The impact of symptoms, coping capacity, and social support on quality of life experience over time in patients with lung cancer

The aims of the study were to investigate lung cancer patients' quality of life (QoL) over time in a palliative setting and to determine how QoL is influenced by symptoms, coping capacity, and social support. One hundred and five consecutive patients with incurable lung cancer were included. A comprehensive set of questionnaires was used at baseline, including the Assessment of Quality of Life at the End of Life, Cancer Dyspnea Scale, Visual Analog Scale of Dyspnea, Hospital Anxiety and Depression scale, Sense of Coherence Questionnaire, and Social Support Survey, of which the first four were used also at three, six, nine, and 12 months. Dyspnea, depression, and global QoL deteriorated over time. Performance status, anxiety, depression, components of dyspnea, pain, and the meaningfulness component of coping capacity correlated with global QoL at all, or all but one follow-up measurements. In a multivariate analysis with global QoL as the dependent variable, depression was a significant predictor at four out of five assessments, whereas coping capacity, anxiety, performance status, pain, and social support entered the model at one or two assessments. Emotional distress and coping capacity influence QoL and might be targets for intervention in palliative care.     

焦虑障碍患者生活质量及相关因素研究——附163例报道

目的：探讨焦虑障碍患者的生活质量及相关影响因素。方法：对163例焦虑障碍患者和162名健康对照者进行WHO生命质量测定量表简表（WHOQOL-BREF）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、匹兹堡睡眠质量指数表（PSQI）和一般情况调查评定。分析比较检测结果。结果：焦虑障碍患者的WHOQOL-BREF各维度评分及总分均显著低于健康对照组（P〈0.01）,患者的SAS、SDS、PSQI评分均与WHOQOL-BREF总分及各维度评分呈显著负相关（r值-0.344~-0.627,P〈0.01）。结论：焦虑障碍患者的生活质量低于一般正常人群,患者的焦虑抑郁情绪以及睡眠质量等均影响其生活质量。     

Caregiver strain and factors associated with caregiver self-efficacy and quality of life in a community cohort with multiple sclerosis

Purpose. To describe the level of caregiver strain and factors associated with caregiver self-efficacy and quality of life (QoL) in a community cohort with multiple sclerosis (MS).

Method. A cross-sectional survey of 62 informal caregivers and 101 participants with confirmed MS and quantified physical and cognitive disability recruited from a tertiary hospital MS database. Structured interviews conducted at home using standardized assessments to measure: (i) Caregiver strain and subjective burden of care; (ii) participant with MS and caregiver QoL and self-efficacy; and (iii) participant with MS level of depression, anxiety and stress.

Results. The mean caregiver age was 54 years (range 37 - 62). The mean caregiver strain score was 5.63 (SD 3.63). Twenty-six of 62 (42%) caregivers reported strain for items such as emotional adjustments, demands on time, change in personal plan and disrupted sleep. Caregiver burden was higher in those caring for the more severely affected persons with MS, especially those with higher depression, anxiety and stress levels. The caregiver strain correlated with a lower QoL in both the person with MS and their caregiver, but not with their self-efficacy scores.

Conclusion. Caregivers of persons with MS reporting high levels of caregiver strain experienced a lower QoL and were caring for persons with MS with a lower QoL and higher levels of depression and anxiety. Interventions to reduce caregiver strain and burden in those at risk are necessary to reduce poor outcomes among both caregivers and care recipients with MS.     

Quality of life in patients with multiple sclerosis in Eastern Slovakia

Purpose.?Quality of life (QoL) is an important measure of the burden of disease and could be useful in evaluating patient management and practical interventions. The aim of this study was to explore the association of psychological and clinical variables with QoL in patients with multiple sclerosis (MS).

Methods.?One hundred and fourteen consecutive patients (mean age 36.1 ± 10.3 years, 72%% female) from one MS centre completed the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale and the Short-Form-36 Health Survey (SF-36). Functional disability was assessed using the Expanded Disability Status Scale. Multiple linear regression analyses were performed to analyse demographic, psychological and clinical data.

Results.?Functional disability, depression and fatigue were found to be related inversely to the physical health subscale. Disease course, anxiety and depression were associated negatively with the mental health subscale.

Conclusions.?Functional disability, depression and fatigue were the main variables related to the perceived physical health subscale, and disease course, anxiety and depression to the perceived mental health subscale in the group of patients with MS. Thus, effective treatment of fatigue, anxiety and depression could be assumed to increase a patient's QoL.     

Comorbidity of depressive and anxiety disorders in chronic daily headache and its subtypes

OBJECTIVE: To investigate the frequency of depressive and anxiety disorders in patients with chronic daily headache. BACKGROUND: There is a lack of data in the literature on the extent of psychiatric comorbidity in patients with different subtypes of chronic daily headache. METHODS: We recruited consecutive patients with chronic daily headache seen in a headache clinic from November 1998 to December 1999. The subtypes of chronic daily headache were classified according to the criteria proposed by Silberstein et al. A psychiatrist evaluated the patients according to the structured Mini-International Neuropsychiatric Interview to assess the comorbidity of depressive and anxiety disorders. RESULTS: Two hundred sixty-one patients with chronic daily headache were recruited. The mean age was 46 years, and 80% were women. Transformed migraine was diagnosed in 152 patients (58%) and chronic tension-type headache in 92 patients (35%). Seventy-eight percent of patients with transformed migraine had psychiatric comorbidity, including major depression (57%), dysthymia (11%), panic disorder (30%), and generalized anxiety disorder (8%). Sixty-four percent of patients with chronic tension-type headache had psychiatric diagnoses, including major depression (51%), dysthymia (8%), panic disorder (22%), and generalized anxiety disorder (1%). The frequency of anxiety disorders was significantly higher in patients with transformed migraine after controlling for age and sex (P =.02). Both depressive and anxiety disorders were significantly more frequent in women. CONCLUSION: Psychiatric comorbidity, especially major depression and panic disorders, was highly prevalent in patients with chronic daily headache seen in a headache clinic. These results demonstrate that women and patients with transformed migraine are at higher risk of psychiatric comorbidity.     

Caregiver strain and factors associated with caregiver self-efficacy and quality of life in a community cohort with multiple sclerosis

Purpose. To describe the level of caregiver strain and factors associated with caregiver self-efficacy and quality of life (QoL) in a community cohort with multiple sclerosis (MS).

Method. A cross-sectional survey of 62 informal caregivers and 101 participants with confirmed MS and quantified physical and cognitive disability recruited from a tertiary hospital MS database. Structured interviews conducted at home using standardized assessments to measure: (i) Caregiver strain and subjective burden of care; (ii) participant with MS and caregiver QoL and self-efficacy; and (iii) participant with MS level of depression, anxiety and stress.

Results. The mean caregiver age was 54 years (range 37 – 62). The mean caregiver strain score was 5.63 (SD 3.63). Twenty-six of 62 (42%) caregivers reported strain for items such as emotional adjustments, demands on time, change in personal plan and disrupted sleep. Caregiver burden was higher in those caring for the more severely affected persons with MS, especially those with higher depression, anxiety and stress levels. The caregiver strain correlated with a lower QoL in both the person with MS and their caregiver, but not with their self-efficacy scores.

Conclusion. Caregivers of persons with MS reporting high levels of caregiver strain experienced a lower QoL and were caring for persons with MS with a lower QoL and higher levels of depression and anxiety. Interventions to reduce caregiver strain and burden in those at risk are necessary to reduce poor outcomes among both caregivers and care recipients with MS.     

帕金森病患者睡眠障碍相关因素分析及其对生活质量的影响

目的探讨帕金森病(PD)患者伴发睡眠障碍(SD)的特点、影响因素、与运动症状(MS)及非运动症状(NMS)的相关性及其对患者生活质量的影响。方法收集2010年4月至2011年11月就诊于北京天坛医院神经内科的132例PD患者的人口学资料,采用匹兹堡睡眠指数量表(PSQI)、爱泼沃斯瞌睡量表(ESS)评估患者睡眠状况,完成相关MS、NMS及生活质量量表的评定。结果 (1)132例PD患者中86例(65.2%)伴发SD(PSQI评分≥5分),为SD组,PSQI平均分为(9.7±3.9)分;46例(34.8%)不伴发SD(PSQI评分<5分),为NSD组;同时完成ESS量表评定的114例患者中,15例(13.2%)有白天困倦(ESS评分≥10分),ESS平均分为(13.5±3.2)分,99例(86.8%)无白天困倦(ESS评分<10分)。(2)PD患者PSQI量表前三位因子及评测结果分别为白天功能紊乱(1.6±1.0)分,睡眠紊乱(1.3±0.5)分,主观睡眠质量(1.3±0.8)分。(3)SD组和NSD组除受教育水平(P=0.032)外,性别、年龄、起病年龄、病程、起病侧别及临床类型均无显著差异(P>0.05)。(4)SD组和NSD组除了统一帕金森病量表(UPDRS)Ⅲ评分外(P=0.007),H-Y分期、改良Webster评分、剂末现象个数、UPDRSⅣ评分均无显著差异(P>0.05)。(5)SD组NMS个数、运动症状期后NMS个数明显多于NSD组(P=0.000),而运动症状期前NMS无显著差异(P>0.05);SD组眩晕、噩梦、入睡困难、白天思睡、性生活障碍、性冷淡、焦虑、抑郁、淡漠、注意力下降、疼痛及梦游的发生率明显高于NSD组(P<0.05);SD组UPDRSⅠ、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、ESS、自主神经症状量表(SCOPA-AUT)、疲劳量表(FS-14)、疲劳严重度量表(FSS)及不宁腿综合征严重程度评定量表(RLSRS)评分均明显高于NSD组(P<0.05)。(6)SD组UPDRSⅡ、日常生活能力量表(ADL)评分明显高于NSD组(P<0.05);SD组39项帕金森病生活质量问卷(PDQL-39)量表评分明显低于NSD组(P<0.05)。(7)相关分析发现,焦虑、抑郁与PSQ     

Impact of yoga on psychopathologies and quality of life in persons with HIV: A randomized controlled study

BackgroundEvidence suggests that individuals with human immunodeficiency virus (HIV) often exhibit poor physical and mental health, which contributes to a reduced Quality of Life (QoL). Yoga is a form of alternative therapy that has positive influences on general health and QoL.ObjectivesThis study examined the effects of yoga on i) anxiety, depression, and psychological well-being and ii) QoL among individuals with an HIV positive status.MethodologySixty individuals with HIV-positive (aged 30–50 years) from rehabilitation centres across Bangalore were randomly assigned to the yoga intervention group (n = 30; 11 men) or the wait-listed control group (n = 30; 10 men). Participants in the yoga group underwent 8 weeks of intense yoga practice performed an hour a day for 5 days a week. The yoga practice consisted of physical postures, breathing practices, relaxation techniques, and meditation. Participants in the wait-listed control group followed their normal routine. Anxiety, fatigue, depression, and QoL were assessed twice for all subjects in each group – once at the start of the study to establish a baseline and once more at the end of the 2-month study period to assess any changes. Data analysis was performed on the assessments using SPSS software version 10.ResultsBetween group analysis demonstrated that a significantly different reduction in anxiety (p < 0.001), depression (p < 0.001), and fatigue (p < 0.001) was observed in the yoga group compared to the control group, as well as significant improvements in well-being (p < 0.001) and all domains of QoL (p < 0.001) in the yoga group compared to the control group.ConclusionThis study indicates that yoga intervention appears to improve the psychological health and QoL of individuals who are HIV-positive. Therefore, based on these findings, yoga may be recommended as a complementary therapy to enhance conventional HIV care.     

精神专科护士工作压力对抑郁焦虑情绪的影响

目的:探讨精神专科护士工作压力对抑郁、焦虑情绪的影响.方法:采用护士工作压力源量表、焦虑自评量表(SAS)以及抑郁自评量表(SDS)对106名精神专科在职护士进行调查.结果:精神专科护士的抑郁和焦虑情绪的检出率分别为51.9%和53.8%,有抑郁和焦虑情绪者的工作压力均明显高于无焦虑者(P＜0.01),抑郁、焦虑情绪与工作压力呈显著正相关关系(P＜0.01).结论:精神专科护士的抑郁、焦虑情绪明显,精神专科护理工作的特殊性对其抑郁、焦虑情绪具有重要影响.     

Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women.

The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (> or = 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.     

观察脑血管病合并睡眠障碍患者的认知行为与运动功能

目的:观察脑血管病合并睡眠障碍患者的认知行为与运动功能。方法:选取2020年6月至2021年6月内蒙古乌兰察布市中心医院收治的脑血管病患者100例作为研究对象,按照是否伴有睡眠障碍分为观察组和对照组,其中对照组46例,未合并睡眠障碍,观察组54例,合并睡眠障碍,采用爱泼沃斯嗜睡量表(Epworth Sleepiness Scale,ESS)、匹兹堡睡眠指数量表(Pittsburgh Sleep Quality Index,PSQI)比较2组患者的睡眠质量;采用肢体运动功能Fugel-Meyer(FMA)评定量表、简易智能精神状态量表(Mini-Mental State Examination,MMSE)、Loewenstein认知功能评定表(LOTCA)评估2组患者的运动功能与认知行为;采用心理健康评估量表比较2组患者的心理情况,主要从患者的躯体化、强迫症状、人际关系敏感、抑郁、焦虑、恐怖、敌对、偏执和精神病性等方面进行分析比较;采用生命质量综合评定问卷(Generic Quality of Life Inventory-74,GQOL-74)评估2组患者的生命质量。结果:与对照组比较,观察组脑血管病患者的ESS、PSQI评分显著高于对照组,2组比较差异有统计学意义(P<0.05);观察组脑血管病患者的FMA、MMSE与LOTCA评分显著低于对照组,2组比较差异有统计学意义(P<0.05);观察组脑血管病患者的GQOL-74生命质量评分显著低于对照组,2组比较差异有统计学意义(P<0.05);观察组脑血管病患者的心理健康评分显示患者的躯体化、强迫症状、人际关系敏感、抑郁、焦虑、恐怖、敌对、偏执、精神病性指标分值更高,2组比较差异有统计学意义(P<0.05)。结论:脑血管病合并睡眠障碍患者的睡眠质量较低,对运动功能与认知行为、生命质量以及心理健康造成不利影响,需采取相应的干预对策。     

心理干预对体像障碍患者情绪及生活质量的影响

目的探讨心理干预对体像障碍患者情绪及生活质量的影响。方法将64例体像障碍患者随机分为研究组和对照组各32例，研究组给予心理干预，观察3mo。分别于干预前后采用焦虑自评量表、抑郁自评量表、生活质量综合评定问卷观察两组患者情绪状态和生活质量的变化。结果焦虑自评量表、抑郁自评量表评分，研究组心理干预后较干预前均有显著下降（t=2．66、3．21，P〈0．05），且均显著低于对照组（P〈0．05）。对照组无显著变化。生活质量综合评定问卷测评研究组心理干预后躯体功能、心理功能、社会功能维度分均较干预前显著提高（t=2．61、2．54、2．92，P〈0．05），且均高于对照组（t=2．56、2．89、7．45，P〈0．05或0．01）。对照组均无显著变化。结论心理干预可改善体像障碍患者的焦虑抑郁情绪，提高其的生活质量。     

功能性消化不良者心理因素与食管动力的关系

目的探讨心理因素与功能性消化不良(FD)食管动力的关系。方法使用高分辨率旁道灌注测压系统对20例健康对照组及121例FD进行食管动力测定,同时以焦虑自评量表及抑郁自评量表评定两组的心理状态,并观察食管动力与心理状态的联系。结果9.8%(24/121)的FD患者有食管动力障碍,主要表现为非特异性食管动力障碍70.8%(17/24);胡桃夹食管2例、弥漫性食管痉挛5例;60.7%(73/121)的FD者有心理障碍,其中抑郁障碍38.0%(46/121)、焦虑障碍48.8%(59/121),对照组1例有轻度的抑郁障碍,P<0.01。有心理障碍FD者食管动力障碍发生率(26.0%,19/73)比非心理障碍FD者(10.4%,5/48)显著增高(P<0.05),且前者LES压力、食管体蠕动波幅、持续时间均显著高于后者(P<0.05)。结论食管动力障碍是FD重要功能紊乱之一,长期抑郁或焦虑可能影响FD食管动力。     

Impaired functioning and quality of life in severe migraine: the role of catastrophizing and associated symptoms

Migraine characteristics are associated with impaired functioning and quality of life (Fn/QoL), but the impact of other factors on Fn/QoL in headache patients is largely unexplored. We examined catastrophizing, comorbid anxiety/depression and migraine characteristics as related to Fn/QoL, and explored the consistency of these relationships across five Fn/QoL measures. We evaluated 232 frequent migraine sufferers for comorbid psychiatric diagnosis, and they completed anxiety, depression and catastrophizing measures, recorded migraine characteristics in a diary and completed five Fn/QoL measures (four self-report questionnaires, one diary disability measure). Backward regression revealed catastrophizing and severity of associated symptoms (photophobia, phonophobia, nausea) independently predicted Fn/QoL across all five measures (beta weights 0.16-0.50, all P < 0.01). This is the first demonstration that a psychological response to migraines (catastrophizing) is associated with impaired Fn/QoL independent of migraine characteristics and other demographic and psychological variables. Severity of associated symptoms also emerged as an important contributor to Fn/QoL.     

Quality of life and functional status of patients treated with venovenous extracorporeal membrane oxygenation at 6 months

PurposeQuality of life (QoL) outcomes of patients treated with extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) have been conflicting. This study reports on QoL outcomes for a broad group of ARDS patients managed with up-to-date treatment modalities.MethodsWe prospectively recruited patients at a quaternary hospital in the United Kingdom from 2013 to 2015 who were treated with ECMO for ARDS. We evaluated their pulmonary function and QoL at 6-months after admission using three QoL instruments: EuroQoL 5D (EQ-5), HADS, and PTSS-14.ResultsForty-three patients included in the analysis had near-normal pulmonary function at 6 months. HADS showed moderate-to-severe anxiety and depression in 32% and 11% of patients, respectively. PTSS-14 showed 29% had signs of post-traumatic stress disorder. EQ-5D showed that 67% of patients had difficulty returning to usual activities, 74% suffered some pain, none reported severe problems and 77% were able to return to work. No clinical or demographic variables were associated with poor 6-month QoL.ConclusionsPatients with ARDS treated with ECMO generally had good QoL outcomes, similar to outcomes reported for patients managed without ECMO. With respect to QoL, VV-EMCO represents a valid treatment modality for patients with refractory ARDS.     

Academic stress,COVID-19 anxiety,and quality of life among nursing students: The mediating role of resilience

Aim

This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic.

Background

The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students’ QoL remains understudied.

Methods

This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses.

Results

Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students.

Conclusions

Filipino nursing students' QoL was affected by academic stress and COVID-19–related anxiety. However, resilience mediated this impact, preserving QoL.

Implications for nursing and health policy

Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience.     

Quality of life of Nigerian stroke survivors during first 12 months post-stroke

There have been few studies on quality of life (QoL) of Nigerian stroke survivors and none have reported QoL over a long period. This study describes QoL in Nigerian stroke survivors over the first 12 months post-stroke. Sixty-five (33 male and 32 female) stroke survivors were recruited within 72 hours of stroke onset. QoL and depression were assessed monthly for 12 months using the Stroke-Specific Quality of Life Scale and Center for Epidemiologic Studies Depression Scale. Data were analysed using the KruskaleWallis test, Friedman test and logistic regression. Fifty-five participants (aged 57.4 ± 14.8 years) completed this study. QoL improved significantly from onset to 6 months but nonsignificantly from 6 months to 12 months. Most (85.2%) stroke survivors had severe depression at 1 month. At 3 months, marital status and spousal support had a significant positive influence on QoL. At 6, 9 and 12 months, marital status, spousal support, educational qualification, and occupational status had a significant positive influence on QoL. Depression was a major determinant of QoL at 3, 6, 9 and 12 months. Our findings suggest that QoL of Nigerian stroke survivors is low at stroke onset, increases steadily during the first 6 months and little between 6 months and 12 months post-stroke; is influenced positively by marital status, spousal support, educational qualification and occupational status; and negatively influenced by age and depression.     

Do patients undergoing physical therapy in a rehabilitation center have a high prevalence of pelvic floor dysfunction and psychological disorders? A cross–sectional study

BackgroundPrevalence of pelvic floor dysfunction (PFD) and its relationship with anxiety in a population undergoing physical therapy treatment in Rehabilitation Centers seems to have been little investigated in the literature.Objective1) to investigate the prevalence of PFD, anxiety, depression; 2) to assess quality of life (QoL) in patients undergoing physical therapy in a Rehabilitation Center, 3) to compare the results by sex; and 4) to assess the relationship between PFD and anxiety, depression, and QoL.MethodsThis cross-sectional study included participants receiving physical therapy care in a Rehabilitation Center. Validated questionnaires were used to assess PFD, QoL, depression, and anxiety. The Chi-square test, Pearson's correlation coefficient, and a binary logistic regression model were used for data analysis.Results253 participants (56.9% female) were included, 45% of them reported at least one PFD symptom. Females had higher prevalence of urinary incontinence (UI) (28% vs 14%); constipation (25% vs 10%); sexual dysfunction (75% vs 9%); anxiety (47% vs 35%); and depression (34% vs 17%) than males. A weak correlation was found between anxiety and depression with UI and sexual dysfunction for females. For all participants, poor QoL was found in physical functioning, physical role, bodily pain and emotional role. Being elderly (OR: 2.58 [1.24, 5.37]), partnered (OR: 1.82 [1.04, 3.17]), female (OR: 3.38 [1.91, 5.99]), and anxious (OR: 2.03 [1.14, 3.62]) were risk factors for reporting PFD.ConclusionThis study found a high prevalence of PFD symptoms in patients attending a Rehabilitation Center. All symptoms except fecal incontinence were more prevalent in females than in males. There was a weak correlation between UI with QoL and psychological disorders among females.