Effect of lens surgery on health-related quality of life in preschool children with congenital ectopia lentis

AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center.Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study.All of them completed the child and proxy(parental)PedsQL™4.0 before and after the surgery.Their preoperative scores were compared to their postoperative ones.Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children.RESULTS:Thirty-two children with CEL successfully underwent surgery without any complications,among whom 8 had monocular surgery and 24 had binocular surgery.Preoperative and postoperative questionnaires were completed by 32 child-parent pairs.Surgical intervention could significantly improve the vision of affected children(P<0.001).The medians of physical,psychosocial and total health scores self-reported by the children were 68.75(62.50,81.25),65.00(60.00,80.00)and 67.39(60.87,78.26)preoperatively and were 93.75(87.50,100.00),90.00(83.33,96.67)and 89.13(85.32,95.65)postoperatively.The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children(P<0.001).All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents(P<0.001).In the physical functioning evaluation,the preoperative score reported by parents of girls was higher than parents of boys(P=0.041),and the postoperative score of girls was higher than that of boys(P=0.036).CONCLUSION:CEL is associated with significantly worse quality of life in preschool children.Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.

Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: SF-36 health survey questionnaire

BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different conclusions.AIM To explore the medium-term effect of postoperative HRQoL in such patients.METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups.HRQoL was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(SF-36)Health Survey questionnaire,emphasizing eight specific items.RESULTS This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical procedures.More episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR group.The results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo postoperatively.Only the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 mo.CONCLUSION Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo postoperatively.Patients should undergo LR if there is no contraindication.

A systematic review: How to choose appropriate health-related quality of life (HRQOL) measures in routine general practice?

In more recent times, health-related quality of life (HRQOL) measurements have formed an important part of as- sessing the quality of routine care in general practice. For a measure to have clinical usefulness it must not only be valid, appro- priate, reliable, responsive, and capable of being interpreted, but it must also be simple, fast to complete, easy to score, and provide useful clinical data. The Two-step method of choosing appropriate measures is introduced. Then through comparison of generic instruments with disease-specific instruments, we can conclude that sometimes a combination of generic and disease-specific HRQOL measures may be more appropriate for monitoring changes in a patient’s health status due to an intervention.

Health-related quality of life after liver transplantation: the experience from a single Chinese center

BACKGROUND: Few studies have been performed to assess health-related quality of life (HRQOL) in liver transplantation (LT) patients in the mainland of China. This study aimed to investigate the HRQOL of post-LT patients in a single center. METHODS: HRQOL was evaluated by the SF-36 (Chinese version) questionnaire in 60 patients (LT group) who had received LT for benign end-stage liver disease (BELD). Fifty-five patients with BELD (BELD group) and 50 healthy volunteers from the general population (GP group) were also evaluated, and the results were compared among the three groups. RESULTS: There was a significant difference among the three groups in terms of the scores of eight domains in the SF-36 (P<0.01). Patients in the BELD group had lower scores in each domain of the SF-36 in comparison with those in the GP group (P<0.025). The LT group had mental health scores equivalent to those of the BELD group (P>0.025), but higher scores for the remaining seven domains (P<0.025). Compared with the GP group, the LT group scored equivalently for role physical, body pain, vitality, social function and role emotion (P>0.025), but had lower scores for the remaining three domains (P<0.025). Lower family income was found to be associated with reduced physical function and mental health scores (P<0.05). Better education was associated with increased mental health scores (P<0.05). CONCLUSIONS: LT patients generally have a good HRQOL although some respects of their HRQOL remains to be improved. Lower family income and poor education are important factors relating to the poor HRQOL of LT patients.

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.

Correlation between exercise, personal income level and health-related quality of life in patients with newly diagnosed stable angina

Background:Stable angina is one of the most common clinical types of coronary artery disease(CAD)and associated with poor health-related quality of life(HRQL).However,few studies have evaluated the risk factors associated with HRQL in patients with newly diagnosed stable angina.Methods:A cross-sectional survey was conducted with 342 consecutive outpatients with newly diagnosed stable angina from October 2017 to January 2018 at the Second Affiliated Hospital of Army Medical University,Chongqing,China.Eight dimensions of HRQL were evaluated via the 36-item Short-Form Health Survey,including physical functioning,role limitation due to physical problems,bodily pain,general health,vitality,social functioning,role limitation due to emotional problems,and mental health.Physical and mental component summaries were calculated.Multiple stepwise regression was performed to determine the factors associated with HRQL.Results:Patients who were older,were females,did not exercise,had lower educational levels,had lower monthly incomes,had smoking/drinking habits,and had diabetes,hypertension,or hyperlipemia showed lower physical HRQL scores,while those who were older with lower educational levels and lower monthly incomes showed lower mental HRQL scores.The results of the multiple stepwise regression analyses showed that physical and mental HRQL were positively correlated with exercise and monthly income and negatively associated with age.Patients with monthly income≥5000 Yuan showed higher HRQL scores than those with monthly income<5000 Yuan.Sleep quality and drinking were negatively associated with physical,but not mental HRQL.Conclusions:Our findings indicated that exercise and personal income level,both modifiable factors,were positively associated with physical and mental HRQL.These findings could have implications for clinical suggestions and strategies to improve HRQL in patients with stable angina.

Generic and disease-specific health-related quality of life in patients with Hirschsprung disease:A systematic review and meta-analysis

BACKGROUND Patients with Hirschsprung disease(HD)are at risk of persistent constipation,fecal incontinence or recurrent enterocolitis after surgical treatment,which in turn may impact physical and psychosocial functioning.Generic health-related quality of life(HRQoL)and disease-specific health-related quality of life are relevant outcome measures to assess the impact of HD on the QoL of these patients.AIM To summarize all available evidence on HRQoL of patients with HD after surgery and the impact of possible moderating factors.METHODS Pubmed,Web of Sciences,Psyc Info and Embase were searched with search terms related to’Hirschsprung disease’,’Pediatrics’and’Quality of life’.Mean and standard deviation of generic HRQoL overall and domain scores were extracted from each study,as well as data describing potential factors associated with QoL.Random effect models were used for meta-analytic aggregation of generic HRQoL scores.Meta-regression was used to assess the relationship between patient and clinical characteristics and generic HRQoL.Disease-specific HRQoL outcomes of patients with HD were systematically reviewed.RESULTS Seventeen articles were included in the systematic review(n=1137 patients)and 15 in the quantitative meta-analysis(n=1024 patients).Four studies reported disease-specific HRQoL.Patient’s age ranged between 0 and 21 years.Meta-analytic aggregation showed a nonsignificantly impaired generic HRQoL(d=-0.168[95%CI:-0.481;0.145],P=0.293,I^(2)=94.9)in patients with HD compared to healthy controls.Physical(d=-0.042[95%CI:-0.419;0.335],P=0.829,I^(2)=95.1),psychosocial(d=-0.159[95%CI:-0.458;0.141],P=0.299,I^(2)=93.6)and social HRQoL(d=-0.092[95%CI:-0.642;0.457],P=0.742,I^(2)=92.3)were also not significantly lower compared to healthy controls.There was no relation between health-related outcomes and the sex of the patients and whether generic HRQoL was measured by parental proxy or self-report.Disease-specific complaints of patients with HD impaired physical HRQoL,but not psychosocial and social HRQoL.CONCLUSION In this systematic review and meta-analysis,no evidence was found for impaired generic HRQoL in patients with HD compared to healthy controls,neither for moderating effects of sex,parental proxy or self-report.

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.

Health-related quality of life in living liver donors after transplantation

BACKGROUND:Living donor liver transplantation (LDLT) has recently emerged as an effective therapeutic alternative for patients with end-stage liver disease.In the meantime,the health-related quality of life (HRQoL) of the donors is becoming better appreciated.Here we aimed to review the current literature and summarize the effects of liver donation on the long-term HRQoL of living donors.DATA SOURCES:A literature search of PubMed using 'donors','living donor liver transplantation','health-related quality of life',and 'donation' was performed,and all the information was collected.RESULTS:The varied postoperative outcomes of liver donors are attributive to the different evaluation instruments used.On the whole,donors experienced good long-term physical and mental well-being with a few complaining of compromised quality of life due to mild symptoms or psychiatric problems.The psychosocial dimension has received increasing attention with the vocational,interpersonal and financial impact of liver donation on donors mostly studied.CONCLUSIONS:Generally,donors have a good HRQoL after LDLT.Nevertheless,to achieve an ideal donor outcome,further work is necessary to minimize the negative effects as well as to incorporate recent progress in regenerative medicine.

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.

Supportive care needs and health-related quality of life among Chinese lung cancer survivors

Purpose: The purpose of this study was to explore the supportive care needs and health-related quality of life (HRQoL) of lung cancer survivors, and to identify the association between patient characteristics, HRQoL and supportive care needs. Method: This was a sub-study of a larger scale survey of cancer survivors’ supportive care needs. A total of 48 lung cancer survivors were recruited from a regional teaching hospital, and a three-part structured questionnaire was used to collect 1) socio-demographic and clinical characteristics, 2) supportive care needs and 3) health-related quality of life data. Results: The three most commonly reported unmet needs were all in the health-system information domain: 1) being informed about your results as soon as possible (58%), 2) being informed about cancer which is under control or diminishing (50%), and 3) being informed about things you can do to help yourself get well (46%). The second most common unmet need domain was access to healthcare and ancillary support services. The survivors generally reported satisfactory HRQoL. However, household income and unmet physical and psychological needs were independently associated with HRQoL among these survivors. Conclusion: The high unmet needs in the health-system information area call for a review of the content and amount of information provided to lung cancer survivors. In addition, more attention should be given to lung cancer survivors with low incomes but high physical and psychological unmet needs, who require appropriate follow-up and long-term care of a physical, social and psychological kind.

Health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy An ecological perspective

Parkinson＇s disease has a negative impact on health-related quality of life in Parkinson＇s disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson＇s disease patients in nOrtheastern Sicily, Italy. Ninety Parkinson＇s disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi ＂Bonino-Pulejo＂ （Messina）, were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale （UPDRS-Ⅲ） scores, the Parkinson Disease Questionnaire-39 Item scores （as a disease-specific measure of health-related quality of life）, scores on the Short Form （36） Health Survey Questionnaire （as a generic measure）, and answers to a brief checklist were recorded. A total of 85 Parkinson＇s disease patients （49% males and 51% females; mean age 70.8 ± 8.6 years mean UPDRS-Ⅲ 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years） completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.

Resistance Training in People at Risk of Developing Type 2 Diabetes and Their Experience of Health-Related Quality of Life

Background: Research indicates an association between impaired glucose metabolism and overweight, a serious public health problem involving an increased risk of Type 2 diabetes, related hypertension, and a reduced quality of life. Aim: The first aim is to assess different dimensions of Health-Related Quality of Life (HRQoL) in overweight individuals at risk of developing Type 2 diabetes compared to a normal population. The second aim is to examine the impact of resistance training on the pre-post HRQoL dimension scores of the intervention group. Methods: Eighteen participants were randomly assigned to one of the two resistance training groups. Group 1 engaged in supervised maximal resistance training (Bernstein inverted pyramid system: 5× 3 - 4, 60% - 85% of 1 Repetition Maximum (RM)), three days/week over four months, and Group 2 performed endurance resistance training (including lower weight loads and more repetitions over four months). The intervention consisted of eight exercises involving the entire body. The subjects completed the Short-Form Health Survey (SF-36) on HRQoL. The HRQoL scores of the norm population were higher than those of people at risk of developing Type 2 diabetes, and resistance training seemed to have a limited significant positive effect on the different HRQoL dimensions.

Predictors of Health-Related Quality of Life in Children with Cyanotic Heart Disease Who Underwent Palliative and Total Repair

Background:Studies on predictors of health-related quality of life(HRQOL)in pediatric patients with cyanotic heart disease who are waiting for the next stage and those who have undergone total repair are scarce.Therefore,we aimed to identify such predictors in children who received the modified Blalock–Taussig shunt(MBTS)and those who underwent total repair.Methods:In this historical cohort and concurrent follow-up study,data of children who underwent MBTS at the age of 0–3 years between January 2005 and December 2016 at a super-tertiary care hospital in Southern Thailand were obtained.Children who were alive in December 2017 were recruited to evaluate the quality of life at least 1 year after their operation.Between January and December 2018,the“Pediatric Quality of Life Inventory 4.0 Generic Core Scales”with both child self-report and parent proxy-report scores were used to examine the HRQOL.Multivariate linear regression analysis was performed to identify independent predictors of HRQOL.Beta-coefficient(β)and 95% confidence intervals(95%CIs)were calculated and considered statistically significant at p<0.05.Results:Among the 380 enrolled children,148 died,122 survived and waited for total repair,and 110 survived after total repair.In the multivariate analysis,chronic lung disease was a common predictor of lower physical and psychosocial HRQOL reported by the parents(β[95%CI]:−0.42[−0.81,−0.03]and−0.49[−0.89,−0.09],respectively).Total repair was a predictor of higher physical HRQOL according to both parents and children(β[95%CI]:0.33[0.09,0.57]and 0.70[0.36,1.03],respectively).A predictor of higher psychosocial HRQOL reported by the parents was younger age during MBTS surgery compared with older age(β[95%CI]:0.012[0.001,0.022]).In the total repair subgroup,undergoing the Fontan procedure(vs.Glenn procedure)was a predictor for lower physical HRQOL reported by the parents(β[95%CI]:−0.82[−1.52,−0.13]).Higher socioeconomic status was a predictor of both physical and psychosocial HRQOL(β[95%CI]:0.018[0.001,0.034]and 0.012[0.0001,0.04],respectively).Conclusions:Successful total repair was a predictor of higher physical HRQOL,and younger age during MBTS surgery was a predictor of higher psychological HRQOL in children with cyanotic heart disease.Higher socioeconomic status was a predictor of both physical and psychological HRQOL following total repair[Thai Clinical Trials Registry:TCTR20161221003].

Impact of physical activity on health-related quality of life in osteoporotic and osteopenic postmenopausal women:A systematic review

Objective:This meta-analysis included papers which evaluated the effects of physical activity on the health-related quality of life(HRQoL)of osteoporotic and osteopenic postmenopausal women.Methods:Four English databases were searched for relevant randomized clinical trials(RTCs)published from 1970 to June,2014.Eligible RCTs which used the Quality of Life Questionnaire of the European Foundation for Osteoporosis(QUALEFFO)as their outcome measure were selected for inclusion.Results:Five RCTs were included in the final meta-analysis.The results showed that physical activity produced favorable effects in the HRQoL domains of physical function(p=0.001)and pain(p=0.01),but not in other domains.Compared with a single exercise,combined exercise produced more favorable effects on both physical function(p=0.0004)and pain(p=0.02).Short-term physical activity produced significant favorable results in all general health domains of HRQoL(p=0.01),whereas middle-term physical activity produced significant improvements only in the physical function(p<0.01)domains of HRQoL.Long-term physical activity produced significant improvement only in the pain domains of HRQoL(p<0.01),and only in the physical activity group when compared with a control group.Conclusion:Only weak evidence supports the notion that physical activity effectively improves the health-related quality of life of osteoporotic and osteopenic postmenopausal women.Compared with a single exercise,combined exercise produced favorable effects on both physical function and pain.However,different lengths of exercise produced improvements in different domains.

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.

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.

The Relationship among Chronic Disease, Feeling-for-Their-Age, Sleep Quality, Health-Related Quality of Life and Activities of Daily Living of Community-Dwelling Persons over 55 Years of Age

Japan’s aging population rate is increasing and healthy life expectancy has decreases by 10 years shorter than average life expectancy. The aim of this study is to determine the relationship among chronic disease, sleep quality, health-related quality of life (HRQOL), and activities of daily living in people over 55 years old who live in the community. Subjects were 161 persons aged 57 to 90 years who were treated with chronic disease in the outpatient department of the A hospital. Exclusion criteria included patients with dementia, cancer and severe heart disease. The survey evaluation questionnaires included the Pittsburgh Sleep Quality Index (PSQI), HRQOL by Short-Form 8 Health Survey (SF-8), and activities of daily living. Variables associated with quality of sleep, HRQOL in univariate analysis with p < 0.05 were entered into multivariate analysis using logistic regression with a stepwise forward selection procedure to determine independent variables and their association with major causes. The logistic regression analysis was done using SPSS software and the post-hoc power of the study was estimated using G*power. The level of significance was set at p < 0.05. The risk factor of poor sleep quality was because of history of cancer [odds ratio (OR): 3.53, 95% confidence interval (CI): 1.06 - 11.77], and insomnia (OR: 3.25, 95% CI: 1.55 - 6.79). The risk factors of poor physical HRQOL were motor disease (OR: 2.62, 95% CI: 1.36 - 5.07), respiratory disease (OR: 3.24, 95% CI: 1.27 - 8.26) and having pain (OR: 11.71, 95% CI: 5.35 - 25.66). In addition, anemia was found to be a risk factor of poor mental HRQOL (OR: 4.87, 95% CI: 1.11 - 21.33). The feeling-for-their-body-age (OR: 0.30, 95% CI: 0.15-0.59) was as “younger than actual age” and advanced the risk factor of poor sleep quality. In addition, feeling-for-their-age (OR: 0.44, 95% CI: 0.21 - 0.92) resulted in reduced risk factor of poor physical HRQOL. The risk factor of poor sleep quality was due to a patient with history of cancer. The factor for good sleep quality and the good factor for physical HRQOL were indications of feeling younger than the actual age.

Evaluation of the Impact of Tinnitus on Health-Related Quality of Life amid Sawmill Workforces

Background: Tinnitus is the phantom aural perception of sound lacking an exterior stimulus, a sub-type of auditory hallucination and it is a common sensation among noise-exposed employees. It is a symptom, not an illness. Tinnitus can be extremely perplexing for its subjects and it may perhaps dis-turb their health-related quality of life (HR-QoL) if exposed to extreme noises in many ways. Objective: This study is intended to discover the effects and pattern of tinnitus on health-related quality of life (HR-QoL) amid noise-exposed saw mill workforces. Method: This study was a prospective and public-centered cross-sectional study, including 510 sawmill personnel. 510 directorial staff was used as the control. Health-related quality of life (HR-QoL) of all subjects was assessed with the WHO Quality of Life brief questionnaire. Self-reported tinnitus morbidity was assessed by means of the Tinnitus Handicap Inventory. A correlation was established amid health-related quality of life scores and tinnitus severity scores. Result: There were 510 sawmill employees enlisted into the study, out of which 490 were men and 20 were women with control of the same age and sex. The mean age was 36.85 ± 7.68 years for the sawmill workers and 35.75 ± 8.65 years for the control group (t = 1.02, P = 0.275). The mean tinnitus score for the sawmill workers was 20.80 ± 2.56. Out of the 510 sawmill workers, 52 (10.2%) had tinnitus and one of the controls had tinnitus. The mean health-related quality of life scores were 62.20 ± 8.62 and 72.56 ± 5.98 for the sawmill workers and control group respectively. There was a substantial and remarkable difference between the health-related quality of life of the sawmill workers and the control group (P Conclusion: The prevalence of tinnitus from this study was found to be 10.20% and an upsurge in tinnitus rigorousness was seen to be related with a substantial drop in physical, psychological and social domains of the health related quality of life. We highly endorse hearing conservation programmes and use of personal protective equipments for sawmills workers which will aid to decrease the effects of exposure to loud noise. Those sawmill labors already having tinnitus must attempt to go for treatment.

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.