Health-related quality of life outcomes after cholecystectomy

Gallbladder diseases are very common in developed countries. Complicated gallstone disease represents the most frequent of biliary disorders for which surgery is regularly advocated. As regards, cholecystectomy represents a common abdominal surgical intervention; it can be performed as either an elective intervention or emergency surgery, in the case of gangrene, perforation, peritonitis or sepsis. Nowadays, the laparoscopic approach is preferred over open laparotomy. Globally, numerous cholecystectomies ar...     

Health-related quality of life in HCV-infected patients

In March 2007, a systematic review was conducted of published research on the topic of health-related quality of life (HRQOL) in patients with hepatitis C virus (HCV) infection. Recent studies indicate that significant decrements in HRQOL exist for patients with HCV under many circumstances and arise from multiple sources. Future research is needed on finding interventions that address all sources of reduced HRQOL in patients with HCV, whether or not they are on treatment. It is also important to continue work on identifying the direct mechanisms behind lower HRQOL in patients with HCV.     

Health-related quality of life in patients with sinusitis

The goal of treatment for patients with sinusitis is the prompt and complete relief of symptoms and consequent improvement in health-related quality of life (HRQL). HRQL has been defined as the component of overall quality of life, determined primarily by the person’s health, which can be influenced by clinical interventions. HRQL is especially useful for conditions like sinusitis in which there is no gold-standard diagnostic test, and "objective" tests correlate poorly with disease severity and outcomes. Patients with sinusitis have measurable, significant decrements in HRQL. Many studies evaluating treatment efficacy in patients with sinusitis have used unvalidated HRQL measures, making their findings, at best, difficult to interpret or, at worst, potentially biased. In this article, we review the definition of HRQL, the meaning and importance of validating HRQL measures, the impact of sinusitis on HRQL, and validated measures of HRQL for use in research and in clinical practice.     

Health-related quality of life in primary immune deficient patients

The primary immunodeficiency (PI) disorders are abnormalities in development and maturation of the immune system. Individuals with PI disease may experience frequent infections, which limit their abilities to exhibit physical and psychological well-being secondary to their illness. In this survey we compared health-related quality of life of primary immune deficient patients with healthy children. The case-control study was designed for patients with PI disease who were referred to Children Medical Center in 2004-2005. Demographic information was taken and Pediatric Quality Of Life (PEDQOL) questionnaire were filled for 50 PI patients and 100 healthy children. The mean age in PI patients was 12.62+/- 3.65 (range from 8 to 18) years and in the control group was 11.04+/- 3.3 years. In PI patients 68% were male and 32% female .Most patients with PI disease had a diagnosis of common variable immunodeficiency (54%) or X-linked agammaglobulinemia (24%). Patients with PI disease had great limitations in physical functioning and psychological well-being (p<0.001 and p<0.001 respectively) compared with children without a chronic health condition. Patients had lower PEDQOL scores in all age groups compared with normal sample (p<0.001). Long duration of disease significantly correlated with low psychological score. (r =-3.23. P= 0.03) Children with PI disease experience poorer health related quality of life than healthy children, indicating more attention should be paid to early diagnosis and treatment of PI disease, as well as more attention to their social limitation. PI patients may need psychological consultation for better coping with their illness.     

Health-related quality of life factor in chronic hemodialysis patients

AIM: The purpose of this study was to investigate the related factors of the health-related quality of life (HRQOL) measured by KDQOL-SF version 1.3 Japanese version) in chronic hemodialysis patients. METHODS: Using a cross-sectional survey design, we hand-delivered a self-administered questionnaire to the chronic hemodialysis patients and finally obtained 67 subjects' data to analyze. The response rate was 65.7%. Among the related factors, disease/dialysis-related factors and rehabilitation-related factors in addition to demographic factors were examined. The HRQOL was divided into a physical component summary (PCS) and a mental component summary (MCS). RESULTS: Multiple linear regression analysis revealed that the independent factors related to PCS were symptom score, serum albumin level, patients' satisfaction with dialysis care, and the work status. These four factors could explain 60% of PCS variance (adjusted R2 = 0.601). The independent factors related to MCS were revealed to be quality of social interaction and understanding of effectiveness of self-exercise. These two factors could explain only a quarter of MCS variance (adjusted R 2 = 0.223). CONCLUSION: These results suggest that highly satisfactory care of dialysis, improvement of dialysis-related symptoms, and good nutritional management are important for improving HRQOL in chronic hemodialysis patients, and that the promotion of social participation and interpersonal relationships as well as a positive attitude to self-exercise may lead to a beneficial outcome of rehabilitation for chronic hemodialysis patients.     

Health-related quality of life in patients with pancreatic cancer

BACKGROUND: Pancreatic cancer is an aggressive cancer with low survival time, with health-related quality of life (HRQoL) being of major importance. The aim of our study was to assess both generic and disease-specific HRQoL in patients with pancreatic cancer. METHODS: Patients with pancreatic cancer were consecutively included at admission to hospital. HRQoL was determined with the disease-specific European Organization for Research and Treatment of Cancer (EORTC) and generic EuroQoL (EQ-5D) health status instruments. Scores of patients were compared to those of norm populations. The association of symptoms with overall HRQoL was analysed using linear regression. RESULTS: A total of 45 patients with pancreatic cancer were included. The mean age was 64 years, 53% were females. Of all patients, 44% had metastases at the time of admission. HRQoL was significantly impaired for most EORTC and EQ-5D scales in comparison to norm populations. Symptoms of fatigue (-0.34 regression coefficient; 95% CI -0.63, -0.11) and pain (-0.21; 95% CI -0.39, -0.02) were significantly associated with impaired overall HRQoL. CONCLUSIONS: HRQoL was severely impaired in patients with pancreatic cancer. Symptom control and palliative care appear to be of particular importance.     

Health-related quality of life in chronic hepatitis B patients

The relationship between stages of chronic hepatitis B liver disease and health-related quality of life (HRQoL) is an important aspect of the overall management of hepatitis B virus (HBV) infection, yet is not well characterized. Consequently we sought to examine HRQoL in HBV patients, stratified by disease severity, compared with normal controls and hypertensive patients, using the Short Form 36 Health Survey (SF-36) and the EQ-5D self-report questionnaire. Univariate and multivariate analyses were then performed. A total of 432 HBV (156 asymptomatic carriers, 142 chronic hepatitis B, 66 compensated cirrhosis, 24 decompensated cirrhosis, 22 hepatocellular carcinoma, and 22 post-liver transplant) patients, 93 hypertensive patients, and 108 normal controls participated in the study. Multivariate analysis showed that normal controls and asymptomatic carriers had similar SF-36 scores, which were better than those for hypertensive patients, but with development of chronic hepatitis B and compensated cirrhosis, showed a significant decrease in general health and the mental dimension, whereas those with advanced liver disease (decompensated cirrhosis and hepatocellular carcinoma) had significantly lower scores in all components (P < 0.05), indicating that the physical component deteriorates only with advanced liver disease. Similar results were obtained with EQ5D. Post-liver transplant patients had similar HRQoL to patients with decompensated cirrhosis and hepatocellular carcinoma, although there was a trend toward improvement. Conclusion: Our results showed that HRQoL in asymptomatic carriers is comparable to those of normal controls and better than hypertensive patients, but deteriorates with disease progression, initially in general health and mental dimensions, but with advanced disease all dimensions are affected.     

Health-related quality of life in psoriatic arthritis patients in Spain

PurposeTo describe the demographic and clinical characteristics, including health-related quality-of-life (HRQL), in patients with psoriatic arthritis (PsA).Methods287 patients from 18 Spanish centres were assessed. PsA severity was measured using the following criteria: (1) Psoriasis Area and Severity Index (PASI score 0–72, from low to high severity); (2) number of swollen and tender joints; and (3) Health Assessment Questionnaire (HAQ score 0–3 from low to high impairment in daily activities). HRQL assessment was performed using the following criteria: (a) EuroQol-5D (EQ-5D scores 1–3, with a higher score representing a worse HRQL), Visual Analogue Scale (VAS score 0–100, with a higher score representing a better HQRL) and (b) Short Form-36 (SF-36 score 0–100, with a higher score representing a better HRQL).Results24.7% of patients were treated with infliximab. In the two groups, 55.7% of the patients were male with a mean age of 52.40 ± 12.53 years. The average number of swollen joints was higher in patients not receiving biological therapy than in those receiving treatment (2.98 vs. 1.54). The mean PASI score was 3.73 ± 5.83, and there was no difference between groups.HAQ scores were higher in patients receiving infliximab than in those not receiving treatment (0.93 vs. 0.70). The mean EQ-5D scores in the two groups indicated a poorer status based on pain and inability to perform usual/daily activities. HRQL measured by VAS score mean was 60.41 ± 20.08, and there was no difference between the groups. The domains in the SF-36 suggesting poorer functioning in the two groups were the physical role (50.76 ± 43.43), physical pain (49.35 ± 25.69) and the overall physical component (37.88 ± 10.87).ConclusionsPsA is associated with an impaired HRQL characterised by physical pain and poorer functioning in daily activities.     

丙型肝炎患者的长期生存质量

生存质量源于health-related quality of life，称之为健康相关生存质量，又称为生命质量或生活质量。在医学模式的发展过程中，传统生物医学和社会医学的结合越来越引起人们的重视，使过去对健康的客体评价转变为对客体和主体的双重评价。丙型肝炎病毒感染的慢性化率高，并有可能存长期发展中发生肝硬化、肝癌，不仅影响感染者的生理状态，由于病程长、肝外表现多、晚期并发症多，也影响患者的社会心理健康。甚至在疾病早期，对患者生理影响还不显著时已经出现了生存质量的变化。     

Health-related quality of life in Moroccan patients with ankylosing spondylitis

The main objective of this study was to assess the aspects of health-related quality of life (QOL) in patients with ankylosing spondylitis (AS) and to explore the disease-related parameters influencing it. One hundred patients with AS according to New York Classification criteria were recruited in this cross-sectional study. The Medical Outcomes Study Short Form 36 Health Survey (SF-36) was used to assess health-related QOL. Assessment criteria included the evaluation of disease activity (Bath Ankylosing Spondylitis Disease Activity index [BASDAI]), global well-being (Bath Ankylosing Spondylitis Global Index [BASGI]), enthesitis (Mander enthesis index [MEI]), functional status (Bath Ankylosing Spondylitis Functional Index [BASFI]); metrology (Bath Ankylosing Spondylitis Metrology Index [BASMI]) and radiographic damage (Bath Ankylosing Spondylitis Radiologic Index [BASRI]). In this study, males comprised 67% of the subjects; mean age was 38 ± 13 years and mean disease duration was 9.5 ± 6.8 years. Among these patients, 52% had hip involvement. Our patients had a moderately active disease and severe functional disability. All domains of SF-36 were deteriorated with low scores. The SF-36 subgroups most affected were role limitation (18.8 ± 28.1), role emotional (19.4 ± 35), general health (44.9 ± 20.3) and vitality (38.0 ± 18.2). Lower scores of SF-36 had good statistically significant correlations with altered functional status (BASFI), worse general well-being (BASGI), altered metrology (BASMI); and moderate correlations with high disease activity (BASDAI), important radiological damage (BASRI); restricted chest expansion and prolonged morning stiffness (p < 0.001). This study states that health-related QOL in Moroccan patients with AS is damaged in a significant way. Mental as well as physical aspects were affected. Functional disability, patient’s well-being, metrology and disease activity are the main factors associated with deteriorating domains of QOL in AS. Recognizing complicated relationships between clinical measures and QOL in patients with AS can help us to develop further management strategies to improve their QOL.     

Health-related quality of life in Swedish patients with ulcerative colitis

Objective: The aim of this study was to characterize the health-related quality of life (HRQOL) in a Swedish population of patients with ulcerative colitis.
Methods: A total of 211 patients with ulcerative colitis were studied. Demographic and disease-related factors were noted. HRQOL was measured by one disease specific questionnaire, the Rating Form of IBD Patient Concerns (RFIPC) and one generic, The Sickness Impact Profile (SIP). Additional questions regarding information needs, medication, and well-being were asked. Disease activity was measured by symptom cards, laboratory samples, endoscopy, and two indices of disease activity. The influence of additional concomitant disease was also evaluated.
Results: Functional impairment as measured by the SIP was primarily in psychological and social areas and to a lesser extent in the physical areas. The highest scores for individual items of the RFIPC were those related to potential complications, e.g. , needing an ostomy appliance, needing surgery, developing cancer, losing bowel control, and uncertainty about the disease and effects of medication. Patients with active disease scored higher on both SIP and RFIPC when compared to patients in remission. Presence of coexisting disease weighted heavily on HRQOL.
Conclusion: Ulcerative colitis has a negative influence on the subjective functional status and seems to cause many worries and concerns. Patients in relapse had greater concerns, more impairment of functional status, and a reduced subjective sense of well-being than patients in clinical remission. Nevertheless, the patients in this Swedish study scored a much better HRQOL than has previously been reported using these questionnaires in patients with ulcerative colitis from the US, France, and Austria.     

Health-related quality of life in Egyptian patients after liver transplantation

Introduction-Aim. Health-Related Quality of Life (HRQOL) has become an important focus of patient care and clinical outcomes research with the improvement in patient and graft survival after liver transplantation (LT). The current study was designed to evaluate the post-transplant HRQOL profiles using the Liver Disease Quality of Life 1.0 (LDQOL 1.0) Questionnaire and demonstrate the possible effect of peri-transplant clinical covariates on these profiles.Material and methods. Participants included pre-transplant group (waiting-list patients n = 50) and post-transplant group (mean 5 ± 4 years after deceased or living donor LT n = 103) who were recruited from 3 specialized centers in Egypt. We applied the LDQOL 1.0 questionnaire; a 111-item containing the Short Form-36 version 2.0 (SF-36v2) as a generic component supplemented by 75 disease-specific items. The etiology of cirrhosis, co-morbidities, model for end-stage liver disease (MELD), Child-Pugh class and post-operative complications were analyzed.Results. All recipients had significant higher HRQOL scores than patients in waiting-list using both questionnaire components. Recipients with pre-LT MELD ≥ 15, Child-Pugh class C, history of hepatocellular carcinoma (HCC) demonstrated low HRQOL scores. Recipients without post-operative surgical complications had a statistically better HRQOL using the disease-specific, but not the SF-36v2 component. On the other hand, both components demonstrated non-significant lower scores in recipients with rejection episodes, cytomegalovirus (CMV) infection and hepatitis C recurrence had compared to those without medical complications.Conclusion. Generally HRQOL improves dramatically after LT as assessed by LDQOL questionnaire. Moreover, combined questionnaires can provide accurate information about the possible impaired HRQOL post-LT due to pre-transplant disease severity and post-operative complications.     

Health-related quality of life in Moroccan patients with rheumatoid arthritis

We aimed to assess the aspects of health-related quality of life (HRQoL) in Moroccan patients with rheumatoid arthritis (RA) and to evaluate the disease-related parameters influencing it. Two hundred fifty-five patients with RA were consecutively included. We assessed sociodemographic characteristics, cigarette smoking status, disease duration, diagnosis delay, joint pain intensity (on a 0–100-mm visual analogue scale), disease activity (by the disease activity score (DAS 28) and biological tests), structural damage (by radiographs scored using the Sharp’s method as modified by Van der Heijde), functional disability (by the Health Assessment Questionnaire), extra-articular manifestations, immunological status, and treatments. The Arabic version of the Medical Outcomes Study Short Form 36 Health Survey (SF-36) was applied to assess HRQoL. All domains of SF-36 were deteriorated in a significant way comparing to the general population. The most affected subgroups of SF-36 were role limitation, role emotional, vitality, and social functioning. Women had significantly lower scores of SF-36 compared to men. Patients with decreased levels of education and low socioeconomic status had significantly lower scores of SF-36 (for all p?≤?0.01). Current and ex-smokers had lower scores in physical domains of quality of life. Patients treated with methotrexate had better scores of mental health. Furthermore, patients receiving biologic agents had better scores of physical and social domains. Decreased scores of SF-36 were significantly correlated with disease duration, joint pain intensity, clinical and biological disease activity, functional disability, and radiographic damage. The level of antibodies against citrullinated peptides had significant correlations with the impairment of physical domains of SF-36. Physical as well as mental aspects of HRQoL in our RA patients were significantly deteriorated. Recognizing complicated relationships between HRQoL and disease-related variables among our RA patients can help to develop further management strategies to improve patients’ daily living particularly with the advent of new treatments.     

Health-related quality of life in asthma

One aim of caring for adults and children with asthma should be the identification and treatment of the functional impairments that are troublesome to these patients in their daily lives. Studies have shown that correlations between measures of clinical asthma severity and control and health-related quality of life (HRQL) impairment are only weak to moderate. Therefore, HRQL must be measured directly. In recent years, HRQL questionnaires have been developed and validated to measure the functional (physical, social, emotional, and occupational) impairments that are important to both adults and children with asthma. Most questionnaires are now available in a range of languages. More recently, methods have been developed for the clinical interpretation on HRQL data. Assessment of asthma-specific HRQL can be included in both clinical trials and clinical practice, in conjunction with the conventional measures of airway function, to provide a complete picture of patients' health status.     

Health-related quality of life in emphysema

Patients with emphysema may experience reduced health-related quality of life (HRQOL). HRQOL measures have evolved from two different measurement traditions: psychometric theory and decision theory. Psychometric methods typically create a profile of outcomes, whereas decision theory methods offer a summary score on a continuum ranging from 0.0 (for death or worst possible health) to 1.0 (for best possible health). Decision theory methods are better suited for cost-effectiveness studies. Generic HRQOL measures can be applied to any disease population, whereas disease-targeted measures are tailored to a specific clinical condition. Disease-targeted measures are typically more sensitive to clinical change, but cannot offer a comparison basis for different clinical conditions. This article reviews the measurement of HRQOL in patients with emphysema. The National Emphysema Treatment Trial (NETT) offers an example of the application of both generic and disease-targeted, as well as profile and decision theory, methods. The NETT illustrates how HRQOL measures can be used to assess outcomes and estimate cost-effectiveness in a major clinical trial.     

Health-related quality of life in patients with pulmonary arterial hypertension

STUDY OBJECTIVES: Patients with pulmonary arterial hypertension (PAH) often present with dyspnea and severe functional limitations, but their health-related quality of life (HRQOL) has not been studied extensively. This study describes HRQOL in a cohort of patients with PAH. DESIGN: Cross-sectional study. SETTING: A tertiary care, university hospital-based, pulmonary hypertension (PH) clinic. PARTICIPANTS: We studied HRQOL in 53 patients with PAH (mean age, 47 years; median duration of disease, 559 days). Eighty-three percent were women, 53% received epoprostenol, and 72% reported moderate-to-severe functional limitations with a New York Heart Association class 3 or 4 at enrollment. MEASUREMENTS AND RESULTS: We examined HRQOL by administering the Nottingham Health Profile, Congestive Heart Failure Questionnaire, and Hospital Anxiety and Depression Scale. We used the Visual Analog Scale and standard gamble (SG) techniques to measure preferences for current health (utilities). Compared with population norms, participants reported moderate-to-severe impairment in multiple domains of HRQOL, including physical mobility, emotional reaction, pain, energy, sleep, and social isolation. Mean SG utilities were 0.71, suggesting that, on average, participants were willing to accept a 29% risk of death in order to be cured of PH. CONCLUSIONS: PAH is a devastating condition that affects predominately young women in the prime of their life. Understanding HRQOL and preferences are important in the care and management of these patients. Compared with population norms, patients with PAH have substantial functional and emotional limitations that adversely affect their HRQOL.     

Health-related quality of life in patients with congestive heart failure

BACKGROUND: Despite abundant evidence attesting to poor physical, psychological and social functioning of congestive heart failure (CHF) patients, little is known about the impact of the disease itself on health-related quality of life (HRQL). Most previous work has focused on general quality of life issues rather than specifically on the impact of CHF on HRQL. AIM: To identify the significant demographic, clinical and psychosocial factors associated with HRQL in patients with CHF. METHODS: A total of 227 CHF patients were recruited from the medical unit of a general hospital in Hong Kong. Cross-sectional data on HRQL, functional status, psychological state, social support and health perception were obtained from each patient and clinical data were obtained from hospital records. RESULTS: In hierarchical regression analysis, psychological distress, poor health perception, higher NYHA grading and lower education level were identified as the significant factors associated with poorer HRQL. These correlates in total explained 52% of the variance for the HRQL scores. Among these correlates, psychological distress and NYHA grading demonstrated the greatest effect on HRQL scores. CONCLUSION: The findings highlight the significance of addressing the psychological and functional health of CHF patients. Assisting these patients to cultivate a positive attitude towards their own health status is also an important treatment goal.     

Health-related quality of life in insulin-treated diabetic patients in the Sudan

To determine health-related quality of life (HRQL) in people with insulin-treated diabetes mellitus in Sudan, a total of 89 patients aged 25-55 years and with > or = 5 years diabetes duration was studied. HRQL was measured with a 68-item questionnaire from the Medical Outcomes Study. Late diabetic complications were assessed, and haemoglobin A1c (HbA1c) was measured to assess the metabolic control. Of the patients (m = 36; f = 53), only 13.5%, had good metabolic control ((HbA1c) < 7.5%). These patients rated their HRQL as worse than patients with poor metabolic control ((HbA1c) > 10%). However, the latter were significantly younger, had shorter diabetes duration, and were free from late complications. Overall, 49.4% of the patients had one or more of the late diabetic complications. These patients rated their HRQL significantly lower when compared with patients without complications. Older age and the presence of late diabetic complications were the most important predictors for HRQL. It is concluded that self-rated HRQL in this group of patients is generally low. Improving diabetes knowledge and the metabolic control since early in the course of the disease, will not only retard the development of late complications, but will certainly improve the HRQL of these patients.