WHO BREF Quality of Life Score as a Prognostic Indicator of Survival in Patients recovered from COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis.

Coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19, this study was designed to assess the QOL in patients with and its predictability for survival in CAM victims. This long term prospective observational study of 290 patients with CAM was conducted over 2 years using a standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]), Karnofsky performance scale (KPS), palliative performance scale (PPS) and patient rated improvement (PRI) ranging from 0 to 9. Cut-off values of ≤ median score was considered to indicate poor QOL or poor improvement. The overall 2 year survival rate was 78.27% with mean survival time of 763.2 ± 1.2 days (Mean ± S.E) (95% CI: 760.76-765.6). The disease specific mortality was 22.1%. The overall mean QOL was 53.5(10.2) with 51% of population exhibiting poor QOL. Spearman rho correlation showed strong positive correlation between the three QOL scales and PRI (ρ-0.72, p < 0.001). On Cox regression analysis the stage, all four domains of WHO BREF, KPS, and PPS were independent predictors of long term survival in CAM patients. Approximately half of the patients with CAM had poor QOL and poor improvement. All 4 domains of WHO BREF score can be used as a predictor of long term survival in CAM patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM.

Assessment of Quality of Life Among Type 2 Diabetes Mellitus Patients in an Urban Health Center of Tiruvallur District, Tamil Nadu.

Introduction Diabetes mellitus (DM) is one of the leading causes of death and disability, in addition to its rapidly increasing prevalence in developing countries. The key element of managing diabetes is quality of life (QoL). It is a factor that is positively related to treatment adherence, and QoL motivates the patient to manage their disease and achieve health and happiness in the long term. We undertook this study in a district of South India among patients with type 2 diabetes mellitus (T2DM) to assess their QoL. Methodology A cross-sectional study was conducted among T2DM patients registered in a noncommunicable disease (NCD) clinic in an urban health center in Tiruvallur District, Tamil Nadu. Participants were selected using a systematic random sampling method from the NCD clinic register. Sociodemographic details of the participants were collected using a pretested, semistructured questionnaire, following which the World Health Organization Quality of Life-Brief Version Scale (WHOQOL-BBREF) questionnaire was used to assess the QoL. Data was entered in MS Excel (Microsoft Corporation, Redmond, Washington, United States) and analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). Results The mean age of the study participants was 53.5 ± 9.2 years. Females constituted 63.81% of the study population compared to males (36.19%). Domain-wise, 55.83% had good physical QoL, 49.1% had good psychological QoL, 49.69% had good social QoL, and 57.1% had good environmental QoL. Overall, 52.8% had a good QoL across all the domains. Conclusion The current study found that patients with diabetes had a good QoL with the exception in educational category. However, it is essential to create an awareness among the diabetic patients about the QoL and also the measures that they can practice to improve their QoL, which should be emphasized through health education, information education communication (IEC), and counselling in NCD clinics.

Quality of life following a maternal near-miss event during the COVID-19 pandemic at a tertiary care center in South India.

OBJECTIVE: To assess the quality of life (QoL) in women following a maternal near-miss event and to assess the women's attitude towards future fertility and their contraceptive choices. METHODS: A cross-sectional observational study was conducted in Government Medical College, Kozhikode, India among women who had experienced a near-miss event (n = 50) between January 1, 2020 and May 31, 2021 during the peak of the COVID-19 pandemic. The QoL was assessed using the WHO Quality of Life, BREF Version, questionnaire, which was administered to the consenting participants over phone. Information regarding desire for future fertility, contraceptive choices, and urogenital symptoms was also collected. A comparison between the short-term and long-term effects on the QoL was also done. RESULTS: A maternal near-miss event was not found to adversely affect the overall quality of life in the present study. The scores in all the four domains-physical, psychological, social relationships, and environmental-suggested good QoL, although greater variability in values were observed in the physical and psychological domains. The influence in these two domains was more pronounced following a perinatal loss and following prolonged physical morbidities. There was no difference in short- and long-term QoL following a maternal near miss (MNM). The MNM did not influence the contraceptive choices and there was no subsequent pelvic floor dysfunction in most women. CONCLUSION: MNM was not found to adversely affect the overall subsequent QoL in the present study. There was no difference in short- and long-term QoL following a MNM. Studies carried out over a longer period of time with a control group would yield more information.

Assessment of Quality of Life Among the Geriatric Population in an Urban Slum Settlement of Bhubaneswar, Odisha.

BACKGROUND: Multidimensional components of quality of life such as well-being, satisfaction, and lifestyle together ensure an improvement in longer life expectancy. Therefore, it is important to emphasize the assessment of the quality of life (QoL) of the elderly population and its association with various background characteristics. METHODOLOGY: A community-based cross-sectional study was carried out from April to September 2017 among 270 consenting elderly people residing in urban slums under the field practice area of a medical college, using a well-structured, globally validated World Health Organization Quality of Life Brief Version (WHOQOL-BREF) tool. The scores were computed for the different domains of WHO QoL, and the mean score of these domains was compared among the different socio-economic and demographic factors. RESULTS: The majority (67.41%) of the sampled population belonged to the 60- to 69-year-old age group; females (63.70%) outnumbered males. The total QoL score was 47.52 ± 15.06 showing that the average population had a fair QoL. The environmental domain had a poor QoL (43.15) score, and the rest of the domains showed a fair QoL. Higher age groups, persons other than self-employed, and the upper class were seen to have significantly lower QoL scores in all four domains. Females had a lower QoL score in the physical as well as social domains as compared to males. CONCLUSION: Aging is associated with a decrease in social and economic participation. In areas of compromised living conditions, like slums, the environmental domain adds to the decrease in quality along with the other domains. Ageing, employment status, socio-economic class, and the female gender had significantly lower QoL scores in all four domains.

Health-related quality of life in asthma measured by the World Health Organization brief questionnaire (WHO-BREF) and the effect of concomitant allergic rhinitis-A population-based study.

BACKGROUND AND OBJECTIVE: The impact of allergic rhinitis (AR), a common comorbidity in asthma, on global quality of life (QoL) using generic QoL questionnaires has not been extensively evaluated. METHODS: This was a cross-sectional population-based study among adults ≥18 years old. Generic QoL was measured using the World Health Organization (WHO) questionnaire (WHOQOL-BREF), and asthma control was assessed using the Asthma Control Test. Participants were categorized into four groups: Group 1 (No asthma, no AR), Group 2 (Asthma only), Group 3 (AR only) and Group 4 (Concomitant asthma and AR). The student t-test or the ANOVA was used for comparison between groups and based on the level of asthma control. Linear regression was used to assess the association between the level of asthma control and QoL scores, adjusted for age and sex. A p-value of less than 0.05 was considered significant for all associations. RESULTS: There were 9115 participants; 906 (9.9%) had asthma, and 1998 (21.9%) had AR. The lowest QoL scores were in the environment domain. Mean QoL scores were significantly lower in asthma compared to 'no asthma' and in AR compared to 'no AR'. Either asthma or rhinitis (Group 2 or 3) had significantly lower scores compared to no disease (Group 1) only in the environment domain, but the concomitant disease (Group 4) had lower scores across all categories and domains. Scores were significantly lower for uncontrolled asthma compared to controlled asthma and for 'concomitant asthma and AR' compared to 'asthma only'. Increasing age and uncontrolled asthma predicted worse health-related quality of life (HRQoL) consistently. CONCLUSION: Although asthma and AR negatively impact HRQoL independently, concomitant asthma and AR are worse. Uncontrolled asthma underpins poor QoL in asthma because QoL is not impaired in controlled disease. This underscores the need for recognition and treatment of AR in asthma and reinforces the benefits of achieving asthma control as a priority in asthma treatment.

Socio-demographic features and quality of life post burn injury.

Introduction: Burn injury is a highly devastating injury accounting for the major cause of disability-adjusted life years (DALYs) lost mostly in developing countries. Physical trauma, body disfigurement, the social stigma associated with injury completely shatter an individual's life. Aim: To study the quality of life among burn injury patients. Methodology: A cross-sectional hospital-based descriptive study was done on 150 burn injury patients. During the initial recruitment from Burns and Plastic Surgery Ward, socio-demographic profile and burn incident-related data were collected, whereas the WHO QoL-BREF tool was applied after 3 months of discharge during a follow-up visit in the outpatient department of Burns and Plastic Surgery to assess the quality of life among subjects. Data were compiled in MS Excel and statistical analysis was done using SPSS 20 version. Results: The study revealed poor quality of life among four domains of QoL; it was most inferior in the psychological domain followed by the physical health domain, environment domain, and social relationship domain. Conclusion: Advancement in the medical field has improved the survival rate in victims although the patients recover from the acute painful phase of physical trauma. However, the psychological and social impacts of injury remain unaddressed leading to a poor QoL. There is a need for an integrated approach for prevention and enhancement of the quality of care for the victims in all four domains of life. More emphasis is needed on rehabilitative care for long-term improvement in the QoL of the affected person.

Quality of Life and Its Association with Androgenetic Alopecia Patients in Shanghai: A Cross-Sectional Study.

Background: Health-related quality of life (HRQoL) of androgenetic alopecia patients has become increasingly important, but the influencing factors associated with the different domains are poorly understood. Objective: This study aimed to investigate the influencing factors in HRQoL of androgenetic alopecia patients and identify its strongly associated domains. Patients and Methods: We enrolled 170 androgenetic alopecia patients. HRQoL was measured using the World Health Organization Quality of Life Brief Version (WHO-BREF), and Hairdex. Results: HRQoL was significantly impaired in patients <30 years, (WHO-BREF: P=0.022, Hairdex: P=0.004), less educated (WHO-BREF: P=0.021, Hairdex: P=0.003), single patients (Hairdex: P=0.023), and urban residence (Hairdex: P=0.043). By domains, those <30 years were impaired by physical health (P=0.038) and psychological (P=0.030) by WHO-BREF, and symptoms (P=0.002) and emotions (P=0.002) by Hairdex. Singles were impaired by symptoms (P=0.020), and emotions (P=0.009) by Hairdex. Less-educated individuals had impaired all domains in the WHO-BREF and Hairdex, except for physical health. Women had impaired symptoms (P=0.013) and stigmatization (P=0.041) in Hairdex. Conclusion: Androgenetic alopecia is associated with significantly reduced HRQoL in young, less educated, and single patients. Dermatologists should inquire about Quality of Life and appropriately support androgenetic alopecia patients.

Quality of life among Oral Potentially Malignant Disorder (OPMD) patients: A prospective study.

OBJECTIVE: The purpose of this study was to evaluate the quality of life among the Oral Potentially Malignant Disorder (OPMD) patients during diagnosis, at one month and 3 months after intervention (surgical or conservative). METHODS: The University of Washington Quality of Life version (4UWQOL v4) and World Health Organization (WHO-BREF) were repeatedly administered on 54 OPMD patients. RESULTS: The results of Friedman's ANOVA showed a statistically significant change in the mean scores for pain, activity, speech, shoulder, taste, saliva, mood, and anxiety domains of UWQOL with time, (p-value <0.05); while physical health, social relationships, environment domains of WHO- BREF have shown significant changes in their respective mean scores. CONCLUSION: The assessment of Quality of Life (QOL) should routinely be done by the clinicians. If the clinicians start considering the QOL as the primary outcome of a treatment protocol, it will enhance patients' identity, well-being, and personality.

A Quality of Life Study in Patients with Leprosy Using DLQI and WHOQOL-BREF Questionnaires.

CONTEXT: India accounts for 60% of the global leprosy burden. Deformities lead to a negative impact on the quality of life (QoL). There is a paucity of Indian studies evaluating the QoL in patients with leprosy. AIMS: This study was undertaken to assess QoL in leprosy patients with two different questionnaires, correlate QoL with demographic and clinical profile and evaluate the impact on health-related QoL scores. SETTINGS AND DESIGN: A cross-sectional study to evaluate the QoL was conducted in the dermatology OPD of a tertiary center in Maharashtra, India. MATERIALS AND METHODS: Demographic and clinical profile along with evaluation of QoL using DLQI and WHOQOL-BREF questionnaires was conducted in 60 leprosy patients. STATISTICAL ANALYSIS USED: Parametric test, R test, Chi-square test, Z test, Student's t-test (t), and Pearson's correlation coefficient (r) were used. RESULTS: The mean DLQI score was 8.4 ± 4.4 and 40% of patients had moderate impact on QoL, and the mean WHOQOL-BREF score was 3.13 ± 0.9. The demographic profile, type of leprosy and reactions did not have a statistically significant correlation with DLQI. Presence of deformity had significant impact on DLQI and a statistically significant impact on physical, psychological, and environmental domain in WHOQOL-BREF analysis. CONCLUSIONS: Deformities have a profound impact on QoL in leprosy patients on evaluation with DLQI and WHOQOL- BREF questionnaires. The social domain was least affected, whereas severe impact was noted in psychological domain. DLQI is a practical and simple questionnaire, whereas WHOQOL- BREF provides a comprehensive approach on all domains.

Assessment of the quality of life of spinal cord injury patients in Peshawar.

OBJECTIVE: To assess the quality of life of spinal cord injury patients. METHODS: This cross-sectional study was conducted at Paraplegic Centre Hayatabad, Peshawar, Pakistan, from November 2015 to January 2016, and comprised spinal cord injury patients. A 26-item World Health Organisation quality of life questionnaire was used. Some of the patients were recruited from the paraplegic centre while others participated by filling an online questionnaire. SPSS 20 was used for data analysis. RESULTS: Of the 54 participants, 35(64.8%) were male and 19(35.2%) were female. Besides, 50(92.6%) participants were paraplegic while 4(7.4%) were tetraplegic. The overall mean score for the physical health domain was 54.79±18.39, psychological health domain 52.33±19.37, social relationship 58.79±20.69 and environmental domain 54.11±17.25. CONCLUSIONS: Patients with spinal cord injuries had moderate level of quality of life.

The Quality of Life and Its Influencing Factors among Medical Students / 中国医科大学学报

Objective To understand the present status and explore the influencing factors of quality of life(QOL)among medical students,so as to provide a reference for the improvement of the QOL. Methods A total of 1 898 medical students sampled by stratified cluster sampling method were recruited and investigated by wHO-BREF scale. The influencing factors were assessed by t-test and one-way ANOVA. The data were analyzed by SPSS 19.0. Results Scores of the physical,psychological,social relationship,environmental domain of quality of life were 64.99±13.28,61.85± 13.79,61.58±14.53,and 54.91±13.91,respectively. The results indicated grade,monthly income of family,physical training,quality of sleep and history of trauma were the influencing factors of QOL among medical students,and the differences were all statistically significant(P<0.05). Con?clusion The score of environmental domain of QOL among medical students was the lowest. In order to improve the QOL of medical students, schools should take different measures to them according to different grades or monthly income.

Health-related quality of life (hr-qol) in patients with type 2 diabetes mellitus.

BACKGROUND: Quality of life is an important aspect in diabetes because poor quality of life leads to diminished self-care, which in turn leads to worsened glycemic control, increased risks for complications, and exacerbation of diabetes overwhelming in both the short run and the long run. AIMS: The aim of our study is to examine the health-related quality of life of diabetic patients in rural India. MATERIALS AND METHODS: This case-control study was done among type 2 diabetes mellitus patients attending Medicine Outpatient department of a 780-bedded rural medical college located in central India. We used the World Health Organization Quality of Life Questionnaire - short version (WHOQOL-BREF) to assess quality of life. RESULTS: The HRQOL among diabetics and non-diabetic controls is comparable to each other with bad physical health, bad psychological health, deteriorating social relationships, and bad environmental conditions affecting the HRQOL of both the groups equally. The overall HRQOL of the total study population (cases and controls) was poor. CONCLUSION: The finding of this study will help in health promotion in rural medical practice in India. It would beckon the much awaited avenue of holistic care of a diabetic patient with equal importance to the mental wellbeing and quality of life, as compared to physical well being.

Quality of life in Wilson's disease.

BACKGROUND: Assessment of Quality of life (QoL) is fast assuming significance as the measure of health in many disorders. AIM: To correlate clinical severity and QoL in patients with Wilson's disease (WD). MATERIALS AND METHODS: We evaluated patients of WD on regular follow up for at least two years and aged over 18 years using Neurological Symptom Score (NSS) for clinical severity and WHO-BREF for QoL at a university teaching hospital. Patients with inability to respond to the questionnaire due to behavioral problems, low IQ or other disease related factors were excluded. These 30 patients (M:F:: 23:7) had a mean age of 27.97 +/- 11.16 years at evaluation and the mean duration of treatment of 9.2 +/- 6.4 years. RESULTS: All four domains of WHO-QoL-BREF viz., Physical, Psychological, Social and Environmental correlated well with each other (p < 0.01). The NSS correlated inversely with the physical domain (p < 0.02), while the duration of treatment had a positive correlation with the physical domain (p < 0.01). None of the other features of QoL showed any significant correlation with age, NSS or duration of treatment. CONCLUSION: QoL is complementary to formal neurological assessment and should be routinely incorporated in the evaluation of outcome of patients with WD and other chronic neurological disorders.