Polovica bolnikov, ki so ozdravljeni, trpi za kasnimi zapleti zdravljenja, npr. telesnimi, psihosocialnimi, kognitivnimi in seksualnimi. Poleg tega so zaskrbljeni zaradi morebitne kasne ponovitve ...tega ali pojava novega raka. Preživeli se pogosto soočajo z brezposelnostjo in diskriminacijo na delovnem mestu. Kako se bodo odzvali na diagnozo rak, zdravljenje in posledicami le-tega oz. same bolezni, pa je v veliki meri odvisno tudi od informacij, ki jim jih nudi zdravstveno osebje. Samoocena z zdravjem povezane kakovosti življenja (angl. Health-Related Quality of Life - HRQOL) bolnikov z rakom postaja sestavni del onkološke klinične prakse. Pomaga nam pri izbiri za bolnika najprimerrnejšega zdravljenja. Spremembe v HRQOL med zdravljenjem lahko napovedo slabši odgovor na zdravljenje in ponovitev bolezni. Pri napredovali bolezni je v pomoč pri presoji pričakovanega preživetja in tako pri optimalni paliativni obravnavi oziroma podpornem zdravljenju.
Acute myocardial infarction (AMI) affects patients' health-related quality of life (HRQOL). AMI may decrease HRQOL, thus negatively affecting QOL. However, the improvements in interventional ...treatment and early rehabilitation after AMI may have a positive effect on HRQOL.
We evaluated HRQOL in patients after the first AMI treated in a reference cardiology centre in Poland and assessed which clinical variables affect HRQOL after AMI.
We prospectively evaluated HRQOL in 60 consecutive patients suffering after their first AMI during the index hospitalisation and again after 6 months, using: (i) MacNew, (ii) World Health Organization Quality of Life (WHOQOL) BREF, and (iii) Short Form (SF) 36.
As measured by the MacNew questionnaire, global, social, and physical functioning did not change (p≥0.063), whereas emotional functioning improved 6 months after AMI, compared to index hospitalisation (p=0.002). As measured by WHOQOL BREF, physical health, psychological health, and environmental functioning did not change (p≥0.321), whereas social relationships improved 6 months after AMI (p=0.042). As assessed by SF-36, the global HRQOL improved after AMI (p=0.044). Patients with improved HRQOL in SF-36 often had a higher baseline body mass index (p=0.046), dyslipidaemia (p=0.046), and lower left ventricle ejection fraction (LVEF; p=0.013). LVEF<50% was the only variable associated with improved HRQOL in multivariate analysis (OR 4.463, 95% CI 1.045 - 19.059, p=0.043).
HRQOL increased 6 months after the first AMI, especially in terms of emotional functioning and social relationships. Patients with LVEF<50% were likely to have improved HRQOL.
Due to the availability of the EQ-5D-5L instrument official translation into Slovenian its use is widespread in Slovenia. However, the health profiles obtained in many studies cannot be ascribed ...their appropriate values as the EQ-5D-5L value set does not yet exist in Slovenia. Our aim was to estimate an interim EQ-5D-5L value set for Slovenia using the crosswalk methodology developed by the EuroQol Group on the basis of the EQ-5D-3L Slovenian TTO value set. Our secondary aim was to compare the interim values obtained with the EQ-5D-3L Slovenian values.
To obtain a Slovenian interim EQ-5D-5L value set, we applied the crosswalk methodology developed by the EuroQol Group to the Slovenian EQ-5D-3L TTO value set. We examined the differences between values by comparing the mean 3L and 5L value scores and the distribution of values across all respondents.
By definition, 3-level and 5-level versions have the same range (from 1 to -0.495) and a health state coded 22222 in the 3-level version corresponds to 33333 in the 5-level version. While the addition of a "slight" severity level (22222) in the 5-level version has a low informational value, the addition of a "severe" health state (44444) covers larger range of the scale. The 5-level version results in fewer health states being valued below 0 and above 0.8.
The EQ-5D-5L value set, based on the crosswalk methodology, should be used until a value set for the EQ-5D-5L is derived from preferences elicited directly from a representative sample of the Slovenian general population.
To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population.
A ...cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients' data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile-version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL.
Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52-0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51-0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47-0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit.
OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients' general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients' OHRQoL as well as HRQoL.
To provide physicians and patients with the tools needed to evaluate patients' problems and health-related quality of life by cross-culturally adapting and validating the Chronic Otitis Media ...Questionnaire 12 (COMQ-12), the Dizziness Handicap Inventory (DHI), the Neuropsychological Vertigo Inventory (NVI) and the Tinnitus Handicap Inventory (THI).
COMQ-12, DHI, NVI and THI were translated into the Slovenian language and completed by patients treated at our department for chronic otitis media, vertigo or tinnitus. The control group for each questionnaire consisted of healthy volunteers. Internal consistency, test-retest reliability, discriminant validity, diagnostic accuracy and cut-off value were determined for each questionnaire.
Test-retest reliability was excellent for DHI (ICC A=0.946) and NVI (p=0.315, ICC A=0.975), good to excellent for COMQ-12 (p=0.680, ICC A=0.858) and satisfactory for THI (p=0.120). Discriminant validity was confirmed for each questionnaire (p>0.05) using the Mann-Whitney U test (COMQ-12, DHI, THI) or the Welch t-test (NVI). COMQ-12 had acceptable (α=0.796) and DHI (α=0.910), NVI (α=0.950) and THI (α=0.924) perfect internal consistency. COMQ-12 and DHI had excellent, NVI acceptable and THI perfect diagnostic accuracy (AUC=0.987, AUC=0.999, AUC=0.781 and AUC=1.000 respectively). Cut-off values determined by Youden's index were 7, 7, 9 and 56 for COMQ-12, THI, DHI and NVI, respectively.
Slovenian COMQ-12, DHI, NVI and THI are a valid and accurate tool for the diagnosis and measurement of health-related quality of life in patients with chronic otitis media, vertigo and tinnitus. They could aid general practitioners, occupational health specialists, neurologists and otorhinolaryngologists.
With the aim of improving personalized treatment of patients on chemotherapy, the objective of the study was to assess the degree of association between selected Quality of life (QoL) indicators and ...both clinical and imaging cardiac status indicators when detecting deterioration in QoL of these patients.
In a cohort clinical study in Hamburg, from August 2017 through October 2020, 59 cancer patients, aged 18-80 years, were evaluated before chemotherapy, and at several follow-ups, using EQ-5D and SF-36 QoL questionnaires, fast strain-encoded (fast-SENC) cardiac magnetic resonance (CMR), conventional CMR, and echocardiography, and further received a clinical and biomarker examination. Data was analyzed using survival analyses. A decline of more than 5% in each observed QoL metric value was defined as the observed event. Patient were separated into groups according to the presentation of cardiotoxicity as per its clinical definition, the establishment of the indication for cardioprotective therapy initiation, and by a worsening in the value of each observed imaging metric by more than 5% in the previous follow-up compared to the corresponding pre-chemotherapy baseline value.
Among clinical cardiac status indicators, the indication for cardioprotective therapy showed statistically good association with QoL scores (EQ-5D p=0.028; SF-36 physical component p=0.016; SF-36 mental component p=0.012). In terms of imaging metrics, the MyoHealth segmental myocardial strain score was the only one demonstrating consistently good QoL score association (EQ-5D p=0.005; SF-36 physical component p=0.056; SF-36 mental component p=0.002).
Established fast-SENC CMR scores are capable of highlighting patients with reduced QoL, who require more frequent/optimal management.
The objective of this study was to assess pre-treatment quality of life and the relevant clinical variables in adult patients with malocclusion in order to improve orthodontic treatment strategies.
...The study was conducted in 240 consecutive adult patients with malocclusions divided into two groups: patients for whom an orthodontic treatment plan was considered, and patients for whom an orthognathic treatment plan was selected. Patients were examined between December 2015 and February 2017, at the School of Dental Medicine, University of Belgrade. Malocclusion severity was recorded using the Peer Assessment Rating index pre-treatment score. Skeletal malocclusion parameters were measured using lateral cephalometric radiographs. Quality of life was assessed by means of a generic questionnaire (Medical Outcomes Study Short Form-36 (SF-36)), and the disease-specific Orthognathic Quality of Life Questionnaire (OQLQ).
There were significant differences in the mean values of the OQLQ domain scores between orthodontic and orthognathic patients. Patients for whom orthodontic treatment was planned had statistically significantly lower scores in comparison to those for whom orthognathic treatment was planned. This was the case in all OQLQ domains except for "Awareness of facial deformity". Statistically significant correlations (p<0.05) were presented between OQLQ scores and following demographic and clinical variables: gender, age, malocclusion severity, maxillary and mandibular sagittal, maxillary vertical, and lower incisor positions, intermaxillary angle, and the Beck Depression Inventory and Beck Anxiety Inventory levels. The independent predictors for the planning of orthodontic and orthognathic treatment in patients with malocclusion were two OQLQ domains, "Facial aesthetics" and "Awareness of facial deformity", as well as total OQLQ score, after adjustment for demographic characteristics, skeletal parameters, anxiety and depression.
Our findings suggest that patients for whom orthodontic treatment was planned demonstrated better quality of life according to the OQLQ scores in comparison to those for whom orthognathic therapy was planned.
In a cross-sectional cohort study, health-related quality of life of Slovenian children and adolescents with cerebral palsy was examined, and factors associated with it have been identified.
...Caregivers of 122 children and adolescents with cerebral palsy were addressed to fill out proxy versions of HRQoL questionnaires (DISABKIDS generic and cerebral palsy module). Children and adolescents without cognitive deficit were asked to fill out the self-report versions.
Ninety-one families of 43 children (the mean age is 10 years, 6 months, SD 1.2; 26 males and 17 females) and 48 adolescents (the mean age is 14 years, SD 0.9; 23 males and 25 females) completed proxyreports. Forty-eight individuals were able to self-report (26 children and 22 adolescents). Health-related quality of life was perceived as good. Self-reporting participants scored higher than their caregivers (mean score 75.6, SD 15.9 versus mean 72.3, SD 17.9; p=0.048). Adolescents scored lower than children in all domains (mean score 69.4, SD 19.4 versus mean 80.8, SD 10.0; p=0.01). Higher age (p<0.001), pain (p<0.001) and disturbed sleep (p=0.002) were strong predictors of worse health-related quality of life. Social Inclusion and Independence domains received the lowest scores.
Slovenian children and adolescents with cerebral palsy have a good health-related quality of life, with Social Inclusion and Independence being the weakest domains. Children reported higher scores than adolescents or their caretakers. Pain was the strongest predictor of poor health-related quality of life.
There is a gap in our knowledge of health-related quality of life (HRQoL) in a population presumed healthy, so this study aimed to assess the associations between HRQoL, demographics and clinical ...variables.
The participants were attendees, presumed healthy, at 40 pre-selected model family medicine practices (MFMPs), aged between 30 and 65 years and recruited during a preventive check-up in 2019. Each MFMP pragmatically invited 30 attendees to voluntarily participate. The EQ-5D questionnaire was administered as a measure of HRQoL; the independent variables were demographic characteristics, smoking, alcohol consumption, stress perception, physical activity, signs of depression, cardiovascular risk, body mass index, blood pressure values, and blood sugar and lipidogram laboratory test values. Ordinal logistic regression was used to calculate associations between self-assessed quality of life, demographics, and clinical variables, with P<0.05 set as statistically significant.
Of 986 participants, 640 (64.9%) were women and 346 (35.1%) men, aged 42.7±8.6 years. The average values for the EQ-5D-3L were 0.91±0.15. In the multivariate model, a positive association between adequate physical activity (p=0.003), and a negative association between higher age (p<0.001), female gender (p=0.009), signs of depression (p<0.001), stress (p=0.013), and EQ-5D score were identified.
Given that physical activity was shown to be positively associated with HRQoL, it is of the utmost importance for family physicians to motivate their middle-aged patients, especially women and those with signs of depression and excessive stress, to adopt a more rigorously physically active lifestyle.
Dentofacial disorders may potentially significantly affect the quality of life. Objectives of this study were to validate translated and culturally adapted Orthognatic Quality of Life Questionnaire ...(OQLQ) on a cohort of Serbian patients with malocclusions.
The questionnaire was validated in 111 consecutive patients with malocclusions, seen between December 2014 and February 2015 at the Clinic of Orthodontics, Faculty of Dental Medicine, University of Belgrade. Clinical validity was assessed comparing the mean scores for the four subscales of the OQLQ and mean PAR pre-treatment score. In order to assess whether the allocation of items in the subscales corresponds to their distribution in the original questionnaire, an exploratory factor analysis (principal component analysis with varimax rotation) was conducted.
The results of the internal consistency analysis demonstrated good relationships between the items; Cronbach's alpha coefficients for the four subscales were highly significant (p<0.001) (0.88-0.91). All items were significantly correlated between baseline and the retest (6 weeks after). The correlations between the PAR and all four domains of the OQLQ were all significant (p<0.01). The loading weights obtained in the exploratory factor analysis showed that this model revealed four factors with eigenvalue greater than 1, explaining the 64.0% of the cumulative variance. The majority of the items (86.4%) in the Serbian version of the OQLQ presented the highest loading weight in the subscales assigned by the OQLQ developer.
The psychometric properties of the OQLQ (Serbian version) have exceptional internal consistency and reproducibility as an instrument for evaluation of dental malocclusions. Additionally, this questionnaire may be useful as a supplementary outcome measure in persons with malocclusions.