Quality of Life and Posttraumatic Stress Disorder: A Pilot Study Assessing Changes in SF-36 Scores Before and After Treatment in a Placebo-Controlled Trial of Fluoxetine

In this small pilot study, we evaluated quality of life for 16 posttraumatic stress disorder (PTSD) patients by administering the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) at baseline and endpoint during a 12-week double-blind trial of fluoxetine and placebo. At baseline, our subjects reported greater impairment relative to subjects with major depression or obsessive-compulsive disorder on several SF-36 domains. Significant effects of fluoxetine relative to placebo were observed for vitality, social functioning, and mental health. Overall, PTSD was associated with greatly reduced quality of life, but considerable improvement was achieved through treatment.     

Outcomes research in orthopaedics: health-related quality of life and the SF-36

There is no abstract available for this article.Arthroscopy 1998 Mar;14( 2):127-9     

Validation of an English Version of the Padova Quality of Life Instrument to Assess Quality of Life Following Ileal Pouch Anal Anastomosis

Objective  Ileal pouch anal anastomosis (IPAA) is the procedure of choice for most patients requiring surgery for ulcerative colitis and familial adenomatous polyposis because of its perceived improvement in health-related quality of life (HRQL). The aims of this cross-sectional study were to validate an English version of the Padova Inflammatory Bowel Disease Quality of Life questionnaire (PIBDQL) in patients undergoing IPAA and to investigate the pre- and postoperative predictors of long-term HRQL. Materials and Methods  In May 2005, the English version of the PIBDQL, Short Inflammatory Bowel Disease Questionnaire, and the SF-36 were mailed to 1,379 patients who underwent IPAA at the Mount Sinai Hospital between 1982 and 2004. The test–retest reliability, internal consistency, construct validity, and discriminative ability of the English version of the PIBDQL were assessed. Results  Nine hundred fifty-five patients (69%) (475 female, 480 male; mean, age 43 years) returned the questionnaires. The mean PIBDQL score was 21.1 (3.4), suggesting good quality of life. Test–retest reliability [intraclass correlation coefficient (ICC) = 0.784] and internal consistency (Cronbach’s α = 0.83) were good. Construct validity and discriminative ability of the English version of PIBDQL were adequate. Multivariate analysis revealed that women (p < 0.01) and Crohn’s disease patients (p < 0.01) had significantly worse PIBDQL scores. Conclusions  The English version PIBDQL is a reliable and valid disease-specific instrument for assessing quality of life in patients with IPAA. In this series, female gender and CD were significant predictors of worse HRQL. Presented as a poster at Digestive Disease Week, San Diego, California, May 21, 2008.     

Factors Predicting Health-Related Quality of Life Recovery in Patients Undergoing Surgical Treatment for Renal Tumors: Prospective Evaluation Using the RAND SF-36 Health Survey

Background

Most newly diagnosed kidney cancers present at localized stages. With appropriate treatments, the cancer-specific survival rates of such patients are extremely high, which makes patients’ health-related quality of life (HRQoL) a relevant issue. To date, most of the available studies on HRQoL have been biased by the absence of baseline HRQoL assessments and by retrospective designs.

Objective

To evaluate the baseline HRQoL of patients with kidney cancer, comparative HRQoL during the first year after surgery, and the prognostic factors predictive of HRQoL recovery.

Design, setting, and participants

We prospectively collected the data of all patients undergoing surgery for kidney tumors at a tertiary academic referral center from February 2006 to September 2007.

Interventions

Patients underwent nephron-sparing surgery (NSS) or radical nephrectomy (RN).

Measurements

Patients were invited to self-complete the validated, Italian version of the RAND 36-Item Health Survey 1.0 (SF-36) before surgery, 6 mo after surgery, and 12 mo after surgery.

Results and limitations

Overall, 129 consecutive patients were evaluated. No significant differences were found between the baseline scores of our patients and age- and sex-matched normative data for the Italian general population. Comparing the baseline SF-36 scores to those at 6 mo and 12 mo, there was statistically significant worsening in the physical domains and improvement in the emotional domains (all p < 0.05). About 50–80% of patients returned to baseline scores 6 mo and 12 mo after surgery. Age, body mass index (BMI), educational level, occupational status, New York Heart Association (NYHA) functional class, tumor mode of presentation, pathologic stage, size, and histologic subtype were associated with 6-mo and 12-mo return to the baseline HRQoL scores. The main limitation of the study was the lack of a disease-specific questionnaire.

Conclusions

Most patients returned to preoperative HRQoL within 12 mo after RN or NSS. Several patient features, clinical variables, and pathologic tumor variables predict the return of HRQoL.     

SF-36量表评价胸外科住院患者生活质量的信度和效度

目的 评价SF-36量表用于特定区域医学中心胸外科住院患者生活质量的信度和效度,以帮助该群体治疗和护理计划的制定。 方法 选取在2012年3～5月期间就诊于华西医院胸外科的患者95例,其中有效问卷94例,男68例、女26例,平均年龄 （62.0±13.0） 岁,术前诊断：肺鳞癌8例,肺腺癌6例,肺小细胞癌1例,食管癌12例,不明性质肺肿块67例。术后诊断：肺鳞癌39例,肺腺癌28例,肺小细胞癌8例,食管癌12例,肺结核3例,肺炎性假瘤4例。以SF-36量表中文版作为生活质量评价工具,以Cronbach＇s α系数和分半信度评价其信度,因子分析评价其效度。 结果 SF-36量表测量的各维度Cronbach＇s α系数为生理机能 （PF） 0.873,生理职能 （RP） 0.859,躯体疼痛 （BP） 0.888,一般健康状况 （GH） 0.721,精力 （VT） 0.899,社会职能 （SF） 0.852,情感职能 （RE） 0.872,精神健康 （MH） 0.598,分半信度系数为生理机能 （PF） 0.725,生理职能 （RP） 0.784,躯体疼痛 （BP） 0.789,一般健康状况 （GH） 0.758,精力 （VT） 0.749,社会职能 （SF） 0.745,情感职能 （RE） 0.740,精神健康 （MH） 0.426,结构效度检验共提取9个公因子,基本反映了量表的8个维度,与量表的结构构思基本相符。 结论 SF-36量表用于评价胸外科住院患者生活质量具有可靠的信度和效度。     

Long-Term Health-Related Quality of Life in Major Pediatric Trauma: A Pilot Study

Abstract Background:   Major trauma is the leading cause of mortality and morbidity in children of developed countries. Little research has been done about the health-related quality of life (HRQL) in these children. The aim of the current research is to describe the HRQL of children in the long term after major trauma and to compare it with healthy peers. Methods:   A prospective cohort study of severely injured children (ISS ≥ 16, age < 16 years) who survived the trauma and were admitted to the emergency department of a Dutch level 1 trauma center in 1999 and 2000 (n = 40) was conducted. Between 6 and 8 years after trauma (mean 7.3, SD 0.7 years), outcome was assessed by the Pediatric Quality of Life Inventory (PedsQL 4.0), the EuroQol 5D (EQ-5D), and the EuroQol Visual Analogue Scale (EQ-VAS). Results:   The mean age at the time of the accident was 8.9 years (SD 4.6 years), the mean ISS was 24.9 (SD 11.1), and 25 (63%) cases were male; 28 out of 40 patients were followed up. The mean score on the PedsQL was 81.2 and this did not differ significantly from the norm value. On the EQ-5D, more health problems were reported than in a healthy reference population. The mean EQ-VAS score was 79.4 and was significantly lower than in healthy peers. The lowest scores on the PedsQL and the EQ-VAS were seen in teenagers and in respondents with spinal cord and/or severe cerebral injury. Conclusion:   The results on HRQL in children in the long term after major trauma are inconclusive. Special attention should be given to teenagers with spinal cord or severe cerebral injury who reported the lowest HRQL.     

A Pilot Study of Noninvasive Methods to Assess Healed Acute and Chronic Wounds

BACKGROUND: A variety of instruments are available that can objectively assess physical parameters of the skin such as strength, firmness, elasticity, hydration, and color, often undetected by clinical assessment. OBJECTIVE: To assess the physical properties of healed acute and chronic wounds using several noninvasive instruments. METHODS: Four patients with healed acute wounds and four patients with healed chronic wounds were studied using ballistometric, impedance, levarometric, and spectrophotometric measurements. RESULTS: In general, scars were harder, less elastic, dryer, and more erythematous than control skin. These differences were more pronounced in healed chronic wounds. CONCLUSION: A scar from an acute surgical wound becomes softer, more elastic, dryer, less erythematous, and less pigmented as it ages. In contrast, chronic wound scars become harder as they age. These different properties of healed acute wounds and healed chronic wounds may be a result of the different healing processes in each wound type.     

Baseline Quality of Life and Anxiety in Solid Organ Transplant Recipients: A Pilot Study

BACKGROUND: Solid organ transplant recipients on high doses of immunosuppression are at increased risk for the development of nonmelanoma skin cancer (NMSC). OBJECTIVE: The objective was to assess the possible factors impacting quality of life (QOL) in solid organ transplant recipients. METHODS: Patients were seen in a dermatology clinic integrated within the transplant center at a university-based hospital. One anxiety questionnaire and three QOL questionnaires were administered to each patient. A regression model was used to determine possible predictors of anxiety and lower QOL. RESULTS: The baseline scores on the QOL instruments and anxiety questionnaire indicate poor organ-specific and general QOL as well as high levels of anxiety. Time since transplant was predictive of lower QOL as measured by Skindex-16 (p<.01). While not significant, number of NMSCs correlated with higher anxiety as measured by the STAI (p=.055). CONCLUSIONS: While transplant patients enjoy longer survival, the quality of the extended life has room for improvement. Future studies will determine how QOL changes over time as these patients develop more numerous and aggressive skin cancers. Intervention with regular screening may not only lessen morbidity associated with skin cancer but may improve overall QOL in the posttransplant period.     

Relationships between the Quality of Life Questionnaire (QLQ) and the SF-36 among young adults burned as children

Objective

To examine the relationship between two measures that can be used to examine quality life among pediatric burn survivors.

Design

Prospective, correlational study.

Setting

Acute and rehabilitation pediatric burn care facility.

Participants

Eighty young adult survivors of pediatric burns, who were 18–28 years of age, with burns of 30% or greater, and were at least 2 years after burn.

Interventions

Not applicable.

Main outcome measures

The SF-36 and the Quality of Life Questionnaire (QLQ) were used to assess participant's self-reported general health and long-term adjustment.

Results

Significant correlations (p ≤ 0.001) were found between the total quality of life score of the QLQ and the mental component scale of the SF-36. However, no significant correlations were found between the total quality of life score of the QLQ and the SF-36 physical component scale.

Conclusions

Approximately 100,000 children are treated for burns annually, with a high percentage surviving, creating a challenge for health care professionals who need to prepare burn survivors with their psychosocial and physical well-being as adults. This study found that the SF-36 and QLQ are measuring somewhat different aspects of psychosocial and physical adjustment. It is recommended that both tools could be useful to the burn practitioner in assessing quality of life.     

Bile Gastritis Following Laparoscopic Single Anastomosis Gastric Bypass: Pilot Study to Assess Significance of Bilirubin Level in Gastric Aspirate

Introduction

Laparoscopic single anastomosis gastric bypass (SAGB) is increasingly performed for morbidly obese patients.

Aim of Work

This pilot study aims primarily at evaluating the incidence of bile gastritis after SAGB. The occurrence of reflux oesophagitis and reflux symptoms were also assessed.

Patients and Methods

This study included 20 patients having no reflux symptoms. All patients underwent a SAGB as a primary bariatric procedure by a single surgeon. Patients included consented to have an upper GI endoscopy done at 6 months postoperatively. Gastric aspirate was sent for bilirubin level assessment. Gastric and esophageal biopsies were submitted for histopathology and campylobacter-like organism (CLO) test.

Results

In our study, the rate of bile gastritis was 30%. In 18 patients, the level of bilirubin in gastric aspirate seems to be related to the degree of mucosal inflammation. The remaining two patients had microscopic moderate to severe gastritis with normal aspirate bilirubin level. Two patients with bilirubin level in aspirate more than 20 mg/dl had severe oesophagitis, gastritis with erosions, and metaplasia. Relationship between bilirubin level and histopathological findings of gastric biopsy examination was statistically significant with a P value of 0.001.

Conclusion

The incidence of bile gastritis in this cohort is higher than reported in the literature, and this may be worrying. The correlation between endoscopic findings and patients’ symptoms is poor. Bilirubin level and pH in aspirate might be useful tools to confirm alkaline reflux. Its level might help to choose candidates for revision surgery after SAGB. This needs further validation with larger sample size.

     

Quality of Life in Bile Duct Injury: 1-, 5-, and 10-year Outcomes After Surgical Repair

Background

Quality of life after bile duct injury is a relevant health issue besides physician-oriented outcomes. A prospective study was performed to explore short- and long-term outcomes after surgical repair.

Method

We studied a cohort of patients with Strasberg E injuries who underwent Roux-en-Y jejunal anastomosis from 1990 to 2008. The Short Form Health Survey (SF-36) was selected as the appropriate quality of life assessment instrument. Two groups were comprised: Group I included patients with 10-year follow-up after surgery. Group II included patients operated during 2008 with preoperative 1- and 5-year questionnaires.

Results

Group I patients (N?=?41) were operated from 1990 to 2003 and Group II (N?=?44) during 2008. There is a significant improvement in quality of life after the first year of repair in all domains. Readmissions (48 vs 25 %; p?p?p?Conclusions Quality of life improves significantly after the first year of surgical repair, reaching a plateau at 5 years. No correlation exists with physician-centered outcomes.