Showing papers on "Quality of life published in 1995"
TL;DR: It is concluded that in addition to general HRQOL, disease-targeted measures must be used to assess outcomes of care in men treated for localized prostate cancer.
Abstract: Objective. —To assess health-related quality of life (HRQOL) in men treated for clinically localized prostate cancer. Design. —A cross-sectional analysis of HRQOL after treatment with radical prostatectomy, pelvic irradiation, or observation alone for clinically localized prostatic adenocarcinoma, and in age-matched comparison patients. Setting. —A large managed care population in California. Subjects. —A total of 528 men, including 214 treated for clinically localized prostate cancer (41 with evidence of metastatic disease were excluded from this analysis) and 273 age-matched, ZIP code—matched comparison patients without prostate cancer. Cancer patients were analyzed in three treatment groups: radical prostatectomy (n=98), primary pelvic irradiation (n=56), and observation alone (n=60). Main Outcome Measures. —General HRQOL was measured with the RAND 36-Item Health Survey 1.0. Cancer-specific HRQOL was measured with the CAncer Rehabilitation Evaluation System—Short Form and the Functional Assessment of Cancer Therapy—General form. Disease-targeted quality of life was measured with a new instrument assessing function and bother in three organ systems: sexual, urinary, and bowel. Results. —No differences among treatment groups were seen in comparisons of general HRQOL. Significant differences among treatment groups were seen in both function and bother in the prostate-targeted measures of sexual, urinary, and bowel domains. When cancer patients were compared with men of similar age without prostate cancer, differences were seen in the sexual, urinary, and bowel function and bother but not in general HRQOL measures. Although cancer-free men were found not to have full potency or continence, prostate cancer patients treated with surgery or radiation reported significantly worse sexual, urinary, and bowel function than men without cancer. Men who had undergone nerve-sparing prostatectomy did not differ from those who had undergone standard prostatectomy, but the power to detect a difference was low. Conclusions. —Although no differences were seen in general HRQOL, three disease-targeted domains were found to differ significantly among the treatment groups and comparison patients. Even after controlling for the sexual and urinary dysfunction experienced by older men without cancer, those receiving therapeutic interventions for their prostate cancer were found to have poorer disease-targeted HRQOL. We conclude that in addition to general HRQOL, disease-targeted measures must be used to assess outcomes of care in men treated for localized prostate cancer. ( JAMA . 1995;273:129-135)
1,013 citations
TL;DR: The importance of measuring the existential domain is highlighted by the finding that, of all the MQOL subscales and Spitzer items, only the meaningful existence subscale correlated significantly with a single item scale rating overall quality of life.
Abstract: This is the first report on the McGill Quality of Life Questionnaire (MQOL), a questionnaire relevant to all phases of the disease trajectory for people with a life-threatening illness. This questionnaire differs from most others in three ways: the existential domain is measured; the physical domain is important but not predominant; positive contributions to quality of life are measured. This study was conducted in a palliative care setting. Principal components analysis suggests four subscales: physical symptoms, psychological symptoms, outlook on life, and meaningful existence. Construct validity of the subscales is demonstrated through the pattern of correlations with the items from the Spitzer Quality of Life Index. The importance of measuring the existential domain is highlighted by the finding that, of all the MQOL subscales and Spitzer items, only the meaningful existence subscale correlated significantly with a single item scale rating overall quality of life.
701 citations
TL;DR: Further validation data on the FACT-G with a subsample of lung cancer patients from the original publication is reported and, more importantly, data is presented on the Lung Cancer Subscale (LCS) which was administered along with the F ACT-G to 116 patients with lung cancer.
660 citations
TL;DR: It is demonstrated that the QOL-CS and its subscales adequately measured QOL in this growing population of cancer survivors.
Abstract: A QOL instrument was developed to measure the specific concerns of long term cancer survivors. The QOL-CS is based on previous versions of the QOL instrument developed by researchers at the City of Hope National Medical Centre (Grant, Padilla, and Ferrell). This instrument was revised over a one year pilot by Hassey-Dow and Ferrell. The revised instrument included 41 items representing the four domains of quality of life incorporating physical, psychological, social, and spiritual well being. The present study was conducted as a mail survey to the membership (n = 1,200) of the National Coalition for Cancer Survivorship with 686 subjects responding to the survey. This survey included a Demographic tool, QOL-CS and the FACT-G tool developed by Cella. Psychometric analysis, performed on 686 respondents, included measures of reliability and validity. Two measures of reliability included test-retest and internal consistency. The overall QOL-CS tool test-retest reliability was 0.89 with subscales of Physical r = 0.88, Psychological r = 0.88, Social r = 0.81, and Spiritual, r = 0.90. The second measure of reliability was computation of internal consistency using Cronbach's alpha coefficient as a measure of agreement between items and subscales. Analysis revealed an overall r = 0.93. Subscale alphas average ranged from r = 0.71 for spiritual well being, r = 0.77 for physical, r = 0.81 for social, and r = 0.89 for psychological. Several measures of validity were used to determine the extent to which the instrument measured the concept of QOL in cancer survivors. The first method of content validity was based on a panel of QOL researchers and nurses with expertise in oncology. The second measure used stepwise multiple regression to determine factors most predictive of overall QOL in cancer survivors. Seventeen variables were found to be statistically significant accounting for 91% of the variance in overall QOL. The fourth measure of validity used Pearson's correlations to estimate the relationships between the subscales of QOL-CS and the subscales of the established FACT-G tool. There was moderate to strong correlation between associated subscales including QOL-CS physical to FACT physical (r = 0.74), QOL-CS Psych to FACT Emotional (r = 0.65), QOL Social to FACT Social (r = 0.44). The overall QOL-CS correlation with the FACT-G was 0.78. Additional measures of validity included correlations of individual items of the QOL-CS tool, factor analysis, and construct validity discriminating known groups of cancer survivors. Findings demonstrated that the QOL-CS and its subscales adequately measured QOL in this growing population of cancer survivors.
600 citations
TL;DR: Health status, functional status, and health-related quality of life have become synonyms for QOL in the clinical trials literature.
Abstract: Within the context of clinical trials, quality of life (QOL) is a multidimensional concept that encompasses health-related constructs, but excludes other dimensions such as economics, housing, or education. Most QOL research has been based on the World Health Organization (WHO) definition of health [1]: ‘Health is not only the absence of infirmity and disease but also a state of physical, mental and social well-being.’ Thus QOL encompasses all health-related outcomes beyond those of survival and physiological responses. Diseases and their treatments affect not only patients’ physical functioning and level of pain, but also their cognitive, emotional, and social functioning. QOL measures have also included assessments of sexual functioning, family and marital relationships, role performance, vitality, sleep, health perceptions, general life satisfaction, and symptoms such as nausea and fatigue. QOL assessment has been employed in developing individual patient treatment plans, performing cost-benefit analyses, making health policy decisions, and conducting clinical trial evaluations. Health status, functional status, and health-related quality of life have become synonyms for QOL in the clinical trials literature.
470 citations
TL;DR: The development and validation of a brain subscale for the FACT scale and the revalidation of the subscales of the general version (FACT‐G), which measure physical, social, family, emotional, and functional well‐being and the quality of the relationship with the physician are described.
Abstract: Background. This report describes the development and validation of a brain subscale for the Functional Assessment of Cancer Therapy (FACT) scale, and the revalidation of the subscales of the general version (FACT-G), which measure physical, social, family, emotional, and functional well-being and the quality of the relationship with the physician.
Methods. 101 patients with primary brain tumors, after giving informed consent, participated in the last two phases of a four-phase validation process: item generation, item reduction, validation, and reliability testing. In the validation phase, FACT-G subscale and total scores as well as the brain subscale scores were correlated with other tests of mood, response, bias, and quality of life (QOL). Test-retest reliability testing was performed with 46 patients who had primary brain tumors.
Results. Validity and reliability coefficients were high for the FACT-G and brain subscale, except for the comparison with a second QOL measure (FP-QLI) and the Karnofsky Performance Status (KPS). The lower scores were the result of inherent differences in the two QOL instruments and the relatively high performance status of the brain tumor patients, which restricted the KPS score range.
Conclusion. The FACT-G has good psychometric properties supporting its broad generalizability and the brain subscale tests substantially different QOL issues than the core instrument. Use of this scale with the addition of the brain subscale provides a well rounded view of the various aspects of QOL from the patient's perspective. With modifications and further psychometric testing, the brain subscale may have broader applicability to subpopulations of patients with other brain disorders. Cancer 1995;75:1151–61.
426 citations
Journal Article•
TL;DR: Cancer survivors experienced altered lives and had needs related to fear of recurrence and facing the spiritual aspects of having survived a life-threatening illness.
Abstract: Purpose/objectives To describe the quality of life (QOL) of long-term cancer survivors Design Descriptive, mailed survey Setting Membership of the National Coalition for Cancer Survivorship (NCCS), which is a nonprofit, peer-support network for people living with cancer Sample 687 (57%) of the 1,200 members of NCCS completed the survey The mean age of the sample was 496 years; 81% were female The predominant cancer diagnoses were breast (43%), lymphoma (9%), ovarian (8%), and Hodgkin's disease (8%) Methods Mailed survey using three instruments: a demographic tool, the Quality of Life-Cancer Survivors (QOL-CS) tool, and the Functional Assessment of Cancer Therapy-General (FACT-G) tool Main research variables Subscale and individual items of QOL including physical, psychological, social, and spiritual well-being Findings Results include areas of positive effects for cancer survivors and continued demands of survivorship Based on scoring of 0 (worst outcome) to 10 (best outcome), cancer survivors' mean QOL-CS subscores were 588 for psychological well-being, 659 for spiritual well-being, 662 for social well-being, and 778 for physical well-being Several demographic factors (eg, evidence of active disease; female gender; presence of spouse/partner or children; length of time since diagnosis; income) had significant influence on QOL Conclusions Cancer survivors experienced altered lives and had needs related to fear of recurrence and facing the spiritual aspects of having survived a life-threatening illness Implications for nursing practice The growing population of cancer survivors has long-term needs for nursing care that address multidimensional aspects of QOL
342 citations
TL;DR: The results demonstrate the ability of many Medicare patients to adapt to adverse outcomes, such as loss of sexual function and incontinence, and reinforce the importance of individualized decision making for patients facing a decision about radical prostatectomy for prostate cancer.
341 citations
TL;DR: Data indicate that the SWN is a useful tool for investigating a hitherto neglected psychopathological dimension in schizophrenic patients, and should be considered more thoroughly in clinical routine as well as in clinical trials of potential neuroleptic drugs.
Abstract: The benefit of neuroleptic drugs in the treatment of schizophrenic patients is objectively beyond any doubt. However, most patients discontinue their neuroleptic drugs within some months. This low compliance might be caused by the lack of insight into the disease and the necessity of therapy. Also of major importance are adverse effects, not restricted to motor symptoms, but also affecting cognition and emotion. They are often too subtle to be detected by objective examination, but reported by patients who complain of a reduced quality of life with restrictions of emotionality, straight thinking and spontaneity. This syndrome, similar to negative symptoms of schizophrenia, has been named 'pharmacogenic depression' or 'neuroleptic-induced deficit syndrome'. To investigate this issue of major clinical relevance, a self-rating scale was developed to measure subjective well-being under neuroleptic treatment (SWN). First analyses indicate good practicability, reliability, validity and sensitivity. Data obtained from 280 remitted schizophrenic patients showed that the SWN was significantly correlated to objective psychopathology (Positive and Negative Symptom Scale, PANSS; r = -0.35), quality of life (r = 0.60) and other self-ratings of mood states [Profile of Mood Scale (POMS), Self-rating Depression Scale (SDS), Befindlichkeits Scale (BFS); r = 0.25-0.75]. A repeated application after 3 months in 53 patients did not show any change in SWN in those with constant neuroleptic medication, but there were marked alterations if the dosage or the drug was changed. The SWN in 28 patients treated with clozapine because of therapy resistance or major side effects was, despite negative selection, significantly better (t = 1.79, p = 0.03) than in 38 patients under classical neuroleptics. Moreover, even at dismissal, patients who were non-compliant 4-6 months later (n = 14) differed significantly (t = 3.21, p = 0.02) in SWN, but not in PANSS, from those who remained compliant (n = 34). These data indicate that the SWN is a useful tool for investigating a hitherto neglected psychopathological dimension. Subjective effects of neuroleptics are measurable, affect patients' quality of life and should be considered more thoroughly in clinical routine as well as in clinical trials of potential neuroleptic drugs.
333 citations
TL;DR: Results suggest Quantitative quality of life assessments can be used in conjunction with formal neuropsychological testing of mood and cognition when evaluating patients with epilepsy.
Abstract: Objective: To examine the relationship of objectively assessed cognitive functioning to self-reported quality of life. Design: Correlational, multiple regression, and factor analytic comparisons of a new self-report quality of life inventory with neuropsychological tests of cognition and mood. Subjects: Two hundred fifty-seven patients with epilepsy. Setting: Twenty-five epilepsy centers and neurology clinics across the United States. Measures: A recently developed self-report (ie, Quality of Life in Epilepsy—89 inventory) and objective tests of memory, verbal abilities, spatial functions, psychomotor and cognitive processing speed, cognitive flexibility, and mood. Results: Factors that assessed mood, psychomotor speed, verbal memory, and language correlated significantly with selected scales of the Quality of Life in Epilepsy—89 inventory ( P P P r =−.20 to r =−.73) and was the strongest predictor of quality of life in regression analyses (46.7% explained variance, P Conclusions: Mood may be adversely affected by diminished quality of life, or perceived quality of life may be affected by mood disturbance. Quantitative quality of life assessments can be used in conjunction with formal neuropsychological testing of mood and cognition when evaluating patients with epilepsy.
302 citations
TL;DR: In this paper, the authors analyzed 32 universal human values (e.g., happiness, social order, and social justice) across 101 nations and found that wealth correlated significantly with 26 of the 32 values, indicating a higher quality of life in wealthier nations.
Abstract: Does economic prosperity enhance the quality of human life? Across 101 nations, 32 indices were analyzed that reflect a representative sample of universal human values (e.g., happiness, social order, and social justice). Wealth correlated significantly with 26 of the 32 indices, indicating a higher QOL in wealthier nations. Only suicide and CO2 emissions were worse in wealthier societies. Basic physical needs were met early in economic development, whereas advanced scientific work occurred only when basic physical needs were fulfilled for almost all people in the society. Limitations of the conclusions are discussed.
TL;DR: Preliminary results strongly support the importance of BIPAP in ALS patients, though further studies must go on in order to optimize the best time for introducing Bipap.
TL;DR: Patients' self-reported positive expectations were generally associated with good mood, adjustment to the illness, and quality of life, even in patients who experienced health setbacks, and high preoperative expectations predicted later adherence to a complex medical regimen.
Abstract: We explored the relations between positive expectations and adjustment, adherence, and health in cardiac transplant patients. Thirty-one patients and their nurse completed questionnaires before transplantation and at 3 times after surgery. As predicted, patients' self-reported positive expectations were generally associated with good mood, adjustment to the illness, and quality of life, even in patients who experienced health setbacks. High preoperative expectations predicted later adherence to a complex medical regimen. Positive expectations measured before the transplant predicted a substantial amount of the variance in the nurse's ratings of physical health 6 months after surgery, covarying for adherence behavior and preoperative health.
TL;DR: A new index of the quality of life (QOL) of nations was created by combining two indices, designed primarily to assess QOL in highly industrialized nations and between developing countries, which produced a reliable measure of QOL that systematically covers diverse human values.
Abstract: A new index of the quality of life (QOL) of nations was created. The measured variables are selected based on a universal set of human values derived from the work of Schwartz (1994). The Basic QOL Index, designed primarily to discriminate between developing countries, includes seven variables: purchasing power, homicide rate, fulfillment of basic physical needs, suicide rate, literacy rate, gross human rights violations, and deforestation. The Advanced QOL Index, designed primarily to assess QOL in highly industrialized nations, includes seven variables: physicians per capita, savings rate, per capita income, subjective well-being, percent attending college, income equality, and environmental treaties signed. Combining the two indices produced a reliable measure of QOL that systematically covers diverse human values. The nations scoring highest on the Combined QOL Index were Canada, Switzerland, Netherlands, U.S.A., and Norway, and those scoring lowest were Ethiopia and Rwanda.
TL;DR: The data suggest that many patients with heart failure would accept some risk of drug-induced death for improved quality of life, and a 5-point improvement in the Living With Heart Failure score may be clinically significant depending on costs and adverse effects.
TL;DR: Clinicians need to be aware of this morbidity, and their ability to detect patients with psychological problems needs to be improved, and the GHQ-20 can facilitate the communication process in a clinical setting.
Abstract: Long-term survivors of head and neck cancer may suffer from psychological distress and reduced quality of life because of late side-effects of the treatment. In a follow-up study of patients randomised to two different radiation fractionating regimens, 204 patients filled in a mailed questionnaire 7-11 years after treatment. The questionnaire consisted of the General Health Questionnaire, 20-item version (GHQ-20), and the EORTC Core Quality of Life Questionnaire (EORTC QLQ-C30). There were no differences in psychological distress between patients receiving conventional radiotherapy and those receiving a slightly hypofractionated regimen. A high prevalence of psychological distress was found in both treatment groups (30% of 'cases' according to the GHQ-20), especially in patients with impaired cognitive or social function, or with pain. Clinicians need to be aware of this morbidity, and their ability to detect patients with psychological problems needs to be improved. The GHQ-20 can facilitate the communication process in a clinical setting. With an increased awareness of these problems and by using valid instruments for identification of patients at risk, the clinicians may intervene and help the patients to reduce their psychological distress.
TL;DR: A seizure‐based surgery outcome system is derived that most closely reflects self‐reported health‐related quality of life (HRQOL) when applied over the latest 1‐year postoperative interval.
Abstract: Epilepsy surgery is an increasingly common treatment for intractable epilepsy; yet there is no clear consensus among experts on how to report epilepsy surgery outcome. Most published outcome reporting systems focus on seizure frequency and type but differ in how they define clinically distinct outcome categories. We used a reliable and valid measure of self-reported health-related quality of life (HRQOL), the Epilepsy Surgery Inventory (ESI)-55, as an external standard by which to evaluate seven previously published, seizure-based outcome classification systems. The ESI-55 was administered to 133 adults who had previously undergone surgery for intractable epilepsy, and results were linked to data on their seizure occurrence before and after surgery (over the year prior to their HRQOL reports). These 133 patients were classified according to each seizure-based outcome system, and variation in HRQOL across outcome groups was evaluated using analysis of variance. Results reveal noteworthy variation in the extent to which different systems reflect patients' HRQOL at follow-up. We modified existing systems to derive a seizure-based surgery outcome system that most closely reflects HRQOL when applied over the latest 1-year postoperative interval.
TL;DR: The indications for total abdominal hysterectomy for women with nonmalignant disease and the immediate (initial ten days) and medium term outcome are described.
TL;DR: Account must be taken of all symptoms at presentation, in addition to the traditionally recognised chest symptoms, in order to assess fully the benefit of palliative treatments in patients with lung cancer.
Abstract: The ten most frequently reported pretreatment symptoms on the Rotterdam Symptom Checklist, which was completed by more than 650 patients entering two MRC Lung Cancer Working Party multicentre randomised trials, included general symptoms (tiredness, lack of appetite) and psychological distress (worry, anxiety) in addition to disease-related chest symptoms (cough, shortness of breath). Although the number and severity of symptoms increased with worsening performance status, the commonest symptoms were found to be virtually the same for patients with small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC), and for different grades of performance status. Women with NSCLC reported more psychological symptoms than males, but this difference was much less evident in patients with SCLC. Thus, in order to assess fully the benefit of palliative treatments in patients with lung cancer, account must be taken of all symptoms at presentation, in addition to the traditionally recognised chest symptoms.
TL;DR: Almost all long-term survivors were leading full and meaningful lives, and demonstrated good mood and low psychological distress compared to cancer and population norms, and had the same perceptions as the general population of their current health and expectation of future health.
TL;DR: Dramatic improvements in health status and QOL occur after successful lung transplant and remain stable over time.
TL;DR: Patients treated surgically for intractable epilepsy had better seizure control with less antiepileptic medication, and there were no significant differences in employment status or prospectively assessed quality of life.
TL;DR: While many BMT recipients reported normal QOL, the majority indicated that their QOL was compromised relative to premorbid status, and evidence for improved functional status with the passage of time post BMT was obtained.
Abstract: Questionnaires assessing a range of quality of life (QOL) outcomes were completed by 200 adult bone marrow transplant (BMT) recipients from five BMT treatment centres. Respondents had undergone allogeneic (46%) or autologous BMT (54%) for a haematological malignancy and were disease free and at least 12 months post BMT (mean 43 months). Variability in post-BMT QOL was reported with deficits in physical, sexual and occupational functioning particularly likely. Allogeneic recipients reported poorer QOL than autologous recipients. Greater age at BMT, lower level of education and more advanced disease at BMT were consistent risk factors for poorer QOL. Contrary to previous research, evidence for improved functional status with the passage of time post BMT was obtained. Factors generally not associated with post-BMT QOL included disease diagnosis, dose of total body irradiation, presence of chronic graft-versus-host disease (GVHD), type of GVHD prophylaxis and extent of marrow graft match. In conclusion, while many BMT recipients reported normal QOL, the majority indicated that their QOL was compromised relative to premorbid status. Prospective, longitudinal research will be necessary to further identify risk factors for poor post-BMT QOL and identify the temporal trajectory of post-BMT QOL.
Journal Article•
TL;DR: The pain education program was effective in improving knowledge and attitudes regarding pain management and demonstrated the physical and psychological impact of family caregiving and pain management.
Abstract: Purpose/objectives To examine the impact of pain education on family members providing home care to elderly patients with cancer. Design Quasiexperimental. Setting Homes of selected patients from two California medical centers. Sample Fifty family caregivers of patients experiencing cancer-related pain. Methods The pain education program included three components: pain assessment, pharmacologic interventions, and nonpharmacologic interventions. Patients and their family caregivers were evaluated prior to initiation of the program and at one and three weeks following the interventions. Main research variables Quality of life (QOL); knowledge and attitudes about pain; and caregiver burden. Findings Findings based on measures of QOL and caregiver burden demonstrated the physical and psychological impact of family caregiving and pain management. Comparison between elderly patients with cancer and family caregivers revealed the pain experience's significant impact on family members caring for a loved one in pain. Conclusions The pain education program was effective in improving knowledge and attitudes regarding pain management. Implications for nursing practice Pain management is a priority for nurses, and use of interventions such as structured pain education improves QOL outcomes for elderly patients and their family caregivers.
TL;DR: Comparison of patients before RP with those after RP at 12 month follow-up revealed significant deterioration in sexual function, continence and hardship scores following RP while tension scores improved significantly, indicating minimal voiding and bowel dysfunction was reported.
Abstract: Objective To evaluate the impact of radical prostatectomy (RP) upon quality of life (QOL) in patients with prostate cancer.
Patients and methods Seventy-nine patients with prostate cancer were recruited to evaluate the impact of RP upon QOL. The patients comprised two groups: the first group (n= 51) was evaluated 12 months or longer after RP; and the second group (n= 28) was evaluated 1 month prior to RP. All patients completed two previously reported QOL measures: the Functional Living Index Cancer (FLIC) and Profile of Mood States (POMS), and a series of questions which evaluated bladder, bowel and sexual function.
Results Comparison of patients before RP with those after RP at 12 month follow-up revealed significant (P<0.05) deterioration in sexual function, continence and hardship scores following RP while tension scores improved significantly. Although 10 other subscale parameters were analysed, no other differences were observed. Of the 51 post-RP patients, 46 (90%) stated that given a choice they would have their surgery again.
Conclusion The Results reported show that RP has minimal overall impact upon patient QOL. Although minimal voiding and bowel dysfunction was reported, many patients were dissatisfied with post-operative sexual function.
TL;DR: It is concluded that quality of life may be more impaired in patients with functional dyspepsia than in Patients with other conditions, who present for upper endoscopy.
Abstract: Little information on functional status and well-being is available in patients with functional gastrointestinal disease. We aimed to evaluate whether quality of life is poorer in patients with functional dyspepsia. A consecutive sample of 73 patients with functional dyspepsia completed a validated questionnaire prior to endoscopy. Organic disease controls comprised 658 outpatients attending endoscopy. Quality of life was measured using the validated Medical Outcomes Survey (which assessed physical, role, and social functioning; mental health; health perception; and any bodily pain) and the Brief Symptom Inventory (for current anxiety and depression); additional specific gastrointestinal items were also included. A stepwise logistic regression analysis was used to assess the association between diagnostic group and the quality of life measures, adjusting for potential confounders. Patients who reported more interruptions in their daily activities due to abdominal pain and who had fewer limitations of physical functioning were more likely to have functional dyspepsia (vs other disease,P<0.01). Mental health, social functioning, and health perception also tended to be poorer in functional dyspepsia. We conclude that quality of life may be more impaired in patients with functional dyspepsia than in patients with other conditions, who present for upper endoscopy.
TL;DR: It is indicated that pain causes emotional distress in addition to the distress associated with the spinal cord injury itself.
Abstract: The prevalence and classification of pain were investigated in 46 patients admitted consecutively with traumatic spinal cord injury to a rehabilitation hospital. All were studied within 2 years of trauma. Forty-six percent experienced pain of moderate-to-severe intensity. The patients with pain were classified into five categories: diffuse pain, segmental pain, root pain, visceral pain and non-neurogenic pain. Most patients experienced more than one type of pain. Pain appeared more intense in the evening than in the morning or at noon. Older age (median 40 years vs 24 years) was related to increased prevalence of pain. Significantly more patients with pain (70%) than without pain (24%) had a case-score on the 20-item version of the General Health Questionnaire, indicating psychological distress and reduced quality of life. The present study indicates that pain causes emotional distress in addition to the distress associated with the spinal cord injury itself.
TL;DR: The need for an improved and more frequent assessment of ovarian cancer patients' psychological status, particularly as physical functioning declines, is suggested to improve early detection and referral to treatment of those suffering from psychiatric sequelae of cancer.
TL;DR: Total joint arthroplasty dramatically improves the quality of life and function of patients afflicted with arthritis; however, because of the poor ability of the SF-36 to predict postoperative improvement on an individual basis, it cannot be used alone to determine treatment selection.
Abstract: A group of 114 patients undergoing total hip and knee arthroplasty were evaluated to assess the effect of total joint arthroplasty on quality of life, as measured by the SF-36 Health Status Questionnaire, and to determine the predictive relationship between preoperative and postoperative scores. A highly significant improvement was seen comparing preoperative with postoperative scores at 2 years for physical function, social function, physical role function, emotional role function, mental health, energy, and pain. Despite a significant change in health status ( P ≤ .001), no change was seen in the patient's health perception ( P = .61). Regression analysis failed to indicate a predictive relationship between preoperative and postoperative scores for any scale. Total joint arthroplasty dramatically improves the quality of life and function of patients afflicted with arthritis; however, because of the poor ability of the SF-36 to predict postoperative improvement on an individual basis, it cannot be used alone to determine treatment selection.
TL;DR: This questionnaire differentiates clearly between the two clinically distinct groups of patients, but to be an entirely appropriate indicator of QOL in patients with oesophageal cancer, an additional specific oesphageal module including a dysphagia scale is required.
Abstract: Quality of life (QOL) measurement may aid decision making in the treatment of patients with oesophageal cancer but must be clinically valid to be useful. This study considered if the European Organisation for Research and Treatment of Cancer QOL questionnaire, the QLQ-C30, showed differing results in two clinically distinct groups of patients with oesophageal cancer and also investigated the correlation between dysphagia grade and various scales of QOL. Patients treated by oesophagectomy reported significantly better physical, emotional, cognitive, and global health scores than those in the palliative treatment group. Patients who received palliative treatment had significantly worse pain, fatigue, appetite loss, constipation, and dysphagia. The correlations between dysphagia grade and each of the QOL scales and items in both groups of patients were poor. This questionnaire differentiates clearly between the two clinically distinct groups of patients, but to be an entirely appropriate indicator of QOL in patients with oesophageal cancer, an additional specific oesophageal module including a dysphagia scale is required.