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Objective: To develop and validate a sensitive tool for assessment of quality of life (QoL) in heart failure (HF) patients in Indian settings. Methods: The authors conducted literature review, in depth interviews, clinical observations and designed the first draft of the QoL tool. The tool was validated using content and face validity by a panel of experts. For internal consistency reliability, the questionnaire was administered among 270 HF patients. Test-retest reliability was assessed in 20 HF patients. Principal component factor analysis with varimax rotation was employed to assess the dimensionality and to reduce the number of items. Cronbach's alpha, and Intra-class correlation coefficients (ICCs) were employed to investigate reliability of questionnaire. The responsiveness data were collected 6 months after the baseline data collection from 30 HF patients. IBM® SPSS® Statistics Version 21 was used for statistical analysis. Results: The principal component factor analysis revealed mainly 5 domains. The final tool included 25 items. Cronbach's alpha (α) for the overall tool was 0.915. Intra-class correlation coefficients (ICCs) based on test-retest was 0.734. The final tool showed good responsiveness to changes with a mean ± SD of the change in response of 46 ± 12.4 and a standardized mean response of 3.7 within six-months. Conclusion: The HF specific QoL tool developed for Indian patients is a valid and reliable instrument and it can be applied in daily clinical practice, and research. Short summary: We had developed and validated a quality-of-life tool for heart failure patients in India. This is the first ever attempt to develop a measure for heart failure patients in India. We had used a mixed methodology approach to identify all the domains in the tool. The newly developed tool is a valid, reliable, sensitive and responsive tool to measure quality of life in HF patients in India. This tool can be applied in daily clinical practice, research and health system for patients with HF in India.

Context: Oral diseases are an important public health problem because of their high prevalence, their impact on individuals and society, and the expensive nature of their treatment. The oral health of the older population is a global concern. Major problems include a high prevalence of missing teeth, dental caries, periodontal disease, and wasting diseases. Poor oral health has an influence on the quality of life (QoL) as well. We attempted to assess the impact of oral diseases on oral health-related QoL (OHRQoL) using the Geriatric Oral Health Assessment Index (GOHAI) questionnaire. Aim: To investigate the impact of oral diseases on OHRQoL using the GOHAI questionnaires. Settings and Design: The study was a population-based cross-sectional survey conducted among the older populations in South Kerala. Subjects and Methods: This was a population-based cross-sectional study, in which 399 people participated: 200 were female and 199 were male. People above 60 years of age, who were permanent residents of the district, were recruited for the study. The sampling method used was circular systemic random sampling. Clinical examination was done according to the World Health Organization Oral Health Assessment Form 2013, and OHRQoL was recorded using GOHAI questionnaire. Statistical Analysis Used: Descriptive analysis was performed using frequencies of variables, such as means and standard deviations. The bivariate analysis used Student's t-test to determine the association between variables. Results: The mean age of the subjects was 65 ± 5.5 years. Significant associations were found between the psychosocial domain and missing teeth (P < 0.05) and periodontitis (P < 0.05). In multivariate regression analysis, an association between the pain/discomfort domain was found in denture wear (P < 0.046) and tooth sensitivity (P < 0.003). Conclusions: The study found a reduction in the OHRQoL among the study population. The study finding underscores the impact of oral diseases on QoL.