Quality of Life in a US National Sample of Adults with Diabetes and Motility-Related Upper Gastrointestinal Symptoms

Our objective was to describe the health-related quality of life (HRQoL) of individuals with diabetes with and without motility-related upper gastrointestinal symptoms compared to individuals without diabetes. A total of 483 individuals with diabetes and 422 age- and gender-matched nondiabetic controls were recruited from a prior US national health survey for a telephone interview on upper gastrointestinal symptoms. Individuals with diabetes self-reported a physician's diagnosis of diabetes and provided confirming information on clinical management measures. Subjects were asked about upper gastrointestinal symptoms in the month before interview using an instrument with demonstrated high reliability. HRQoL was measured using the SF-12 Health Survey. Individuals with diabetes reporting upper gastrointestinal symptoms scored significantly lower in HRQoL measures of physical health and mental health than either individuals with diabetes who did not report upper gastrointestinal symptoms or individuals without diabetes (P < 0.0001). Individuals with diabetes and no upper gastrointestinal symptoms had physical and mental health summary scores similar to those of individuals without diabetes. Early satiety was the strongest predictor (P < 0.0001) of differences in physical health scores between individuals with and without diabetes. Nausea was the strongest predictor (P < 0.0001) of differences in mental health scores between individuals with and without diabetes. In conclusion, this is the first US national survey to demonstrate that motility-related upper gastrointestinal symptoms are associated with a significantly lower quality of life in individuals with diabetes.     

Quality of Life and Clinical Symptoms in Asthmatic Subjects

Objective: Quality of Life (QoL) measurements are more responsive to clinically significant changes than conventional clinical measures. The aim of the study was to evaluate the relationship between asthma symptoms and QoL in asthmatic patients. Methods: A total of 277 asthmatics subjects, divided into three groups showing different symptoms, underwent complete clinical evaluation, baseline respiratory function, and methacholine challenge test and completed an Asthma Quality of Life Questionnaire (AQLQ). Results: One hundred and forty‐five subjects with asthmatic crisis, chest tightness, and dyspnea (group 3) reported a significantly lower median value in single domains and all items compared to the values scored by the 97 subjects with wheezing, rhinitis, and conjunctivitis (group 2) (p < 0.01). No statistical significance was found between the 35 patients of group 1 (with only cough) and group 3. Conclusions: The main advantage for the clinician is to evaluate important areas in which QoL could be improved and the possibility to correct and optimize compliance to chronic therapy.     

A Longitudinal Analysis of the Efficacy of Environmental Interventions on Asthma-Related Quality of Life and Symptoms Among Children in Urban Public Housing

In an environmental intervention study in public housing, we examined monthly Juniper Paediatric Asthma Quality of Life (QOL) Questionnaires for 51 children. Longitudinal analysis and spline models were used to identify time periods with significant improvements in QOL to inform judgments about causality. We found significant improvements in QOL, with moderate improvements before environmental interventions, increased rates of improvement immediately after, and reduced rates more than 5 months post-intervention. Effect modification analyses identified high-risk subpopulations and emphasized the importance of environmental, social, and economic conditions. Our results demonstrate the value of longitudinal techniques in evaluating the benefits of environmental interventions for asthma.     

A Longitudinal Analysis of the Efficacy of Environmental Interventions on Asthma-Related Quality of Life and Symptoms Among Children in Urban Public Housing

In an environmental intervention study in public housing, we examined monthly Juniper Paediatric Asthma Quality of Life (QOL) Questionnaires for 51 children. Longitudinal analysis and spline models were used to identify time periods with significant improvements in QOL to inform judgments about causality. We found significant improvements in QOL, with moderate improvements before environmental interventions, increased rates of improvement immediately after, and reduced rates more than 5 months post-intervention. Effect modification analyses identified high-risk subpopulations and emphasized the importance of environmental, social, and economic conditions. Our results demonstrate the value of longitudinal techniques in evaluating the benefits of environmental interventions for asthma.     

Presence of Asthma with Night-time Asthma Symptoms is Associated with Impaired Health-Related Quality of Life in Children

Few studies have compared health-related quality of life between asthmatic and healthy children. This study used data from a cross-sectional survey of parents'/guardians of 406 children residing in rural areas. Multinomial logistic regression analysis was used to evaluate association between a categorical outcome variable (No asthma/No asthma symptoms; night-time asthma symptoms only; asthma diagnosis without night-time asthma symptoms; and asthma diagnosis with night-time asthma symptoms) and health-related quality of life indicators. Presence of night-time asthma symptoms among children with asthma was significantly associated with reduced health-related quality of life adjusting for other covariates. Children who had asthma without any night-time asthma symptoms did not have reduced health-related quality of life. Proper control of night-time asthma symptoms may help increase health-related quality of life in children.     

Quality of Life in Functional Dyspepsia

Our purpose was to assess the quality of life of functional dyspepsia patients using the SF-36 generic scale and the Gastrointestinal Symptoms Rating Scale (GSRS). In all, 328 dyspeptic patients were included in a multicenter, prospective, observational study. Both scales were filled out at baseline and one and three months after a prokinetic agent was given as a single-drug therapy. A total of 250 patients completed the study. An improvement in all SF-36 dimensions was observed, although the final scores were lower than the population reference values. Physical role (27% change), emotional role (20%), and physical pain (16%) dimensions showed the greater change. The GSRS total and domain scores also showed significant decreases. The best predictors of quality of life improvement were certain basal symptoms, drug compliance, and the absence of idiopathic dyspepsia. In conclusion, both the generic and the specific scales provide useful and sensitive measures of quality of life in functional dyspepsia patients on single-drug treatment.     

Urinary and Fecal Incontinence and Quality of Life in African Americans

OBJECTIVES: To investigate associations between quality of life (QoL) and incontinence in a population‐based African‐American sample. DESIGN: Cross‐sectional survey. SETTING: Metropolitan St. Louis, Missouri. PARTICIPANTS: Eight hundred fifty‐three non‐institutionalized African Americans aged 52 to 68 in the African American Health study. MEASUREMENTS: Respondents who reported having involuntarily lost urine over the previous month were classified as having urinary incontinence (UI), and respondents who reported having lost control of their bowels or stool over the past year were classified as having fecal incontinence (FI). QoL was measured using the Medical Outcomes Study 36‐Item Short‐Form Health Survey (SF‐36) and the 11‐item Center for Epidemiologic Studies Depression Scale (CES‐D). RESULTS: Prevalences of UI and FI were 12.1% (weighted n=102/841) and 5.0% (weighted n=42/841). Participants with UI and those with FI had worse SF‐36 scores than their referent groups (physical function ?15.5 and ?38.1 points, respectively; role physical ?13.2 and ?26.5 points; bodily pain ?15.7 and ?24.5 points; general health perceptions ?15.5 and ?27.6 points; vitality ?15.0 and ?16.5 points; social functioning ?18.4 and ?25.6 points; role emotional ?13.2 and ?22.1 points; mental health ?12.2 and ?17.5 points; all Ps<.001), adjusting for age, sex, body mass index, and chronic conditions. Proportions with clinically relevant levels of depressive symptoms were also higher in both groups (UI+17.9%; P<.001) and FI (+37.2%; P<.001) than in their referent groups. CONCLUSION: UI and FI were strongly associated with worse health‐related QoL as well as symptoms of depression in this population‐based sample of African Americans.     

IBS-Like Symptoms in Patients with Inflammatory Bowel Disease in Remission; Relationships with Quality of Life and Coping Behavior

The aim of this study was to assess the prevalence of irritable bowel syndrome-like symptoms in healthy controls and inflammatory bowel disease patients in remission using the Rome II criteria. Furthermore, the possible relation of irritable bowel syndrome-like symptoms with the quality of life and coping behavior was studied. Seventy-three ulcerative colitis patients in remission, 34 Crohn's disease patients in remission, and 66 healthy controls completed questionnaires on irritable bowel syndrome, quality of life, and coping. Using the Rome II criteria, irritable bowel syndrome-like symptoms were found in one-third of ulcerative colitis patients and in 42% of Crohn's disease patients in remission. The presence of irritable bowel syndrome-like symptoms impaired the quality of life of patients, while no relation was found between the presence of symptoms and coping strategies.     

不同过敏原对变应性鼻炎患者症状及生活质量影响的比较

目的探讨武汉地区常见过敏原——尘螨和艾蒿所致的变应性鼻炎(AR)患者之间的症状严重程度以及对患者生活质量影响的差异。方法选取经血清变应原特异性IgE(sIgE)检测的单一对尘螨过敏的变应性鼻炎患者46例、单一对艾蒿过敏的变应性鼻炎患者39例。用症状视觉模拟评分量表(VAS)评价患者症状的严重程度;用鼻结膜炎相关生活质量问卷(RQLQ)评价患者的生活质量。通过对调查结果的分析判断,对比2种不同过敏原所致变应性鼻炎患者VAS和RQLQ评分,并初步计算同种过敏原不同性别之间、同性别不同过敏原间患者症状及生活质量影响的差异。结果对尘螨过敏的变应性鼻炎患者在VAS得分各方面均较艾蒿组高,其中2组之间鼻部症状差异有统计学意义(P<0.05),眼部以及胸部症状差异无统计学意义(P>0.05)。尘螨组及艾蒿组内男性和女性之间各项症状差异均无统计学意义(P>0.05);两过敏原组之间男性和男性、女性和女性相比,除鼻部症状差异有统计学意义(P<0.05)外,其余症状差异无统计学意义(P>0.05)。RQLQ评分两过敏原组差异无统计学意义(P>0.05),尘螨组及艾蒿组内男女之间相比除鼻炎相关行为和情感反应项目得分差异有统计学意义(P<0.05)外,其余生活质量评分项目差异无统计学意义(P>0.05);两过敏原组之间男性和男性,女性和女性相比各项生活质量评分差异均无统计学意义(P>0.05)。结论由尘螨和艾蒿所致的变应性鼻炎患者的症状存在差异,尘螨所致的变应性鼻炎患者症状较重;这2种过敏原均影响变应性鼻炎患者的生活质量,但两者之间无明显差异。     

Correlations among Lower Urinary Tract Symptoms,Bother, and Quality of Life in Patients with Benign Prostatic Hyperplasia and Associated Fluctuations with Tamsulosin Administration

Objectives: To estimate correlations among lower urinary tract symptoms (LUTS), bother, and quality of life (QOL) and assess fluctuations in these parameters after α1‐blocker administration in patients with benign prostatic hyperplasia (BPH). Methods: Untreated BPH patients with international prostate symptom scores (IPSS) ≥ 8 and IPSS‐QOL scores ≥ 2 were administered tamsulosin at 0.2 mg/day for 4 weeks in a prospective multicenter study. We subsequently estimated the IPSS, bother score for each IPSS item, BPH impact index (BII), and IPSS‐QOL score before and 4 weeks after tamsulosin administration. We also analyzed the LUTS that might strongly influence QOL by using a path analysis model. Results: Analyzable data were obtained from 198 of the 257 patients enrolled. The IPSS were highest for LUTS such as slow stream, followed by increased daytime frequency and nocturia. The bother score was highest for slow stream, followed by nocturia. We observed dissociations between IPSS and bother scores for both urgency and nocturia. After tamsulosin administration, total and individual IPSS, total and individual bother scores, total and individual BII scores, and IPSS‐QOL score demonstrated significant improvements. Path analysis showed that physical discomfort and bothersomeness were BII items that strongly influenced QOL. Furthermore, feeling of incomplete emptying, urgency, and slow stream were LUTS that strongly influenced QOL. Conclusion: Tamsulosin administration improved patient QOL by possible mechanisms via improvement in subjective symptoms and bother. The LUTS that strongly influenced QOL comprised feeling of incomplete emptying, urgency, and slow stream.     

Quality of Life and Measures of Asthma Control in Primary Health Care

Aim. To study quality of life and asthma control in primary care. A total of 1,477 patients 15 to 45 years of age received questionnaires regarding asthma control (77% responded) and quality of life, Mini Asthma Quality of Life Questionnaire (MiniAQLQ), (74% responded). Patients using short-acting beta-agonists more than twice in the last week had clinically significant lower MiniAQLQ scores (5.17 versus 5.91). This finding was consistent for night awakenings during the previous week (4.42 versus 5.86), courses of oral corticosteroids (4.82 versus 5.69), and reported emergency consultations during the last 6 months (4.85 versus 5.71). Good asthma control is associated with better quality of life in asthma patients in primary care.     

Quality of Life and Measures of Asthma Control in Primary Health Care

Aim. To study quality of life and asthma control in primary care. A total of 1,477 patients 15 to 45 years of age received questionnaires regarding asthma control (77% responded) and quality of life, Mini Asthma Quality of Life Questionnaire (MiniAQLQ), (74% responded). Patients using short-acting beta-agonists more than twice in the last week had clinically significant lower MiniAQLQ scores (5.17 versus 5.91). This finding was consistent for night awakenings during the previous week (4.42 versus 5.86), courses of oral corticosteroids (4.82 versus 5.69), and reported emergency consultations during the last 6 months (4.85 versus 5.71). Good asthma control is associated with better quality of life in asthma patients in primary care.     

Gender Differences in Asthma Management and Quality of Life

We mailed a survey to a sample of adults with persistent asthma to assess gender differences in asthma management and quality of life. Women were more likely to regularly use a peak flow meter, have a regular clinician for their asthma care, and to have a written asthma management plan. No gender differences in self-reported asthma severity were observed, and men and women ranked their knowledge and confidence in their self-management skills similarly. Women reported significantly worse health status than men, but the differences observed were small and were attenuated after adjusting for socioeconomic status, smoking, body mass index, and comorbid illness.     

Symptoms Burden and Health-related Quality of Life in Chinese Patients with Primary Biliary Cholangitis

Background and AimsPrimary biliary cholangitis (PBC) is a chronic liver disease that negatively affects the health-related quality of life (HRQoL) of patients. Furthermore, the HRQoL of Chinese patients has been neglected for a long time. The present study aimed to assess the HRQoL of Chinese patients with PBC and explore the clinical variables correlating to the improvement of itch and fatigue.MethodsThis was an observational, cross-sectional study. The PBC-40 and itch numerical rating scales were used to evaluate the symptoms and HRQoL of patients.ResultsA total of 383 patients were recruited, and 86.4% were female, with a median age of 55 years (range: 49–63 years). We found that females had significantly higher scores than males in symptoms (p=0.033) and cognitive domains (p=0.021), and the fatigue domain was higher in elderly patients (p=0.007). Meanwhile, patients whose body mass index was <18.5 had the highest scores in the symptoms (p=0.009), fatigue (p=0.010), and cognitive (p=0.019) domains. Age at participation (odds ratio [OR]=1.068, p=0.015) and albumin level at 12 months after ursodeoxycholic acid treatment (OR=208.807, p=0.025) were independent factors that affected the improvement of the itch and fatigue domains, respectively.ConclusionsThe HRQoL of Chinese patients with PBC was significantly impaired depending on sex, age, and body mass index. Age and albumin level were significantly associated with the improvement of itch and fatigue, respectively. Therefore, treatment and support aimed at these two factors can be provided to improve the HRQoL of patients.     

Efficacy of Propiverine in Improving Symptoms and Quality of Life in Female Patients with Wet Overactive Bladder

Objectives: The present prospective study was conducted to assess the effects of propiverine hydrochloride in improving symptoms and quality of life (QoL) in female patients with wet OAB. Methods: Propiverine was administered orally for 8 weeks to 58 female patients who had urgency incontinence. Prior to administration, and at 4 and 8 weeks after administration, symptoms and QoL of the patients were assessed using a micturition diary, the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF), and the King's Health Questionnaire (KHQ). In addition, the relationships between changes in frequency of urinary incontinence or amount of urine leakage following treatment and changes in each domain of the KHQ were investigated by multiple regression analysis. Results: After administration of propiverine, the mean numbers of daily micturitions, incontinence episodes, and urgency episodes assessed on the basis of the micturition diary significantly improved in comparison to the baseline: from 11.7 to 9.6 for daily micturitions, from 2.8 to 1.1 for incontinence episodes, and from 5.9 to 2.3 for urgency episodes in 8 weeks. The mean of the ICIQ‐SF total scores significantly decreased, from 8.4 to 4.6 points at 4 weeks and to 3.6 points at 8 weeks. The mean scores for three individual items in the ICIQ‐SF, namely, frequency of incontinence episodes, amount of leakage, and impact on everyday life also significantly improved. The KHQ scores significantly improved at both 4 and 8 weeks post‐administration in all domains except personal relationships. In the multiple regression analysis, improvement in frequency of incontinence was significantly related to the domain of severity measure of the KHQ, while improvement in amount of leakage was significantly related to the domains of general health perception and social limitations. Conclusion: Propiverine hydrochloride contributed to improvements not only in symptoms but also in QoL in female patients with wet OAB.