Quality of life among women with sexual dysfunction undergoing hemodialysis: a cross-sectional observational study

ABSTRACT: BACKGROUND: Sexual function among women undergoing hemodialysis (HD) is under-studied and there is no consensus about the effect of sexual dysfunction (SD) on their quality of life (QoL). We aimed to determine the prevalence of SD and to compare QoL between women undergoing maintenance HD with and without SD. METHODS: We included female end-stage renal disease (ESRD) patients undergoing HD during June 2011 in the only renal unit in the north of Ceara state, northeastern Brazil. The criteria for inclusion were age between 18 and 55, at least three months on dialysis and being sexually active. Women using antidepressant medication were excluded. We used the Female Sexual Function Index (FSFI), which evaluates six domains of sexual function, including desire, arousal, lubrication, orgasm, satisfaction and pain. The patients were classified as presenting SD if the total FSFI score was less than 26. For QoL evaluation, we used the validated Brazilian version of SF-36. This is a widely used 36-item questionnaire covering eight dimensions of QoL. Demographic data, time on dialysis, underlying etiology of ESRD, and laboratory measures were assessed in unit records. RESULTS: Of a total of 58 women, 46 (79.3%) presented SD. There were lower scores related to physical functioning (48.2 vs. 71.2; p=0.007), bodily pain (45 vs. 67.5; p=0.010), vitality (52.1 vs. 69.1; p=0.026) and social functioning (57.2 vs. 76.1; p=0.034) among women with SD compared to women without SD. Physical functioning and role-physical presented positive linear correlation with FSFI scores, respectively, r=0.322 (p=0.013) and r=0.345 (p=0.007). CONCLUSION: The prevalence of SD among women on HD is very high, reaching nearly 80%. Women on HD with SD had worse QoL, especially physical aspects of QoL, when compared to women without SD. Therefore, approaches aiming to improve QoL among women undergoing HD should be considered.     

Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

Quality of Life Research - This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in...     

Quality of life in patients with type 2 diabetes after switching to insulin degludec: results from a cross-sectional survey

Quality of Life Research - Five quality of life (QoL) domains are particularly important to patients with type 2 diabetes (T2D) using basal insulin—sense of physical well-being, sense of...     

Quality of life in Sardinian patients with transfusion-dependent Thalassemia: a cross-sectional study

Purpose

The aim of this study has been to evaluate the physical, psychological, and social well-being in a large group of Sardinian adult patients with transfusion-dependent beta-Thalassemia when compared with a group of healthy subjects of the same age and geographical extraction.

Methods

Male or female patients?≥?18 years of age with Thalassemia major on regular transfusion at Thalassemia Center in Cagliari (Italy) were requested to complete the World Health Organization Quality of life-BREF (WHOQOL-BREF) questionnaire. The WHOQOL-BREF was also made available online to age- and sex-matched non-thalassemic adult subjects living in Sardinia.

Results

Two hundred and seven subjects with Thalassemia were invited to participate in the study. The questionnaire was also completed by 211 age- and sex-matched non-thalassemic subjects living in Sardinia. Scores suggestive of a good quality of life were obtained in all the areas investigated. Thalassemia patients had scores at least as good as those of non-thalassemic subjects in all items and the percentage of those with a score?≥?60 was higher among patients. The analysis of demographic actually highlights that the disease has a little effect on their personal and social lives. There was a positive association between subjective well-being and effective clinical conditions. Moreover, the association between health perception and adherence to treatment suggests that compliance with treatment contributes to the well-being of the patient, both physically and psychologically.

Conclusions

Adult subjects with Thalassemia who live in Western countries have a good quality of life in accordance with the advances in the management of the disease.

     

Contraceptive method selection by women with inflammatory bowel diseases: a cross-sectional survey

Objective

Women with inflammatory bowel diseases (IBDs) utilize contraception at a lower rate than the general population. We sought to identify factors associated with contraceptive use and selection of more effective methods in IBD patients at risk for unintended pregnancy.

Study Design

An online survey was distributed to women with IBD in January 2013. Contraceptive methods were categorized by effectiveness and associations with use explored by demographics, disease characteristics and reproductive goals.

Results

A total of 162 respondents were analyzed: 62% had Crohn’s disease and 38% ulcerative colitis. Mean age was 31 (range 20–45), 97% identified as White, and 53% were nulliparas. Seventy-four percent were currently using IBD medications. A quarter of participants (23%) used no contraception, 17% used highly effective methods, 41% used short-term hormonal methods, and 19% chose barrier/behavioral methods. Prior IBD-related surgery, biologic therapy use and low education attainment were associated with no contraception use. Of contraceptive users, age, parity, insurance status, IBD surgery and prior immunomodulator use were associated with highly effective method selection.

Conclusions

A quarter of women with IBD at risk for pregnancy in this study population reported no contraceptive method use. Higher levels of IBD activity influence contraceptive use and method selection, which could guide future patient and provider educational interventions.

Implications

Pregnancy planning is important for women with inflammatory bowel diseases to avoid adverse outcomes in a disease-poor state. Use of contraception assists in avoidance of unintended pregnancy. IBD characteristics are targets for educational interventions to improve uptake of highly effective contraceptive methods.     

罗湖区225例糖尿病老年患者流感和肺炎疫苗接种意愿影响因素分析

  目的   了解广东省深圳市社区医生流感疫苗接种意愿及其影响因素,为制定社区医生流感疫苗接种策略提供参考依据。  方法  2020年4月1 — 7日采用多阶段抽样方法对深圳市社区健康服务中心的医生进行问卷调查,收集基本信息、接种意愿、既往接种史、态度及疫苗接种相关知识等资料,使用χ²检验做单因素分析,多因素logistic回归分析流感疫苗接种意愿的影响因素。  结果   共回收问卷2407份,有效问卷2399,问卷有效率99.67 %。83.83 %（2011/2399）的被调查者具有接种意愿,多因素logistic回归分析结果显示,接种意愿高的人群主要为既往有流感疫苗接种史（OR = 7.738,95 % CI = 5.99～9.99）、认为成人有必要接种疫苗（OR = 5.525,95 % CI = 3.66～8.34）、信任疫苗安全性（OR = 3.485,95 % CI = 2.75～4.42）、认为有必要接种非国家免疫规划疫苗（OR = 2.147,95 % CI = 1.58～2.91）、信任国产疫苗质量（OR = 1.613,95 % CI = 1.21～2.16）、年龄 ≤ 40岁的医生（OR = 1.331,95 % CI = 1.02～1.73）和疫苗接种知识高认知者（OR = 1.331,95 % CI = 1.03～1.72）。  结论   深圳市社区医生流感疫苗接种意愿较高,医务人员既往接种史、对接种疫苗及疫苗质量与安全性的态度、对疫苗知识认知情况、年龄是影响接种意愿的主要因素。     

Older adults' beliefs about physician-estimated life expectancy: a cross-sectional survey

Background

A major marketing technique used by pharmaceutical companies is direct-to-physician marketing. This form of marketing frequently employs promotional marketing brochures, based on clinical research, which may influence how a physician prescribes medicines. This study's objective was to investigate whether or not the information in promotional brochures presented to physicians by pharmaceutical representatives is accurate, consistent, and valid with respect to the actual studies upon which the promotional brochures are based.

Methods

Physicians in five clinics were asked to consecutively collect pharmaceutical promotional brochures and to send them all to a centralized location. The brochures for any class of medication were collected on a continuous basis until 20 distinct promotional brochures were received by a central location. Once the brochure was received, the corresponding original study was obtained. Two blinded reviewers performed an evidence-based review of the article, comparing data that was printed on the brochure to what was found in the original study.

Results

Among the 20 studies, 75% of the studies were found to be valid, 80% were funded by the pharmaceutical company, 60% of the studies and the corresponding brochures presented patient-oriented outcomes, and 40% were compared to another treatment regimen. Of the 19 brochures that presented the data as graphs, 4 brochures presented a relative risk reduction while only 1 brochure presented an absolute risk reduction. 15% of the promotional marketing brochures presented data that was different from what was in the original published study.

Conclusion

Given the present findings, physicians should be cautious about drawing conclusions regarding a medication based on the marketing brochures provided by pharmaceutical companies.     

Quality of life of elderly patients with antipsychotic-induced parkinsonism: a cross-sectional study

ObjectivesAntipsychotic-induced parkinsonism (AIP) is one of the most common adverse effects of haloperidol. The purpose of this study was to investigate the association between AIP and quality of life of elderly patients treated with haloperidol.DesignCross-sectional study design.SettingEleven nursing homes, geriatric departments of 2 hospitals, and 3 mental health care centers in the Netherlands.ParticipantsParticipants were 140 elderly patients aged 65 years and older treated for at least 5 days with haloperidol.MeasurementsThe presence of AIP was determined with the Simpson Angus Scale. Quality of life was scored with the QUALIDEM scale. Multivariate linear regression analysis was used to assess whether the presence of AIP and quality of life were correlated. The data of patients with advanced dementia were analyzed separately.ResultsOf the 140 included patients, 65 (46%) were diagnosed with AIP. Patients with AIP scored lower than patients without AIP on the QUALIDEM subscales “positive affect,” “negative affect,” “social relations,” “social isolation,” and “having something to do.” In patients with advanced dementia, quality of life was not significantly different in patients with or without AIP.ConclusionThe presence of AIP is negatively associated with the quality of life of elderly patients treated with haloperidol.     

Quality of life in women with lipoedema: a contextual behavioral approach

Purpose

Lipoedema is a chronic, progressive adipose disorder of unknown etiology, often underdiagnosed or misdiagnosed as obesity. It manifests itself with accumulation of the fat in lower parts of the body and associated edema and, due to numerous physical and psychological consequences, affects the quality of life (QOL) of those who suffer. The aim of this study was to investigate the psychological factors that might have an impact on the QOL of women with lipoedema from the contextual behavioral viewpoint.

Methods

In an Internet-based cross-sectional study, women suffering from lipoedema (N = 120) were asked to fill in questionnaires assessing: symptom severity, QOL (WHOQOL-BREF), satisfaction with life (SWLS), psychological flexibility (Acceptance and Action Questionnaire-II), social connectedness (Social Connectedness Scale-Revised) and other psychological factors. The majority of participants were from the USA, the UK, and Australia.

Results

Multiple hierarchical regression analyses showed that a higher level of QOL was predicted by higher levels of psychological flexibility and social connectedness, while controlling for symptom severity. Higher level of SWL was predicted only by higher level of social connectedness.

Conclusions

Acceptance and Commitment Therapy with psychological flexibility as the target of change and Functional Analytic Psychotherapy with social connectedness as the target of change might be useful in treating women with lipoedema; however, further research in this area is needed. The authors conclude that psychological and biomedical interventions for women with lipoedema and their QOL merit more attention from researchers and the medical community than is currently received.

     

Comparison of regimens containing oral micronized progesterone or medroxyprogesterone acetate on quality of life in postmenopausal women: a cross-sectional survey

A cross-sectional survey was conducted to examine quality of life (QOL) related to physiological, somatic, and vasomotor effects of changing progestogen treatment from medroxyprogesterone acetate (MPA) to micronized progesterone in postmenopausal women. Eligible women (n = 176) were currently using hormone replacement therapy (HRT) containing micronized progesterone for 1-6 months and had previously received HRT containing MPA. QOL was assessed via telephone interview using the Greene Climacteric Scale and the Women's Health Questionnaire. When compared with the MPA-containing regimen, women using micronized progesterone-containing HRT experienced significant improvement in vasomotor symptoms, somatic complaints, and anxiety and depressive symptoms. Women reported improved perceptions of their patterns of vaginal bleeding and control of menopausal symptoms while on the micronized progesterone-containing regimen. Approximately 80% of women reported overall satisfaction with the micronized progesterone-containing regimen. A micronized progesterone-containing HRT regimen offers the potential for improved QOL as measured by improvement of menopause-associated symptoms.     

Quality of life after gastric bypass surgery: a cross-sectional study

OBJECTIVE: Numerous reports document significant weight loss after gastric bypass; however, there is little objective data on postsurgical changes in health-related quality of life (HRQL). RESEARCH METHODS AND PROCEDURES: This study examined HRQL in four groups of patients: presurgery (T1), several weeks postsurgery (T2), 6 months postsurgery (T3), and 1 year postsurgery (T4). Subjects were given three HRQL measures: the short form 36 (SF-36), the Impact of Weight on Quality of Life-Lite Questionnaire (IWQOL-Lite), and the Bariatric Analysis and Reporting Outcome System (BAROS). Subjects also completed the Beck Depression Inventory (BDI) and the Rosenberg Self-Esteem Scale (RSE). RESULTS: There were no significant differences among the groups on demographics or presurgical body mass index. Results showed significant differences between T1 and T2 on several SF-36 and IWQOL-Lite subscales, as well as the RSE and BDI. Significant differences were found on all measures between T2 and T3. Significant differences were found on all subscales of the IWQOL-Lite, but no subscales of the SF-36, the RSE, or the BDI between T3 and T4. DISCUSSION: This study is the first to objectively document these differences in several objective measures of HRQL, depression, and self-esteem after gastric bypass in a large sample. It is notable that many differences are apparent within several weeks after surgery. Furthermore, results indicate that the IWQOL-Lite may be more sensitive than the SF-36 to the changes of quality of life that gastric bypass patients report.     

Factors associated with quality of life among married women in rural China: a cross-sectional study

Purpose

Specific medical and living conditions in rural China may predispose people there to a poor quality of life. This study aimed to evaluate factors affecting the quality of life among married women in rural China.

Methods

This cross-sectional study was conducted in rural areas of Liaoning Province in China. Out of the 3900 married women, 3163 (81%) completed the questionnaire survey. Quality of life was assessed using the WHOQOL-BREF scale. Sociodemographic factors, such as monthly income, and living and health conditions, such as left-behind status, stress (quantified by the Perceived Stress Scale), and coping styles (assessed by the Simplified Coping Style Questionnaire) were collected through self-reported questionnaires. Hierarchical multiple regression was used to explore the factors related to quality of life.

Results

The mean scores of quality of life were 14.08?±?2.27 for the domain of physical health, 11.78?±?2.28 for psychological health, 13.07?±?2.69 for social relationships, and 12.26?±?2.67 for environmental conditions. Older age, having chronic diseases, being left-behind, sense of marriage insecurity, and stress were all negatively associated with quality of life scores, whereas a higher monthly income was associated with higher scores. Coping styles could be moderating factors in the relationship between stress and quality of life.

Conclusions

Overall, married women living in rural China had relatively low scores for quality of life. Improving family income, providing access to affordable and high-quality medical care, facilitating couple communication, and promoting active coping styles could be intervention strategies to improve the quality of life of these rural residents.

     

Urinary bisphenol-A concentration in infertile Japanese women and its association with endometriosis: A cross-sectional study

Objectives Bisphenol A (BPA), a raw material commonly used in the manufacture of resins such as polycarbonate and epoxy, is a possible xenoestrogen that is hypothesized to disrupt the human endocrine system. Humans are widely exposed to BPA. We investigated the urinary concentration of BPA in infertile Japanese women and its possible association with endometriosis. Materials and Methods We recruited 166 women (aged 20–45) who had complained of infertility and visited a university hospital in Tokyo. The subjects were interviewed and their urine samples were obtained prior to a laparoscopic diagnosis of endometriosis between January 2000 and December 2001. Urinary total BPA concentration in 140 eligible urine samples was then measured using enzymatic deconjugation of glucuronide and sulfate and high-performance liquid chromatography isotope-dilution tandem mass spectrometry. Results Median (25th–75th percentile) unadjusted and creatinine-adjusted urinary BPA concentrations were 1.6 (0.69–2.8) μg/L and 0.80 (0.45–1.3) μg/g creatinine. No significant monotonic association of endometriosis with urinary BPA concentration was observed. Median urinary BPA concentration in women with stage 0–1 endometriosis (0.74 μg/g creatinine) did not significantly differ from that in those with stage II–IV endometriosis (0.93 μg/g creatinine) (p for difference=0.24). Conclusions This study, based on a larger number of samples than those in previous studies in Japan and using the most reliable analytical method currently available, showed that urinary concentrations of BPA in women who consulted a physician for infertility were not higher than those in other populations. Moreover, no association between urinary BPA concentration and endometriosis was found in this cross-sectional study.     

Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey

Purpose

We assessed the associations between multimorbidity and health-related quality of life (HRQL), and healthcare utilization, based on 16 common self-reported chronic conditions.

Methods

A cross-sectional questionnaire survey including the EQ-5D was conducted in a sample of the general population of adults (≥18 years) living in Alberta, Canada. Multiple linear and logistic regressions were used to assess the association between multiple chronic conditions and HRQL, hospitalization and emergency department (ED) use.

Results

A total of 4,946 respondents reported their HRQL, noting problems mostly with pain or discomfort (48.0 %). All chronic conditions were associated with a clinically important reduction in HRQL, the highest burden with anxiety or depression (?0.19, 95 % CI ?0.21, ?0.16) and chronic pain (?0.19, 95 % CI ?0.21, ?0.17). Multimorbidity was associated with a clinically important reduction in the EQ-5D index score (?0.12, 95 % CI ?0.14, ?0.11) and twice the likelihood of being hospitalized (OR = 2.2, 95 % CI 1.7, 2.9) or having an ED visit (OR = 1.8, 95 % CI 1.4, 2.2).

Conclusions

Pain or discomfort is a common problem in people living with chronic conditions, and the existence of multimorbidity in these individuals is associated with a reduction in the HRQL as well as frequent hospitalization and emergency department visits.     

Examining subjective wellbeing and health-related quality of life in women with endometriosis

The purpose of this study was to explore the subjective wellbeing, health-related quality of life and lived experience of women living with endometriosis. In 2015 five hundred participants between the ages of 18–63 (M = 30.5, SD = 7.46) were recruited through Endometriosis Australia and social media, completing an online questionnaire comprising the Personal Wellbeing Index, the Endometriosis Health Profile-30 and various open-ended questions. Results found that women with endometriosis reported low levels of subjective wellbeing (mean PWI total scores of 51.5 ± 2.03), considerably below the normative range of 70–80 for western populations. The mean Endometriosis Health Profile total score indicated a very low health-related quality of life amongst the women in this sample (78.9, ±13.14). There was also a significant relationship between scores on the Endometriosis Health Profile and Personal Wellbeing Index. The findings from the qualitative data suggest that endometriosis impacts negatively on women's lives in several areas such as; social life, relationships and future plans, this in turn affects women's overall life quality. The study highlights the strong negative impact that endometriosis can have on women's subjective wellbeing and health related quality of life, contributing to productivity issues, relationship difficulties and social dissatisfaction and increasing the risk of psychological comorbidities.     

Prevalence and associations of partner abuse in women attending general practice: a cross-sectional survey

OBJECTIVE: To determine the prevalence and socio-demographic associations of physical, emotional and sexual abuse by a partner or ex-partner for women attending Australian general practices. METHOD: In 1996, women attending 20 randomly chosen Brisbane inner south region general practices were screened for a history of partner abuse using a self-report questionnaire. Multivariate analyses were conducted on the data, using presence of abuse or not adjusting for cluster effect to obtain prevalence rate ratios for socio-demographic background data and history of violence in the family of origin. RESULTS: Thirty-seven per cent (CI 31.0-42.4) of the survey participants (n = 1,836, response rate 78.5%) admitted to having ever experienced abuse in an adult intimate relationship. One in four women (23.3%) had ever experienced physical abuse, one in three (33.9%) emotional abuse and one in 10 (10.6%) sexual abuse. Abused women were 64.1 (Cl 44.4-94.1) times more likely to have ever been afraid of any partner than non-abused women. Of women in current relationships (n = 1,344), 8.0% self-reported physical or emotional or sexual abuse in the past 12 months and 1.5% all three types of abuse. Associations of abuse included being younger (< 60 years), separated or divorced, having a history of child abuse or domestic violence between their parents. CONCLUSION: Partner abuse is very common in women attending general practices and clinicians need to be alert to possible indications of partner abuse (age, marital status, past history of abuse).     

Quality of life for women with arthritis

The purpose of this study is to describe the quality of life for women with arthritis using using the Flanagan Quality of Life Scale developed originally on a randomly selected population of Americans. Two hundred twenty‐five women with chronic arthritis responded to the Scale. When compared to women in Flanagan's study, the women with arthritis placed significantly more importance on passive recreational activity and on a close relationship with their spouse or significant other and significantly less importance on participating in governmental or local affairs. They were most satisfied with their material comforts, relationships with relatives and close friends, helping and encouraging others, and passive recreation but were considerably less satisfied with their health, work, and participation in active recreation. Overall, the Flanagan Quality of Life Scale reflected a difference in quality of life that may be attributable to the effects of arthritis in this group of women.