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.

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.

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.

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.

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.

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.

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.

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.

Assessment of health-related quality of life in Chinese patients with minimal hepatic encephalopathy

AIM:To evaluate the health-related quality of life (HRQOL) based on the Chinese version of SF-36 and Chronic Liver Disease Questionnaire (CLDQ) in subjects with chronic hepatitis B,liver cirrhosis,including patients with minimal hepatic encephalopathy (MHE). METHODS:The SF-36 and CLDQ were administered to 160 healthy volunteers,20 subjects with chronic hepatitis B and 106 patients with cirrhosis (33 cases exhibited MHE). HRQOL scores were compared among the different study groups. The SF-36 includes eight health concepts:physical functioning,role-physical,body pain,general health,vitality,social functioning,role-emotion,and mental health. Six domains of CLDQ were assessed:abdominal symptoms,fatigue,systemic symptoms,activity,emotional function and worry. RESULTS:Compared with healthy controls (96.9 ± 4.5,86.6 ± 18.4,90.1 ± 12.5,89.0 ± 5.7,87.5 ± 4.3,95.8 ± 7.1,88.5 ± 15.9,88.7 ± 5.2 in SF-36 and 6.7 ± 0.5,6.1 ± 0.6,6.3 ± 0.6,6.5 ± 0.5,6.3 ± 0.5,6.8 ± 0.4 in CLDQ),patients with chronic hepatitis B (86.3 ± 11.0,68.8 ± 21.3,78.9 ± 14.4,60.8 ± 10.5,70.8 ± 8.6,76.1 ± 12.6,50.0 ± 22.9,72.2 ± 10.6 and 5.5 ± 1.0,4.5 ± 1.0,5.2 ± 1.1,5.3 ± 0.9,4.8 ± 0.9,4.9 ± 1.0) and cirrhosis (52.8 ± 17.4,32.8 ± 27.9,61.6 ± 18.9,30.2 ± 18.3,47.9 ± 20.1,54.0 ± 19.2,28.9 ± 26.1,51.1 ± 17.8 and 4.7 ± 1.2,3.9 ± 1.2,4.7 ± 1.2,4.7 ± 1.3,4.7 ± 1.0,4.4 ± 1.1) had lower HRQOL on all scales of the SF-36 and CLDQ (P < 0.01 for all). Increasing severity of liver cirrhosis (based on the Child-Pugh score/presence or absence of MHE) was associated with a decrease in most components of SF-36 and CLDQ,especially SF-36.CONCLUSION:The Chinese version of SF-36 along with CLDQ is a valid and reliable method for testing MHE in patients with liver cirrhosis. Cirrhosis and MHE are associated with decreased HRQOL.

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.

Health-related quality of life in high-grade glioma patients

Gliomas are malignant primary brain tumors and yet incurable. Palliation and the maintenance or improvement of the patient's quality of life is therefore of main importance. For that reason, health-related quality of life(HRQoL) has become an important outcome measure in clinical trials, next to traditional outcome measures such as overall and progression-free survivals, and radiological response to treatment. HRQoL is a multidimensional concept covering physical, psychological, and social domains, as well as symptoms induced by the disease and its treatment. HRQoL is assessed by using self-reported, validated questionnaires. Various generic HRQoL questionnaires, which can be supplemented with a brain tumor- specific module, are available. Both the tumor and its treatment can have a negative effect on HRQoL. However, treatment with surgery, radiotherapy, chemotherapy, and supportive treatment may also improve patients' HRQoL, in addition to extending survival. It is expected that the impact of HRQoL measurements in both clinical trials and clinical practice will increase. Hence, it is important that HRQoL data are collected, analyzed, and interpreted correctly. Methodological issues such as selection bias and missing data may hamper the interpretation of HRQoL data and should therefore be accounted. In clinical trials, HRQoL can be used to assess the benefits of a new treatment strategy, which should be weighed carefully against the adverse effects of that treatment. In daily clinical practice, HRQoL assessments of an individual patient can be used to inform physicians about the impact of a specific treatment strategy, and it may facilitate the communication between the physicians and the patients.

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. METHODS: A cohort of 220 IBD patients including 141 Crohn's disease(CD) and 79 ulcerative colitis(UC) patients was followed-up at a tertiary IBD center. A subgroup of the cohort(n = 26) took VD supplements for > 3 mo. Health related quality of life was assessed using the short IBD questionnaire(s IBDQ). VD serum concentration and s IBDQ score were assessed between August and October 2012(summer/autumn period) and between February and April 2013(winter/spring period). The mean VD serum concentration and its correlation with disease activity of CD were determined for each season separately. In a subgroup of patients, the effects of VD supplementation on winter VD serum concentration, change in VD serum concentration from summer to winter, and winter s IBDQ score were analyzed.RESULTS: During the summer/autumn and the winter/spring period, 28% and 42% of IBD patients were VD-deficient(< 20 ng/m L), respectively. In the winter/spring period, there was a significant correlation between s IBDQ score and VD serum concentration in UC patients(r = 0.35, P = 0.02), with a trend towards significance in CD patients(r = 0.17, P = 0.06). In the winter/spring period, VD-insufficient patients(< 30 ng/m L) had a significantly lower mean s IBDQ score than VD-sufficient patients; this was true of both UC(48.3 ± 2.3 vs 56.7 ± 3.4, P = 0.04) and CD(55.7 ± 1.25 vs 60.8 ± 2.14, P = 0.04) patients. In all analyzed scenarios(UC/CD, the summer/autumn period and the winter/spring period), health related quality of life was the highest in patients with VD serum concentrations of 50-59 ng/m L. Supplementation with a median of 800 IU/d VD day did not influence VD serum concentration or the s IBDQ score.CONCLUSION: VD serum concentration correlated with health related quality of life in UC and CD patients during the winter/spring period.

The effects of an exercise program on health-related quality of life in postpartum mothers: A randomized controlled trial

Background and Objective: There is controversy on the psychological effects of postpartum exercise. The study aimed to evaluate the effectiveness of a postpartum exercise program on health-related quality of life and psychological well-being. Methods: We conducted a randomized controlled trial in Tokyo, Japan. The intervention groups participated in ball-exercise classes (weekly exercise of 90 minutes for four weeks) at three months postpartum. The exercise class included the following: 1) greeting and warm-up;2) aerobic exercise involving bouncing on an exercise ball 55 or 65 cm in diameter;3) rest and self-introduction;4) stretching and cooling down. The primary outcome measure was health-related Quality of Life (QOL) assessed using the MOS Short-Form 36-Item Health Survey (SF-36v2). The secondary outcome measures were Rosenberg Self-Esteem Scale (RSES) and Edinburgh Postnatal Depression Scale (EPDS) scores. The intervention group was compared to the control group at four months postpartum. Results: Of the 120 women screened, 110 women met the study criteria. Nine could not be included and the remaining 101 were allocated randomly into intervention and control groups (50 and 51 participants respectively). Analysis of covariance adjusting for baseline values indicated that the SF36 subscales of physical functioning (p = 0.018) and vitality (p = 0.016) significantly improved in the intervention group compared to the control group, although there were no significant differences between the groups in the SF36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. The RSES increased in the intervention group (p = 0.020) compared to the control group. No significant group differences were observed in EPDS scores. Conclusions: The postpartum exercise class program provided to healthy postpartum women appears to have contributed to promoting health-related QOL and self-esteem.

Factors influencing health-related quality of life in chronic liver disease

AIM: To investigate the factors contributing to health- related quality of life (HRQL) in chronic liver disease (CLD). METHODS: Patients with CLD and age- and sex- matched normal subjects performed the validated Thai versions of the short-form 36 (SF-36) by health survey and chronic liver disease questionnaire (CLDQ). Stepwise multiple regression analysis was used to assess the impact of disease severity, demography, causes of CLD, socioeconomic factors, and self-rating health perception on HRQL. RESULTS: Two-hundred and fifty patients with CLD and fifty normal subjects were enrolled into the study. Mean age and the numbers of low educated, unemployed, blue-collar career and poor health perception increased significantly from chronic hepatitis to Child’s Classes A to B to C. Advanced stage of CLD was related to deterioration of HRQL. Increasing age and female reduced physical health area. Low socioeconomic factors and financial burden affected multiple areas of HRQL. In overall, the positive impact of self-rating health perception on HRQL was consistently showed. CONCLUSION: Advanced stages of chronic liver disease, old age, female sex, low socioeconomic status and financial burden are important factors reducing HRQL. Good health perception improves HRQL regardless of stages of liver disease.

Health-related quality of life evaluated by tumor node metastasis staging system in patients with hepatocellular carcinoma

AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM StageⅠto Stage Ⅱ, Stage ⅢA, Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage Ⅰ to Stage ⅢB (P = 0.002 vs Stage Ⅰ; P = 0.032 vs Stage Ⅱ; P = 0.033 vs Stage ⅢA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage Ⅱ; P = 0.032 vs Stage ⅢA). For the social and family well-being subscale, only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were significant differences for Stages ⅡΙ, ⅢA and ⅢB (P = 0.002vs StageⅠ). CONCLUSION: HRQoL of patients with HCC worsens gradually with progression of TNM stages. The most impaired subscales of HRQoL, as measured by FACT-Hep, were physical and emotional well-being.

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.

Health-related quality of life of 256 recipients after liver transplantation

AIM:To investigate health-related quality of life(HRQoL) and psychological outcomes in 256 adults who had undergone liver transplantation(LT).METHODS:A stratified random sampling method was used in this follow-up multicenter study to select a representative sample of recipients undergoing either living donor liver transplantation(LDLT) or deceased donor liver transplantation(DDLT).HRQoL was measured by using the Chinese version of Medical Outcome Study Short Form-36(SF-36),and psychological outcomes by using the beck anxiety inventory(BAI) and the self-rating depression scale(SDS).Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires.RESULTS:A total of 256 patients were sampled,including 66(25.8%) receiving LDLT and 190(74.2%) undergoing DDLT;15(5.9%) recipients had anxiety and four(1.6%) developed severe depression after the operation.Compared with LDLT recipients,DDLT patients had higher scores in general health(60.33 ± 16.97 vs 66.86 ± 18.42,P = 0.012),role-physical(63.64 ± 42.55 vs 74.47 ± 36.46,P = 0.048),roleemotional(61.11 ± 44.37 vs 78.95 ± 34.31,P = 0.001),social functioning(78.60 ± 22.76 vs 88.16 ± 21.85,P = 0.003),vitality(70.30 ± 15.76 vs 75.95 ± 16.40,P = 0.016),mental health(65.88 ± 12.94 vs 71.85 ± 15.45,P = 0.005),physical component summary scale(PCS,60.07 ± 7.36 vs 62.58 ± 6.88,P = 0.013) and mental component summary scale(MCS,52.65 ± 7.66 vs 55.95 ± 10.14,P = 0.016).Recipients > 45 years old at the time of transplant scored higher in vitality(77.33 ± 15.64 vs 72.52 ± 16.66,P = 0.020),mental health(73.64 ± 15.06 vs 68.00 ± 14.65,P = 0.003) and MCS(56.61 ± 10.00 vs 54.05 ± 9.30,P = 0.037) than those aged ≤ 45 years.MCS was poorer in recipients with than in those without complications(52.92 ± 12.21 vs 56.06 ± 8.16,P = 0.017).Regarding MCS(55.10 ± 9.66 vs 50.0 ± 10.0,P < 0.05) and PCS(61.93 ± 7.08 vs 50.0 ± 10.0,P < 0.05),recipients scored better than the Sichuan general and had improved overall QoL compared to patients with chronic diseases.MCS and PCS significantly correlated with scores of the BAI(P < 0.001) and the SDS(P < 0.001).CONCLUSION:Age > 45 years at time of transplant,DDLT,full-time working,no complications,anxiety and depression were possible factors influencing postoperative HRQoL in liver recipients.

Systematic review of health-related quality of life after esophagectomy for esophageal cancer

This study is aimed to assess the long-term health-related quality of life(HRQL) of patients after esopha-gectomy for esophageal cancer in comparison with es-tablished norms,and to evaluate changes in HRQL during the different stages of follow-up after esopha-geal resection. A systematic review was performed bysearching medical databases(Medline,Embase andthe Cochrane Library) for potentially relevant studiesthat appeared between January 1975 and March 2011.Studies were included if they addressed the questionof HRQL after esophageal resection for esophage alcancer. Two researchers independently performed the study selection,data extraction and analysis processes.Twenty-one observational studies were included witha total of 1282(12-355) patients. Five studies were performed with short form-36(SF-36) and 16 with European Organization for Research and Treatment of Cancer(EORTC) QLQ C30(14 of them also utilized the disease-specific OES18 or its previous version OES24) .The analysis of long-term generic HRQL with SF-36showed pooled scores for physical,role and socialfunction after esophagectomy similar to United Statesnorms,but lower pooled scores for physical function,vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 globalscale during a 6-mo follow-up showed that global scaleand physical function were better at the baseline. The symptom scales indicated worsened fatigue,dyspneaand diarrhea 6 mo after esophagectomy. In contrast,however,emotional function had significantly improved after 6 mo. In conclusion,short- and long-term HRQLis deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-termconsequence of esophagectomy involving either the respiratory system or the alimentary tract. The short-and long-term improvement in the emotional function of patients who have undergone successful operationsmay be attributed to the impression that they have survived a near-death experience.

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.

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.