Validation of the prolapse quality of life questionnaire (P-QOL) in a Turkish population

OBJECTIVE: To validate the Turkish translated version of the prolapse quality of life questionnaire (P-QOL). STUDY DESIGN: After establishing the test-retest reliability and internal consistency in a pilot study, 310 patients were enrolled in the study and general and subscale scores of the questionnaires were calculated. All participants underwent the International Continence Society (ICS) prolapse score (POP-Q). RESULTS: One hundred and forty-five (49.7%) women were symptomatic and 147 (50.3%) were asymptomatic. The level of missing data ranged from 0 to 2.2%. For the test-retest reliability, Spearman's rho was from 0.91 to 1.00 for all domains (p<0.001). The severity of P-QOL was strongly correlated with the vaginal examination findings among the symptomatic group (p<0.001). Items correlated with the objective vaginal examination findings. The total and domain scores for P-QOL of symptomatic and asymptomatic women were found to be statistically significant (p<0.001). CONCLUSION: The Turkish translated version of the P-QOL is reliable, consistent and valid instrument for assessing symptom severity, impact on quality of life in women with uterovaginal prolapse. It is easy to understand may be easily administered and self-completed by the women.     

The fertility quality of life (FertiQoL) questionnaire in Taiwanese infertile couples

ObjectiveTo characterize the fertility quality of life (QoL) in Taiwanese infertile couples using an objective measurement tool—the FertiQoL questionnaire, and establish a reference level of QoL for clinical applications and future studies.Materials and MethodsThe FertiQoL tool, a self-report questionnaire, was distributed to seven infertility centers across Taiwan for infertile couples who were undergoing the treatment of in vitro fertilization. The online version of the FertiQoL questionnaire was issued on the website of Taiwan Society for Reproductive Medicine and was opened to the public.ResultsA total of 534 copies of eligible FertiQoL questionnaires were collected. The total scores for the Core FertiQoL and Treatment FertiQoL are 55.12 ± 13.72 and 56.40 ± 10.96, respectively. Both the Core and Treatment FertiQoL were significantly higher in the males of infertile couples than the females (60.63 ± 14.07 vs. 54.39 ± 13.52, p = 0.001, and 59.13 ± 12.44 vs. 56.03 ± 10.71, p = 0.035, respectively). Significantly better QoL was found in infertile patients in the Southern Taiwan, with a Core FertiQoL of 58.21 ± 12.70 and a Treatment FertiQoL of 58.79 ± 10.15.ConclusionThe results of this study provide a baseline QoL in infertile couples in Taiwan, and could potentially be used as a guide for clinical counseling and future works.     

Patient satisfaction and disease specific quality of life after uterine artery embolization

OBJECTIVES: This study was undertaken to evaluate changes in fibroid specific symptom severity and health-related quality of life (HRQOL) after uterine artery embolization (UAE) and to consider the impact of these changes on satisfaction with the procedure. STUDY DESIGN: A validated, fibroid specific, symptom, and HRQOL questionnaire was mailed to 80 women who had undergone UAE from 1998 through 2002. Pre- and postprocedure symptom severity and HRQOL scores were obtained. The primary outcome measure was change in fibroid symptoms and HRQOL after UAE. Secondary outcomes included objective measures of patient satisfaction, and the decrease in uterine volume after UAE. RESULTS: Questionnaires were completed by 64 women (80.0%) at a mean of 32.1 months from UAE (range: 57.5-6 months). After UAE, mean uterine volume decreased by 26.3% (95% CI 19.6-33.0), and 17 of 79 women (21.5%) underwent an additional procedure after a mean of 18.6 months. Symptom severity scores decreased by a mean of 35.2% (95% CI 29.3-41.1) and HRQOL scores increased by a mean of 35.7% (95% CI 28.9-42.4). Satisfaction with UAE was correlated with the change in symptom severity and HRQL scores (P <.0001 and P=.0004, respectively) and the decrease in uterine volume after UAE (P=.0196). CONCLUSION: Women who undergo UAE have a significant decrease in symptom severity and increase in HRQOL, associated with high levels of satisfaction with the procedure, even when subsequent therapies are pursued.     

Contribution of demographic, psychological and disease-related factors to quality of life in women with high-grade vulval intraepithelial neoplasia

Women with VIN experience significant psychological morbidity. Psychological factors and to some extent demographic factors were much stronger determinants of QoL in women with VIN compared to clinical factors. Multidisciplinary management of these women should therefore be considered in order to take into account the psychological co-morbidity. Accurate written information should be provided about the risk of developing invasive disease.Further research is needed to establish a VIN-specific instrument to measure quality of life, the benefit of multidisciplinary input and the true impact of VIN on partners.

Conflict of interest statement

The authors declare that they have no conflicts of interest to disclose.     

Translation and validation of Taiwan Chinese version of the self-regulation questionnaire for gynecologic cancer survivors

ObjectiveTo culturally adapt the self-regulation questionnaire to the Taiwan Chinese version (TC-SRQ) and to evaluate its psychometric properties for gynecologic cancer survivors.Materials and methodsA cross-sectional study was employed with a purposive sample of 287 gynecologic cancer survivors. The TC-SRQ was adapted from a Germany version through back-translation to ensure its quality. For construct validity, confirmatory factor analysis (CFA) was used to assess the TC-SRQ measurement model with fit indexes including the χ² test, the root mean square error of approximation (RMSEA), and the normed fit index (NFI), the comparative fit index (CFI), and non-normed fit indices (NNFI). For concurrent validity, the Taiwanese version of the European Organization for Research and Treatment of Cancer's 30-item core quality of life (EORTC QLQ-C30) questionnaire was used as a criterion measure for quality of life (QOL). Reliability was evaluated by internal consistency and test-retest reliability.ResultsFor a modified measurement model of TC-SRQ, the model fit (χ² = 311.23, P = .0; RMSEA = .088; NFI = .97, CFI = .98, NNFI = .97) was acceptable. The evidence of construct validity of TC-SRQ scale was confirmed by the model estimates. TC-SRQ correlated positively with the global QOL, physical, cognitive, emotional, and social functioning domains, and negatively with fatigue and pain domains of EORTC QLQ-C30. For known groups validity, TC-SRQ was correlated with groups attributed by age, family support, health status, and sleep quality. A Cronbach's α of .91 indicated good internal consistency; the test-retest reliability was .82.ConclusionsTC-SRQ is a valid and reliable instrument for assessing self-regulation in gynecologic cancer survivors.     

Chronic pelvic pain and quality of life after laparoscopy

OBJECTIVES: To examine the long-term relationship between chronic pelvic pain (CPP) and quality of life and see if this is affected by a negative laparoscopy result. STUDY DESIGN: A postal questionnaire survey of CPP and quality of life in 63 women who underwent a diagnostic laparoscopy 12-18 months previously. RESULTS: Women with CPP still reported pain 12-18 months after laparoscopy and a significantly poorer quality of life than UK norms for women of a similar age. Factor analysis showed that reports of pain symptoms clustered into two dimensions: (1) pain associated with menstruation and (2) pain associated with sexual intercourse and bladder and bowel function. Most dimensions of quality of life were significantly associated with pain. However, 'role limitation due to emotional problems' and 'mental health' were only associated with pain due to sexual intercourse and bladder and bowel function. Pain and quality of life were not affected by laparoscopy result or follow-up appointment. CONCLUSIONS: Women with CPP continue to have pain and a low quality of life 12-18 months after laparoscopy. Laparoscopy results and follow-up appointments do not appear to affect either pain symptoms or quality of life in the long term, although this may be confounded by women obtaining treatment elsewhere.     

Cognitive function and quality of life in ovarian cancer

Objectives

As advances in treatment have prolonged survival for many patients with ovarian cancer, there has been growing interest in assessing the adverse effects of disease and treatment. The aim of this study was to review the literature on cognitive function and quality of life (QOL) in this population.

Methods

A review of published studies including formal assessment of neurocognitive functions and self-reported domains of quality of life, with an emphasis on cognitive function, was performed.

Results

The small number of studies including formal evaluations of neurocognitive function suggests that many ovarian cancer patients experience cognitive difficulties associated with their disease and treatment. Several studies described declines in self-reported cognitive function that may impact QOL, but the results were not consistent across studies.

Conclusions

Adequately powered longitudinal studies including formal neurocognitive and QOL assessments are needed to advance our understanding of the incidence of cognitive dysfunction and its impact on functional ability and QOL in ovarian cancer patients. These research efforts may ultimately contribute to treatment decision-making through the identification of vulnerable patients, and to the development of appropriate intervention strategies to improve cognitive function and QOL.     

Effect of infertility on quality of life of women: a validation study of the Turkish FertiQoL

The fertility quality of life (FertiQoL) measure specifically evaluates the impact of fertility problems in various life areas. The aim of this study was to examine the relationship between FertiQoL and the hospital anxiety and depression scale (HADS) in the Turkish population. All female patients who underwent various fertility treatments in our infertility clinic from May 2011 to May 2014 were approached to participate in the study and 389 completed the questionnaires. Our results showed that the four core scales of the FertiQoL measure had a Cronbach’s α value that was between 0.70 and 0.89. Two scales (anxiety and depression) of HADS both had a Cronbach’s α value of 0.80. These values present a reliable usage of FertiQoL and HADS measures (α?>?0.60). Significant negative correlations were found between the FertiQoL scales and HADS scales, ranging from ?0.27 (between relational scale of FertiQoL and anxiety scale of HADS) to ?0.65 (between mind–body scale of FertiQoL and depression scale of HADS). The results of this study provide supportive data to confirm that the Turkish version of FertiQol can accurately evaluate QoL in women who seek fertility treatment in Turkey.     

Characterizing anxiety,pain, sleep,and quality of life among patients in a state Medical Marijuana Program

BackgroundCannabis is increasingly used for symptom management, but its effects on health-related quality of life (QoL) have been inconclusive.ObjectivesThe goal of the present study was to characterize self-reported symptoms and QoL among patients certified to use medical cannabis.MethodsThese data are from the baseline assessment of a 12-month longitudinal study. The survey assessed certifying conditions, current medications, symptoms and symptom severity. QoL was assessed using the Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-Pal) which includes Physical Well-Being (PWB), Social/Family Well-Being (SWB), Emotional Well-Being (EWB), Functional Well-Being (FWB), and the Palliative Care subscale. Higher scores indicated better QoL.ResultsOverall, 210 patients (114 female, 92 male, 3 non-binary, 1 refused) completed the survey. The most common certifying conditions were pain (48.6%), anxiety (36.7%), and PTSD (15.7%) and the most common symptoms were anxiety (65.2%), pain (56.7%), sleep disturbance (38.6%), and depression (31.4%). Compared to normative data, this sample reported lower QoL, specifically EWB and SWB scores (i.e., T-Scores<45). Opioid/benzodiazepine/sedative-hypnotic use was associated with lower QoL on all subscales (except SWB and FWB) (ps < 0.05). Greater number of self-reported symptoms and medical conditions were associated with lower QoL (ps < 0.01).ConclusionDespite mixed evidence regarding cannabis’ efficacy for anxiety, 36.7% of the current sample were certified by a physician for anxiety. Lower QoL was associated with more self-reported comorbid medical conditions, higher total symptom count, and reported use of an opioid and/or benzodiazepine. Future longitudinal data will provide critical information regarding the trajectory of these symptoms and QoL.     

Caring for women with ovarian cancer in the last year of life: A longitudinal study of caregiver quality of life,distress and unmet needs

Purpose

Caregiver burden, quality of life (QOL) and unmet needs are poorly understood, particularly at the end of life. We explored these issues in caregivers of women with ovarian cancer.

Patients and methods

The Australian Ovarian Cancer Study (AOCS) is a prospective population-based study of women newly diagnosed with primary epithelial ovarian cancer. Ninety-nine caregivers of women participating in the AOCS QOL sub-study (88% response rate) rated their QOL (SF-12), psychological distress (HADS), optimism (LOT), social support (Duke) and unmet needs (SCNS-carers), and patients rated their QOL (FACT-O), every three months for two years. This analysis included measurements in the patient's last year of life.

Results

Caregivers had significantly lower mental and physical QOL than population norms (p < 0.01). Mean distress (p = 0.01) and unmet needs increased over time, however social support remained constant. In linear mixed models, (using scores for each psychosocial variable over time), optimism (p < 0.0001), social support (p < 0.0001), higher unmet needs (p = 0.008), physical wellbeing (p < 0.0001), and time to death (p < 0.0001) but not patient QOL, predicted caregiver mental well-being and distress. Highest unmet needs in the last 6 months related to managing emotions about prognosis, fear of cancer spread, balancing one's own and the patient's needs, impact of caring on work and making decisions in the context of uncertainty.

Conclusions

Aspects of caregiver functioning, rather than patient quality of life, predict caregiver quality of life and distress. Caregivers need help with managing emotions about prognosis, balancing their own and the patient's needs, work, and decision-making when there is uncertainty.     

Sit,breathe, smile: Effects of single and weekly seated Qigong on blood pressure and quality of life in long-term care

Long-term care (LTC) facilities house individuals with diverse combinations of cognitive and physical impairments, and the practice of Seated Qigong eliminates common exercise barriers. This study hypothesized: 1) a single session would lower blood pressure (BP) and improve quality of life (QOL) in a generalized LTC population, and 2) these responses would be attenuated with chronic (weekly) Seated Qigong practice. Ten residents (6 female; 86 ± 7 years) participated in 1X/week Seated Qigong sessions for 10-weeks. BP and QOL were assessed pre- and post-session at baseline and following 5- and 10-weeks of Qigong. Systolic BP was significantly reduced immediately post-session after 10-weeks of Qigong (P = 0.03), yet unchanged at baseline and after 5-weeks (all P > 0.05). Diastolic BP and QOL remained unchanged (P > 0.05). A session of Seated Qigong elicits a hypotensive response with exposure, supporting the notion that repeated sessions may provide advantageous health benefits.     

Persistent stress urinary incontinence during pregnancy and one year after delivery; its prevalence,risk factors and impact on quality of life in Taiwanese women: An observational cohort study

Objective

The study was to investigate the prevalence and risk factors of stress urinary incontinence (SUI) and its impact on the quality of life during pregnancy and 12 months after delivery.

Non-cancer life stressors contribute to impaired quality of life in ovarian cancer patients

Objectives

Diagnosis and treatment for a life threatening illness such as cancer are known to be psychologically impactful. However, little is known about the influence that non-cancer life stressors have on the quality of life (QOL) of ovarian cancer patients. The goal of the present study was to examine associations between non-cancer life stressors and QOL in 123 women with invasive epithelial ovarian cancer who were followed prospectively and longitudinally for one year.

Methods

Mixed models for repeated measures were used to examine the relationship between life stressors and QOL pre-surgery and one year later, while adjusting for age, cancer stage, depressive symptoms, anxiety, and chemotherapy status (at one year). Prospective associations between QOL pre-surgery and one-year QOL were also examined.

Results

Number and severity of life stressors were unrelated to QOL of participants before surgery. At one year, however, participants experiencing a greater number of life stressors reported poorer concurrent physical well-being (PWB) (p = 0.015), functional well-being (FWB) (p < 0.0001), social well-being (SWB) (p = 0.0003), and total QOL (p < 0.0001). Similar effects were found for life event severity. Finally, experiencing a greater number of life stressors pre-surgery predicted poorer overall QOL one year post-diagnosis (p < 0.0001).

Conclusions

Non-cancer life stressors can substantially impact long-term QOL of ovarian cancer patients, adjusting for medical variables such as chemotherapy and cancer stage, thus highlighting the importance of evaluating the stress burden of patients in ongoing cancer care.     

Maternal perceived quality of life following childbirth

OBJECTIVE: To examine preterm, near-term, and term mothers' self-reported quality of life in the early postpartum period. DESIGN: Prospective, longitudinal repeated measures design. SETTING: Four medical centers in the Midwest. PATIENTS/PARTICIPANTS: A convenience sample of 184 mothers of either a preterm, near-term, or term infant. MAIN OUTCOME MEASURE: Maternal Postpartum Quality of Life tool. RESULTS: Mothers of preterm infants scored significantly lower on the subscale psychological/baby of the Maternal Postpartum Quality of Life tool compared to mothers of near-term and term infants. CONCLUSIONS: Infant gestational age at birth has relevance for maternal quality of life during the postpartum period. Health care professionals need to be cognizant relative to infant gestational age and individualize nursing care.     

盆腔脏器脱垂患者阴道封闭术后生活质量调查分析

目的:评价阴道封闭手术对盆腔脏器脱垂患者生活质量的影响。方法:2003年3月至2009年5月北京大学人民医院妇产科为27例POP-Q分期Ⅱ～Ⅳ期的盆腔脏器脱垂患者实施了阴道封闭手术。患者填写术前及术后生活质量调查问卷。术后定期复查,判定主客观复发情况。结果:可进行生活质量评价的阴道封闭手术患者27例,均为联合盆腔缺陷。随访时间7～79个月,平均35.5个月,主观满意率96.3%,客观治愈率100%。术前及术后生活质量自评分有显著统计学差异(χ2=60,P<0.01)。术后患者性功能完全丧失,1例患者随访79个月,仍有下腹部及会阴部坠胀感。结论:老年女性特别是有合并症不能耐受较大手术的患者阴道封闭术疗效肯定,可显著改善患者术后生活质量,但术后患者完全失去性功能,且部分患者术后有下腹部及会阴部坠胀感,应引起重视。     

Prolapse severity, symptoms and impact on quality of life among women planning sacrocolpopexy.

OBJECTIVES: To explore the relationship between severity of pelvic organ prolapse (POP), symptoms of pelvic dysfunction and quality of life using validated measures. METHOD: Baseline data from 314 participants in the Colpopexy And Urinary Reduction Efforts (CARE) trial were analyzed. Pelvic symptoms and impact were assessed using the Pelvic Floor Distress Inventory (PFDI) and the Pelvic Floor Impact Questionnaire (PFIQ). PFDI and PFIQ scores were compared by prolapse stage and history of incontinence or POP surgery. Regression analyses were performed to identify other predictors of symptoms and impact. RESULTS: Women were predominantly (90%) Caucasian and had mean age of 61 years. Women with stage II POP, especially those with prior surgery, reported more symptoms and impact than women with more advanced POP. There were no other significant predictors of symptoms or life impact. CONCLUSIONS: Women planning sacrocolpopexy with stage II prolapse and prior pelvic surgery reported more symptoms and quality of life impact than those with more advanced prolapse.     

Self-efficacy,quality of life,and weight loss in overweight/obese endometrial cancer survivors (SUCCEED): A randomized controlled trial

Objective

More patient-centered programming is essential for endometrial cancer (EC) survivors needing to lose weight to reduce cardiovascular disease risk (CVD). The purpose of this study was to improve self-efficacy (SE) and quality of life (QOL) using a lifestyle intervention program designed for weight loss.

Methods

Overweight and obese early-stage EC survivors, n = 75, were randomized into two groups: 1) Survivors of Uterine Cancer Empowered by Exercise and Healthy Diet (SUCCEED), a six-month lifestyle intervention or 2) a usual care group (UC). Participants completed the Weight Efficacy Lifestyle Questionnaire (WEL) to assess SE and the Functional Assessment of Cancer Therapy—General (FACT-G) to measure QOL, and their body mass index (BMI) was calculated at baseline, 3, 6, and 12 months. Mixed, repeated-measures ANCOVA models with baseline covariates were employed using SPSS 20.0.

Results

Positive effects in every WEL domain, including the total score, were statistically significant in the SUCCEED group versus the UC group. A linear regression model demonstrated that, if BMI decreased by 1 unit, the total WEL score increased by 4.49 points. Significant negative correlations were found in the total WEL score and a change in BMI of R = − 0.356 (p = 0.006). Between-group differences in the FACT-G were significant from baseline in the fatigue domain at three months (p = .008) and in the physical domain at six months (p = .048). No other significant differences were found.

Conclusion

Overall, this study shows promise for targeted interventions to help improve SE, thus improving BMI.