey.
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Soni K, Patro SK, Aneja J, Kaushal D, Goyal A, Shakrawal N. Post-rhinoplasty outcomes in an Indian population assessed using the FACE-Q appraisal scales: a prospective observational study. J Laryngol Otol 2020; 134:247-51. [PMID: 32172693 DOI: 10.1017/S0022215120000638] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The primary goal of rhinoplasty is patient satisfaction and improved quality of life. The present study was conducted to assess patient satisfaction with face and nose appearance, and quality of life after rhinoplasty. METHODS Patients presenting for rhinoplasty completed the FACE-Q survey. This is a new instrument that measures patient-reported outcomes in those undergoing aesthetic procedures. The FACE-Q scales include satisfaction with facial appearance overall, satisfaction with the nose, psychological well-being, psychosocial distress and social function. RESULTS Sixty-five patients completed the FACE-Q at pre-operative and at post-operative follow-up visits. Post-operative scores increased significantly in terms of: satisfaction with facial appearance (p < 0.0001, t = 15.639, degrees of freedom = 64); social function (p < 0.0001, t = 12.208, degrees of freedom = 64); psychosocial distress (p < 0.0001, t = 13.864, degrees of freedom = 64); psychological function (p < 0.0001, t = 12.681, degrees of freedom = 64); and satisfaction with nose (p < 0.0001, t = 16.421, degrees of freedom = 64). Most patients reported more than 79 per cent satisfaction with the post-operative outcome. CONCLUSION The FACE-Q is an adequate instrument for determining successful aesthetic surgery based on patient satisfaction.
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Santa Maria C, Santa Maria PL, Bulsara V, Jayawardena J, Caldow JD, Png LH, Atlas MD. Long-term quality of life in patients with vestibular schwannoma managed with microsurgery. J Laryngol Otol 2019; 133:953-9. [PMID: 31668161 DOI: 10.1017/S0022215119002172] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Little is known about the long term (greater than 10 years) quality of life in patients with vestibular schwannoma. This study aimed to evaluate long-term outcomes in patients with vestibular schwannoma. METHOD A retrospective cohort study was performed across 2 academic institutions, with patients followed at least 10 years after vestibular schwannoma surgery (2000 to 2007). Telephone interviews were used to assess quality of life using the Glasgow Benefit Inventory and short form 12 item (version 2) health survey. RESULTS A total of 99 out of 110 patients were included. Increasing age and symptom burden were associated with poorer quality of life (p = 0.01 and 0.02, respectively). The presence of imbalance, headache and facial nerve dysfunction were all associated with poorer quality of life scores (p = 0.01, 0.04 and 0.02, respectively). CONCLUSION Identifying and managing post-operative symptoms may improve quality of life in vestibular schwannoma patients and can guide clinical decision making.
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Younossi ZM, Stepanova M, Younossi I, Racila A. Validation of Chronic Liver Disease Questionnaire for Nonalcoholic Steatohepatitis in Patients With Biopsy-Proven Nonalcoholic Steatohepatitis. Clin Gastroenterol Hepatol 2019; 17:2093-2100.e3. [PMID: 30639779 DOI: 10.1016/j.cgh.2019.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/19/2018] [Accepted: 01/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The chronic liver disease questionnaire for nonalcoholic steatohepatitis (CLDQ-NASH) was developed in a systematic manner for assessment of patient-reported outcomes. This instrument collects data on 36 items grouped into 6 domains: abdominal symptoms, activity/energy, emotional health, fatigue, systemic symptoms, and worry. We aimed to validate the CLDQ-NASH in a large group of patients with NASH. METHODS We collected data from patients with biopsy-proven NASH enrolled in 2 international phase 3 trials of selonsertib (NCT03053050 and NCT03053063). Our final analysis comprised 1667 patients who completed the CLDQ-NASH (age, 58 ± 9 y; 40% male; 52% with cirrhosis; and 69% with type 2 diabetes). The CLDQ-NASH was administered before treatment initiation. A standard patient-reported outcome instrument validation pipeline with internal consistency and validity assessment was applied. RESULTS The domains of CLDQ-NASH showed good to excellent internal consistency: the Cronbach's α values were 0.80 to 0.94 and item-to-own-domain correlations were greater than 0.50 for 33 of 36 items. All items correlated to the greatest extent with their own domains (discriminant validity). Known-group validity tests indicated that the instrument consistently discriminated between patients with NASH based on the presence of cirrhosis (vs bridging fibrosis; all but 1 P value < .02), obesity (all but 1 P value < .001), psychiatric comorbidities (all P values < .0001), fatigue (all P values < .001), and type 2 diabetes (all but 1 P value < .01). Of the CLDQ-NASH domains, the highest correlated domains with the Short Form-36 were as follows: physical functioning for activity (rho = 0.70), mental health for emotional (rho = 0.72), vitality for fatigue (rho = 0.75), and body pain for systemic (rho = 0.72) (all P values < .0001). In contrast, the domains of abdominal and worry, which are disease-specific, did not correlate with the domains in the Short Form-36 (all rho ≤ 0.50). CONCLUSIONS We validated the CLDQ-NASH by an analysis of data from 1667 patients with biopsy-proven NASH enrolled in phase 3 trials, observing excellent psychometric characteristics of the instrument.
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Affiliation(s)
- Zobair M Younossi
- Center For Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia.
| | - Maria Stepanova
- Center for Outcomes Research in Liver Diseases, Washington, District of Columbia
| | - Issah Younossi
- Center for Outcomes Research in Liver Diseases, Washington, District of Columbia
| | - Andrei Racila
- Center For Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Center for Outcomes Research in Liver Diseases, Washington, District of Columbia
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Scott AJ, McGuire JK, Manning K, Leach L, Fagan JJ. Quality of life after total laryngectomy: evaluating the effect of socioeconomic status. J Laryngol Otol 2019; 133:129-34. [PMID: 30773143 DOI: 10.1017/S0022215119000215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Total laryngectomy is considered the primary treatment modality for advanced laryngeal carcinoma. This study assessed the quality of life in patients after total laryngectomy, and ascertained whether quality of life is affected by socioeconomic status. METHOD Forty-seven patients (20 state- and 27 private-sector) who underwent total laryngectomy between 1998 and 2014 responded to the University of Washington Quality of Life Questionnaire, the Voice-Related Quality of Life Questionnaire and the Brief Illness Perception Questionnaire. RESULTS Significant differences were found in socioeconomic status between state- and private-sector patients (p < 0.001). There was no significant difference in overall quality of life between groups (p = 0.210). State-sector patients scored significantly higher Voice-Related Quality of Life Questionnaire scores (p = 0.043). Perception of illness did not differ significantly between groups. CONCLUSION Overall quality of life after total laryngectomy appears to be similar in patients from different socioeconomic backgrounds. However, patients from lower socioeconomic circumstances have better voice-related quality of life. The results illustrate the importance of including socioeconomic status when reporting voice outcomes in total laryngectomy patients.
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Voth BL, Sheppard JP, Barnette NE, Ong V, Nguyen T, Jacky Chen CH, Duong C, Arsenault JJ, Lagman C, Gopen Q, Yang I. The Gopen-Yang Superior Semicircular Canal Dehiscence Questionnaire: development and validation of a clinical questionnaire to assess subjective symptoms in patients undergoing surgical repair of superior semicircular canal dehiscence. J Laryngol Otol 2018; 132:1110-8. [PMID: 30674366 DOI: 10.1017/S0022215118002219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To characterise subjective symptoms in patients undergoing surgical repair of superior semicircular canal dehiscence. METHODS Questionnaires assessing symptom severity and impact on function and quality of life were administered to patients before superior semicircular canal dehiscence surgery, between June 2011 and March 2016. Questionnaire sections included general quality of life, internal amplified sounds, dizziness and tinnitus, with scores of 0-100 points. RESULTS Twenty-three patients completed the questionnaire before surgery. Section scores (mean±standard deviation) were: 38.2 ± 25.2 for general quality of life, 52.5 ± 23.9 for internal amplified sounds, 35.1 ± 28.8 for dizziness, 33.3 ± 30.7 for tinnitus, and 39.8 ± 22.2 for the composite score. Cronbach's α statistic averaged 0.93 (range, 0.84-0.97) across section scores, and 0.83 for the composite score. CONCLUSION The Gopen-Yang Superior Semicircular Canal Dehiscence Questionnaire provides a holistic, patient-centred characterisation of superior semicircular canal dehiscence symptoms. Internal consistency analysis validated the questionnaire and provided a quantitative framework for further optimisation in the clinical setting.
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Abstract
BACKGROUND Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed. METHODS A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: 'health assessment questionnaire', 'structured questionnaire', 'questionnaire', 'patient reported outcome measures', 'PROM', 'quality of life' or 'survey', and 'children' or 'otolaryngology'. The search was limited to English-language articles published between 1996 and 2016. RESULTS The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures. CONCLUSION A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.
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Affiliation(s)
- J Powell
- Department of Paediatric Otolaryngology,Great North Children's Hospital,Newcastle upon Tyne,UK
| | - S Powell
- Department of Paediatric Otolaryngology,Great North Children's Hospital,Newcastle upon Tyne,UK
| | - A Robson
- Department of Otolaryngology,North Cumbria University Hospitals,Carlisle,UK
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Moriarty F, Cahir C, Bennett K, Hughes CM, Kenny RA, Fahey T. Potentially inappropriate prescribing and its association with health outcomes in middle-aged people: a prospective cohort study in Ireland. BMJ Open 2017; 7:e016562. [PMID: 29042380 PMCID: PMC5652466 DOI: 10.1136/bmjopen-2017-016562] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To determine the prevalence of potentially inappropriate prescribing (PIP) in a cohort of community-dwelling middle-aged people and assess the relationship between PIP and emergency department (ED) visits, general practitioner (GP) visits and quality of life (QoL). DESIGN Prospective cohort study. SETTING The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort study of ageing. PARTICIPANTS Individuals aged 45-64 years recruited to TILDA who were eligible for the means-tested General Medical Services scheme and followed up after 2 years. EXPOSURE PIP was determined in the 12 months preceding baseline and follow-up TILDA data collection by applying the PRescribing Optimally in Middle-aged People's Treatments (PROMPT) criteria to participants' medication dispensing data. OUTCOME MEASURES At follow-up, the reported rates of ED and GP visits over 12 months (primary outcome) and the CASP-R12 (Control Autonomy Self-realisation Pleasure) measure of QoL (secondary outcome). ANALYSIS Multivariate negative binomial (rates) and linear regression (CASP-R12) models controlling for potential confounders. RESULTS At 2-year follow-up (n=808), PIP was detected in 42.9% by the PROMPT criteria. An ED visit was reported by 18.7% and 94.4% visited a GP (median 4 visits, IQR 2-6). Exposure to ≥2 PROMPT criteria was associated with higher rates of healthcare utilisation and lower QoL in unadjusted regression. However, in multivariate analysis, the associations between PIP and rates of ED visits (adjusted incidence rate ratio (IRR) 0.92, 95% CI 0.53 to 1.58), and GP visits (IRR 1.06, 95% CI 0.87 to 1.28), and CASP-R12 score (adjusted β coefficient 0.35, 95% CI -0.93 to 1.64) were not statistically significant. Numbers of medicines and comorbidities were associated with higher healthcare utilisation. CONCLUSIONS Although PIP was prevalent in this study population, there was no evidence of a relationship with ED and GP visits and QoL. Further research should evaluate whether the PROMPT criteria are related to these and other adverse outcomes in the general middle-aged population.
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Affiliation(s)
- Frank Moriarty
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Caitriona Cahir
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kathleen Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Carmel M Hughes
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
- Clinical and Practice Research Group, School of Pharmacy, Queen’s University Belfast, Belfast, Northern Ireland
| | - Rose Anne Kenny
- The Irish Longitundinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Tom Fahey
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
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Ali A, Weiss TR, McKee D, Scherban A, Khan S, Fields MR, Apollo D, Mehal WZ. Efficacy of individualised diets in patients with irritable bowel syndrome: a randomised controlled trial. BMJ Open Gastroenterol 2017; 4:e000164. [PMID: 29018540 PMCID: PMC5628288 DOI: 10.1136/bmjgast-2017-000164] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/26/2017] [Accepted: 08/18/2017] [Indexed: 12/12/2022] Open
Abstract
Background Patients with irritable bowel syndrome (IBS) are often placed on diets guided by food intolerance assays, although these have not been validated. We assessed the effects of individualised diets in patients with IBS guided by a leucocyte activation test. Methods This is a parallel-group, double-blind, randomised controlled trial of 58 adults with IBS seen at an academic health centre in Northeast USA. Peripheral venous blood was analysed using a leucocyte activation test; individual foods were reported to produce positive or negative results. Participants were randomised to a 4-week diet with either individualised guidance to eliminate foods with positive assay results and allow foods with negative assay results (intervention), or with individualised guidance, matched in rigour and complexity, to eliminate foods with negative assay results and allow foods with positive assay results (comparison). The primary outcome was between-group differences in the IBS Global Improvement Scale (GIS). Secondary outcomes included reductions in IBS Symptom Severity Scale (SSS) scores and increases in IBS Adequate Relief (AR) and Quality of Life (QOL) scores. An aptamer-based proteomic analysis was conducted in strong responders. Results The intervention group had significantly greater increases in mean GIS score after 4 weeks (0.86 vs comparison; 95% CI 0.05 to 1.67; p=0.04) and 8 weeks (1.22 vs comparison; 95% CI 0.22 to 2.22; p=0.02). The intervention group also had significantly greater reductions in mean SSS score at 4 weeks (–61.78 vs comparison; 95% CI –4.43 to –119.14; p=0.04) and 8 weeks (–66.42 vs comparison; 95% CI –5.75 to –127.09; p=0.03). There were no significant differences between intervention and comparison groups in mean AR or QOL scores. A reduction in neutrophil elastase concentration was associated with reduced symptoms. Conclusions Elimination diets guided by leucocyte activation tests reduced symptoms. These findings could lead to insights into the pathophysiology of IBS. Trial registration number NCT02186743.
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Affiliation(s)
- Ather Ali
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Theresa R Weiss
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Douglas McKee
- Department of Economics, Cornell University, Ithaca, New York, USA
| | - Alisa Scherban
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Sumiya Khan
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Maxine R Fields
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Damian Apollo
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Wajahat Z Mehal
- School of Medicine, Yale University, New Haven, Connecticut, USA
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Abstract
A 22-year-old woman presented with diabetic ketoacidosis, acute right eye blindness and complete ophthalmoplegia. Despite early suspicion and treatment for rhino-orbito-cerebral mucormycosis, her extensive spread of infection led to right internal carotid artery occlusion and cavernous sinus thrombosis, right-sided cerebral watershed infarctions and large abscesses in her right cerebellum, temporal lobe and pons. She underwent surgical removal of her right eye, paranasal sinuses, maxilla and palate, suboccipital craniectomy and shunting for hydrocephalus. Despite the grave prognosis, she has gradually improved and has remained on antifungal treatment for the 18 months since presentation. We discuss the factors that may have influenced her recovery. The case highlights the aggressive nature of rhino-orbito-cerebral mucormycosis, the need for multiple surgeries and the ethical issues in managing such patients.
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Affiliation(s)
- Saman Zafar
- Department of Neurology, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Aparna Prabhu
- Department of Neurology, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
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Chappidi MR, Kates M, Sopko NA, Joice GA, Tosoian JJ, Pierorazio PM, Bivalacqua TJ. Erectile Dysfunction Treatment Following Radical Cystoprostatectomy: Analysis of a Nationwide Insurance Claims Database. J Sex Med 2017; 14:810-817. [PMID: 28460994 DOI: 10.1016/j.jsxm.2017.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/08/2017] [Accepted: 04/01/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION To improve care for patients after radical cystoprostatectomy (RCP), focus on survivorship issues such as sexual function needs to increase. Previous studies have demonstrated the burden of erectile dysfunction (ED) after RCP to be as high as 89%. AIM To determine the rates of ED treatment use (phosphodiesterase type 5 inhibitors, injectable therapies, urethral suppositories, vacuum erection devices, and penile prosthetics) in patients with bladder cancer before and after RCP to better understand current patterns of care. METHODS Men with bladder cancer undergoing RCP were identified in the MarketScan database (2010-2014). ED treatment use was assessed at baseline (during the 1 year before RCP) and at 6-month intervals (0-6, 7-12, 13-18, 19-24 months) after RCP. Multivariable logistic regression models were used to identify predictors of ED treatment use at 6-month intervals after RCP. OUTCOMES ED treatment rates and predictors of ED treatment at 0-6, 7-12, 13-18, 19-24 month follow-up after RCP. RESULTS At baseline, 6.5% of patients (77 of 1,176) used ED treatments. The rates of ED treatment use at 0 to 6, 7 to 12, 13 to 18, and 19 to 24 months after RCP were 15.2%, 12.7%, 8.1%, and 10.1% respectively. Phosphodiesterase type 5 inhibitors were the most commonly used treatment at all time points. In the multivariable model, predictors of ED treatment use at 0 to 6 months after RCP were age younger than 50 years (odds ratio [OR] = 3.17, 95% CI = 1.68-6.01), baseline ED treatment use (OR = 5.75, 95% CI = 3.08-10.72), neoadjuvant chemotherapy (OR = 1.72, 95% CI = 1.13-2.61), and neobladder diversion (OR = 2.40, 95% CI = 1.56-3.70). Baseline ED treatment use continued to be associated with ED treatment use at 6 to 12 months (OR = 5.63, 95% CI = 2.42-13.10) and 13 to 18 months (OR = 8.99, 95% CI = 3.05-26.51) after RCP. CLINICAL IMPLICATIONS While the burden of ED following RCP is known to be high, overall ED treatment rates are low. These findings suggest either ED treatment is low priority for RCP patients or education about potential ED therapies may not be commonly discussed with patients following RCP. Urologists should consider discussing sexual function more frequently with their RCP patients. STRENGTHS & LIMITATIONS Strengths include the use of a national claims database, which allows for longitudinal follow-up and detailed information on prescription medications and devices. Limitations include the lack of pathologic and oncologic outcomes data. CONCLUSION ED treatment use after RCP is quite low. The strongest predictor of ED treatment use after RCP was baseline treatment use. These findings suggest ED treatment is a low priority for patients with RCP or education about potential ED therapies might not be commonly discussed with patients after RCP. Urologists should consider discussing sexual function more frequently with their patients undergoing RCP. Chappadi MR, Kates M, Sopko NA, et al. Erectile Dysfunction Treatment Following Radical Cystoprostatectomy: Analysis of a Nationwide Insurance Claims Database. J Sex Med 2017;14:810-817.
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Affiliation(s)
- Meera R Chappidi
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Max Kates
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nikolai A Sopko
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gregory A Joice
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffrey J Tosoian
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Phillip M Pierorazio
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Trinity J Bivalacqua
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Kosyakov SI, Minavnina JV, Phillips JS, Yung MW. International recognition of the Chronic Otitis Media Questionnaire 12. J Laryngol Otol 2017; 131:514-7. [PMID: 28345505 DOI: 10.1017/S0022215117000603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Chronic Otitis Media Questionnaire 12 was developed initially in the UK to assess patient-reported health-related quality of life associated with chronic otitis media. This study aimed to determine whether this tool is applicable to the Russian population, which has a materially different healthcare system. METHOD A total of 108 patients with different forms of chronic otitis media completed the Russian Chronic Otitis Media Questionnaire 12. RESULTS The average Russian Chronic Otitis Media Questionnaire 12 score was 19.4 (standard deviation = 8.3). The internal consistency of the Russian Chronic Otitis Media Questionnaire 12 was high, with a Cronbach's alpha value of 0.860. CONCLUSION The Russian version of the Chronic Otitis Media Questionnaire 12 was found to be a reliable tool for the assessment of health-related quality of life in patients with chronic otitis media. This sets the scene for international collaboration, using this tool to assess the effectiveness of surgical treatments even amongst countries with different healthcare systems.
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Montaño-Velázquez BB, Nolasco-Renero J, Parada-Bañuelos JE, Garcia-Vázquez F, Flores-Medina S, García-Romero CS, Jáuregui-Renaud K. Quality of life of young patients with recurrent respiratory papillomatosis. J Laryngol Otol 2017; 131:425-8. [PMID: 28193306 DOI: 10.1017/S0022215117000354] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess quality of life of children and teenagers with recurrent respiratory papillomatosis, according to the evidence of infection by human papillomavirus types 6 and 11, compared with healthy volunteers and patients with chronic otitis media. METHOD Participants and their parents completed the Pediatric Quality of Life Inventory 4.0. RESULTS Patients with recurrent respiratory papillomatosis and their parents reported lower quality of life than healthy subjects (p < 0.01), but similar quality of life to patients with chronic otitis media. Those with human papillomavirus type 11 showed the lowest scores among all participants (p < 0.05). CONCLUSION Young Mexican patients with recurrent respiratory papillomatosis and their parents perceive a poor quality of life, and they may experience limitations in interactions with their peers. Infection by human papillomavirus type 11 may increase the impact of the disease on quality of life.
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Fong E, Garcia M, Woods CM, Ooi E. Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis. J Laryngol Otol 2017; 131:S2-S11. [PMID: 28164779 DOI: 10.1017/S0022215116009269] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery. METHODS Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes. RESULTS Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37-0.72). Hyaluronic acid use was not associated with any significant adverse events. CONCLUSION Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.
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Ugarte AU, López-Peña P, Vangeneberg CS, Royo JGT, Ugarte MAA, Compains MTZ, Medrano MPR, Toyos NM, Lamo EA, Dueñas MBB, González-Pinto A. Psychoeducational preventive treatment for women at risk of postpartum depression: study protocol for a randomized controlled trial, PROGEA. BMC Psychiatry 2017; 17:13. [PMID: 28086766 PMCID: PMC5237273 DOI: 10.1186/s12888-016-1162-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/07/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Postpartum depression is a disease with a prevalence of 20% that has deleterious consequences not only for the mother but also for the baby and can cause delays in physical, social and cognitive development. In this context, the European Union Committee on Public Health has declared it essential that preventative measures are taken by centres providing care for women with a multidisciplinary approach. PROGEA is a multicentre, single-blind randomized, 3-year, longitudinal clinical trial aiming to evaluate the efficacy of a psychoeducational programme in preventing postpartum depression in at-risk women, based on a range of clinical variables, and explore prognostic factors. This paper describes the methods and rationale behind the study. METHODS We will study women receiving treatment as usual plus a psychoeducation cognitive behavioural therapy (CBT)-based intervention and a control group receiving only treatment as usual. The sample will be recruited from an incidental sampling of pregnant women in two health regions. We will recruit 600 women in the third trimester of pregnancy who consent to take part in the study. Almost half of the women, about 280, would be expected to have some risk factors for postpartum depression. All those found to have risk factors will be evaluated, and we estimate that a quarter will be classified as at-risk of developing postpartum depression as measured with the Edinburgh Postnatal Depression Scale. This subset will be randomly allocated to receive treatment as usual with or without the CBT intervention. Six sessions of CBT (1 individual and 5 group) will be offered by a psychologist. DISCUSSION Findings from this study will be used to design a definitive study that will examine the clinical and cost-effectiveness of the CBT-based intervention in improving the mood of women in the postpartum period. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02323152 ; Date: December 2014.
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Affiliation(s)
- Amaia Ugarte Ugarte
- Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain. .,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain.
| | - Purificación López-Peña
- Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain ,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain
| | | | | | | | | | | | - Nerea Muñoz Toyos
- Obstetrics and Gynecology Service, OSAKIDETZA, Basque Country, Spain
| | | | | | - Ana González-Pinto
- Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain ,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain ,School of Medicine, University of the Basque Country, Vitoria, Spain
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Taheri-Kharameh Z, Zamanian H, Montazeri A, Asgarian A, Esbiri R. Negative Religious Coping, Positive Religious Coping, and Quality of Life Among Hemodialysis Patients. Nephrourol Mon 2016; 8:e38009. [PMID: 27896237 PMCID: PMC5120233 DOI: 10.5812/numonthly.38009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 04/19/2016] [Accepted: 05/04/2016] [Indexed: 12/01/2022] Open
Abstract
Background Religious coping is known as a main resource influencing how individuals cope with the complications and stressors of chronic disease. Objectives The aim of this study was to assess the relationship between religious coping and quality of life among hemodialysis patients. Methods This cross-sectional study was conducted in Qom, Iran, from June 2012 to July 2013. Ninety-five end-stage renal disease (ESRD) patients undergoing hemodialysis were selected via the convenience sampling method. Data were collected via a questionnaire comprising items on sociodemographic information, quality of life, the anxiety and depression scale, and religious coping. Following this, the data were analyzed using descriptive statistics and logistic regression analysis. Results The mean age of patients was 50.4 (standard deviation [SD] = 15.7) years, and most were male (61%). The mean score for positive religious coping was 23.38 (SD = 4.17), while that for negative religious coping was 11.46 (SD = 4.34). It was found that 53.6% of patients had higher than the mean score of positive religious coping, while those with negative religious coping made up 37.9%. Negative religious coping was associated with worse quality of life, including physical functioning (odds ratio [OR] = 0.72; P = 0.009), role physical (OR = 0.79; P = 0.04), vitality (OR = 0.62; P = 0.005), social functioning (OR = 0.69; P = 0.007), and mental health (OR = 0.58; P = 0.01) after controlling for sociodemographic, clinical, and anxiety and depression variables. Conclusions The results indicated that patients with negative religious coping abilities were at risk of a suboptimal quality of life. Incorporating religious support in the care of hemodialysis patients may be helpful in improving quality of life in this patient population. Further longitudinal studies are needed to determine whether these associations are causal and the direction of effect.
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Affiliation(s)
- Zahra Taheri-Kharameh
- Students Research Center, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
- School of Public Health, Qom University of Medical Sciences, Qom, IR Iran
| | - Hadi Zamanian
- School of Public Health, Qom University of Medical Sciences, Qom, IR Iran
- Corresponding author: Hadi Zamanian, School of Public Health, Qom University of Medical Sciences, Qom, IR Iran. E-mail:
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Tehran, IR Iran
| | - Azadeh Asgarian
- Izadi Hospital, Qom University of Medical Sciences, Qom, IR Iran
| | - Roya Esbiri
- School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
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Jog M, Wein T, Bhogal M, Dhani S, Miller R, Ismail F, Beauchamp R, Trentin G. Real-World, Long-Term Quality of Life Following Therapeutic OnabotulinumtoxinA Treatment. Can J Neurol Sci 2016; 43:687-96. [PMID: 27430524 DOI: 10.1017/cjn.2016.262] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND OnabotulinumtoxinA is an efficacious treatment option for patients with various conditions. Although studies have reported on the efficacy of onabotulinumtoxinA, quality of life (QoL) data are limited. This study evaluated QoL in patients treated with onabotulinumtoxinA across various therapeutic indications. METHODS MDs on BOTOX Utility (MOBILITY) was a prospective, multicenter, observational Canadian study in patients initiating (naïve) or receiving ongoing (maintenance) onabotulinumtoxinA treatment. Health utility was the primary outcome measure and was obtained from the Short Form-12 Health Survey using the Short Form-6D at baseline, week 4 posttreatment, and up to five subsequent treatment visits. The safety cohort included patients who received ≥1 onabotulinumtoxinA treatment. RESULTS The efficacy cohort included 1062 patients; the majority were Caucasian, female, and on maintenance onabotulinumtoxinA treatment. Adult focal spasticity (n=398), blepharospasm (n=81), cerebral palsy (n=22), cervical dystonia (n=234), hemifacial spasm (n=116), and hyperhidrosis (n=211) patients were included. Baseline health utility was generally higher in maintenance versus naïve patients; however, naïve patients showed the greatest improvements over time. Health utility was generally maintained or trended toward improvement across all cohorts, including maintenance patients who had been treated for up to 22 years before study entry. Eighteen of 1222 patients (2%) in the safety cohort reported 28 treatment-related adverse events; eight were serious in four patients. CONCLUSION MOBILITY is the largest prospective study to date to provide QoL data over a variety of therapeutic indications following treatment with onabotulinumtoxinA. Although the QoL burden varies by disease, data suggest that long-term treatment may help improve or maintain QoL over time.
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Ghosh A, Philiponis G, Bewley A, Ransom ER, Mirza N. You can't pay me to quit: the failure of financial incentives for smoking cessation in head and neck cancer patients. J Laryngol Otol 2016; 130:278-83. [PMID: 26878376 DOI: 10.1017/S0022215116000037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE A prospective randomised study was conducted at a tertiary care hospital to evaluate the effects of financial incentives for smoking cessation targeted at a high-risk population. METHODS Patients with a past history of head and neck cancer were voluntarily enrolled over a two-year period. They were randomised to a cash incentives or no incentive group. Subjects were offered enrolment in smoking cessation courses. Smoking by-product levels were assessed at 30 days, 3 months and 6 months. Subjects in the incentive group received $150 if smoking cessation was confirmed. RESULTS Over 2 years, 114 patients with an established diagnosis of head and neck cancer were offered enrolment. Twenty-four enrolled and 14 attended the smoking cessation classes. Only two successfully quit smoking at six months. Both these patients were in the financially incentivised group and received $150 at each test visit. CONCLUSION Providing a financial incentive for smoking cessation to a population already carrying a diagnosis of head and neck cancer in order to promote a positive behaviour change was unsuccessful.
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Joseph J, Miles A, Ifeacho S, Patel N, Shaida A, Gatland D, Watters G, Kiverniti E. Comparison of quality of life outcomes following different mastoid surgery techniques. J Laryngol Otol 2015; 129:835-9. [PMID: 26314319 DOI: 10.1017/S0022215115001917] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Mastoid surgery carried out to treat chronic otitis media can lead to improvement in objective and subjective measures post-operatively. This study investigated the subjective change in quality of life using the Glasgow Benefit Inventory relative to the type of mastoid surgery undertaken. METHOD A retrospective multicentre postal survey of 157 patients who underwent mastoid surgery from 2008 to 2012 was conducted. RESULTS Eighty-three questionnaire responses were received from patients who underwent surgery at one of three different hospitals (a response rate of 53 per cent). Fifty-seven per cent of patients had a Glasgow Benefit Inventory score of 0, indicating no change in quality of life post-operatively. Thirty-five per cent scored over 50, indicating significant improvement. The only significant difference found was that women fared worse after surgery than men. CONCLUSION The choice of mastoid surgery technique should be determined by clinical need and surgeon preference. There is no improvement in quality of life for most patients following mastoid surgery.
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Abstract
OBJECTIVE To review the literature on the outcomes of ENT operations in order to assess whether ENT operations are effective. METHODS The value of evidence-based medicine in relation to ENT was appraised, as was the perception of effectiveness. Literature on common ENT operations, including grommet insertion, tonsillectomy and adenoidectomy, and correction of the nasal septum, was evaluated. RESULTS AND CONCLUSION When evaluating the effectiveness of ENT operations, the patient's overall condition and improvements after surgery should be measured. Objective and subjective factors should both be considered as good evidence, especially with the increasing role that evidence-based medicine plays in decisions of whether to operate. The literature review provides evidence that ENT operations are effective.
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Song Y, Wang M, Xie J, Li W, Zhang X, Wang T, Tan G. Prevalence of allergic rhinitis among elementary and middle school students in Changsha city and its impact on quality of life. J Laryngol Otol 2015; 129:1108-14. [PMID: 26391176 DOI: 10.1017/S0022215115002492] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate the prevalence of allergic rhinitis among elementary and middle school students and examine its impact on their quality of life. METHODS Stratified sampling and cluster sampling surveys were performed among 10-17-year-old students in Changsha city from June 2011 to April 2012. RESULTS In the stratified sampling survey, the self-reported allergic rhinitis rate was 42.5 per cent. Further examination demonstrated that the average prevalence of allergic rhinitis was 19.4 per cent. The cluster sampling survey demonstrated that 214 of 814 students appeared to be atopic (26.3 per cent). The prevalence of allergic rhinitis and asthma was 17.2 and 2.1 per cent, respectively. In total, 71 atopic individuals (8.7 per cent) were without any symptoms of allergic disease. Further analysis showed that allergic rhinitis influenced the students' sleep, emotions and memory (p < 0.001). CONCLUSION The prevalence of allergic rhinitis was 15.8 -19.4 per cent, showing an increase with age. Allergic rhinitis affected students' sleep, emotions and memory.
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Al-Shidhani A, Al-Rashdi S, Al-Habsi H, Rizvi S. Impact of acne on quality of life of students at sultan qaboos university. Oman Med J 2015; 30:42-7. [PMID: 25830000 DOI: 10.5001/omj.2015.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/19/2014] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess the impact of acne on the quality of life. Its secondary objective was to assess the influence of gender of students and severity of symptoms on the quality of life. . METHODS A cross sectional study was conducted on 100 students at Sultan Qaboos University (SQU) (40 males and 60 females) diagnosed with acne who attended the Student Clinic during a period of three months from September to December 2009. The Acne Quality Of Life index (Acne-QoL) questionnaire was used to assess the patient's quality of life in four different domains: self-perception, social, emotional, and acne symptoms. . RESULTS Acne affected all areas of the patients, quality of life with the emotional domain found to be the most affected. Overall, female patients reported more adverse QoL effects. The mean score for self-perception for female students was 2.5 and 2.8 for males (p=0.300). The role-social domain approached a significant difference between genders (p=0.078). There was a statistically significant correlation between severity of acne symptoms and the other three domains. The correlation was highest between acne symptoms score and self-perception score. . CONCLUSION This study showed that acne affects the quality of life of affected SQU students treated by primary care physicians at the Student Clinic. Therefore, physicians should take into account the effect of acne on the persons' quality of life when individualizing treatment.
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Affiliation(s)
| | | | - Hamdan Al-Habsi
- Family Medicine, Sultan Qaboos University Hospital, Al-Khoud, Oman
| | - Syed Rizvi
- Statistics, Sultan Qaboos University, Al-Khoud, Oman
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Abstract
INTRODUCTION The use of patient reported outcome measures to support routine inflammatory bowel disease (IBD) care is not widespread and suggests that existing questionnaires lack relevance to day-to-day decisions or are too cumbersome to administer. We developed a simple, generic tool for capturing disease control from the patient's perspective to address these barriers. METHODS Development based on literature review, patient focus groups/interviews and a steering group, defining a limited set of generic questions. The 'IBD-Control' questionnaire comprises 13 items plus a visual analogue scale (VAS) (0-100). Prospective validation involved baseline completion of IBD-Control, quality of life (QoL) questionnaire (UK-IBD-Q), EuroQol (EQ-5D), Hospital Anxiety and Depression Score; and clinician assessment (blinded to questionnaire; recording Harvey-Bradshaw Index or Simple Clinical Colitis Activity Index; Global Clinician Rating; treatment outcome). RESULTS 299 patients returned baseline surveys (Crohn's disease, n=160; ulcerative colitis, n=139) and 138 attended for repeat visits. Completion time (mean; SD): 1 min 15 s; 25 s; Internal consistency: Cronbach's α for all 13 items (0.85); for subgroup of eight questions ('IBD-Control-8'; 0.86). Strong correlation between IBD-Control-8 and IBD-Control-VAS (r=0.81). Test-retest reliability (2 week repeat): intra-class correlation=0.97 for IBD-Control-8 and 0.96 for IBD-Control-VAS. Construct validity: Moderate-to-strong correlations between IBD-Control-8 and IBD-Control-VAS versus activity indices, UK-IBD-Q and EQ-5D (utility) with r values 0.52-0.86. Discriminant validity (mean instrument scores for remission, mild, moderate or severe): p<0.001 (analysis of variance (ANOVA)). Sensitivity to change: Effect sizes: 0.76-1.44. CONCLUSIONS The IBD-Control is a rapid, reliable, valid and sensitive instrument for measuring overall disease control from the patient's perspective. Unlike existing patient reported outcome measures, its simplicity, ease-of-use and generic applicability make it a candidate for supporting routine care.
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Affiliation(s)
- Keith Bodger
- Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK,Digestive Diseases Centre, Aintree University Hospital NHS Trust, Liverpool, UK
| | - Clare Ormerod
- Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK,Digestive Diseases Centre, Aintree University Hospital NHS Trust, Liverpool, UK
| | - Daniela Shackcloth
- Digestive Diseases Centre, Aintree University Hospital NHS Trust, Liverpool, UK
| | - Melanie Harrison
- Digestive Diseases Centre, Aintree University Hospital NHS Trust, Liverpool, UK
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