Health Related Quality of Life and Mental Health in ICU Survivors: Post-Intensive Care Syndrome Follow-Up and Correlations between the 36-Item Short Form Health Survey (SF-36) and the General Health Questionnaire (GHQ-28)

We investigated the relationship between health-related quality of life (HRQOL) and psychological distress in intensive care unit (ICU) survivors 12 months after ICU discharge. The purpose of this study, conducted and completed before the onset of the COVID-19 pandemic, was to find correlations among psychiatric symptoms detected by a screening tool as the General Health Questionnaire-28 (GHQ-28) and the different domains of HRQOL measured with the SF-36 health survey (SF-36), in order to identify ICU survivors with Post-Intensive Care Syndrome (PICS) who need a specific psychiatric intervention to improve their HRQOL. Among 298 ICU survivors who stayed in the ICU for at least 72 hours, 48 patients were enrolled one year after discharge undergoing a clinical interview to assess their functional impairment (Barthel index), mental health (GHQ-28), and health-related quality of life (SF-36). 19% of those subjects had a GHQ-28 ≥ 5 and were identified as “psychiatric cases”, and they were older and experienced a greater impairment in HRQOL. Anxiety, insomnia, and depressive symptoms seemed to be particularly involved in the impairment of HRQOL. A negative correlation between GHQ-28 total scores and subscales and SF-36 subscales was found. Our findings highlighted that psychological distress in ICU survivors may negatively impact physical health recovery and quality of life;conversely, physical impairment and functional disability may trigger the onset of psychiatric symptoms after discharge. The present study is firstly to investigate the correlations between HRQOL and psychological distress in ICU survivors through the GHQ-28, and then affirms the need to carry out follow-up checks for psychiatric symptoms in ICU survivors.

Smoking and Health-Related Quality of Life(SF-36).A Population-Based Study in Campinas,SP,Brazil

Introduction: Smoking persists as a global and relevant health problem being one of the major risk factors to non-communicable diseases and early death. Studies on the association between smoking and health related quality of life (HRQL) are scarce in Brazil and Latin America. The aim of this study was to analyze the HRQL according to smoking status on adults aged 20 to 59 years, living in Campinas, Brazil. Method: It is a population-based cross-sectional study, carried out with data from the Campinas Health Survey developed in 2008/2009. The dependent variables were the eight scales and the two components—physical (PCS) and mental component summary (MCS) of the instrument SF-36, version 2. Means and confidence intervals of the SF-36 scale scores and components were estimated according to smoking (never smokers, former smokers, current smokers) and nicotine dependence (mild, moderate, heavy). Results: The sample comprised 957 individuals (mean age of 37.5 years). Comparing with never smokers, smokers had lower score means in all SF-36 scales, except in physical functioning and role-physical;among the former smokers, lower scores were observed in vitality and mental health. A reduction of the MCS score was observed among smokers and former smokers among men;but in the female population, this reduction was observed only in smokers compared with never smokers. According to the nicotine dependence, it was observed an increasing reduction in MCS scores from mild, to moderate and heavy smokers. Conclusion: Smoking is significantly and negatively associated with HRQL in the studied population. The results point out the importance of the strategic policies against smoking, to reduce morbidity and premature death, but also to increase the quality of life and well-being. It is also important to consider the mental health dimension, since that best mental health can be relevant to promote healthier behaviors.

Physical Activity Level and Adult Saudi Health Related Quality of Life

Purpose: Physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to define the relationship between the physical activity level (PAL) and adult Saudi health-related quality of life (HRQoL). Methods: Participants of this study were 100 Saudi adult aged from 18 - 70 years. The 36-Item Short-Form Health Status Survey (SF-36) was used to measure the participant’s HRQoL. The SF-36 is comprised of 8 domains. The electronic version of the General Practice Physical Activity Questionnaire was used to categorize participants in terms of physical activity level into;inactive, moderately inactive, moderately active, and active. Descriptive and inferential statistical tests were used to treat the collected data. Results: Results showed that only 17% of the Saudi adults had active PAL. The PAL had significantly positive relationship with 4 domains of HRQoL including: physical functioning (P = 0.004), role limitations caused by physical health problems (P = 0.048), vitality (P = 0.009), and general health (P = 0.044). Results also confirmed that the younger the subject, the higher the PAL (P = 0.0001) and the better the HRQoL. This is true for all domains except the role limitations caused by emotional problems and emotional wellbeing. Conclusion: The poor physical activity level of adult Saudi negatively impacts their HRQoL.

Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy

BACKGROUND A large number of adults with long-term type 1 diabetes are affected by symmetrical peripheral neuropathy.These complications increase socioeconomic expenses and diminish the individual quality of life.The 36-Item Short Form Health Survey(SF-36)is a generic patient reported questionnaire,measuring mental and physical health related quality of life.We hypothesized that diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and that clinical appearance may be associated with the decline.AIM To investigate if diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and if clinical appearance may be associated with the decline.METHODS Forty-eight adults[age 50±9 years,10 females,disease duration 32(14-51)years]with verified diabetic symmetrical peripheral neuropathy and 21 healthy participants(age 51±6 years,6 females)underwent standardised nerve conduction testing and completed the SF-36 questionnaire.Furthermore,disease duration,number of comorbidities,both diabetes related and nondiabetes related,vibration perception threshold,number of hypoglycaemic events,HbA1c and administration way of insulin was notified.RESULTS In comparison to healthy subjects,patients’mental composite score was not significantly diminished(51.9±8.9 vs 53.1±5.5,P=0.558),while the physical composite score was(46.3±11.7 vs 54.6±3.3,P=0.002).As expected,the overall physical health related symptoms in patients were associated to total number of comorbidities(P<0.0001),comorbidities relation to diabetes(P=0.0002)and HbA1c(P=0.005)as well as comorbidities not related to diabetes(P=0.0006).CONCLUSION The finding of this study emphasises the importance of focusing on quality of life in adults with diabetes and especially in those with multiple comorbidities as well as the possibility of HbA1c as a biomarker for severe complication.

PDCA nursing in improving quality management efficacy in endoscopic submucosal dissection

BACKGROUND Endoscopic submucosal dissection(ESD) is a common surgical strategy for the treatment of early gastrointestinal tumors and precancerous lesions.PDCA nursing can effectively prevent potential risks in the nursing process,protect patient privacy,and improve patient satisfaction,nursing integrity,and service quality.AIM To explore the effects of PDCA nursing model on the quality management of gastrointestinal ESD,the 36-item Shot-Form Health Survey(SF-36) score,and negative emotions.METHODS A total of 178 patients who underwent ESD between January 2020 and January 2021 were divided into two groups.The usual care mode was the control group,with 80 cases from January to July 2020;from July 2020 to January 2021,98 patients were enrolled in the PDCA care mode as the research group.The length of hospital stay and the costs of the two groups were statistically analyzed.The visual analog scale(VAS),SF-36 score,Zung self-rating scale for anxiety and depression,and postoperative complications were also assessed.RESULTS The length of hospitalization and cost in the research group were lower than in the control group(P < 0.05),and the VAS scores were lower than those before care(P < 0.05).Moreover,the VAS score of the research group was lower than that of the control group(P < 0.05).The SF-36 scores for physical function,role status,social function,pain,mental health,and physical strength were higher in the research group than in the control group(P < 0.05).Depression and anxiety scores of the research group were lower than those of the control group(P < 0.05).The postoperative complication rate in the research group(6.12%) was lower than in the control group(32.50%)(P < 0.05).CONCLUSION PDCA nursing can improve the quality of management of ESD surgery,shorten the length of hospital stay and cost,reduce the VAS and Zung scale scores to alleviate adverse emotions,improve the SF-36 score,and reduce postoperative complications.

Effects of Biologics on Mental Health and Health-Related Quality of Life in Patients With Psoriasis:A Repeated Cross-Sectional Survey in Chinese Population

Objective:Psoriasis is a chronic inflammatory systemic disease that severely impacts patients’ quality of life (QoL) and psychological health.While biologics have been shown to be effective in treating psoriatic lesions,thus improving QoL,real-life data regarding such effects remain scant.We administered a repeated cross-sectional survey to assess the effects of 8 weeks of biologics treatment on the QoL and mental health status of patients with moderate-to-severe plaque psoriasis.Methods:From March to May 2022,patients with moderate-to-severe plaque psoriasis were enrolled and treated with biologics in the outpatient clinic at the Dermatology Hospital of Southern Medical University.Assessments were performed before treatment and after 4 and 8 weeks of treatment with biologics.Psoriasis severity,QoL,and mental health status were evaluated using the Psoriasis Area and Severity Index (PASI),Dermatology Life Quality Index (DLQI),36-Item Short-form Health Survey (SF-36),and Hospital Anxiety and Depression Scale (HADS).A multivariate generalized estimating equations (GEE) analysis was used to account for repeated measures and to determine the effects of treatment duration and type of biological agent on relevant indicators.Results:Among the 78 enrolled patients,the ranges of pretreatment scores were 4.6 to 46.8 for the PASI,1 to 30 for the DLQI,31.5 to 100.0 for the physical component score (PCS) of the SF-36,16.6 to 100.0 for the mental component score (MCS) of the SF-36,0 to 15 for the HADS-A,and 0 to 17 for the HADS-D.After 8 weeks of biologics treatment,98.7% (77/78) of patients had obtained PASI 75.All assessed scores changed over time (GEE,P < 0.001).Moreover,there were group-by-time interaction effects for the DLQI score (GEE,P = 0.023) and PCS (GEE,P = 0.029).The HADS-A and HADS-D scores were both decreased at week 8 compared with pretreatment values.Correlation analyses revealed that higher DLQI scores were associated with lower levels of QoL and higher levels of anxiety or depression.Conclusion:Biologics are not only effective in the treatment of skin lesions but also exert beneficial effects upon the QoL and mental health of patients with psoriasis as determined in the short-term assessments conducted in this study.

On Practice of the Effect of Systematic Family Nursing Guidance on the Quality of Life of Elderly Patients with Implanted Cardiac Pacemaker

Objective: To inquire into the effect of systematic family nursing guidance on improving the Quality of Life for elderly patients with implanted cardiac pacemaker. Methods: 41 elderly patients in accordance with the corresponding requirements were studied after offering systematic family nursing guidance and surveyed through the questionnaires about the QOL (quality of life) respectively 1 month, 3 months and 6 months after leaving hospital. Results: Compared with that of 1 month and 3 months after the operation, the questionnaire scores for 6 months after the operation were found to have significant improvement, and the differences were statistically significant. Conclusion: Systematic family nursing guidance can effectively improve the QOL for elderly patients with implanted cardiac pacemaker, which makes them spend their old age in comfort and happiness.

Acupuncture and moxibustion for the elderly patients with depression:A randomized controlled trial

Objective:To identify the effects of acupuncture and moxibustion therapy by soothing liver and regulating mind on the quality of life among the elders with depression.Methods:This was a single-blind,randomized,controlled trial of 75 elders with depression conducted in Guangdong Province,China,in January to December 2010.Eligible patients were randomly divided into three treatment groups.22 patients received acupuncture and moxibustion treatment of soothing liver and regulating mind[group A,in acupuncture procedure:Hegu(合谷L14),Taichong(太冲LR3),Baihui(百会GV20)and Yinting(印堂GV29)were selected,in moxibustion procedure,bilateral Geshu(膈俞BL17)and Danshu(胆俞BL19)were selected,the moxibustion cones was placed on the acupoints,five cones were given to each point.In intradermal needling procedure,Xinshu(心俞BL15),and Ganshu(肝俞BL18)were selected].28 patients received acupoint shallow puncturing treatment(group B,patients received the same acupoints as in the group A,with a 2-3 mm needling depth and no needle sensation was required.A shorter duration of moxibustion and only 1-2 mm of needle body was inserted into the points when intradermal needling).25 patients received non-acupoint shallow puncturing treatment(group C,patients received non-acupoint shallow puncturing at points 10 mm lateral to LI4 and LR3,10 mm left side of GV20 and GV29 in acupuncture procedure;10 mm lateral to BL17 and BL19 in moxibustion procedure;10 mm lateral to BL15 and BL18 in intradermal needling procedure,with the same manipulation method as that in the group B).In all three groups,the treatment was given twice a week for 12 weeks.The Short Form(36)Health Survey(SF36)and TCM Symptom Scale Score as clinical efficacy and quality of life were used to quantitatively assess patients'outcomes before and after treatment.Results:The TCM Symptom Scale scores showed significant differences between the group A and C,and between group B and C(both P<0.05),while there was no significant difference between group A and B(P>0.05).An item-by-item analysis of the SF36 showed the elders in group A obtained the highest scores at each time point after treatment(all P<0.05).Among the results,mental health and report health transition items showed no significant differences between the group A and group B at time point of after treatment(all P>0.05).Vitality and social functioning items at a month after treatment time point,social functioning and report:health transition items at 3 months after treatment time point,role emotional item at after treatment time point showed no significant differences between the group B and group C(all P>0.05).Conclusions:The therapeutic effect of acupuncture and moxibustion by soothing liver and regulating mind can obviously improve the quality of life of depression elders.