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Hamid YH, Mohammed M, Hamid S, Mohamedahmed W, Ahmed O. Impact of Diabetic Foot Ulcer on the Health-Related Quality of Life of Diabetic Patients in Khartoum State. Cureus 2024; 16:e52813. [PMID: 38389641 PMCID: PMC10883763 DOI: 10.7759/cureus.52813] [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] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background This is a novel study from Sudan aimed at comparing health-related quality of life (HRQoL) between diabetic foot ulcer (DFU) patients and diabetes patients without DFU. Additionally, this study aimed to determine the factors correlating with lower HRQoL. Methodology A descriptive, cross-sectional study with a comparative group was conducted in three diabetes centers in Khartoum, Sudan, in 2020. A total of 120 Sudanese diabetic patients (mean age = 52 years) were divided into two groups, without DFU and with DFU, and interviewed in person. Demographic and clinical variables were recorded. HRQoL was evaluated using the standardized RAND-36 (36-Item Short Form Health Survey) survey for all participants. HRQoL domains and total scores were compared in the two groups using the t-test. Inference against sociodemographic data was determined using Pearson's test and analysis of variance. Results The DFU group (36 males, 24 females) scored significantly lower in five (yet higher in two out of the eight subscales) compared to the non-DFU diabetic group (31 males, 29 females). Energy/fatigue levels remained insignificant. Being a female (p = 0.03), painful ulcers (p = 0.001), insulin use (p = 0.04), and newly developed ulcers (p = 0.005) were associated with lower HRQoL total scores in the DFU group. However, educational levels had a positive correlation (p = 0.02). Conclusions DFU patients have lower HRQoL than diabetic patients without ulcers. They need more support, including disease-specific education, realistic expectations (regarding ulcer's impact, healing, and management), physical rehabilitation, and culturally sensitive assessment tools.
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Affiliation(s)
- Yusra H Hamid
- Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, SDN
| | - Mathani Mohammed
- General Surgery, Sudan Medical Specialization Board, Khartoum, SDN
| | - Safaa Hamid
- General Surgery, Sudan Medical Specialization Board, Khartoum, SDN
| | | | - Osama Ahmed
- Community Medicine and Public Health, National University, Khartoum, SDN
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Ghosh CK, Islam S, Tabassum N, Mohiuddin SA, Hossain MM, Sarkar A, Bari A. Quality of Life of Patients With Inflammatory Bowel Disease in Bangladesh. Cureus 2023; 15:e39929. [PMID: 37283595 PMCID: PMC10239544 DOI: 10.7759/cureus.39929] [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] [Accepted: 06/03/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction The importance of maintaining quality of life in managing inflammatory bowel disease (IBD) has increased in recent years. However, there is a lack of studies examining the health-related quality of life (HRQoL) of IBD patients in Bangladesh. Methodology This cross-sectional study was carried out in the IBD clinic, Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2020 to 2022. Data were collected from both ulcerative colitis (UC) and Crohn's disease (CD) patients. HRQoL was recorded on the EuroQol 5 Dimension 5 Level (EQ-5D-5L) questionnaire. Statistical analysis was done by Statistical Analysis Software (SAS, SAS Institute, Cary, NC). Results The mean age was 36.3 years. The majority of the patients were male and had low incomes. People with more monthly income, more frequent relapse, extraintestinal involvement, and moderate to severe disease had lower utility index (p = 0.01, 0.01, 0.0004, and <0.0001, respectively). Among the five individual components, only usual activity was lower in UC patients (p = 0.03); all the other components and consequently the overall utility index did not vary between UC and CD. The visual analog scale (VAS) score seemed to be comparable in UC and CD patients. Conclusion In more severe and frequently relapsing cases of IBD, the utility index representing HRQoL was found to be lower. Comparatively, the HRQoL was mostly similar between patients with UC and CD. Additionally, the mean utility score in IBD patients was higher than that observed in patients with type 2 diabetes mellitus in Bangladesh.
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Affiliation(s)
- Chanchal Kumar Ghosh
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Sumona Islam
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Nowrin Tabassum
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Syed Arafat Mohiuddin
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Md Mosarrof Hossain
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Aditi Sarkar
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Amit Bari
- Department of Nephrology, Kidney Foundation Hospital and Research Institute, Dhaka, BGD
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Alroqi A, Abaalkhail MB, Albuhayjan N, Alorainy J, Jomah M, Alromaih S, Binkhamis K. Evaluation of Chronic Rhinosinusitis Symptoms' Severity Following COVID-19 Infection: A Retrospective Analysis. Cureus 2023; 15:e38517. [PMID: 37288207 PMCID: PMC10241694 DOI: 10.7759/cureus.38517] [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] [Accepted: 04/30/2023] [Indexed: 06/09/2023] Open
Abstract
Objectives This study aims to compare the severity of chronic rhinosinusitis (CRS) symptoms pre- and post-COVID-19 infection and estimate the impact of the COVID-19 pandemic on the use of intranasal corticosteroids (ICS) among adult CRS patients. Methods This was an observational retrospective cohort study conducted at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between July 2022 and October 2022. Adult CRS patients with sino-nasal outcomes test-22 (SNOT-22) scores documented prior to March 2020, marking the occurrence of Saudi Arabia's initial reported case of COVID-19, were requested to complete the SNOT-22 questionnaire following COVID-19 infection. A comparison was subsequently made between the two scores obtained. Results The study enrolled a total of 33 patients, with 16 assigned to the control group and 17 with a history of COVID-19 infection. The mean age of the patients was 43 years, and the majority (52%) were males. Statistical analysis did not reveal any statistically significant differences in the total SNOT-22 scores or domain-level scores between the two groups. Furthermore, the use of ICS during the COVID-19 pandemic did not show any significant associations, except for patients with asthma, where 80% of them used ICS during the pandemic (p=0.0073). Conclusion There was no statistically significant disparity observed in the SNOT-22 scores between patients who tested positive for COVID-19 and those who did not. The use of corticosteroids during the COVID-19 pandemic was found to be more prevalent in this study compared to previous studies conducted before the pandemic, particularly among patients with asthma. The use of ICS during the pandemic was not associated with the presence of polyps, functional endoscopic sinus surgery (FESS), allergic rhinitis, or eczema.
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Affiliation(s)
- Ahmad Alroqi
- Otolaryngology-Head & Neck Surgery, King Saud University, Riyadh, SAU
| | | | - Nawaf Albuhayjan
- Otolaryngology-Head & Neck Surgery, King Saud University, Riyadh, SAU
| | - Jehad Alorainy
- Otolaryngology-Head & Neck Surgery, King Saud University, Riyadh, SAU
| | - Mohammed Jomah
- Otolaryngology-Head & Neck Surgery, King Saud University, Riyadh, SAU
| | - Saud Alromaih
- Otolaryngology-Head & Neck Surgery, King Saud University, Riyadh, SAU
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Gillies M, Tan K, Anthony L, Miller F. Effect of Psychosocial, Behavioral, and Disease Characteristics on Health-Related Quality of Life (HRQoL) After Breast Cancer Surgery: A Cross-Sectional Study of a Regional Australian Population. Cureus 2023; 15:e36054. [PMID: 36923016 PMCID: PMC10008704 DOI: 10.7759/cureus.36054] [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] [Accepted: 03/12/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Increasing long-term breast cancer survivorship has highlighted the importance of patient-reported outcomes such as health-related quality of life (HRQoL) in addition to traditional outcomes that were used to define successful operative management. This study aimed to describe HRQoL in patients who underwent breast cancer resection in a regional Australian setting and identify the psychosocial, demographic, and operative characteristics associated with poor HRQoL. METHODS Consecutive patients who underwent breast cancer resection between 2015 and 2022 were included. Patients were asked to complete a survey instrument that included validated measures of HRQoL, emotional distress, fear of cancer recurrence (FCR), and social support. Demographic, disease, and operative data were collected from the medical record of the respondents. RESULTS Forty-six patients completed the survey (100% female, mean age = 62.68 years). Most HRQoL domains were significantly lower than an Australian reference population. HRQoL was more strongly associated with psychosocial factors (emotional distress, FCR, and social support) but was also associated with socioeconomic status, stage of cancer at presentation, and surgical complications. HRQoL was not related to breast conservation, management of the Axilla, or time since operation. CONCLUSION Long-term changes in HRQoL should be considered during the management and surveillance of breast cancer patients in regional Australia.
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Affiliation(s)
| | - Keith Tan
- Surgery, St. Vincent's Hospital Melbourne, Melbourne, AUS
| | | | - Francis Miller
- General Surgery, Goulburn Valley Health, Shepparton, AUS
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Tayeb HO, Alsawwaf Y, Khoja AA, Batarfi B, Baduwailan A, Yousef M, Aldaheri R, Alaklouk SE, AlOthman SA, Alqurashi Y. Determinants of Health-Related Quality of Life of Epilepsy Patients in Jeddah, Saudi Arabia. Cureus 2022; 14:e24118. [PMID: 35573498 PMCID: PMC9106369 DOI: 10.7759/cureus.24118] [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] [Accepted: 04/13/2022] [Indexed: 11/05/2022] Open
Abstract
Background Epilepsy puts an enormous burden on the physical and mental health of patients and can negatively impact their Health-Related Quality of Life (HRQoL). Previous studies have identified multiple factors impacting patients' HRQoL; however, a consensus has not been reached, as these factors vary among different populations. This has not been sufficiently investigated in Saudi Arabia. Thus, this study aims to assess the HRQoL of epilepsy patients, as measured by the Quality Of Life In Epilepsy-31 (QOLIE-31) questionnaire, to determine the effects of demographics, disease characteristics, and antiepileptic drugs (AEDs) on patients in Jeddah, Saudi Arabia. Methods This was a cross-sectional, questionnaire-based study of adult epilepsy patients receiving AEDs who followed up at the epilepsy clinic at King Abdulaziz University Hospital between April 2018 and June 2018. Recruited individuals participated by phone interview. Results A total of 200 participants fulfilled our inclusion criteria and consented to participate; 57.4% were males. The average age was 32.8 years. The total average score on the QOLIE-31 was 61.56 (±17.52). QOLIE-31 scores correlated inversely with seizure frequency (p<.000) while the class of medication used, and the number of drugs administered did not correlate with HRQoL. Conclusion Whereas previous work has suggested a better quality of life when using newer generation AEDs, our study found no significant difference between the class of medication and whether monotherapy or polytherapy is used. Our findings suggest that efforts to improve HRQoL should be directed toward proper control of seizures regardless of medication class, as the frequency of attacks has the most detrimental effect on patients' quality of life.
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Affiliation(s)
- Haythum O Tayeb
- Neurology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Yousef Alsawwaf
- Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, SAU
| | - Abeer A Khoja
- Neurology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | | | | | | | - Reem Aldaheri
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | | | - Yara Alqurashi
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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Jia H, Zack MM, Thompson WW, Crosby AE, Gottesman II. Impact of depression on quality-adjusted life expectancy (QALE) directly as well as indirectly through suicide. Soc Psychiatry Psychiatr Epidemiol 2015; 50:939-49. [PMID: 25660550 PMCID: PMC4590980 DOI: 10.1007/s00127-015-1019-0] [Citation(s) in RCA: 36] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 01/27/2015] [Indexed: 01/04/2023]
Abstract
PURPOSE To estimate quality-adjusted life expectancy (QALE) loss among US adults due to depression and QALE losses associated with the increased risk of suicide attributable to depression. METHOD We ascertained depressive symptoms using the eight-item Patient Health Questionnaire (PHQ-8) on the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) surveys. We estimated health-related quality of life (HRQOL) scores from BRFSS data (n = 276,442) and constructed life tables from US Compressed Mortality Files to calculate QALE by depression status. QALE loss due to depression is the difference in QALE between depressed and non-depressed adults. QALE loss associated with suicide deaths is the difference between QALE from only those deaths that did not have suicide recorded on the death certificate and QALE from all deaths including those with a suicide recorded on the death certificate. RESULTS At age 18, QALE was 28.0 more years for depressed adults and 56.8 more years for non-depressed adults, a 28.9-year QALE loss due to depression. For depressed adults, only 0.41 years of QALE loss resulted from deaths by suicide, and only 0.26 years of this loss could be attributed to depression. CONCLUSION Depression symptoms lead to a significant burden of disease from both mortality and morbidity as assessed by QALE loss. The 28.9-year QALE loss at age 18 associated with depression markedly exceeds estimates reported elsewhere for stroke (12.4-year loss), heart disease (10.3-year loss), diabetes mellitus (11.1-year loss), hypertension (6.3-year loss), asthma (7.0-year loss), smoking (11.0-year loss), and physical inactivity (8.0-year loss).
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10032, USA,
| | - Matthew M. Zack
- Division of Population Health, National Center for Chronic, Disease Prevention and Health Promotion, Centers for Disease, Control and Prevention, Atlanta, GA, USA,
| | - William W. Thompson
- Division of Population Health, National Center for Chronic, Disease Prevention and Health Promotion, Centers for Disease, Control and Prevention, Atlanta, GA, USA
| | - Alex E. Crosby
- Division of Violence Prevention, National Center for Injury, Prevention and Control, Centers for Disease Control and, Prevention, Atlanta, GA, USA,
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Wu J, Xiao J, Li T, Li X, Sun H, Chow EPF, Lu Y, Tian T, Li X, Wang Q, Zhuang X, Zhang L. A cross-sectional survey on the health status and the health-related quality of life of the elderly after flood disaster in Bazhong city, Sichuan, China. BMC Public Health 2015; 15:163. [PMID: 25884807 PMCID: PMC4359459 DOI: 10.1186/s12889-015-1402-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 01/12/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Flood is common in China and causes extensive loss of property and human lives. Elderly is a vulnerable population prone to the detrimental impacts of floods. This survey aims to investigate the health status and the HRQoL of the elderly in Bazhong city after a major flood in 2011. METHODS A total of 1183 elderly (aged > 60) were surveyed through random sampling from eight villages in Bazhong city. Two-week healthcare-seeking rate and chronic diseases prevalence were recorded anonymously. Health-related quality of life (HRQoL) was measured by the Medical Outcomes Study Short Form-36 (MOS SF-36). Multivariate regression analysis was conducted to determine the associated factors of poor HRQoL. RESULTS The two-week healthcare-seeking rate among post-flood Bazhong elderly was significantly higher than the references rate among rural elderly in Sichuan province (59.3% versus 55.7%, χ2 = 5.134, p = 0.013), but Bazhong elderly demonstrated a significantly lower prevalence of chronic disease (33.2% versus 44.4%, χ2 = 48.847, p < 0.001). All dimension scores among Bazhong elderly were significantly lower than the references scores in rural Sichuan elderly. The determinants of poor physical health included older age, singlehood, poor sleep patterns, and chronic diseases and so on. CONCLUSIONS A marked decline in health status among elderly in Bazhong after the 2011 flood. Post-flood management targeting elderly need to be sensitive to their age, gender, married status and status of chronic diseases.
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Affiliation(s)
- Jun Wu
- Nantong Tumor Hospital Affiliated of Nantong University, Jiangsu, China.
- School of Public Health, Wuhan University, Wuhan, China.
| | - Jian Xiao
- Nantong Shipping College, Jiangsu, China.
| | - Tong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong City, 226019, Jiangsu, China.
| | - Xiaoshan Li
- School of Public Health, Southeast University, No. 82 Chengxian Street, Xuanwu District, Nanjing City 210018, Jiangsu, China.
| | - Huamin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong City, 226019, Jiangsu, China.
| | - Eric P F Chow
- The Kirby Institute, the University of New South Wales, Sydney, Australia.
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Melbourne, Victoria, Australia.
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
| | - Yihua Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong City, 226019, Jiangsu, China.
| | - Tian Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong City, 226019, Jiangsu, China.
| | - Xiaoyan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong City, 226019, Jiangsu, China.
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong City, 226019, Jiangsu, China.
| | - Xun Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong City, 226019, Jiangsu, China.
| | - Lei Zhang
- The Kirby Institute, the University of New South Wales, Sydney, Australia.
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Klinnert MD, Silveira L, Harris R, Moore W, Atkins D, Fleischer DM, Menard-Katcher C, Aceves S, Spergel JM, Franciosi JP, Furuta GT. Health-related quality of life over time in children with eosinophilic esophagitis and their families. J Pediatr Gastroenterol Nutr 2014; 59:308-16. [PMID: 24897164 DOI: 10.1097/MPG.0000000000000451] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Existing treatments for pediatric eosinophilic esophagitis (EoE) effectively reduce inflammation. The impact of treatment on health-related quality of life (HRQoL) over time for pediatric patients with EoE and their families, however, has not been systematically assessed. We hypothesized that individualized multidisciplinary treatment would improve both child and family HRQoL over time, with improvements associated with decreased symptom severity. METHODS Children with EoE treated in 4 tertiary care centers were enrolled. Baseline assessments occurred at the time of patients' first evaluation; follow-up assessments occurred at 2 and 6 months after baseline. Presence and severity of 8 EoE symptoms were measured. HRQoL was measured with the Pediatric Quality of Life Inventory parent proxy report, child self-report (CR), and Family Impact Module (FIM). Statistical analyses used mixed-effects modeling to test changes over time for child and family HRQoL. RESULTS Ninety-seven children were enrolled (ages 2-18 years, mean age 7.7 years ± 4.8, 78% boys, 80% white). Baseline mean symptom number was 3.5 (standard deviation 2.3), and symptom severity was 5.5 (standard deviation, 4.5). HRQoL scores were significantly related to symptom scores (P < 0.001). EoE symptom severity decreased during the study (P = 0.03). Pediatric Quality of Life Inventory parent proxy Total and FIM Total scores improved from baseline to 6 months (respectively, adjusted means 78.4 vs 81.0, P = 0.0006; 68.9 vs 70.1, P = 0.03). Interactions with baseline symptom severity revealed that subjects with lowest symptom severity showed the most improved HRQoL scores (P = 0.0013). CONCLUSIONS HRQoL improved during the course of evaluation and treatment, with positive changes being strongest for patients with less symptom severity at baseline.
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Abstract
PURPOSE To examine the magnitude of differences in health-related quality of life (HRQOL) by body mass index (BMI) in a population-based sample of United States adolescents overall and by sex, and to provide national prevalence estimates of reported HRQOL outcomes for not only obese and overweight but also underweight adolescents. METHODS From the 2001 through 2010 cross-sectional National Health and Nutrition Examination Surveys, we estimated the percentages of four HRQOL outcomes-self-rated health, physically unhealthy days, mentally unhealthy days, and activity limitation days-in four BMI categories-obese, overweight, normal weight, and underweight-of approximately 6,000 US adolescents aged 12-17 years. We also estimated the percentages for boys and girls separately. RESULTS Substantial gaps in self-rated health exist between normal-weight adolescents and those who are obese and overweight, but not underweight. Eighteen percent (95% CI 15-22) of obese adolescents reported fair or poor health compared to only 5% (95% CI 4-7) of normal-weight adolescents. Thirty-seven percent (95% CI 33-42) of obese adolescents reported excellent or very good health, compared to 65% (94% CI 63-67) of normal-weight adolescents. However, all BMI groups reported similar percentages of physically unhealthy days, mentally unhealthy days, and activity limitation days. The associations between HRQOL and BMI groups did not vary by sex. Boys generally reported significantly better self-rated health and mental health than girls. Specifically, obese boys reported better self-rated health, mental health, and fewer activity limitation days than obese girls. CONCLUSIONS Substantially, significant differences in some domains of HRQOL are found between above normal-weight and normal-weight US adolescents. This relationship between BMI and HRQOL is robust and observed among both boys and girls.
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Affiliation(s)
- Wanjun Cui
- Division of Population Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS F-78, Atlanta, GA, 30341, USA,
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Holmgren M, Lindgren A, de Munter J, Rasmussen F, Ahlström G. Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden. BMC Public Health 2014; 14:381. [PMID: 24742257 PMCID: PMC4036728 DOI: 10.1186/1471-2458-14-381] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 04/11/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Increasing obesity in adults with mobility disability has become a considerable health problem, similar to the increasing trend of obesity in the general population. The aims of this study were to investigate the association of mobility disability with overweight status and obesity in a large population-based Swedish cohort of adults, and to investigate whether mobility disability, high body mass index (BMI), and increasing BMI over time are predictors of health-related quality of life and participation in society after 8 years of follow-up. METHODS The study cohort included 13,549 individuals aged 18-64 years who answered questions about mobility disability, weight, height, health-related quality of life and participation in society in the Stockholm Public Health Survey 2002 and 2010. The cohort was randomly selected from the population of Stockholm County, and divided into six subgroups based on data for mobility disability and overweight status. Multiple binary logistic regression analyses were performed to assess the likelihood for low health-related quality of life and lack of participation. RESULTS Respondents with mobility disability had a higher mean BMI than those without mobility disability. Respondents both with and without mobility disability increased in BMI, but with no significant difference in the longitudinal changes (mean difference: 0.078; 95% CI: -0.16 - 0.32). Presence of mobility disability increased the risk of low health-related quality of life and lack of participation in 2010, irrespective of low health-related quality of life and lack of participation in 2002. The risk of pain and low general health (parts of health-related quality of life) increased for every 5 units of higher BMI reported in 2010. In respondents without low general health at baseline, the risk of obtaining low general health increased for every 5 units of higher BMI in 2010 (OR:1.60; CI: 1.47 - 1.74). CONCLUSIONS The greatest risk of low general health after 8 years was observed for respondents with both mobility disability and high BMI. These results indicate the importance of working preventively with persons with mobility disability and overweight status or obesity based on the risk of further weight gain.
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Affiliation(s)
- Marianne Holmgren
- The Swedish Institute for Health Sciences, Department of Health Sciences, Lund University, P.O. Box 187, SE-221 00 Lund, Sweden
| | - Anna Lindgren
- The Swedish Institute for Health Sciences, Department of Health Sciences, Lund University, P.O. Box 187, SE-221 00 Lund, Sweden
- Centre for Mathematical Sciences, Lund University, P.O. Box 118, SE-221 00 Lund, Sweden
| | - Jeroen de Munter
- Department of Public Health Sciences, Karolinska Institutet, P.O. Widerströmska huset, Tomtebodavägen 18A, plan 9, SE-171 77 Stockholm, Sweden
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institutet, P.O. Widerströmska huset, Tomtebodavägen 18A, plan 9, SE-171 77 Stockholm, Sweden
| | - Gerd Ahlström
- The Swedish Institute for Health Sciences, Department of Health Sciences, Lund University, P.O. Box 187, SE-221 00 Lund, Sweden
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Jia H, Zack MM, Thompson WW. The effects of diabetes, hypertension, asthma, heart disease, and stroke on quality-adjusted life expectancy. Value Health 2013; 16:140-7. [PMID: 23337225 PMCID: PMC4590983 DOI: 10.1016/j.jval.2012.08.2208] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 08/23/2012] [Accepted: 08/27/2012] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Quality-adjusted life expectancy (QALE) is a summary measure that combines mortality and health-related quality of life across different stages of life. The objective of this study was to estimate QALE loss due to five chronic diseases-diabetes mellitus, hypertension, asthma, heart disease, and stroke. METHODS Health-related quality of life scores were from the 1993-2009 Behavioral Risk Factor Surveillance System. Using age-specific deaths from the Compressed Mortality File, this study constructed life tables to calculate losses in life expectancy and QALE due to each of the five diseases from 1993 through 2009 and for 50 US states and the District of Columbia. RESULTS In 2009, the individual-level QALE loss for diabetic people, compared with nondiabetic people, was 11.1 years; for those with hypertension, 6.3 years; for those with asthma, 7.0 years; for those with heart disease, 10.3 years; and for those with stroke, 12.4 years. At the population level, diabetes, hypertension, asthma, heart disease, and stroke contributed 1.9, 2.2, 0.8, 1.2, and 0.8 years of population QALE loss at age 18 years, respectively. CONCLUSIONS Persons with each of the five diseases had significantly lower life expectancy and QALE. Because the prevalence of diabetes and hypertension has increased significantly in the United States in the last two decades, the burdens of these two conditions, measured by population QALE losses, had increased 83% and 29% from 1993 to 2009, respectively. Also, by examining changes in population QALE loss at different ages, policymakers can identify age groups most affected by particular diseases and develop the most cost-effective interventions by focusing on these groups.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, NY 10032, USA.
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Vogl M, Wenig CM, Leidl R, Pokhrel S. Smoking and health-related quality of life in English general population: implications for economic evaluations. BMC Public Health 2012; 12:203. [PMID: 22429454 PMCID: PMC3352300 DOI: 10.1186/1471-2458-12-203] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 03/19/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known as to how health-related quality of life (HRQoL) when measured by generic instruments such as EQ-5D differ across smokers, ex-smokers and never-smokers in the general population; whether the overall pattern of this difference remain consistent in each domain of HRQoL; and what implications this variation, if any, would have for economic evaluations of tobacco control interventions. METHODS Using the 2006 round of Health Survey for England data (n = 13,241), this paper aims to examine the impact of smoking status on health-related quality of life in English population. Depending upon the nature of the EQ-5D data (i.e. tariff or domains), linear or logistic regression models were fitted to control for biology, clinical conditions, socio-economic background and lifestyle factors that an individual may have regardless of their smoking status. Age- and gender-specific predicted values according to smoking status are offered as the potential 'utility' values to be used in future economic evaluation models. RESULTS The observed difference of 0.1100 in EQ-5D scores between never-smokers (0.8839) and heavy-smokers (0.7739) reduced to 0.0516 after adjusting for biological, clinical, lifestyle and socioeconomic conditions. Heavy-smokers, when compared with never-smokers, were significantly more likely to report some/severe problems in all five domains--mobility (67%), self-care (70%), usual activity (42%), pain/discomfort (46%) and anxiety/depression (86%). 'Utility' values by age and gender for each category of smoking are provided to be used in the future economic evaluations. CONCLUSION Smoking is significantly and negatively associated with health-related quality of life in English general population and the magnitude of this association is determined by the number of cigarettes smoked. The varying degree of this association, captured through instruments such as EQ-5D, may need to be fed into the design of future economic evaluations where the intervention being evaluated affects (e.g. tobacco control) or is affected (e.g. treatment for lung cancer) by individual's (or patients') smoking status.
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Affiliation(s)
- Matthias Vogl
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Member of the German Centre for Lung Research, Institute of Health Economics and Health Care Management, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
- Ludwig-Maximilians-Universität München, Institute of Health Economics and Health Care Management & Munich Centre of Health Sciences, Ludwigstrasse 28, 80539 Munich, Germany
| | - Christina M Wenig
- Ludwig-Maximilians-Universität München, Institute of Health Economics and Health Care Management & Munich Centre of Health Sciences, Ludwigstrasse 28, 80539 Munich, Germany
| | - Reiner Leidl
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Member of the German Centre for Lung Research, Institute of Health Economics and Health Care Management, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
- Ludwig-Maximilians-Universität München, Institute of Health Economics and Health Care Management & Munich Centre of Health Sciences, Ludwigstrasse 28, 80539 Munich, Germany
| | - Subhash Pokhrel
- Health Economics Research Group, Brunel University, West London, UK
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Abstract
BACKGROUND Obesity is a worldwide public health issue, and the prevalence of obesity is also increasing steadily in Taiwan. Obesity leads to several chronic diseases. Often, impaired quality of life is a consequence of obesity. The aim of this study was to determine if body weight-loss could improve health-related quality of life (HRQOL) in Taiwan. METHODS The cutoff for obesity is body mass index (BMI) = 27 as compared with 30 in US and Europe. We enrolled 67 participants with BMI ≥ 27 and more than one criterion of the metabolic syndrome, who underwent 3 months of body weight-loss intervention by diet control and regular exercise. We performed anthropometric measurements and blood tests, and administered the WHOQOL-BREF questionnaire Taiwanese version to assess HRQOL before and after the weight loss intervention. This is the first study using the WHOQOL-BREF to examine HRQOL in Taiwan. The questionnaire included D1 physical, D2 psychological, D3 social relationships and D4 environmental domains; each was scored from 4 to 20. RESULTS Obese subjects had lower D1 and D2 scores as compared with the Taiwan healthy population reference group at baseline. In this study, 38 participants completed the 3-month intervention program and 29 participants dropped out. Twenty-five participants reached the 5% of initial BMI goal. Among them, significant statistical improvements were found both in medical comorbidities and in the four domains of the HRQOL questionnaire. CONCLUSION Obesity can cause impaired HRQOL, which can be improved through BMI intervention. In addition to the benefits of biomedical aspect, this could be an incentive goal for keeping body weight control.
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Affiliation(s)
- Hsiang-Ju Pan
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
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Abstract
Amblyopia is a common condition, which can affect up to 5% of the general population. Health-related quality-of-life (HRQoL) implications of amblyopia and/or its treatment have been explored in the literature. A systematic literature search was undertaken during the period of 7-14 May 2010 to identify the HRQoL implications of amblyopia and/or its treatment. A total of 35 papers were included in the literature review. The HRQoL implications of amblyopia related specifically to amblyopia treatment, rather than to the condition itself. These included impact on family life, social interactions, difficulties in undertaking daily activities, as well as feelings and behaviour. The identified studies adopted a number of methodologies. The study populations included children with the condition, parents of children with amblyopia, and adults who had undertaken amblyopia treatment as a child. Some studies developed their own measures of HRQoL, and others determined HRQoL through proxy measures. The reported findings of the HRQoL implications are of importance when considering the management of cases of amblyopia. The issues identified in the literature review are discussed with respect to how HRQoL is measured (treatment compliance vs proxy measures), and whether HRQoL is taken from a child's or a parent's perspective. Changing societal views over glasses and occlusion therapy are also discussed. Further research is required to assess the immediate and long-term effects of amblyopia and/or its treatment on HRQoL using a more standardised approach.
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Affiliation(s)
- J Carlton
- Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
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Punpanich W, Hays RD, Detels R, Chokephaibulkit K, Chantbuddhiwet U, Leowsrisook P, Prasitsuebsai W. Development of a culturally appropriate health-related quality of life measure for human immunodeficiency virus-infected children in Thailand. J Paediatr Child Health 2011; 47:27-33. [PMID: 20973862 PMCID: PMC3033216 DOI: 10.1111/j.1440-1754.2010.01886.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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] [Indexed: 11/30/2022]
Abstract
AIM Develop a reliable and valid self-report health-related quality of life (HRQOL) instrument for human immunodeficiency virus (HIV)-infected children in Thailand. METHODS The Thai Quality of Life for HIV-infected Children instrument, the ThQLHC (an HRQOL measure that uses the Pediatric Quality of Life Inventory as a generic core and a 17-item HIV-targeted scale), was developed and administered cross-sectionally to 292 HIV-infected children in Thailand. The disease-targeted scale included HIV-related symptoms, ability to adhere with their treatment regimens and self-image. The internal consistency reliability (Cronbach's α) and construct validity of the ThQLHC scales were then evaluated. RESULTS Internal consistency reliability coefficients ranged from 0.57 to 0.82, with four of five scales reaching the minimal acceptable level (>0.70). Significant associations were found between poor HRQOL and poor self-rated disease severity, care giver's rated overall quality of life, cluster of differentiation (CD) 4 percent and plasma HIV ribonucleic acid level. CONCLUSION Reliable and valid disease-targeted HRQOL measures for HIV-infected children are essential in the assessment of therapeutic effectiveness. The findings of this cross-sectional survey provide support for the reliability and validity of the ThQLHC as an HRQOL outcome measure for HIV-infected Thai children.
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Affiliation(s)
- Warunee Punpanich
- Division of Infectious Diseases, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Rangsit Medical College, Bangkok, Thailand.
| | - Ron D Hays
- Department of Health Services UCLA School of Public Health, Los Angeles, California, United States
| | - Roger Detels
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, United States
| | - Kulkanya Chokephaibulkit
- Division of Infectious Diseases, Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Umaporn Chantbuddhiwet
- Division of Infectious Diseases, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Rangsit Medical College Mahidol University, Bangkok, Thailand
| | - Pimsiri Leowsrisook
- Division of Infectious Diseases, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Rangsit Medical College Mahidol University, Bangkok, Thailand
| | - Wasana Prasitsuebsai
- Division of Infectious Diseases, Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Baca CB, Vickrey BG, Hays RD, Vassar SD, Berg AT. Differences in child versus parent reports of the child's health-related quality of life in children with epilepsy and healthy siblings. Value Health 2010; 13:778-786. [PMID: 20561342 PMCID: PMC3065295 DOI: 10.1111/j.1524-4733.2010.00732.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Self versus proxy perspectives may produce different results that are important for clinical decision-making and for assessing outcomes in research studies. We examined differences in child versus parent report of the child's health-related quality of life (HRQOL) in a large prospective, community-based study of newly diagnosed childhood epilepsy that included children with epilepsy (case) and sibling controls. METHODS HRQOL was assessed 8 to 9 years after initial diagnosis of epilepsy in a subset of 143 case-control matched pairs using the Child Health Questionnaire (CHQ), a generic HRQOL measure with child (CHQ-CF87), and parent (CHQ-PF50) versions. RESULTS There were no significant differences between self-reported case and sibling control HRQOL scores on 9 of 11 scales or 2 global items. Nevertheless, parent ratings were significantly better (higher HRQOL) for sibling controls compared with epilepsy cases on 10 of 12 scales, global behavior and general health items, and the physical and psychosocial summary scores (P≤0.05). Parent-child agreement was low for cases and controls (kappa 0.27-0.33) for three single-item questions with the same wording on parent and child versions. Parent ratings of the case's HRQOL were often significantly associated with 5-year remission status and current antiepileptic drug use, but the case's self-reported HRQOL scores were not. In contrast, current pharmacoresistance was often associated with the child and parent ratings of the child's HRQOL. CONCLUSION Children with epilepsy report HRQOL that is comparable to that of sibling controls, while parents rate children with epilepsy as having lower HRQOL than sibling controls. Measuring outcomes in studies of this population should incorporate both perspectives.
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Affiliation(s)
- Christine Bower Baca
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA 90024-1736, USA.
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