Impact of infusion frequency on quality of life in patients receiving home parenteral nutrition

Home parenteral nutrition (HPN) may be needed as a long-term therapy for patients with chronic intestinal failure whose clinical condition does not allow complete weaning of the parenteral nutrition (PN) solution. HPN is a time-consuming and clinically complex therapy and can negatively affect quality of life (QOL). The level of dependency on HPN, specifically, infusion frequency, has been proposed as a factor that may have an effect on QOL in patients receiving HPN. The primary aim of this qualitative review is to identify the impact of HPN frequency (days per week of HPN infusion) on QOL measurements in adult patients receiving HPN. A comprehensive literature search was completed in PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Primary clinical research studies were included if they were conducted in adult patients receiving HPN and included the assessment of the associations between the frequency of HPN infusion and QOL measurements. Six articles ultimately met the criteria for this review. There was variability among the studies, including use of different tools to measure QOL. However, all six studies suggest that a reduction in HPN frequency may be associated with an improvement in QOL. Whenever patients’ clinical situation allows, a reduction in HPN frequency should be considered to improve QOL in patients receiving HPN.     

营养和社会支持对大肠癌患者生存质量的影响

目的探讨营养和社会支持对大肠癌患者生存质量的影响。方法用累积比数模型对福州市150例大肠癌患者的生存质量进行分析。结果大肠癌患者的社会支持总分38.83,主观支持评分19.98,客观支持评分10.32,支持利用度评分8.53。社会支持总分、主观支持评分高于国内常模,而客观支持评分、支持利用度评分低于国内常模;营养状况得分为6(中位数)。营养状况、社会支持利用度与大肠癌患者生存质量有关,OR值分别为0.73和1.14。结论加强营养和社会支持,有利于提高大肠癌患者的生存质量。     

Impact of fatigue on quality of life among breast cancer patients receiving chemotherapy

ObjectivesFatigue is the most frequently reported symptom experienced by cancer patients and has a profound effect on their quality of life (QOL). The study aimed to determine the impact of fatigue on QOL among breast cancer patients receiving chemotherapy and to identify the risk factors associated with severe fatigue incidence.MethodsThis was an observational prospective study carried out at multiple centers. In total, 172 breast cancer patients were included. The Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire was used to measure QOL, while the Brief Fatigue Inventory (BFI) was used to assess the severity of fatigue.ResultsThe total average mean and standard deviation of QOL were 84.58±18.07 and 4.65±1.14 for BFI scores, respectively. A significant association between fatigue and QOL was found in linear and multiple regression analyses. The relationships between fatigue severity and cancer stage, chemotherapy dose delay, dose reduction, chemotherapy regimen, and ethnicity were determined using binary logistic regression analysis.ConclusionThe findings of this study are believed to be useful for helping oncologists effectively evaluate, monitor, and treat fatigue related to QOL changes.     

Impact of cancer occurrence on health-related quality of life: A longitudinal pre-post assessment

Background  

Investigations focusing and implementing on the impact of cancer on health-related quality of life (HRQoL) by the way of a mean comparison between cancer patients and subjects from the general population, are scarce and usually cross-sectional. Longitudinal application of HRQoL instruments to a general, initially healthy population allows for change to be assessed as an event occurs, rather than afterwards. The objective of the present study was to investigate the impact of new cancer on HRQoL.     

Impact of nocturia on disease-specific quality of life for men with localized prostate cancer

Objectives

We assessed the impact of nocturia on the general and disease-specific health-related quality of life (HRQOL) for men with localized prostate cancer.

Materials and methods

A total of 620 men with prostate cancer were enrolled to our study. All of the subjects completed the questionnaires before primary treatment. We evaluated general HRQOL with the Short Form 36-Item Health Survey (SF-36). The prostate-specific HRQOL was assessed with the University of California, Los Angeles Prostate Cancer Index (PCI). Night-time urinary frequency was assessed by the seventh score of the International Prostate Symptom Score.

Results

Of the 581 men, 47 (8%) men reported no nocturia, while 189 (32%) were categorized with one void per night and 345 (59%) with two or more voids per night. Disease-specific HRQOL, including urinary function, bowel function, and sexual function, was negatively associated with increase in frequency of nocturia. The subjects who reported two or more voids per night had significantly lower scores than those of the no nocturia or one void per night group in several domains of the SF-36 and PCI. Based on the proportion odds model, age, urinary function, bowel function, and sexual function showed a strong association with frequency of nocturia.

Conclusions

We found a strong association between the frequency of nocturia and disease-specific HRQOL as well as general HRQOL. Increased severity of nocturia is negatively correlated with overall health status and HRQOL outcomes.     

Impact of man-made load on patients' life quality

The present prospective study included 70 females with uterine myoma indicated for surgery. The patients lived in the city districts having different industrial loads. Life quality was studied before and different periods after surgery. The poor environment was ascertained to affect life quality in patients with uterine myoma. Testing the life quality of a patient can significantly alter our views of preparation for surgery and of postoperative rehabilitation.     

Health-related quality of life during adjuvant radiotherapy in breast cancer

Objective

In this study, health- related quality of life (HRQoL) and its determinants were assessed in breast cancer patients undergoing postoperative adjuvant radiotherapy. The aim was to improve our understanding of patient’s situation at the end of adjuvant treatment, as the return to every day life approaches after breast cancer surgery and adjuvant chemo- and radiotherapy.

Methods

Health- related quality of life was measured by the 15D instrument. Self-administered questionnaires were distributed to patients undergoing postoperative radiotherapy. Out of 389 consecutive breast cancer patients, 273 comprised the final study group. The results were compared to 15D results for an age-standardized sample of the female general population in Finland (n = 3,335). Determinants of HRQoL were assessed by a multivariate model.

Results

In patients <53 years, but not in older patients, the total 15D score was lower than in age-standardized controls. Both younger and older patients differed significantly from the controls on specific 15D dimensions of sleeping, depression, distress, vitality, and sexual activity. When clinical and treatment variables were assessed by a multivariate model, depressive symptoms had a negative effect on HRQoL. Further, having undergone breast conserving surgery instead of mastectomy was associated with poorer HRQoL.

Conclusions

Impairment of HRQoL was observed during adjuvant radiotherapy in breast cancer. This finding calls for action to develop supportive and preventive means to smoothen the return to normal activities after completion of adjuvant treatment for breast cancer.     

个体化护理对胰腺癌患者负面情绪及生活质量的影响

目的：对个体化护理方案改善胰腺癌患者负面情绪及生活质量的情况进行探讨。方法：选择2012年2月-2014年2月收治的100例胰腺癌患者作为研究对象,随机抽样分为观察组及对照组各50例。观察组及对照组分别采用个体化护理及常规护理并在患者入院及出院时对其焦虑、抑郁及生活质量进行评估。结果：在负面情绪方面,对照组较干预前无明显变化,而观察组焦虑及抑郁评分均有明显下降,并且两组差异有统计学意义（P〈0.05）。在生活质量上,虽然两组患者在干预过后生活质量评分都有了改善,但是观察组的改善情况优于对照组（P〈0.05）。结论：个体化护理方案能改善胰腺癌患者负面情绪并且可提高生活质量。     

Impact of leprosy on the quality of life.

Leprosy is considered by many as not merely a medical condition, but as a condition encompassing psychological, socioeconomic and spiritual dimensions that dehabilitate an individual progressively, unless properly cared for. The present study was undertaken to document the nature and extent of decreases in the quality of life (QOL) of an affected person. The World Health Organization questionnaire on quality of life was given to a representative random sample of 50 leprosy-affected persons and 50 unaffected individuals in the Bommasamudram Taluk of Chittoor District, Andhra Pradesh, India. This questionnaire explores the following six domains; physical; psychological; level of independence; social relationships; spiritual; and environmental. The mean QOL score of the cases was significantly lower than that of the controls with the exception of the spiritual domain. The mean total score for women was higher than that of males in each domain and age group. Males with deformities had a significantly lower score than those with no visible deformities. Although the scores for females with deformities were also lower than those without deformities, the differences were not statistically significant. Analyses of economic status versus the QOL scores clearly showed that they were positively correlated. The study revealed that quality of life decreased progressively in leprosy-affected persons. Women had a better QOL score than men in almost every domain. Given the secondary role of women in Indian rural society, this may simply imply an acceptance of their situation. The findings are discussed in comparison with other diseases and in the context of a poor socioeconomic environment. With modern amenities, better education and higher expectations, the perception of an individual regarding his or her own quality of life is bound to change. The need for frequent assessments and further studies along these lines is emphasized.     

Determinants of quality of life in home parenteral nutrition

PURPOSE OF REVIEW: To highlight the most important and salient articles regarding home parenteral nutrition and quality of life published within the last 3 years. RECENT FINDINGS: In recent years, quality of life research in home parenteral nutrition has highlighted the need for a therapy-specific validated questionnaire. Several papers suggest a greater psychological input is required to better understand and evaluate this patient population. Issues surrounding the use of home parenteral nutrition in malignancy have arisen, prompting discussion on ideal timing and candidacy for home parenteral nutrition. Intestinal transplantation is evolving and improving, making it a possible alternative to home parenteral nutrition. Earlier referral is suggested as late referral can result in poorer outcome. SUMMARY: Home parenteral nutrition is a life-sustaining therapy for individuals with intestinal failure. There is now a relatively large amount of research into the quality of life in this population, but more focused measurements (in the form of validated therapy-specific questionnaires) are required to answer questions relating to cancer and intestinal transplantation.     

Impact of autism in adolescents on parental quality of life

Purpose

To study the impact of autism spectrum disorders (ASDs) on parental quality of life (QoL) at adolescence using the parental–developmental disorders-quality of life scale (Par–DD-QoL).

Methods

One hundred and fifty-two mothers of adolescents with ASD completed Par–DD-QoL. This scale assesses the following dimensions: emotional, daily disturbance and global QoL. This cross-sectional study uses a subset of data collected at the final time of a follow-up study (EpiTED cohort).

Results

A polytomic regression identified an increase in aberrant behavior scores as the major independent risk factor for parental QoL. The identified protective factors were the increase in daily living, communication and object cognition scores and a higher number of siblings.

Conclusions

Those results suggest that there is a negative effect of externalizing behaviors and a protective effect of adaptive skills, communication and object cognition on parental QoL. Study limitations and implications are discussed.     

自理护理对扩张性心肌病患者生活质量的影 响简

目的：探讨自理护理工作对扩张性心肌病患者生活质量的影响。方法：将100例扩张性心肌病患者随机分成两组，试验组的患者提供自理护理方式进行护理，对照组的患者采用一般形式的常规性护理，对两组患者的生活质量进行标准评分对比。结果：试验组患者的生活质量评分明显高于对照组患者的生活质量评分。结论：对患有扩张性心肌病的患者采用自理护理方式进行护理，可以有效的提高患者自身日常生活中的整体生活质量。     

Outcome and quality of life in paediatric home parenteral nutrition

In this review the current status of home parenteral nutrition is analysed, with respect to the predictability of weaning from nutritional support and the risk of developing major complications associated with the technique, the loss of vascular access and liver disease. These two complications were evaluated because they represent the more important indication for intestinal transplantation, the availability of which has changed the perspectives of patients and of physicians. Analysis of outcomes from the largest series allows the identification of patients who could be weaned from parenteral nutrition. Important prognostic factors in patients affected by short bowel syndrome are the length and type of the remnant and the time to tolerate enteral feeding. The main complications of therapy are sepsis, thrombosis, nutrient imbalances and liver disease. Sepsis and thrombosis could lead to line replacement and the loss of vascular access. Sepsis no longer represents a major cause of death, but it is a frequent complication. In some patients, it is difficult to assess the risk factors for sepsis, which is possibly related to a poorer outcome. The care of gut failure appears to be the best preventative measure for the occurrence of cholestatic liver disease, but further studies are needed to define the eventual role of lipid emulsion and of specific nutrient deficiency. The quality of life still remains to be studied: because home parenteral nutrition in children has a longer duration, its analysis is mandatory.     

Impact of nocturnal calf cramping on quality of sleep and health-related quality of life

Purpose

To evaluate the impact of nocturnal calf cramping (a condition that affects one in two people over 60 years of age) on quality of sleep and health-related quality of life.

Methods

Eighty adults who experienced nocturnal calf cramp at least once per week and eighty age- and sex-matched controls who never experienced nocturnal cramp were recruited from the Greater Newcastle and Central Coast regions of New South Wales, Australia. All participants completed the SF-36v2 and the Medical Outcomes Study Sleep Survey (MOS-SS).

Results

People who experienced nocturnal muscle cramps reported more sleep disturbance (p < 0.001), less adequate sleep (p = 0.001), less quantity of sleep (p = 0.02) and more snoring (p = 0.03). Both sleep problem summary indices for the MOS-SS identified people who experienced nocturnal muscle cramp as having more sleep problems than the controls. People who experienced nocturnal muscle cramps had lower health-related quality of life for the SF-36 domains role physical (p = 0.007), bodily pain (p = 0.003) and general health (p = 0.02). SF-36 domains that primarily relate to mental health were not significantly different between groups. The impact of nocturnal calf cramps on health-related quality of life was largely explained by their negative impact on quality of sleep.

Conclusions

Nocturnal calf muscle cramps are associated with substantially reduced quality of sleep and reduced physical aspects of health-related quality of life.     

Long-term outcome and quality of life of adult patients on home parenteral nutrition

The outcome and prognosis of home parenteral nutrition (HPN) patients may depend on their age and underlying disease and on HPN techniques. Results in the literature are confounded by mixing child and adult populations, short- and long-term HPN treatments and malignant and non-malignant cases. Only four papers have reported the probability of survival and only one of these used multivariate analysis. The quality of life of HPN patients, focusing on community and social rehabilitation, has been reported. The aspects of treatment differ depending upon the circumstances under which HPN is started (acute vs chronic) and the nature of the disease, facts which have to be taken into account in patient management. Prognosis of the underlying disease obviously has a major influence on how rehabilitation is viewed. Patients should be informed of the objectives of HPN by the nutrition team and family circumstances taken into account, before time-consuming and expensive HPN treatment is started.     

The influence of early supplementation of parenteral nutrition on quality of life and body composition in patients with advanced cancer

BACKGROUND: According to current evidence, most organizations, including the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), do not recommend the routine use of artificial nutrition for patients with cancer. Despite the recommendation for parenteral nutrition (PN), data for early PN supplementation (PNS) in patients with an advanced malignancy are extremely limited, especially in terms of the affects on nutrition outcomes, body composition, and quality of life (QOL), as well as effects on oncologic outcomes. The aim of the study was to evaluate the effect of PNS on body composition and the quality of life in patients with advanced malignancies. METHODS: One hundred fifty-two consecutive patients with advanced cancer were prospectively randomized to either use of oral enteral nutrition supplement (PN-) or use of oral enteral nutrition supplement plus supplemental PN (PN+). Body weight, body mass index (BMI), and caloric intake were assessed, and hemoglobin (g/dL) and serum albumin (g/L) were measured. Body composition was assessed by body impedance analysis (BIA), and QOL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire every 6 weeks. RESULTS: No significant differences were evident at baseline between the 2 groups for age, gender, medical diagnosis, weight, BMI, or QOL. A statistically significant difference in mean BMI was observed by week 48 for the PN+ group (PN+ = 21.9, PN-= 20.5, p = .0149), by week 6 in mean body cell mass (PN+ = 55%, PN-= 50,1%, p < .001), mean albumin (PN+ = 40.2 g/L, PN-= 36.2 g/L, p = .015), mean QOL (PN+ = 55.7, PN-= 50.9, p = .035). The cumulative survival rate was significantly greater in the PN+ group (p < .0001). CONCLUSIONS: According to the positive effect of supplemental PN on survival, body composition, and QOL, additional controlled studies must be conducted to confirm these findings.     

Impact of periodontal disease on quality of life for dentate diabetics

The aim of this study was to evaluate the potential impact of periodontal disease on quality of life in diabetics. A total of 159 dentate diabetic individuals registered at the Municipal Hospital in Itaúna, Minas Gerais, Brazil, were examined and interviewed. The clinical periodontal parameters recorded were: gingival bleeding, probing depth, and clinical attachment level. The OHIP-14 form was used to evaluate the impact of periodontal disease on quality of life. In relation to periodontal status, 15.7% of individuals were healthy, 35.2% presented gingivitis, and 49.1% periodontitis (27.7% in the mild-to-moderate and 21.4% in the advanced stages). Association between diagnosis of periodontal disease and impact on quality of life was significant in individuals with periodontitis (p < 0.001). Gingival bleeding, probing depth, and clinical attachment level > 4mm were associated with intensely negative impact on quality of life (p = 0.013, p < 0.001, and p = 0.012 respectively). Diabetics with mild-to-moderate and advanced periodontitis had more negative impact on quality of life than those who were periodontally healthy or with gingivitis.