Health-Related Quality of Life and Work Satisfaction in Working-Aged Adults Pre- and Post-Cochlear Implant: A Longitudinal Study.

Hearing loss is a growing public health concern associated with decreased health-related quality of life (HRQoL) and a negative impact on work life. Knowledge about the long-term benefits for patients receiving cochlear implants may provide knowledge imperative for policymakers to promote better HRQoL and working life outcomes for individuals with hearing loss. The purpose of this study was to explore how HRQoL, hearing disabilities, and work satisfaction outcomes changed in working-aged adults with severe to profound hearing loss from pre- to post-receiving a cochlear implant (CI) between the baseline, year one, and year two. This longitudinal study used Cochlear's Implant Recipient Observational Study (IROS) registry data to assess HRQoL, hearing disabilities, and work satisfaction in 18-65-year-old CI recipients. Data were collected pre- and post-implantation at baseline, year one, and year two follow-up. One hundred and twenty-seven CI recipients participated in the study. Significant improvements were observed for HRQoL outcomes for hearing, speech, emotion, and health utility post-implant. Overall hearing disability decreased post-CI, and work satisfaction improved. With the increasing prevalence of hearing disabilities, this is pertinent knowledge that supports the use of CIs for hearing rehabilitation which may promote better HRQoL and work satisfaction.

Health-related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross-sectional study in Singapore.

Chronic wounds commonly decrease patients' quality of life. Understanding how chronic wounds impact a patient's health-related quality of life (HRQoL) is important for healthcare service delivery and treatment management. This study explored HRQoL among patients suffering from chronic wounds and investigated associations with patients' socio-demographics and wound characteristics. Two hundred and thirty-three patients across six primary care clinics were assessed and responded to a survey that collected information on socio-demographic, wound characteristics, and HRQoL using the EQ-5D-5L instrument. Data were analysed by descriptive statistics and generalised linear models. The mean age of patients was 61.2 (SD: 14.6) years; 68.2% were males; and 61.8% were of Chinese origin. Arterial ulcers had the greatest negative impact on HRQoL related to mobility, self-care, pain/discomfort and anxiety/depression, and the lowest VAS mean score 62.31 (SD: 28.3; range: 0-100) indicating the worst health. HRQoL related to mobility was significantly associated with age (ß = 0.008, P < .001), non-Chinese ethnicity (ß = 0.25, P = .001), mixed ulcers (ß = -0.41, P = .022), atypical hard-to-heal wounds (ß = -0.38, P = .021), wounds with low (ß = 0.24, P = .044) to moderate (ß = 0.29, P = .018) exudate level, and a wound duration ≥6 months (ß = 0.19, P = .033). The findings can be used to improve healthcare delivery for patients with chronic wound to optimise their HRQoL.

A Scoping Review of End-of-Life Communication in International Palliative Care Guidelines for Acute Care Settings.

CONTEXT: End-of-life communication in acute care settings can be challenging and many patients and families have reported low satisfaction with those conversations. OBJECTIVE: To explore existing guidelines around palliative care to increase current understanding of end-of-life communication processes applicable to the acute care setting. METHODS: A scoping review following the method of Arksey and O'Malley was undertaken to identify eligible documents and thematically summarize findings. Web sites of government authorities, departments, and ministries of health as well as palliative care organizations were searched as were MEDLINE, CINAHL (EBSCOhost), EMBASE, Cochrane Library, Joanna Briggs Institute, and PsycINFO databases. Searches were limited to documents published between January 2009 and August 2019 that were nondisease specific and applicable to the acute care setting. RESULTS: Thirteen guidelines from nine different countries were identified. Thematic analysis produced eight themes: 1) The purpose and process of end-of-life communications, 2) cognitive understanding and language in end-of-life communication, 3) legal aspects of end-of-life communication, 4) conflicts and barriers related to end-of-life care, 5) end-of-life communication related to medical record documentation, 6) healthcare professionals' responsibilities and collaboration, 7) education and training, and 8) policies, guidelines, and tools for end-of-life communications. CONCLUSIONS: Palliative and end-of-life guidelines applicable to acute care settings outline the purpose of end-of-life communication and address how, when, and by whom such conversations are best initiated and facilitated. How guidelines are developed and what aspects of communications are included and emphasized may differ across countries related to role differences of physicians and nurses and national laws and regulations.