Changes in acute and late toxicity and patient-reported health-related quality of life following radiotherapy in women with breast cancer:A 1-year longitudinal study

Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.

Health-Related Quality of Life, Depression, and Smoking Status in Patients with COPD: Results from the Behavioral Risk Factor Surveillance System Data

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality. People living with COPD often have a common triad of problems including decreased health-related quality of life (HRQL), smoking, and depression. Identifying barriers to preventing and treating COPD is of the utmost importance. The purpose of this study is to examine the relationship between HRQL, depression, and smoking status for patients with COPD. Methods: The 2016 BRFSS data was used to perform a cross sectional analysis of adult patients with a diagnosis of COPD. A comprehensive descriptive analysis of all study variables for those participants having COPD was performed. Then relationships between general HRQL, depression, and smoking status were examined. Data were analyzed using SPSS. Results: The original 2016 BRFSS dataset contained responses from 486,303 participants. After selecting participants who self-identified as having a diagnosis of COPD, 40,682 individual participants remained in the dataset for further analysis. The participants with COPD were mostly female, over the age of 65, with low-incomes, attended a year of college or less, with some type of healthcare coverage. Patients with a dual diagnosis of COPD and depression have poorer HRQL and an increased number of cigarettes smoked compared to those patients with COPD. Likewise, there is a significant relationship between HRQL and smoking status for patients with a dual diagnosis of COPD and depression. Conclusion: Depression as a comorbidity does have a statistically significant relationship with patients HRQL and smoking status. Future research should be aimed at increasing screening and treatment for depression in patients with COPD who continue to smoke. Further research on the cyclical relationship between COPD, depression, and smoking cessation would be beneficial.

The Effect of Partial Removable Denture Use on Oral Health Related Quality of Life and Masticatory Function, after 5 Years Use

The aim of this study was to evaluate whether partial removable denture use indeed leads to improved oral health related quality of life and masticatory function. Materials and Methods: Partially edentulous patients presenting for removable denture treatment at the Prosthodontics Service in the Hospital Affiliated to Kinshasa University (Democratic Republic of Congo) were assessed for enrolment in this study. After applying exclusion criteria, 378 patients were included in the study, and randomly assigned into 2 groups. Oral health related quality of life (OHIP-23) and mastication time (MaT), number of chewing cycles (MaC), mastication frequency (MaF), and the sizes of the peanut fragments (FraS) were compared in both groups. Statistical significance was set at p < 0.05. Results: The average MaC, MaT, MaF, and FraS were 119 (± SD 53.70), 86.75 (±SD 35.35), 1.38 (±SD 0.25), and 3.3 (±SD 3.25) for the denture group and 77.9 (±SD 23.9), 60.2 (±SD 17.91), 1.29 (±SD 0.15), and 1.5 (±SD 0.7) for the non-denture group, respectively. Conclusion: The overall oral health related quality of life was best in the non-denture than denture.

A Study on Oral Health-Related Quality of Life and Its Influencing Factors in Elderly Diabetic Patients

Objective:To investigate the oral health related quality of life in elderly diabetic patients and analyze its influencing factors.Methods:Convenience sampling was used to select 190 elderly patients with diabetes under the Department of Endocrinology and Department of Integrated Traditional Chinese and Western Medicine in the Affiliated Hospital of Hebei University as the research subjects.The Chinese version of the Oral Health Influence Scale(OHIP-14)was used to conduct a questionnaire survey,and univariate analysis and multiple stepwise regression analysis were used to analyze the influencing factors of oral health related quality of life in elderly diabetic patients.Results:The elderly diabetic patients'oral health related quality of life score was 34.48±3.23,which is in the middle-lower range.The findings of multivariate stepwise regression analysis revealed that the course of disease,regular visits to the dentist,sleep quality,oral health knowledge,and oral health attitude together explained 58.9%of the total variance in elderly diabetic patients in terms of their oral health related quality of life(p<0.05).Conclusion:The oral health related quality of life of elderly diabetic patients is generally low,and is affected by the duration of diabetes,sleep quality,and oral health knowledge,attitude,and behavior(regular visits to the dentist).Improving patientsJ attention to oral health problems by improving sleep as well as their own oral health knowledge,attitude,and behavior is an effective way to enhance oral health related quality of life.

Assessment of disease specific knowledge and health-relatedquality of life among United States military veterans withinflammatory bowel disease

AIM To evaluate the association between patientdisease knowledge of inflammatory bowel disease （IBD）and health related quality of life （HRQoL） and identifypatient and disease related predictors of patientknowledge of IBD.METHODS： We performed a cross-sectional study ofIBD patients with an established diagnosis of IBD longerthan 3 mo prior to enrollment. The Crohn＇s and colitisknowledge score （CCKNOW） and short inflammatorybowel disease questionnaire （SIBDQ） were selfadministeredto assess patient knowledge of IBDand HRQoL, respectively. Demographic and diseasecharacteristics were abstracted from the electronicmedical record. The correlation between CCKNOWand SIBDQ scores was assessed by a linear regressionmodel. Associations of patient knowledge and thevariables of interest were calculated using ANOVA.RESULTS： A total of 101 patients were recruited.Caucasian race, younger age at diagnosis, and having a college or post-graduate degree were significantlyassociated with higher CCKNOW scores. Patients withCD had higher CCKNOW scores compared to patientswith ulcerative colitis and inflammatory bowel diseasetype unclassified, P 〈 0.01. There was no significantcorrelation between overall CCKNOW and SIBDQ scores（r^2 = 0.34, P = 0.13）. The knowledge sub-domain ofdiet in CCKNOW was negatively correlated with HRQoL（r^2 = 0.69, P 〈 0.01）.CONCLUSION： IBD diagnosis at a younger age inaddition to Caucasian race and higher education weresignificantly associated with higher knowledge aboutIBD. However, patient knowledge of IBD was notcorrelated with HRQoL. Further studies are required tostudy the effect of patient knowledge of IBD on otherclinical outcomes.

Higher vitamin D serum concentration increases health related quality of life in patients with inflammatory bowel diseases

AIM: To investigate the effect of vitamin D (VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease (IBD) patients.

Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

BACKGROUND Alterations in health-related quality of life(HRQoL)and neuropsychological disorders were described in the hepatitis C virus(HCV)patients.Although several studies investigated the modifications of HRQoL after HCV eradication,no data exists on the modifications of neuropsychological symptoms.AIM To investigate the effect of directly acting antivirals(DAAs)treatment on HRQoL and neuropsychological symptoms.METHODS Thirty nine patients with HCV infection underwent a neuropsychological assessment,including Zung-Self Depression-Rating-Scale,Spielberg State-Trait Anxiety Inventory Y1-Y2 and the Toronto-Alexithymia Scale-20 items before and after DAAs treatment.HRQoL was detected by Short-Form-36(SF-36).RESULTS All HRQoL domains,but role limitation physical and bodily pain,significantly improved after treatment.Interestingly,after DAAs treatment,all domains of HRQoL returned similar to those of controls.Each neuropsychological test significantly improved after HCV eradication.A significant correlation was observed among each psychological test and the summary components of SF-36.At multiple linear regression analysis including each psychological test as possible covariates,Zung-Self Depression Rating Scale(Zung-SDS)score was independently and significantly related to summary components of the SF-36 in the basal state and the difference between Zung-SDS score before and after treatment was the only variable significantly and independently related to the modification of HRQoL induced by the treatment.CONCLUSION Neuropsychological symptoms strongly influenced HRQoL in HCV patients and there was a significant improvement of neuropsychological tests and HRQoL after DAAs treatment.

Impact of pain on health-related quality of life in patients with inflammatory bowel disease

AIM: To evaluate intensity, localization and cofactors of pain in Crohn’s disease and ulcerative colitis patients in connection with health-related quality of life (HRQOL) and disease activity. METHODS: We reviewed and analyzed the responses of 334 patients to a specifically designed questionnairebased on the short inflammatory bowel disease questionnaire (SIBDQ) and the German pain questionnaire. Pain intensity, HRQOL, Crohn’s disease activity index (CDAI) and colitis activity index (CAI) were correlated and verified on a visual analog scale (VAS). RESULTS: 87.9% of patients reported pain. Females and males reported comparable pain intensities and HRQOL. Surgery reduced pain in both genders (P = 0.023), whereas HRQOL only improved in females. Interestingly, patients on analgesics reported more pain (P = 0.003) and lower HRQOL (P = 0.039) than patients not on analgesics. A significant correlation was found in UC patients between pain intensity and HRQOL (P = 0.023) and CAI (P = 0.027), and in CD patients between HRQOL and CDAI (P = 0.0001), but not between pain intensity and CDAI (P = 0.35). No correlation was found between patients with low CDAI scores and pain intensity. CONCLUSION: Most IBD patients suffer from pain and have decreased HRQOL. Our study reinforces the need for effective individualized pain therapy in IBD patients.

A Review of Systemic Lupus Erythematosus (SLE): Symptoms, Risk Factors, Treatment, and Health Related Quality of Life Issues

In this paper, we present a thorough review of one of the most life-threatening autoimmune diseases, Systemic lupus erythematosus (lupus). Symptoms, risk factors, including genetic and epidemiological factors are discussed. Treatment, life expectancies, and Health Related Quality of Life of patients with SLE will be discussed as well. Special attention will be given to Lupus Nephritis.

Contribution of attachment insecurity to health-related quality of life in depressed patients

AIM: To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life(HRQo L) in patients diagnosed with adjustment disorder(AJD) with depressed mood. METHODS: Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance(ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package(SPSS Inc., Chicago, IL, United States).RESULTS: ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggestthat depressive symptoms were more severe(F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer(F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQo L, accounting for 21.4% and 29.7% of the total variance, respectively [R2 = 0.79; Adjusted R2 = 0.77; F(5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.CONCLUSION: The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQo L outcome in AJD with depressed mood.

Impact of jejunostomy during esophagectomy for cancer on health related quality of life

Background： The aim of this study was to evaluate the impact of jejunostomy during esophagectomy for cancer on postoperative health-related quality of life（HRQL）.Methods： We evaluate all consecutive patients who underwent esophagectomy for cancer at the surgical oncology unit of the Veneto Institute of Oncology（IOV-IRCCS） between January 2008 and March 2014. The primary outcome was HRQL, which was assessed using nine scales of EORTC C30 and OES18 questionnaires. General linear models were estimated to evaluate mean score difference（MD） of each selected scale in patients with and without jejunostomy, adjusting for clinically relevant confounders. The secondary outcomes were morbidity, hospital stay, postoperative weight loss and postoperative albumin impairment. Results： Jejunostomy was performed in 40 on 109 patients（41.3%） who participated in quality of life investigation. A clinically and statistically significantly worse eating at admission（P=0.009） became not clinically significant at 3 months after surgery（MD =9.1）. Jejunostomy was associated to clinically and statistically significantly poorer emotional function（EF） at 3 months after surgery（MD =-15.6; P=0.04）. Hospital stay was longer in jejunostomy group（median, 20 vs. 17 days, P=0.02）.Conclusions： In our series patients who had a jejunostomy during esophagectomy had been selected for their risk for postoperative complication. However, their postoperative outcome was actually similar compared to those without jejunostomy. Nevertheless, jejunostomy was associated to clinically and statistically significantly poorer EF at 3 months after surgery. Therefore, patient candidate to esophagectomy and feeding jejunostomy should receive additional psychological support.

Relationship among Health Related Quality of Life, Quality of Sleep, and Oral Health Condition

Japan’s aging rate (ratio of elderly aged 65 and older to total population) has exceeded 20%. The aim of this study was to clarify the relationships between Health Related Quality of Life, Body Mass Index (BMI), and sleep quality. Subjects were 51 adults over 55 years old with chronic disease who living in the community. Instruments and structured interviews were used giving due consideration to privacy. Interviews were conducted within 10 - 20 minutes at the out-patient department. The evaluation instruments included bodymass index, Pittsburgh Sleep Quality Index (PSQI), Health Related Quality of Life (HRQOL), and Oral Health Impact Profile (OHIP-14). A significant positive correlation (ρ = 0.321, p < 0.05) between PSQI and QOL (OHIP-14) scores was confirmed with sleep quality being lower with lower QOL scores. A negative correlation (ρ = ?0.339, p < 0.05) between physical health component summary scores (PCS) and mental health component summary scores (MCS) of HRQOL was confirmed, demonstrating that PCS was low, and the level of MCS was high. Sleep quality was found lower among those with lower oral health-related QOL scores. Moreover, in subjects with lower MCS scores, the PCS scores were found to be higher. Accordingly, it was considered appropriate that dental treatment and care, support the maintenance of activities and sleep, and mental health promotion which are likely requisites critical for elderly persons’ maintenance of independent lifestyles in their familiar community.

Health related quality of life of university students in Lebanon: Lifestyles behaviors and socio-demographic predictors

Measuring and monitoring health related quality of life (HRQoL) in youth are important for both researchers and decision makers. During the time that young people are at university, many will encounter a number of academic, as well as social, emotional and psychological difficulties. The aims of this study are to: 1) assess the health related quality of life of youths using SF-36 questionnaire and its factor determinants, and 2) provide an objective basis for a health promotion structure. Methods: This is a cross-sectional study in South Lebanon, in a population of 282 young university students attending a public university which is the largest and most widespread institution of higher education in Lebanon. Socioeconomic and lifestyle behaviors data were collected. Students’ HRQoL was measured using the SF-36 Health Survey. Results: The mean age of the respondents was 18.7 years (SD = 1.16), 80.1% were women, 64.5% were living in rural area. The proportion of current smokers was significantly greater among men than women (26.8% vs. 11.5%, p < 0.01). Water pipe was the main type of smoking. Education of the fathers had negatively influenced HRQoL. Younger age scored higher in Social Functioning and Role-Emotional;the area of residence had no influences on SF-36 scales scores. Females had poorer HRQoL than males especially in mental health scales. Smokers had low Vitality and Mental Health scores. Sedentary lifestyle was linked to a lower score of Physical Functioning (β = -5.16, 95% CI = -7.67 -2.65), and Vitality ( β= -5.85, 95% CI = -10.24 -1.45). The HRQoL of the students studying business and economics was higher than those studying health. Conclusion: Youths’ HRQoL is affected by socio-demographic and behavioral characteristics. Effective health-promoting actions, social support, and counseling services should be implemented in the campus and are a necessary step towards the main goal of improving the overall HRQoL of the university young students in Lebanon.

The effect of acculturation in the concordance of oral health related quality of life in Latino children and their parents

The Latino population is the fastest growing and the largest minority group in the United States comprising 16% of the population younger than 18 years of age. Yet, little is known about the effect of acculturation in oral health related quality of life in Latino children and their parents. Objective: The objective of this study was to assess the effect of acculturation in parent and child’s perceptions of the child’s oral health status and oral health related quality of life (OHRQoL) as well as the effect in the concordance between children and parents/caregivers. Method: Sixty-three Latino children between the ages of 8 and 15, and their parents were recruited from the waiting room at the University of California, San Francisco Orthodontic and Pediatric Clinics. Parent and children each separately completed the Child Oral Health Impact Profile questionnaire (COHIP) for children and COHIP for parent/caregiver. Results: Of the sixty-three children, fifteen children (23.8%) had a more negative perception of their oral health than their parents whereas twenty-three children (36.5%) had a more positive perception. In terms of agreement between children and parents, questions about oral health showed the lowest level of agreement (34.9%) and self-image questions the highest (55.6%). Conclusion: The study findings indicate that the more acculturated the child, the more negative their perception of their oral health. The level of disagreement between parent and child, underscores the importance of obtaining both the child and parent OHRQoL perceptions.

Health Related Quality of Life among Osteoarthritis Patients: A Comparison of Traditional Non-Steroidal Anti-Inflammatory Drugs and Selective COX-2 Inhibitors in the United Arab Emirates Using the SF-36

Objectives: Osteoarthritis (OA) has a dramatic impact on patients’ health related quality of life (HRQoL). Chronic use of analgesics and anti-inflammatory medications for pain management may improve symptoms but on long term may affect HRQoL negatively. The objective of the present study was to compare the impact of two different classes of analgesics, traditional non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclo-oxygenase-2 (COX-2) inhibitors on HRQoL among osteoarthritis patients using the SF-36 questionnaire. Methods: Clinic based cross-sectional study conducted at Al-Qassimi Hospital, Sharjah, United Arab Emirates (UAE), over a period of six months. Ethical Approval was obtained from the ethics committee at Al-Qassimi Clinical Research Center. Total of 200 osteoarthritis patients fulfilling the inclusion and exclusion criteria were involved in the study. Patients’ demographics were collected from their medical records. The Medical Outcome Study Short-Form 36 (SF-36) questionnaire was used to measure patients’ HRQoL. SF-36 data were scored using health outcomes scoring software 4.5. Results: Mean age of the subjects was 62.19 ± 9.81 years with females constituting 151 (75.5%) of the patients. In general, females scored lower in most of the HRQoL domains compared to males and there was significant difference between the two groups in the mental health (p = 0.005) & mental component (p = 0.042) domains. Compared to selective COX-2 inhibitors, patients on NSAIDs scored higher on all domains of SF-36 except physical functioning. There was significant difference in mental health domain for patients treated with NSAIDs (p = 0.02). Celecoxib was only better than NSAIDs in osteoarthritis patients with more than one musculoskeletal disorders in the domain of bodily pain (p = 0.009). Conclusion: NSAIDs-treated patients did not differ significantly from celecoxib-treated patients in all domains of the SF-36 except for the mental health domain.

Demographic Factors Associated with Health-Related Quality of Life Among Urban and Rural Tuberculosis Patients in Kenya

Background:Tuberculosis is one of the deadliest and disabling diseases in the world today.The infection exacts its greatest toll on individuals during their most productive years.TB patients record different perceived health related qualities of life(PHRQoL)which could be attributed to certain environmental,social and physical factors.The objective of the study was to determine the demographic factors associated with the PHRQoL among urban and rural Tuberculosis patients in Kenya.Cross sectional design was adopted.The study applied the multi-stage sampling technique.Random sampling method was used to select the TB clinics that participated in the study.Simple random sampling according to probability proportionate to TB patient’s population was preferred to select the study participants.Chisquare test determined association between the various demographic factors and the PHRQoL while ANOVA tests demonstrated the overall association of demographic factors and PHRQoL.Statistical Significance was evaluated at p<0.05.Descriptive statistics summarized and described the data.The study established that demographic factors are associated with PHRQoL(p=0.008).Specifically,age,levels of education,marital status and house hold size(P<0.05).Gender and Household head were not significantly associated with the PHRQoL(p>0.05).These findings will persuade the TB management policy towards developing an intervention programs directed at the social-demographic characteristics of the TB patients for improved treatment outcomes.

The Influence of Socio-Demographic, Health and Work-Related Factors on Health-Related Quality of Life among Iranian Industrial Workers

Health-related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present paper aimed to study the influence of the socio-demographic, health and work-related factors on HRQOL among Iranian industrial workers. In this cross-sectional study, participants were 280 workers of two factories. The Persian version of World Health Organization Quality of Life-Brief (WHOQOL-BREF) was used to assess the HRQOL. A questionnaire was developed to assess the socio-demographic, health and work-related factors. Results showed that the means (SD) of physical health, psychological health, social relationships, and environment domains of HRQOL were 13.2 (2.7), 13.3 (2.6), 14.2 (3.5) and 12.6 (2.5), respectively. A multiple linear regression showed that types of job, exercise activity, working schedule, sleep quality, smoking, and conflict between work and social life were significantly associated with physical health domain;whereas, working schedule, marital status, working demand, sleep quality, BMI, and conflict between work and individual life were significantly associated with psychological health domain. Working schedule, working demand, sleep quality, conflict between work and individual life, and having children over two years were significantly associated with social relationship domain;however, working demand, working schedule, smoking, sleep quality, working hour, job satisfaction, marital status and exercise activity were significantly associated with environment domain. Collectively, work-related factors including unhealthy working conditions, unsafe working environments, long working hours, irregular working schedules, and the lack of occupational training may negatively influence the HRQOL of workers. To improve workers’ HRQOL, intervention programs should focus on improving work environment, working schedule, occupational training and restricting working hours.

Oral health-related quality of life between Chinese and American orthodontic patients: A two-center cross-sectional study

Background:Although oral health-related quality of life(OHRQoL)in orthodontic patients has been assessed in the past,to date,no study has compared the OHRQoL between two nations.We aimed to compare the OHRQoL between Chinese and American orthodontic patients.Methods:We conducted a two-center questionnaire-based cross-sectional study among patients who underwent orthodontic treatments at the Chinese PLA General Hospital(PLAGH)in Beijing,China and Massachusetts General Hospital(MGH)in Boston,Massachusetts,United States.Candidate variables included the participating center,patients’age,sex,Angle’s classification of malocclusion,evaluation stage,and appliances used.The primary outcome was patients’OHRQoL assessed with the Oral Health Impact Profile-14(OHIP-14).Descriptive statistics,stratification,and univariate and multivariate analyses were performed.Results:The average age was lower for PLAGH patients than for MGH patients(21.1±7.9 vs.33.1±14.6 years,P<0.001).The most common type of malocclusion was Angle’s Class III malocclusion at PLAGH(39%)and Class I malocclusion at MGH(59.5%).Clear aligners were used in 34.1%and 2.7%of the patients at MGH and PLAGH,respectively.OHIP-14 scores were lower for PLAGH patients than for MGH patients(18.4±4.7 vs.22.3±7.4,P<0.001),particularly in functional limitation,psychological discomfort/disability,and handicap.Univariate regression analysis demonstrated that participating center,age,Class I malocclusion,and the use of clear aligners were significantly associated with overall OHIP-14 scores.Multivariate regression analysis demonstrated that patients at PLAGH were associated with lower OHIP-14 scores(coefficient:-3;95%CI:-5,-1.3;P=0.001),and age was positively associated with OHIP-14 scores(coefficient:0.1;95%CI:0.004,0.13;P=0.038).Conclusion:Chinese orthodontic patients had lower OHIP-14 scores,indicating a higher OHRQoL than American patients.In addition to the younger age,this difference may be attributed to the different ethical,cultural,educational,and socioeconomic background of Chinese and American orthodontic patients.

Evaluation of Health-Related Quality of Life Associated with Provision of Healthcare to Stroke Patients Living at Home in Japan

Objective: As stroke mortality rates decline in Japan, a large proportion of disabled stroke survivors living in their homes are supported by informal caregivers or formal healthcare services. To evaluate the impact of healthcare provision on outcome of stroke patients living at home, this study investigated the associations of long-term care and health-related quality of life (HRQOL) in patients 1 year after stroke onset. Methods: Data on patient and caregiver characteristics, HRQOL of patients, and healthcare services for those living at home were prospectively collected from 426 patients with stroke at baseline and 12 months. Using general measures of HRQOL, namely, Short Form-36 (SF-36) and EuroQOL 5 dimension (EQ-5D), multivariate regression models were used to determine the contribution of variables to changes in HRQOL scores from discharge to the first year after stroke. Results: Five domains of SF-36—role-physical, vitality, social functioning, role- emotional, and mental health—were significantly improved 1 year after stroke. Factors affecting changes in the five domains of HRQOL were age, independence in activities of daily living, and cognitive function. Home care service was positively associated with role-physical, social functioning, and role-emotional. In addition, home rehabilitation and home bathing services were positively associated with social functioning. Conclusion: This study clarified that improvements of HRQOL 1 year after stroke were associated with use of home-based services involving home care service, home rehabilitation, and home bathing services. The use of home-based services contributed to the improved welfare of patients living at home.

Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment

Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.