Students' Health-Related Quality of Life Across the Preclinical Pharmacy Curriculum

Objectives

To examine health related quality of life (HRQOL), perceived stress, and coping skills in the 3 preclinical years of a doctor of pharmacy (PharmD) curriculum.

Methods

Health-related quality of life, perceived stress, and coping strategies were measured using the Short Form-36, Perceived Stress Scale, and Brief COPE. Average annual scores were compared across curriculum years.

Results

Two hundred thirteen students enrolled in the study. Entering students had physical and mental HRQOL scores that were similar to age-adjusted US norms. Mental HRQOL scores were significantly lower and stress significantly higher during the second year of the PharmD curriculum compared to the first year (p < 0.05). Lower mental HRQOL scores were associated with increased stress and use of maladaptive coping skills in all years of the curriculum.

Conclusion

Increased stress and reduced mental HRQOL were observed across the first 3 years of a PharmD curriculum. Methods to reduce stress and/or use of maladaptive coping skills are needed to improve students'' HRQOL throughout the pharmacy curriculum.     

Health-related quality of life 10 years after oesophageal cancer surgery

PurposeTo determine whether oesophageal cancer survivors recover in health-related quality of life (HRQOL) within 10 years of surgery.MethodsA prospective, nationwide, population-based cohort study including 90% of all oesophageal cancer surgery patients in Sweden in 2001–2005, with follow-up through 2015. HRQOL was assessed 5 and 10 years postoperatively, using questionnaires for cancer in general (EORTC QLQ-C30) and oesophageal cancer specifically (EORTC QLQ-OES18). The HRQOL measures at 10 years after surgery were compared with the 5-year assessment. The 10-year HRQOL scores were compared with a population-based reference population (4910 individuals), individually matched for age, sex and comorbidity, by means of mean score differences with 95% confidence intervals.ResultsAmong 616 patients, 104 (17%) survived at least 10 years. Of these, 92 (88%) responded to the HRQOL questionnaires at 5 and 10 years after surgery. Among the responders, 71% were older than 70 years. Patients did not improve in HRQOL between 5 and 10 years. Instead, the scores for 23 out of 25 HRQOL aspects declined, with clinically relevant and statistically significant deterioration in role function and appetite loss. Compared to the reference population, the 10 year-survivors had worse scores in all 25 HRQOL aspects, with significant deterioration in global quality of life, role functioning, social functioning and most symptoms. The most severe problems compared to the reference population were reflux, eating difficulties, diarrhoea and appetite loss.ConclusionPatients who have undergone curative treatment for oesophageal cancer experience reduced HRQOL with persisting symptoms 10 years after surgery.     

Perceived information after surgery for colorectal cancer – an explorative study

Aim With fast track surgery and shorter hospital stay, discharge from hospital after cancer surgery is becoming more challenging for the individual patient. The aim of this study was to explore how patients perceive information after surgery for colorectal cancer, what their information needs are and to determine factors affecting received information. Method A hundred patients filled in the questionnaires QLQ‐C30, CR38 and INFO25 created by the European Organization for Research and Treatment of Cancer, the Eastern Cooperative Oncology Group (ECOG) instrument and the SOC (sense of coherence) instrument and provided written comments within the first 2 weeks after discharge following surgery for colorectal cancer. The questionnaires were analysed using hierarchical cluster analysis and a multiple linear regression analysis. The written comments were analysed using content analysis. Results In all, 49% of the patients expressed a need for more information. In the written comments they specified these areas of information: they lacked information concerning their surgery, how to handle symptoms and problems at home, someone to contact after discharge and prognostic information about their future. Patients reported most received information in areas of medical tests and disease but less on other services and support in outpatient care. The variation in INFO25 was best explained by gender (P = 0.045) and preoperative health status (American Society of Anesthesiologists score 3, P = 0.022). Conclusion The results from this study indicate that women and patients with a poorer preoperative health status scored less on information received and would need more time and support to prepare for discharge. The patients expressed a desire for more information about the surgery, how to handle symptoms at home and prognostic information about their future.     

Choosing the right survey—patient reported outcomes in esophageal surgery

Patient reported outcomes (PROs) fulfill a crucial and unique niche in patient management, providing health-care providers a glimpse into their patients’ health experience. This is of utmost importance in patients with benign and malignant disorders of esophagus requiring surgery, which carries significant morbidity, in part due to a high burden of symptoms affecting health-related quality of life (HRQOL). There are a variety of generic and disease-specific patient reported outcome measures (PROMs) available for use in esophageal surgery. This article provides a broad overview of commonly used HRQOL instruments in esophageal surgery, including their utility in comparative effectiveness research, prognostication and shared decision-making for patients undergoing surgery for benign and malignant disorders of the esophagus.     

The mediating effects of functions of social support on HIV-related trauma and health-related quality of life for PLHIV in China

ABSTRACT

The purpose of this study was to examine the effect of social support as a buffer between traumatic life events and HRQOL. We hypothesized that social support would mediate the effect of traumatic life events on HRQOL. A total of 2987 PLHIV participated in this study. The sample included 1876 (62.8%) males, and 1111 (37.2%) females. Data were collected using survey instruments measuring exposure to traumatic life events, functions of social support and HRQOL. The Structural Equation Model (SEM) produced a chi-square (χ²?=?486.63, df?=?32, p?<?.001) along with other goodness of fit indices such as CFI/TLI?=?.958/.941 and RMSEA?=?.069 (90%CI: .064, .074). Structural coefficients for traumatic life events, functions of social support, and HRQOL were statistically significant (≤.05). Crisis was the strongest predictor of traumatic life events, emotional support was the strongest predictor of functions of social support, and health distress was the strongest indicator of HRQOL. Traumatic life events had a significant direct effect on HRQOL. For PLHIV, experiencing a financial crisis associated with loss and/ or difficulty finding employment and enacted stigma were experienced as traumatic life events. Emotional support, described as having supportive interpersonal relationships, was identified as essential for HRQOL. Implications for interventions were discussed.     

Quality of life and mood in children with cystic fibrosis: Associations with sleep quality

Background

We aimed to investigate the relationship between sleep quality, mood and health-related quality of life (HRQOL) in children with CF and controls.

Further Validation of the IBS-QOL: Female Mexican IBS Patients Have Poorer Quality of Life Than Females from North Carolina

The Irritable Bowel Syndrome (IBS)-Quality of Life (QOL) is the most extensively validated health-related quality of life (HRQOL)-specific instrument for IBS with appropriate evidence for psychometric validity. Our aim was to linguistically validate the IBS-QOL for Mexico according to standard guidelines, to conduct further psychometric validation, and to compare the HRQOL between IBS patients from Mexico and North Carolina (University of North Carolina). Construct validity was tested by correlating scores from the Mexican Spanish IBS-QOL with those for anxiety and depression obtained by the Hospital Anxiety and Depression scale. Also, HRQOL from Rome I female IBS patients who consulted a tertiary referral center in Mexico was compared with that of female patients from UNC matched by age and bowel habit. A general univariate linear model was done to determine the most important variable over HRQOL, place of origin, or bowel habit. The majority of the IBS-QOL items had a negative correlation with depression as well as with anxiety. Compared to patients from UNC, the Mexican ones reported significant lower scores on Body Image and Health Worry and a trend in Interference with activities and in the Overall score. There were some differences in Dysphoria and Interference that were related to bowel habit, independently of the place of origin. In conclusion, the IBS-QOL validated in Mexican Spanish has shown construct validity. Using this instrument we found that female IBS patients who consulted a tertiary referral center in Mexico have lower HRQOL than those in North Carolina at least in factors such as Body Image and Health Worry.