Abstract
Health-related quality of life (HRQoL) has an increasing role in medical decision-making. This review of the literature aims to provide an overview on HRQoL, costs, and work disability in ...SS, a disease characterized by focal lymphocytic infiltration of exocrine glands with no therapeutics of proven immunomodulatory potential. HRQoL is markedly reduced in SS in multiple studies across many countries when compared with HRQoL in healthy controls. The reduction in HRQoL is similar to that observed in other chronic diseases such as RA, SLE, FM and, interestingly, non-SS sicca syndrome. Impaired HRQoL in SS has been found to be associated with fatigue, pain/articular involvement, ocular and oral involvement, pruritus, sexual dysfunction, impaired sleep, pulmonary manifestations, psychological dysfunction and impaired physical function. Until now, no therapeutic has been shown to improve HRQoL in an adequately powered double-blind, placebo-controlled randomized controlled trial. Although primary SS does not, in general, impair life expectancy and is often inappropriately considered a benign ‘nuisanvce’ disease for those patients without systemic manifestations, the associated costs and work disability are striking. This, together with the significant reduction in HRQoL, strongly argues for the development of new therapeutic approaches to manage this neglected disease.
Objective: Parkinson's disease (PD) has a negative impact on health-related quality of life (HRQoL). Previous studies have shown that participating in group singing activities can improve quality of ...life in some patient populations (e.g., people with chronic mental health or neurological conditions). The aim of this study was to investigate the effects of group singing on HRQoL for people diagnosed with PD. Method: Eleven participants (mean age 70.6 years) with a formal diagnosis of PD between Hoehn and Yahr Stages I-III were recruited from a community singing group for people with PD, their family and their carers. Participants' perceptions of the effect of group singing on their quality of life were captured in a semistructured interview. Interpretive Phenomenological Analysis (IPA), a qualitative methodology, informed data collection and analysis. Results: The IPA analysis revealed 6 categories that characterized the effects of group singing: physical, mood, cognitive functioning, social connectedness, "flow-on" effects, and sense-of-self. All participants reported positive effects across at least 4 of these categories. Three participants reported a negative effect in 1 category (physical, mood, or sense-of-self). Conclusions: The results suggest that group singing improved HRQoL with all participants reporting positive effects regardless of PD stage or symptom severity. Weekly engagement in group singing resulted in multiple benefits for the participants and counteracted some of the negative effects of PD. These findings suggest that group singing "gives back" some of what PD "takes away."
Purpose
The EQ-5D-3L and 5L are widely used generic preference-based instruments, which are psychometrically sound with the general population, but little is known about the instruments’ feasibility ...in the elderly. Therefore, this systematic review summarises the available literature with regard to the feasibility properties of the instruments in the elderly population.
Methods
We conducted a systematic search in PubMed, PsycInfo and EuroQol databases using pre-specified vocabulary and inclusion/exclusion criteria to identify publications until November 2020. Study characteristics and outcomes referring to the feasibility of the EQ-5D-3L and 5L in the elderly were extracted, if all study participants were at least 65+ years.
Results
We identified 17 studies reporting feasibility outcomes based on four criteria: missing values, completion rates, completion time and broad qualitative statements referring to the completion. Missing values per dimension ranged from 0 to 10.7%, although being mostly below 7%. The completion rate was around 90% or better, whereas the EQ VAS rating was missing from 2.3 to 25.3% of the respondents. Only two of the included studies examined the EQ-5D-5L; 15 studies reported on the EQ-5D-3L.
Conclusion
Comparing our findings against the general population from published literature, we find that feasibility outcomes in older age groups are just below that of younger populations. Furthermore, older respondents have a higher propensity of requiring assistance or even an interviewer-based approach. Nonetheless, the reviewed literature indicates that the EQ-5D-3L still has good feasibility properties and, hence, is highly applicable in older respondents. However, further research is needed to explore feasibility properties of the EQ-5D-5L in this population.
Aims
This study systematically reviews the literature regarding preoperative stoma site marking and discusses the effectiveness of the procedure on complication rates, self‐care deficits and ...health‐related quality of life (HRQOL).
Design
Systematic review and meta‐analysis.
Data source
Our review was conducted following the PRISMA guidelines. PubMed, EMBASE, Cochrane and CINAHL databases were searched to obtain articles published in English. Articles were also retrieved from Korean databases as well. Our last search was conducted on 2 June 2019.
Review methods
Two reviewers independently selected relevant studies, evaluated their methodological quality and extracted data. Experimental and observational studies were included. Our main focus was on complication rates, self‐care deficits and HRQOL. We conducted meta‐analysis using the statistical software spss 25.0 and Stata 13.0.
Results
Of the 1,039 articles reviewed, 20 were included for review, and 19 were used for quantitative synthesis. Preoperative stoma site marking reduced complication rates (odds ratio OR: 0.47; 95% confidence interval CI: 0.36–0.62; I2: 70.6%), lowered self‐care deficits (OR: 0.34; 95% CI: 0.18–0.64; I2: 0%), and increased HRQOL (standardized mean difference, 1.05; 95% CI: 0.70–1.40; I2: 0%). Quality appraisal results for both the individual studies and the studies overall were excellent. The possibility of publication bias was low.
Conclusions
Our findings indicate that preoperative stoma site marking improves patient outcomes: stoma‐related complication rates and self‐care deficits decrease and HRQOL rises. For this reason, preoperative stoma site marking should be a mandatory procedure in clinical settings. The practice should also be supported by policymakers and healthcare expert associations.
Impact
Preoperative stoma site marking reduces overall complication rates by 53% and skin problems by 59%. Preoperative stoma site marking also improves self‐care and health‐related quality of life. We recommend that preoperative stoma site marking should be a mandatory procedure in clinical settings.
Objectives
This study aims to evaluate the effects of socioeconomic, behavioral, and psychological factors on oral health status and oral health‐related quality of life in Myanmar adults.
Methods
...Data were from a convenience sample of Myanmar adults who are from a township health center in Yangon city. Face‐to‐face interviews using a paper‐based questionnaire in the Myanmar language and clinical oral examinations were performed at the health center. Mann–Whitney U test and linear regressions were used to assess the association of socio‐demographic, behavioral, and psychological variables with oral health outcomes.
Results
In socio‐demographic variables, significant associations were observed in individual income with periodontal pocket and OHIP‐14, and history of COVID‐19 infection with OHIP‐14. However, there were no associations between behavioral factors and oral health outcomes. After adjustment for sex, age, educational level, and individual income, the depression subscale was statistically significant with the number of present teeth, decayed teeth, decayed, missing, and filled teeth, and OHIP‐14. The anxiety subscale remained significant with periodontal pocket, but no stress subscale was associated with oral health outcomes.
Conclusion
The experiences of oral health status were high, and the oral health‐related quality of life was unfavorable in Myanmar adults. A large proportion of them suffers from psychological distress. Additionally, individuals with lower income and who experienced a history of COVID‐19 infection were susceptible to poor oral health‐related quality of life. Psychological distress indicates a higher risk for oral health problems in Myanmar adults.
Introduction: Recurrent Clostridium difficile infection (rCDI) is an urgent public health threat that is associated with significant mortality, substantial medical costs, and decreased quality of ...life. Microbiota therapy is gaining acceptance to prevent rCDI in multi-recurrent patients. RBX2660, a standardized microbiome-based therapeutic, was previously reported to show efficacy in rCDI prevention in a ran-domized, double-blind, placebo-controlled Phase 2B clinical study (PUNCH CD2). Herein, we evaluated this Phase 2B study data to determine how quality of life (QoL) assessment was associated with RBX2660 treatment. Methods: Subjects enrolled in the double-blinded, placebo-controlled multi-center Phase 2B clinical study were randomized to receive either 2 RBX2660 doses (Group A), 2 placebo doses (Group B) or 1 RBX2660 dose + 1 placebo dose (Group C) via enema, with doses delivered 7 days apart. Enrolled subjects had >2 prior rCDI or >2 prior CDI episodes requiring hospitalization. The primary efficacy endpoint was absence of CDI at 8 weeks from the last dose. The validated SF-36 was used to identify changes to health-related QoL following study treatment. QoL was assessed at Baseline and at weeks 1, 4 and 8 following blinded treatment, and were compared within and across treatments using unpaired t-test. Each component is analyzed on a 0-100 scale with a higher score representing an increase to QoL. Results: The Baseline results for the mean Physical Component Score (PCS) and Mental Component Score (MCS) were comparable across arms, and there were no statistically significant differences at base-line between subjects who later responded to treatment and those who did not. By week 1, statistically significant and clinically important differences were noted for the MCS within each group compared to Baseline scores and were maintained through 8 weeks. Overall, both the mean PCS and MCS improved after treatment across all groups. There were no significant differences identified between treatment groups. Conclusion: The similarity among Baseline SF-36 QoL scores confirms a uniform population among treatment groups. The statistically significant SF-36 increase after treatment underscores the potential QoL benefit for preventing rCDI, even as early as one week after treatment. Larger studies will be needed to confirm these results and to detect a significant difference in QoL scores between RBX2660- and placebo-treated participants.
German Value Set for the EQ-5D-5L Ludwig, Kristina; Graf von der Schulenburg, J.-Matthias; Greiner, Wolfgang
PharmacoEconomics,
06/2018, Letnik:
36, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Objectives
The objective of this study was to develop a value set for EQ-5D-5L based on the societal preferences of the German population. As the first country to do so, the study design used the ...improved EQ-5D-5L valuation protocol 2.0 developed by the EuroQol Group, including a feedback module as internal validation and a quality control process that was missing in the first wave of EQ-5D-5L valuation studies.
Methods
A representative sample of the general German population (
n
= 1158) was interviewed using a composite time trade-off and a discrete choice experiment under close quality control. Econometric modeling was used to estimate values for all 3125 possible health states described by EQ-5D-5L. The value set was based on a hybrid model including all available information from the composite time trade-off and discrete choice experiment valuations without any exclusions due to data issues.
Results
The final German value set was constructed from a combination of a conditional logit model for the discrete choice experiment data and a censored at −1 Tobit model for the composite time trade-off data, correcting for heteroskedasticity. The value set had logically consistent parameter estimates (
p
< 0.001 for all coefficients). The predicted EQ-5D-5L index values ranged from −0.661 to 1.
Conclusions
This study provided values for the health states of the German version of EQ-5D-5L representing the preferences of the German population. The study successfully employed for the first time worldwide the improved protocol 2.0. The value set enables the use of the EQ-5D-5L instrument in economic evaluations and in clinical studies.
Past research has supported the utility of the Double ABCX model of family adaptation for parents raising a child with autism spectrum disorder (ASD). What remains unclear is the impact of ...family-related variables on outcomes in both mothers and fathers within the same family. We explored the potential predictors of maternal and paternal stress and family quality of life in an Australian sample of 196 parents of children with ASD aged 3–16 years. Using a cross-sectional design, parents completed questionnaires assessing factors within the Double ABCX model attributed to family adaptation. Findings provide further evidence of the negative impact of child externalising behaviours and highlight the importance of family sense of coherence on positive parental outcomes.
Purpose
To describe health status and health state utilities measured by the EQ-5D-3L in a population-based sample of individuals aged 85 + in Germany, and to analyze associations with basic ...socio-demographic variables.
Methods
Cross-sectional data from follow-up wave 7 (
n
= 761) of the German AgeCoDe Study were used. The EQ-5D-3L questionnaire was used to record problems in five health dimensions, its visual analogue scale (EQ VAS) was used to record self-rated health status, and the German EQ-5D-3L index was used to derive health state utilities.
Results
Mean age of respondents was 88.9 years (SD 2.9; range 85 to 100), 67.4% were female. 81.9% reported problems in at least one of the EQ-5D dimensions, with 15.3% reporting extreme problems. Most frequent were problems with pain/discomfort (64.8%), followed by mobility (62.5%), usual activities (42.6%), self-care (28.2%), and anxiety/depression (20.5%). Mean EQ VAS score was 62.4 (SD 18.8), and mean EQ-5D index was 0.77 (SD 0.24). Multiple regression analysis showed associations of problem frequency in various EQ-5D dimensions with age, gender, living situation, marital status, and education. The EQ VAS score was negatively associated with age (
β
= − 0.56;
p
< 0.05) and female gender (
β
= − 3.49;
p
< 0.05). The EQ-5D index was negatively associated with not living in the community (
β
= − 0.10;
p
< 0.001) and being single (
β
= − 0.09;
p
< 0.05).
Conclusions
The results show a substantially impaired health status of the oldest-old population. The data can be used for comparing health status of population groups as well as for health economic models.
Purpose The validity of the life satisfaction measures commonly used among adults has been rarely examined in adolescent samples. The present research had two main goals: (1) to evaluate the ...structural validity of the Satisfaction with Life Scale (SWLS) among adolescents and to test measurement invariance across gender; (2) to compare the criterion and convergent validity of the SWLS and single-item life satisfaction measures among adolescents. Methods Three samples of Serbian adolescents were recruited for the present research. Study 1 (N = 481, Mage = 17.01 years) examined the structure of the SWLS via confirmatory factor analysis (CFA) and evaluated measurement invariance of the SWLS across gender by a multi-group CFA. Study 2 (N = 283, Mage = 17.34 years) and Study 3 (N = 220, Mage = 16.73 years) compared the convergent validity of the SWLS and single-item life satisfaction measures. Results The results of Study 1 supported the original one-factor model of the SWLS among adolescents and provided evidence for strong measurement invariance of the SWLS across gender. The findings of Study 2 and Study 3 showed that the SWLS and single-item measures were equally valid and strongly associated (r = .734 in Study 2 and r = .668 in Study 3). No substantial differences in correlations with school success and well-being indicators were found between the SWLS and single-item measures. Conclusions Our findings support the use of the SWLS among adolescents and indicate that single-item life satisfaction measures perform as well as the SWLS in adolescent samples.
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