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Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
BACKGROUND: Tuberculosis (TB) remains one of the leading infectious diseases globally, causing high mortality rates. A significant factor contributing to this issue is nonadherence to treatment, which is influenced by family support and impacts the quality of life (QoL) of patients. AIM: The purpose of this study was to describe the role of family support in enhancing medication adherence and improving QoL in individuals with TB. METHODS: This study utilized a scoping review method to examine literature from the PubMed, Scopus, and EBSCO databases. The keywords used in the search included "social support OR online social support OR perceived social support OR family support" AND "Tuberculosis OR TB OR TBC" AND "medication adherence OR medication compliance OR drug adherence OR drug compliance OR adherence OR compliance OR lost to follow-up" AND "QoL OR HRQoL OR health-related QoL." The inclusion criteria were full-text articles in English, primary research studies, and publications from the last 10 years (2012-2022). RESULTS: Thirteen articles met the inclusion criteria, with sample sizes ranging from 50 to 1342 respondents, predominantly using cross-sectional methods. The study found that family support is crucial in promoting medication adherence and positively influencing the QoL of TB patients. Family members provide emotional and practical support, including supervision of medication intake and encouragement of healthy habits. This support enhances patients' confidence, motivation, and overall treatment outcomes. CONCLUSIONS: The findings underscore the indispensable role of family support in addressing the complex interplay between medication adherence and QoL for individuals with TB.
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Família , Adesão à Medicação , Qualidade de Vida , Apoio Social , Tuberculose , Humanos , Tuberculose/tratamento farmacológico , Família/psicologia , Feminino , Masculino , Apoio FamiliarRESUMO
ABSTRACT Purpose: This prospective, randomized, unmasked, clinical trial aimed to report the visual outcomes of cataract surgery on both eyes versus cataract surgery on one eye in Brazilian patients. Methods: This study included patients with bilateral cataracts and binocular visual acuity worse than or equal to 0.3 logarithm of the minimum angle of resolution. The patients were randomly assigned to undergo surgery on one (Control Group) or both eyes (one eye at a time; Intervention Group). Postoperatively, self-reported visual function using Catquest-9SF (primary outcome measure), binocular visual acuity, stereopsis, and ocular dominance (secondary outcome measures) were compared. Results: A total of 151 patients (77 and 148 eyes in the Control and Intervention Groups, respectively) completed the follow-up. Patients who underwent surgery on both eyes exhibited significantly better self-reported visual function (p=0.036) and stereopsis (p=0.026) than those who underwent surgery on one eye. Binocular visual acuity and ocular dominance did not affect the group comparisons. Conclusions: Surgery on both eyes resulted in significantly better self-reported visual function and stereopsis than surgery on one eye.
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ABSTRACT Objective: The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0-12 years during the strict period of social isolation. Methods: This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis. Results: The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60-3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17-2.24); social distancing considered as "easy" (OR 1.67; 95%CI 1.20-2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08-3.45). Conclusions: This study indicates that the family context can influence children's QOL, especially during the COVID-19 pandemic and home environment reorganization.
RESUMO Objetivo: Investigar os fatores contextuais associados à qualidade de vida (QV) de crianças brasileiras de zero a 12 anos, em momento de ápice de distanciamento social. Métodos: Estudo observacional, transversal, online, de julho a setembro de 2020, com questionário sobre fatores do contexto familiar associados à QV e Inventário Pediátrico sobre QV — PedsQL™. A análise dos dados foi feita por de regressão logística multinomial. Resultados: A amostra foi de 849 crianças, na maioria da Região Sul (75%), brancas (83%), com desenvolvimento típico (79%), sedentárias (68%), com uso de telas (85%) em tempo >3h/dia (44%). As mães eram as cuidadoras principais (90%). Foram significativamente associadas a escores mais elevados de QV: a condição de saúde típica (odds ratio — OR 2,38; intervalo de confiança de 95% — IC95% 1,60-3,55), o tempo de tela ≤2h/dia (OR 1,62; IC95% 1,17-2,24), o distanciamento social considerado "fácil" (OR 1,67; IC95% 1,20-2,32) e a família afirmar estimular a criança (OR 1,93; IC95% 1,08-3,45). Conclusões: Este estudo mostra que o contexto familiar pode influenciar a QV de crianças, especialmente no período de pandemia e de reorganização do ambiente domiciliar.
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Resumo Enquadramento: A solidão e/ou isolamento social (IS) representa um problema de saúde pública. Os enfermeiros de família (EF), têm um papel crucial na prevenção, identificação e intervenção dos mesmos. Objetivo: Avaliar o impacte do acompanhamento por consulta não presencial do EF no IS, qualidade de vida (QdV) e autogestão da doença de pessoas idosas (PI) a viver só na comunidade. Metodologia: Estudo pré-experimental com desenho pré e pós, com 24 PI. Utilizou-se na recolha de dados: a escala breve de redes sociais de Lubben, a escala World Health Organization Quality of Life Group e o instrumento de autocuidado terapêutico. Resultados: Após a intervenção verificou-se uma melhoria no acompanhamento pelo EF (p < 0,001), um aumento de 33,3% na gestão do autocuidado e redução do risco de IS (45,8% para 33,3%). Na QdV houve um aumento no score global, contudo não estatisticamente significativo. Conclusão: O acompanhamento por consulta não presencial do EF teve efeito positivo no contacto e acompanhamento pelo EF, mitigação do IS e na melhoria de atividades de autocuidado.
Abstract Background: Loneliness and social isolation are significant public health issues. Family nurses play a vital role in identifying and preventing these phenomena and designing interventions to address them. Objective: To evaluate the impact of non-face-to-face follow-up consultations with family nurses on social isolation, quality of life, and disease self-management of older adults living alone in the community. Methodology: This pre-experimental study utilizes a one-group pretest-posttest design on a sample of 24 older adult patients. The Lubben Social Network Scale-6 (LSNS-6), the World Health Organization Quality of Life Group (WHOQOL) - OLD scale, and the Portuguese Version of the Therapeutic Self-Care Scale were used for data collection. Results: Following the intervention, patients' satisfaction with the family nurse's follow-up improved (p < 0.001). Additionally, there was a 33.3% increase in self-care management and a reduction in the risk of social isolation (45.8% to 33.3%). Although not statistically significant, there was also an increase in the global score of the quality of life variable. Conclusion: The non-face-to-face telenursing consultations positively affected the older adult patients' satisfaction with the family nurse's contact and follow-up, reduced social isolation, and improved self-care activities.
Resumen Marco contextual: La soledad o el aislamiento social (IS) constituyen un problema de salud pública. Los enfermeros de familia (EF) desempeñan un papel crucial en la prevención, identificación e intervención en estos problemas. Objetivo: Evaluar el impacto del seguimiento mediante consulta no presencial del EF en el IS, la calidad de vida (QdV) y la autogestión de la enfermedad en personas mayores (PI) que viven solas en la comunidad. Metodología: Estudio preexperimental con diseño previo y posterior, con 24 PI. Para la recogida de datos se utilizó la escala breve de redes sociales de Lubben, la escala World Health Organization Quality of Life Group y el instrumento de autocuidado terapéutico. Resultados: Tras la intervención, se produjo una mejora de la supervisión por parte de los EF (p < 0,001), un aumento del 33,3% en la gestión del autocuidado y la reducción del riesgo de IS (45,8% para 33,3%). En la QdV hubo un aumento de la puntuación global, pero no fue estadísticamente significativo. Conclusión: El seguimiento mediante consulta no presencial con el EF tuvo un efecto positivo en el contacto y acompañamiento por parte del EF, la reducción del IS y la mejora de las actividades de autocuidado.
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Abstract Objective: We aim to assess the quality of life of older individuals living in nursing homes. Methodology: A descriptive cross-sectional study was conducted on institutionalized elderly individuals for over three months. The sample size of the study was 260 and Non-randomized convenience sampling was used. The study excluded participants with cognitive impairment, severe medical conditions, physical limitations, communication barriers, severe pain, recent surgery, acute illness, or psychiatric disorders. Ethical approval was obtained, and participants were given informed consent. The study took place in various nursing homes in Lahore in June and July 2023, for the analysis of data Statistical Package for Social Sciences (SPSS version 22) was used, employing frequency distribution, mean, standard deviation, and correlation. Results: The Pearson Correlation coefficient of 0.459 suggests a significant positive correlation between these variables (p < 0.01). This correlation is evident in both directions: Quality of life (QoL) score to Mini Mental Scale and vice versa. Conclusion: While assessing the QoL in elderly inhabitants of nursing residences, cognitive impairment, and high Body mass index (BMI) appeared to influence the overall QoL.
Resumen Objetivo: Nuestro objetivo es evaluar la calidad de vida de las personas mayores que viven en residencias de ancianos. Metodología: Se realizó un estudio descriptivo transversal en ancianos institucionalizados durante más de tres meses. El tamaño de la muestra del estudio fue de 260 y se utilizó un muestreo de conveniencia no aleatorizado. El estudio excluyó a los participantes con deterioro cognitivo, afecciones médicas graves, limitaciones físicas, barreras de comunicación, dolor intenso, cirugía reciente, enfermedad aguda o trastornos psiquiátricos. Se obtuvo la aprobación ética y los participantes dieron su consentimiento informado. El estudio se llevó a cabo en varias residencias de ancianos de Lahore en junio y julio de 2023. Para el análisis de los datos se utilizó Statistical Package for Social Sciences (SPSS versión 22), empleando distribución de frecuencias, media, desviación estándar y correlación. Resultados: El coeficiente de correlación de Pearson de 0,459 sugiere una correlación positiva significativa entre estas variables (p < 0,01). Esta correlación es evidente en ambas direcciones: puntuación de calidad de vida a Escala Mini-Mental y viceversa. Conclusión: Al evaluar la calidad de vida de los ancianos que viven en residencias, el deterioro cognitivo y un índice de masa corporal (IMC) elevado parecen afectar la calidad de vida general.
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Abstract Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique that acts on the activity of the cerebral cortex employing electrical currents. Aim: The objective of this project is to evaluate the effectiveness of rTMS on pain and quality of life in patients with chemotherapy-induced peripheral neuropathic pain. Method: Ten patients with chemotherapy-induced peripheral neuropathic pain received 20 sessions of rTMS, consisting of 15 minutes of treatment repeated 5 times per week for four weeks (10 Hz, 20s, 30 trains with 81% intensity). Patients were evaluated using the Brief pain inventory (BPI) and the Functional Assessment of Cancer Therapy and neurotoxicity (FACT-GOG-NTX 13). Results: There were significant differences in BPI mean severity, interference score and FACT-GOG-NTX 13 (p<0,05). Conclusion: The pilot study results suggest that rTMS is potentially beneficial for the treatment of chemotherapy-induced peripheral neuropathy. rTMS over the M1 had an important reduction in pain severity, interference with daily activities, and quality of life scores. However, results should be taken with caution due to the small sample size, absence of a control group and short period of follow-up.
Resumen Antecedentes: La estimulación magnética transcraneal repetitiva (EMTr) es una técnica no invasiva que actúa sobre la actividad de la corteza cerebral, empleando corrientes eléctricas. Objetivo: El objetivo de este proyecto es evaluar la eficacia de la EMTr sobre el dolor y la calidad de vida en pacientes con dolor neuropático periférico inducido por quimioterapia. Métodos: Diez pacientes con dolor neuropático periférico inducido por quimioterapia recibieron 20 sesiones de EMTr que consistieron en un tratamiento de 15 minutos repetido 5 veces por semana durante cuatro semanas (10 Hz, 20 s, 30 trenes con 81 % de intensidad). Los pacientes fueron evaluados mediante el Inventario Breve de Dolor (BPI) y la Evaluación Funcional de la Terapia del Cáncer y la neurotoxicidad (FACT-GOG-NTX 13). Resultados: Hubo diferencias significativas en la severidad media del dolor del BPI, la puntuación de interferencia y el FACT-GOG-NTX 13 (p<0,05). Conclusión: Los resultados del estudio piloto sugieren que la rTMS es potencialmente beneficiosa para el tratamiento de la neuropatía periférica inducida por la quimioterapia. La rTMS sobre M1 tuvo una reducción importante de la severidad del dolor, la interferencia con las actividades diarias y las puntuaciones de calidad de vida. Sin embargo, los resultados deben tomarse con cautela debido al pequeño tamaño de la muestra, la ausencia de un grupo de control y el corto período de seguimiento.
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As queimaduras provocam efeitos físicos e psicológicos devastadores nos indivíduos, sobretudo em crianças e adolescentes, e podem modificar a qualidade de vida da pessoa. O objetivo foi analisar o impacto das cicatrizes por queimaduras em crianças menores de oito anos na interação com amigos, família e escola, na perspectiva dos pais. Estudo quantitativo de corte transversal realizado com os pais de crianças <8 anos de idade, vítimas de queimaduras e internadas em um Centro de Tratamento de Queimados no norte do Paraná e acompanhadas ambulatorialmente, de 2017 a 2020. A coleta de dados ocorreu por meio de dois instrumentos: caracterização sociodemográfica e clínica; e Brisbane Burn Scar Impact Profile. Realizou-se análise descritiva e teste Qui-quadrado utilizando-se o SPSS®. Participaram 34 pais cujas crianças sofreram queimaduras, sendo 52,9% de 1 a 3 anos de idade, 58,8% sexo masculino, 82,2% por agente etiológico térmico e a internação foi de 73,5% devido à Superfície Corpórea Queimada ≤20%. Após a alta os pais identificaram que as cicatrizes de queimaduras tinham "um pouco" e "pouco" impacto nas cicatrizes nas relações de amizade e na interação social. Para os pais, prevaleceu a resposta "nada" de impacto, seguido por "um pouco" e "muito" na escola, nas brincadeiras, nos jogos e nas atividades diárias. Quanto às reações emocionais e ao humor, a maior parte dos pais considerou "nada". Nesse sentido, os pais responderam às questões quanto à própria percepção sobre as atividades diárias do seu filho e, em geral, a cicatriz de queimadura não impactou na qualidade de vida da criança.
Burns cause devastating physical and psychological effects on individuals, especially children and adolescents, and can change a person's quality of life. The objective was to analyze the impact of burn scars in children under eight years of age in the interaction with friends, family and school, from the parents' perspective. Quantitative cross-sectional study carried out with the parents of children <8 years old who were victims of burns and admitted to a Burn Treatment Center in northern Paraná and monitored on an outpatient basis, from 2017 to 2020. Data collection occurred using two instruments: sociodemographic and clinical characterization; Brisbane Burn Scar Impact Profile. Descriptive analysis and Chi-square test were performed using SPSS®. 34 parents participated whose children suffered burns, 52.9% aged 1 to 3 years old, 58.8% male, 82.2% due to thermal etiological agent and 73.5% hospitalization was due to Burned Body Surface ≤ 20%. After discharge, the parents identified that the burn scars had "a little" and "little" impact on the scars in friendship relationships and social interaction. For parents, the answer "nothing" of impact prevailed, followed by "a little" and "a lot" in school, play, games and daily activities. As for emotional reactions and mood, most parents considered "nothing" that impacted the child with burn scars. In this sense, parents answered questions regarding their own perception of their child's daily activities and, in general, the burn scar did not impact the child's quality of life.
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Humanos , Masculino , Feminino , Lactente , Pré-EscolarRESUMO
RATIONALE & OBJECTIVE: End-stage kidney disease (ESKD) negatively affects patients' physical, emotional, and social functioning. Furthermore, adjustment to dialysis require substantial lifestyle changes that may further impact on patients physical and emotional well-being. However, the relationship between Health-Related Quality of life impairment with future adverse outcomes in dialysis is not well characterized. Our study aims to investigate the relationship between Health-Related Quality of Life (HRQoL) and patients' survival and hospitalization rates within a large European dialysis network. METHODS: A historical cohort study was conducted to evaluate association of HRQoL with hospitalization and mortality rates over a 12-month follow-up period. Patients responded to a self-administered survey as part of a Continuous Quality Improvement Program implemented in clinics affiliated with the Spanish FMC-Nephrocare organization. Health-Related Quality of Life (HRQoL) was measured with the KDQOL-36. Potential confounders included socio-demographic characteristics, comorbidities, biochemical parameters, dialysis treatment. We used Cox's Proportional Hazard regression to assess the hazard of death and Logistic Regression to assess the likelihood of hospital admissions during 12-month follow-up period. RESULTS: A total of 2280 (51.5%) completed the self-administrated survey, and 1838 patients met the inclusion/exclusion criteria of the study. Higher HRQoL scores were associated with significantly lower mortality and hospitalization risk. Risk estimates were robust to adjustment for potential confounders. CONCLUSIONS: Several dimensions of HRQoL are associated with patient-centered outcomes (i.e., mortality and hospitalizations at 1 year). Patient-Reported Outcomes contribute unique pieces of information characterizing patients' health. Residual confounding cannot be fully ruled out; moreover, the high attrition rate could result in selection bias, which may limit the generalizability of the findings to a broader population.
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Hospitalização , Falência Renal Crônica , Qualidade de Vida , Diálise Renal , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Estudos de Coortes , Falência Renal Crônica/terapia , Falência Renal Crônica/psicologia , Falência Renal Crônica/mortalidade , Insuficiência Renal Crônica/terapia , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/mortalidade , Taxa de SobrevidaRESUMO
BACKGROUND: Working in healthcare often involves stressful situations and a high workload, and many healthcare workers experience burnout complaints or suffer from mental or physical problems. This also affects the overall quality of health care. Many previous workplace interventions focused on knowledge exchange instead of other health cognitions, and were not particularly effective. Multicomponent lifestyle interventions may offer the potential in improving lifestyle and well-being of healthcare professionals. This study aims to evaluate the impact of a multicomponent lifestyle intervention "Healthy and Vital" for healthcare professionals on several health-related outcomes. METHODS: A pre- (multiple) post-pilot study has been conducted using data from 2012 to 2018 to evaluate the lifestyle intervention in 126 female healthcare professionals. Measurements were conducted before, directly after the intervention (at 3 months), and 6 months after finishing the intervention (at 9 months). Participants filled out questionnaires and anthropometrics measurements were conducted by a dietitian. The intervention is based on the ASE-model, theory of planned behavior, and motivational interviewing techniques. The intervention included workshops related to stress, eating, sleep, and individual meetings with a dietitian. Multilevel linear mixed models with a random intercept and fixed slope were used to evaluate the impact on lifestyle self-efficacy, eating behavior, anthropometric outcomes and quality of life. RESULTS: Improvements were observed for lifestyle self-efficacy (total: beta= 1.32 95%CI 0.94;1.48, I know: beta= 1.19 95%CI 0.92;1.46, and I can: beta= 1.46 95%CI 1.19;1.73), eating behavior (emotional eating: beta=-0.33 95%CI-0.44;-0.23, external eating: beta=-0.35 95%CI -0.44;-0.26, and diet/restrictive behavior: beta= 0.41 95%CI 0.30;0.51), anthropometric outcomes (weight: beta=-5.03 95%CI -5.93;-4.12, BMI: beta=-1.873 95%CI -2.06;-1.41, waist circumference: beta=-6.83 95%CI -8.00;-5.65, and body fat percentage: beta=-1.80 95%CI -2.48;-1.17) and multiple outcomes of quality of life (physical functioning: beta= 4.43 95%CI 1.98;6.88, vitality: beta= 7.58 95%CI 4.74;10.42, pain: beta=4.59 95%CI 0.91;1.827, general health perception: beta= 7.43 95%CI 4.79;10.07, and health change: beta= 21.60 95%CI 16.41;28.80) directly after the intervention. The improvements remained after a six-month follow-up. CONCLUSIONS: Multicomponent interventions such as "Healthy and Vital" for healthcare professionals may be useful for improving the health of healthcare workers. More research using other designs with a control group, such as a stepped-wedge or RCT, is needed to verify our findings. TRIAL REGISTRATION: Retrospectively registered on May 1 2024 at the Open Science Framework Registries ( https://doi.org/10.17605/OSF.IO/Z9VU5 ).
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Pessoal de Saúde , Humanos , Feminino , Adulto , Pessoal de Saúde/psicologia , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e Questionários , Promoção da Saúde/métodos , Estilo de Vida , Qualidade de Vida , AutoeficáciaRESUMO
BACKGROUND: The present paper focuses on socio-demographics, clinical variables, and the distance from the infection in predicting the long-term psycho-social consequences of COVID-19. METHODS: Patients were screened with a cross-sectional design at the Psychological Service of the University Hospital of Verona (Italy) at 3, 6, 12, and 18 months after their SARS-CoV-2 infection. The assessment was part of the Horizon 2020-funded ORCHESTRA Project and included the Hospital Anxiety and Depression Scale (HADS), the Short Form Health Survey 36 (SF-36), the Impact of Event Scale-Revised (IES-R), and ad-hoc questions measuring pre-post COVID-19 changes on psycho-social dimensions (sleep quality, nutrition, level of autonomy, work, social relationships, emotional wellbeing). RESULTS: Between June 2021 and June 2023, we evaluated 1317 patients (mean age 56.6 ± 14.8 years; 48% male): 35% at three months, 40% at 6, 20% at 12, and 5% at 18 months after the infection. Thirty-five percent were hospitalized due to COVID-19. Overall, 16% reported some form of clinically significant mental distress following the infection (HADS-TOT), with 13% and 6%, respectively, experiencing anxiety (HADS-Anxiety) and depressive symptoms (HADS-Depression). Four percent testified post-traumatic symptoms. The SF-36 scale revealed that 16% and 17% of subjects had physical or psychological deterioration in quality of life, respectively. The regression analyses showed that females experienced higher levels of anxiety and depression compared to males, along with worse mental and physical quality of life and pre-post infection changes in nearly all the investigated psycho-social dimensions. Younger people felt more anxiety and had a reduced mental quality of life than their older counterparts, who, in turn, had poorer scores in terms of autonomy and physical functioning. Hospitalized patients had lower levels of self-sufficiency, social relationships, and work than non-hospitalized people. The latter were more anxious and reported a lower physical quality of life. Finally, patients evaluated for the first time at 12- and 18 months showed a more significant impairment in mental and physical quality of life than those assessed at three months. CONCLUSIONS: Our data show that COVID-19 psychological sequelae tend to persist over time, still needing clinical attention and intervention planning, especially for females.
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Background: Charcot foot is a severe complication of diabetes mellitus. Amputation is associated with 5-year mortality rates as high as 70%, and the overall treatment cost for diabetic foot surpasses that of conditions such as cancer or depression. Objectives: To compare clinical, quality-of-life, and cost outcomes related to Charcot foot management through two distinct treatments: amputation and resection with stabilization using circular external fixation (CEF). Methods: This retrospective study included all adult patients treated at our unit between 2008 and 2022 for acute diabetic foot with infected ulcers. The allocation to treatment groups was based on the timing of patient enrollment. We gathered anthropometric, diagnostic, and surgical data, documenting individualized costs for preoperative, postoperative, and rehabilitation phases. Health status was assessed using the EQ-5D-3L questionnaire, and recorded data included mortality. Results: A total of 31 patients (18 amputations; 13 CEF) were included. Amputees exhibited significantly higher mortality compared to those with a CEF (44.8% vs 7.7%, p = 0.045). The estimated 3-year survival was 60.8% for amputees and 90% for the CEF group (log-rank test, p = 0.096). In terms of quality of life (EQ-5D-3L), amputees reported a reduction of 14.67 points while CEF patients reported an increase of 40.39 points (p < 0.001). The EQ-5D-3L index improved by 1.8 points for amputees, as compared with 62.3 points in the CEF group (p < 0.001). The total mean cost of managing an amputated patient was 222,864, practically identical to the 224,438 incurred in the CEF group (p = 0.767). No statistically significant differences were found in the time distribution of costs. However, some specific expense items demonstrated statistical significance. Conclusion: In treating infected diabetic foot ulcers, external fixation leads to a better quality of life compared to amputation. There's also a trend suggesting higher survival rates with external fixation, and both approaches have similar costs.
Background: - One of the most severe complications of diabetes is the occurrence of infected ulcers on the foot.- The reduced sensitivity of diabetic patients, coupled with their low defense capacity against infections, makes amputation of the foot one of the few viable treatments.- However, amputation in these patients is associated with higher mortality rates than many cancers. And surviving patients experience greatly reduced quality of life.- The economic costs of their treatment are very high.- In recent years, a new treatment option has become popular, consisting of removing all dead or infected tissue and stabilizing the foot with a device known as a circular external fixator. Objectives: - To compare the clinical outcomes, mortality, and quality of life of the two treatment methods: amputation and circular external fixation.- To compare the economic costs associated with each treatment. Methods: - We divided patients with acute diabetic foot with infected ulcers into two groups:â Amputation.â Circular external fixation.- We compared the mortality, clinical results, quality of life, and economic costs. Results: - 31 patients were included in the study. Of these, 18 were treated by amputation and 13 by circular external fixation.- The mortality rate in the amputee group (8 out of 18) was higher than in those treated by circular external fixation (1 out of 13).- The quality of life of amputated patients decreased, while that of patients treated by circular external fixation increased.- The average total cost of treatment for an amputated patient (222,864) and for a patient with circular external fixation (224,438) was very similar. Conclusion: - Patients with infected diabetic foot ulcers treated by circular external fixation have lower mortality rates and better quality of life than those treated by amputation.- The costs of treatment by amputation and by circular external fixation are practically identical.
Amputation versus circular external fixation in the treatment of diabetic foot with infected ulcers: a cost and quality-of-life analysis.
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Background: Myeloproliferative neoplasms (MPN) are a heterogeneous group of disorders characterized by the cellular proliferation of one or more hematologic cell lines. Patients with MPN who are Philadelphia-negative such as those with Polycythemia Vera (PV), Essential Thrombocytosis (ET), or Myelofibrosis (MF) experience a cluster of symptoms related to the disease activity which can affect their quality of life. Objectives: This study aimed to explore the symptoms and symptom experience as well as lived experience of Filipino patients with MPN using a qualitative phenomenological approach to get a deeper understanding of the disease symptomatology. Methods: Twenty-three patients with myeloproliferative neoplasms were purposively selected according to: 1) type of MPN (PV, ET, MF) 2) status of MPN disease (newly diagnosed vs. chronic) 3) age (≤50 years old; >50 years) and 4) sex (male vs. female). The investigators conducted key informant interviews using a semi-structured interview guide. Interview scripts and narratives were transcribed and analyzed using categorical aggregation and thematic analysis. Results: Twenty patients proceeded with the interview (8 PV, 6 ET, 6 MF). The meta-themes identified were 1) symptom experience and 2) disease perception. Three sub-themes under symptom experience were a) heterogenous and complex symptomatology; b) dynamic nature of symptoms; c) living and coping with symptoms. Three sub-themes under disease perception were a) struggle with the concept of the disease; b) anxiety and uncertainty; c) acceptance and hope. The most common symptoms experienced by the patients were fatigue, bone pain, and abdominal discomfort. Vascular symptoms specifically headache, numbness, and problems in concentration were commonly reported by patients with PV. Fever and weight loss were the least common. Sources of anxiety/uncertainty include the unpredictability of symptom occurrence and blood counts, the burden of taking maintenance medications, the financial burden of living with MPN, and the unpredictability of disease and complications. Conclusion: Patients with MPN had heterogenous, co-occurring, and dynamic symptoms which affected their overall productivity both at home and at work. Patients with MF had the most symptom burden while patients with ET had the least. This study provided valuable insights on disease perceptions, sources of anxiety, and coping mechanisms of patients with MPN. A deeper understanding of the symptom experience and disease perceptions of the patients will enhance the physician-patient interaction especially when discussing management options.
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Background Migraine is a primary headache disorder and one of the most common causes of disability worldwide. Prior reports showed a higher prevalence of migraine among physicians. We conducted this study to estimate the prevalence of migraine among physicians in Saudi Arabia, as well as its impact on quality of life. Methods A cross-sectional study was conducted using a validated online questionnaire that was distributed among physicians in various medical and surgical specialties in Saudi Arabia from January to June 2023. The inclusion criteria involved physicians in all specialties, who worked in governmental or private hospitals in Saudi Arabia. Employed or healthcare workers other than physicians were excluded. To measure the impact of headache on a person's quality of life, the Migraine Disability Assessment (MIDAS) test was applied. Statistical analysis of the study was conducted using the Statistical Package for the Social Sciences (SPSS) Version 24 (IBM Corp., Armonk, NY). Results We had 387 respondents, of whom 362 fulfilled the inclusion criteria. The mean age was 33.02 ± 9.07 years, and genders were distributed equally. Most physicians worked in departments of internal medicine, family medicine, general practice, and general surgery. The prevalence of migraine was recorded in 17.1% (62 patients) of all the included participants, with a female predominance. MIDAS revealed a total mean score of 16.823±14.149. The severity grades were classified as moderate (37.1%), severe (35.5%), or little to no (21.0%). Stress and light were cited as the top factors that trigger or worsen migraine, while sleep, rest, and quiet and darknesswere cited as the top relieving factors. The average number of headache attacks (month) was 6.823. Most patients with migraine were board residents (27.4%), living in the western region (53.2%), and working in a governmental hospital (38.7%). Conclusion Migraine is a common disorder among physicians in Saudi Arabia, with significant moderate-to-severe disability. Stress is identified as a major trigger. Proper awareness, stress management programs, and therapeutic intervention may mitigate the untoward consequences of migraine.
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Low anterior resection syndrome (LARS) is a common complication following sphincter-preserving surgical resection for rectal cancer, characterized by symptoms such as fecal incontinence, urgency, and altered bowel habits, which significantly affect patients' quality of life. This cluster of symptoms not only limits their day-to-day physical activity but also has a debilitating effect on their emotional and mental well-being, undermining their integration and overall psychological health. This systematic review aimed to evaluate the effectiveness of invasive and non-invasive interventions for LARS, including pelvic floor rehabilitation, transanal irrigation, and various surgical options such as sacral neuromodulation and stoma formation, either as part of primary surgery or as a definitive treatment option for refractory cases. We systematically searched relevant databases for studies published in the last decade, focusing on adult patients diagnosed with LARS post-low anterior resection (LAR), with outcomes assessed through bowel function and quality of life metrics. The review identified six studies that met our eligibility criteria; a pooled cohort of 794 patients was identified, with sample sizes ranging from 37 to 430 participants. Our analysis revealed that pelvic floor rehabilitation significantly improves bowel function and quality of life in patients with LARS; yet, the optimal management approach remains unclear due to variability in patient responses. These findings highlight the inherent complexity and heterogeneity of LARS management, underscoring the necessity for multifaceted and individualized treatment strategies. Although pelvic floor rehabilitation shows promise, especially among motivated patients, its long-term sustainability remains uncertain. Surgical options are typically reserved for severe cases and carry significant risks and psychological impacts. For patients identified as being at high risk for LARS, treatment options must be considered and discussed at an earlier phase of their care. Our review concludes with the need for a tailored, patient-centered approach to managing LARS, highlighting the importance of ongoing research to fill existing evidence gaps. There is a need for translational research across various treatment modalities, comparing their effects, cost-effectiveness, implementation strategies, and the consequent effects on patients' quality of life and mental health.
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Objectives: Acne scarring occurs from skin damage following acne healing. Treatments such as chemical peels, dermabrasion, and laser therapy can effectively enhance scars' appearance but could be expensive. This study aimed to reflect participants' awareness of treatment options and their willingness to pay (WTP), evaluating their association with sociodemographics, severity, and quality of life (QoL). Material and Methods: A cross-sectional study was conducted in Riyadh, Saudi Arabia, from June to July of 2023. Study participants were chosen using a non-probability sampling technique. Participants were aged 18 or older, had acne scarring, and resided in Riyadh. Data analysis was performed using RStudio, with P < 0.05 indicating statistical significance. Results: A total of 401 adult participants were included in the study. The prevalence of acne scarring among the participants was 63.4%. About 45.8% of the participants expressed a WTP of <1000 Saudi Riyals (SAR), while 42.2% were willing to pay 1000-6000 SAR. The most well-recognized acne scar management modalities were laser resurfacing (66.3%) and chemical peels (64.1%), while the least recognized were collagen/fat filler injections (23.9%) and radiofrequency microneedling (27.7%). Conclusion: The most recognized acne scar treatment modalities were laser resurfacing and chemical peels. Participants were willing to pay for reasons such as psychological impact, income levels, and awareness of treatment modalities. The findings could influence dermatologists to start awareness campaigns to debunk misconceptions about acne scar treatment modalities and their efficacy in improving QoL.
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Background: Because of improvements in initial tumor identification and treatment, as well as longer life expectancies, more people are receiving diagnoses for spinal metastases. Objective: The aim of this study was to assess early functional outcomes and quality of life (QOL) after surgical management of patients with spinal metastases. Patients and Methods: In this prospective cohort study, a total of 33 patients with thoracic and lumbar spine metastases who underwent surgical management between November 2021 and August 2023 were followed up for 1 year or until death. Oswestry Disability Index and the Eastern Cooperative Oncology Group Performance Status were used for the functional outcome; QOL was assessed using European Quality of Life 5-Dimensions (EuroQOL-5D). Scores were recorded preoperatively, 4 weeks postoperatively, and 6 and 12 months postoperatively. Results: The mean age was 52.12 ± 13.4 years (range: 23-70 years), 22 (66.7%) were females, and 11 (33.3%) were males. Patients were divided into three groups according to the revised Katagiri score: 12 (36.4%) patients were at low risk (0-3), 18 (54.5%) patients were at intermediate risk (4-6), and 3 (9.1%) patients were at high risk (7-10). The mean survival was 5.44 ± 3.46 months (range 1-13), and there was no perioperative death (within 1 month postoperative). Sixteen (48.5%) patients survived for more than 1 year and 17 (51.5%) patients died from different causes related to the natural history of tumor metastasis. Conclusion: Following surgical treatment of the spinal metastases, improvements in QoL and functional results were seen in the short-term. For patients with a projected life expectancy of longer than 3 months, surgery is a good alternative.
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Objective: To describe a simple therapeutic intervention for persistent congestion in an advanced heart failure patient using a continuous intravenous furosemide infusion in the home setting with a non-powered elastomeric pump that can be managed by the patient. Key Steps: Patient selected as a known intravenous furosemide responder with a supportive home environment. Shared care decision making with patient, cardiologist, heart failure nurse practitioner, palliative care physician, and general practitioner. Initiate this method of furosemide administration as an inpatient to test feasibility and determine choice of intravenous access. Communication links among lead prescriber, patient, hospital pharmacy, community nursing coordinator, patient's primary care practitioners. Community intravenous nursing support to initially change pumps, maintain intravenous line and site dressing, blood draw, teach patient to self-manage the prefilled pump changes. Baxter for compounding prefilled pumps. Potential Pitfalls: Permanent intravenous lines carry the risk of thrombosis, migration, and infection. High dose furosemide may cause ototoxicity, renal injury, electrolyte disturbance and hypotension. Take-Home Messages: Persistent congestion from chronic heart failure can be safely managed in the home with a continuous high dose intravenous furosemide infusion. In our experience, the use of elastomeric pumps has provided a simple, safe, and effective method of delivering intravenous diuretic therapy when coordinated by heart failure nurses.
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Background: Older adults with cognitive impairment can experience poor oral health due to reduced self-care ability, yet the impact of various oral health indicators on the cognitive ability remains unclear. We investigated the relationship between oral health indicators and mild cognitive impairment (MCI) in older adults. Methods: A cross-sectional study of 234 older adults aged 65 years or over was performed form January to March 2023 at health screening departments of hospitals. This study used the Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living (ADL), Clinical Dementia Rating (CDR), and Hachinski Ischemic Score (HIS) to measure MCI. Two qualified dentists performed clinical oral examinations (number of teeth lost, dental caries, removable dentures, periodontitis). The other oral health status was measured by subjective assessment questionnaires, and the oral health-related quality of life (OHRQoL) was assessed by Geriatric Oral Health Assessment Index (GOHAI). Results: Of the 234 older adults, 166 had MCI and 68 had normal cognitive ability. The univariate analyses revealed that older adults with poor oral health indicators of dental caries, mastication ability, oral and maxillofacial pain, self-perceived oral health status and OHRQoL had lower cognitive levels. The stepwise logistic regression analysis observed that higher education level (OR = 0.06, 95%CI = 0.007, 0.567) and OHRQoL score (OR = 0.92, 95%CI = 0.878, 0.963) were negatively associated with the presence of MCI. The area under the ROC curve (AUC) of MCI was 0.675 (95% CI: 0.600, 0.749) with a low sensitivity of 41.6% and a moderate specificity of 86.8%. Conclusion: OHRQoL was found to be associated with MCI, implying that OHRQoL may be important in cognitive decline. The GOHAI scale can be used to more easily assess the oral health of older adults, which is important for the timely detection of poor oral status to delay cognitive decline.
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Disfunção Cognitiva , Vida Independente , Saúde Bucal , Qualidade de Vida , Humanos , Saúde Bucal/estatística & dados numéricos , Idoso , Masculino , Feminino , Estudos Transversais , Avaliação Geriátrica , Idoso de 80 Anos ou mais , Atividades Cotidianas , Inquéritos e Questionários , Testes de Estado Mental e Demência/estatística & dados numéricosRESUMO
BACKGROUND: In-hospital mortality of septic critically ill patients with COVID-19 is significantly higher than in those without COVID-19. The knowledge on long-term outcomes remains scarce. In this retrospective analysis, we compare clinical characteristics, long-term functional outcomes, and survival in septic critically ill patients with and without COVID-19. METHODS: Data of septic critically ill patients without COVID-19 were collected as part of the Comprehensive Sepsis Center Dresden-Kreischa registry from 2020 to 2023. The data of septic critically ill patients with COVID-19 were collected as part of the local ARDS/COVID-19 registry over the same period. Diagnosis of sepsis was based on the Sepsis-3 definition. Variables collected for analyses were obtained from electronic health records. Long-term follow-up was performed 6-12 months after sepsis diagnosis. Survival was depicted using Kaplan-Meier curves. Associations between long-term mortality and risk factors were modeled by Cox Regression. RESULTS: 372 septic patients without COVID-19 and 301 with COVID-19 were enrolled. Septic patients with COVID-19 were significantly younger, had a significantly lower Charlson Comorbidity Index, and had a significantly higher SOFA score at ICU admission. Long-term follow-up showed a significantly higher mortality in septic patients with COVID-19 (73.4 % vs. 30.1 %; HR 3.4 (95 % CI 2.73-4.27; p < 0.05)). COVID-19 infection was associated with significant increased mortality (adjusted HR 3.27; 95 % CI 2.48-4.33; p < 0.05) and reduced health-related quality of life, measured by the EQ-5D-3 L Index, (0.56 (0.16-0.79) vs. 0.79 (0.69-0.99); p < 0.05). CONCLUSIONS: In our cohort of septic critically ill patients, health-related quality of life and long-term survival were considerably reduced in patients with concomitant COVID-19. Furthermore, COVID-19 could be identified as an independent risk factor for higher long-term mortality in these patients.