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Purpose: Both metabolic syndrome (MetS) and cognitive dysfunction impair health-related quality of life (HRQOL). This study aims to determine whether individuals experiencing both MetS and cognitive dysfunction have lower HRQOL. Methods: This cross-sectional study enrolled 567 participants who attended outpatient clinics at a medical center in northern Taiwan. MetS was diagnosed according to the modified criteria for the Asian population. Cognitive function was categorized as normal, mild cognitive dysfunction, and advanced cognitive dysfunction according to the score of the Montreal Cognitive Assessment, Taiwanese version. HRQOL was assessed using the SF-36v2® Health Survey (SF-36v2). The associations of the comorbidity status of MetS and cognitive dysfunction with HRQOL were analyzed using linear regression models, adjusting for age, sex, marital status, education level, income groups, and activities of daily living. Results: Out of 567 participants, 33 (5.8%) had MetS with mild cognitive dysfunction, and 34 (6.0%) had MetS with advanced cognitive dysfunction. Participants with both MetS and advanced cognitive dysfunction exhibited the lowest scores in the physical component summary and almost all scales of HRQOL. MetS exacerbated the inverse association between mild cognitive dysfunction and the mental component summary. For those with MetS, the scores on scales of role physical, bodily pain, vitality, and social functioning worsened as cognitive function deteriorated (all Ptrend<0.05). Conclusion: As the severity of comorbidity between MetS and cognitive dysfunction varies, patients exhibited poorer performance in different aspects of HRQOL. Future research is needed to find solutions to improve HRQOL for patients with both MetS and cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: Due to a short history of laparoscopic sleeve gastrectomy (LSG) as an independent bariatric procedure, we still lack studies providing analysis of the quality of life (QoL) in patients with type 2 diabetes mellitus (DM2). Aim: We aimed to assess the influence of LSG on QoL in obese patients with DM2. Material and methods: Prospective, observational study included patients with: morbid obesity, body mass index (BMI) ≥ 35 kg/m² and ≤ 50 kg/m², DM2 shorter than 10 years, qualified for LSG. Bariatric Analysis and Reporting Outcome System (BAROS) that included the Moorehead-Ardelt Quality of Life Questionnaire II (MA-QoLQII) score, and the SF-36 Health Survey (SF-36) questionnaire were used for repetitive assessment of QoL before LSG and after one and 12 months following surgery. Selected clinical and biochemical parameters were also repeatedly measured. Results: Thirty-three patients were included in the study (23 females). Patients' mean age was 45 ±10 years. BAROS significantly increased before LSG, one month, and one year after surgery (0.63 ±1.12, 2.94 ±1.90, and 4.97 ±2.08, respectively). The MA-QoLQII score significantly rose with an increase of excess body mass index loss (EBMIL) (P = 0.002) and remission of DM2 (P = 0.049), while inversely correlated with Homeostatic Model Assessment for Insulin Resistance index (HOMA-IR) (P = 0.003). Degenerative joint disease (P = 0.025) and average time of low glucose concentration in continuous glucose monitoring (CGM) (P = 0.005) had an inverse correlation with SF-36 Physical Component Summaries (PCS), standardized for cardiovascular comorbidity, EBMIL and HOMA-IR (P = 0.839; P = 0.086; P = 0.571, respectively). EBMIL (P = 0.003), remission of DM2 (P < 0.001) had a positive correlation with Mental Component Summaries (MCS), while HOMA-IR (P < 0.001) and count of low glucose concentration events (P = 0.022) had an inverse correlation with MCS, while standardized for average glucose concentration in CGM after 12 months (P = 0.586). Discussion: Significant improvement in QoL was observed in patients with DM2 after LSG. Remission of DM2, higher EBMIL, lower HOMA-IR, fewer and shorter low glucose concentration events in CGM after 12 months were factors that increased selected QoL scores. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the impact of selected Pilates exercises on the quality of life among elderly residents of Kalat Naderi, focusing on improvements in physical functioning, mental health, and general well-being. Methods and Materials: A randomized controlled trial design was employed, with 60 participants aged 55 and above, randomly assigned to either an intervention group that participated in a structured Pilates exercise program or a control group that received no intervention. Quality of life was measured at baseline, immediately post-intervention, and at a 3-month follow-up using the SF-36 Health Survey. Data analysis involved ANOVA with repeated measurements and Bonferroni post-hoc tests, conducted using SPSS version 27. Results: The intervention group demonstrated a significant improvement in quality of life scores from baseline (Mean = 54.67, SD = 5.34) to post-test (Mean = 55.23, SD = 4.89), and these gains were maintained at the 3-month follow-up (Mean = 56.12, SD = 4.56). In contrast, the control group showed minimal changes over the same periods. ANOVA results indicated a significant difference between the groups (F = 23.45, p < 0.001), and Bonferroni post-hoc analysis confirmed the significance of improvements in the intervention group compared to the control. Conclusion: The Pilates exercise program significantly enhanced the quality of life for the elderly participants in this study, suggesting that Pilates is an effective intervention for improving physical and mental well-being in this population. These findings indicate the necessity and importance of incorporating structured physical activity, such as Pilates, into the lifestyles of the elderly to promote better health outcomes and quality of life. [ABSTRACT FROM AUTHOR]

The Short Form 36 (SF-36) Health Survey has been widely used and has proven to be a valid and reliable scale for assessing health-related quality of life (HRQoL). However, research on HRQoL and validation of measurement scales in Mexico for its use with older persons is still incipient. The objective of this study was to evaluate the psychometric properties of SF-36 in a sample of 1,915 community-dwelling Mexicans 60 years and older, from two Mexican cities. Item mean scores were lowest in the dimensions of General Health (58.6), Social Functioning (58.9) Role Physical (66.5) and Vitality (67.8), and the highest mean scores were obtained in the Role Emotional (82.2), Mental Health (76.9), Bodily Pain (72.2) and Physical Functioning (70.3). The SF-36 showed appropriate internal consistency, construct validity, and factor structure. Reliability results showed a Cronbach's alpha with coefficient for all subscales between 0.79 and 0.87 indicating good reliability. Exploratory factor analysis showed six factors, different from its original structure. The Social functioning subscale presented the least acceptable results, which may reflect different understandings in the Mexican older population. The SF-36 showed good discrimination between groups of individuals with and without chronic diseases, and high correlation between depressive symptoms, economic situation, and social support. Results show that the SF-36 is adequate for use in Mexican older persons. In future studies, health outcomes for this population group in Mexico may be consistently assessed using the SF-36. [ABSTRACT FROM AUTHOR]

Abstract Background As a precarious clinical condition and a public health problem, heart failure (HF) is associated with a significant burden of morbidity, mortality, and health care costs. As almost all of the published research has been conducted in Western countries, there is a need for culturally relevant studies in Saudi Arabia. This is the first study to investigate health-related quality of life (HRQoL) and its associated factors among Saudi patients with HF in the Qassim region. Methods A cross-sectional study was conducted at the only tertiary care hospital in the Qassim region of Saudi Arabia during the period from November 2020 to July 2021. The participants were interviewed face-to-face by trained interviewers using the standard validated 36-item Short-Form Health Survey (SF-36) questionnaire for HRQoL assessment. The data were analyzed using STATA version 16. Results The participants included 246 HF patients whose mean (SD) age was 56.7 (10.9) years. A majority of the respondents (80%, n = 197) were male, and 49% (n = 121) had an education level of less than secondary school. The median scores were high for the domains of social functioning (100 points) and bodily pain (75 points) and low for role-physical functioning (25 points). In general, the median scores for the physical and mental component summaries were 58.1 and 63.7, respectively. Patients with an education level less than secondary school were more likely to have a low physical component summary score (aOR 3.00, 95% CI 1.46–6.17), while female patients were more likely to have a low mental component summary score (aOR 2.67, 95% CI 1.38–5.16). Conclusions Health-related quality of life was found to be moderate among these HF patients. Periodic HRQoL assessment is recommended for HF patients to minimize their physical and psychological concerns, particularly for patients with low education levels and female patients.

Background: While outcomes following reverse shoulder arthroplasty (rTSA) have often been gauged through radiological assessments focusing on prosthesis position, there is increasing recognition of patient-reported outcomes, particularly satisfaction, as indicators of surgical success. The objective of this study was to correlate radiological findings with clinical outcomes, patient satisfaction, and health-related quality of life (HRQoL)., Materials and Methods: A retrospective evaluation was conducted on patients following rTSA at a minimum of two years postoperatively. Functional outcome [Active ROM, Constant Score (CS), American Shoulder and Elbow Surgeons Score (ASES), Simple Shoulder Test (SST)] and the Short Form-36 (SF-36) were evaluated. Strictly anteroposterior radiographs were used to determine pre- and postoperative parameters. Preoperative measurements included acromiohumeral interval (AHI), reverse shoulder arthroplasty angle (RSA), center of rotation (COR), and deltoid length. Postoperatively, the lateralization angle (LSA), distalization angle (DSA), acromiohumeral distance (AHD), peg-glenoid rim distance (PGRD), sphere-bone overhang distance (SBOD), RSA, COR, and deltoid length were measured. Scapular notching was classified according to Sirveaux et al. RESULTS: A total of forty-nine patients were evaluated at an average of 30.78 ± 7.15 months postoperatively at last follow-up. Active range of motion (ROM), pain on the Visual Analogue Scale (VAS), and Constant Score (CS) showed significant improvement (p < .05). There was a high level of patient contentment, which correlated positively with the American Shoulder and Elbow Surgeons Score (ASES) and CS, and negatively with postoperative pain VAS. Postoperative HRQoL, measured by the SF-36, showed strong positive correlations with all clinical scores (p < .05). Distalization had a negative impact on external rotation (p = .001) and strength capacity (p = .031). Medialization of the COR showed a contrary relationship to external rotation (p < .001) and strength capacity (p < .001)., Conclusion: This study confirms rTSA's effectiveness in reducing pain and improving daily function, with a high readiness among patients to undergo the surgery again. Patient contentment and HRQoL showed a strong correlation with the clinical outcomes of the surgery. Radiological measurements may predict postoperative ROM and scapular notching yet fail to accurately reflect patient quality of life., (Copyright © 2024. Published by Elsevier Inc.)

Aims: Open tibial fractures are often life-changing injuries and patient outcomes remain poor despite the introduction of national management guidelines. The longer-term impact to the patient can be considerable but this is often overlooked in the literature. This study aims to establish the functional, physical, and psychosocial impact of sustaining an open tibial fracture.Methods: We reviewed 69 consecutive Gustilo-Anderson grade IIIB and IIIC open tibial fractures that presented to our Major Trauma Centre (MTC) between September 2012 and April 2018. Each participant was interviewed and sent patient-reported outcome questionnaires, a minimum of 12 months following injury. Our primary outcome was the Lower Extremity Functional Scale (LEFS). Secondary outcomes included the Short-Form 36 Healthy Survey (SF-36), Sickness Impact Profile 128 (SIP) and return to occupation. Subgroups were analysed according to age, Injury Severity Score (ISS) and limb amputation.Results: The mean follow up was 43 months. 96% were grade IIIB and 4% grade IIIC. The response rate for our study was 72%. The mean LEFS was 42 (IQR 21.5-58.5). All total and sub-domain scores within both the SF-36 and SIP questionnaires were reduced when compared to normative population data. Only 48% of patients returned to full time employment. Subgroup analysis revealed significantly reduced LEFS, SIP and SF-36 subdomain scores for those with a presenting ISS >14 and those undergoing limb amputation.Conclusion: Patients are at significant risk of longer-term functional, physical and psychosocial harm after suffering an open tibial fracture. Those sustaining major polytrauma or amputation demonstrated to have the greatest risk of poor outcome. Early identification of these individuals likely to suffer most from their injury would help direct appropriate resources to those with greatest need at the earliest opportunity. [ABSTRACT FROM AUTHOR]

Objective: To carry out both an objective and subjective assessment of the facial esthetics, clinical outcome, and quality of life evaluation in 25 OSAS patients treated with telegnathic surgery. Methods: Patients were analyzed using AHI, Legan and Burstone and airway cephalometric analysis for the objective study together with youthful and esthetic perception and SF-36 health surveys for the subjective part. Results: Facial convexity, nasolabial and lower face-throat angle, upper lip protrusion, and vertical height-depth ratio improved the facial and neck esthetics, while the maxillary and mandibular prognathism increased. Eighty-eight percent considered an esthetic change on their facial profile and 52% a more youthful profile. FS-36 survey (pre- 48.86 and post-surgery 71.74) and AHI (pre- 41.32 and post-surgery 7.80) scores improved significantly. Discussion: Results after telegnathic surgery were both esthetically and clinically satisfactory. The FS-36 survey should be considered for monitoring treatment in OSAS patients. [ABSTRACT FROM AUTHOR]

Background: As a precarious clinical condition and a public health problem, heart failure (HF) is associated with a significant burden of morbidity, mortality, and health care costs. As almost all of the published research has been conducted in Western countries, there is a need for culturally relevant studies in Saudi Arabia. This is the first study to investigate health-related quality of life (HRQoL) and its associated factors among Saudi patients with HF in the Qassim region.Methods: A cross-sectional study was conducted at the only tertiary care hospital in the Qassim region of Saudi Arabia during the period from November 2020 to July 2021. The participants were interviewed face-to-face by trained interviewers using the standard validated 36-item Short-Form Health Survey (SF-36) questionnaire for HRQoL assessment. The data were analyzed using STATA version 16.Results: The participants included 246 HF patients whose mean (SD) age was 56.7 (10.9) years. A majority of the respondents (80%, n = 197) were male, and 49% (n = 121) had an education level of less than secondary school. The median scores were high for the domains of social functioning (100 points) and bodily pain (75 points) and low for role-physical functioning (25 points). In general, the median scores for the physical and mental component summaries were 58.1 and 63.7, respectively. Patients with an education level less than secondary school were more likely to have a low physical component summary score (aOR 3.00, 95% CI 1.46-6.17), while female patients were more likely to have a low mental component summary score (aOR 2.67, 95% CI 1.38-5.16).Conclusions: Health-related quality of life was found to be moderate among these HF patients. Periodic HRQoL assessment is recommended for HF patients to minimize their physical and psychological concerns, particularly for patients with low education levels and female patients. [ABSTRACT FROM AUTHOR]

Aims/introduction: COVID-19 pandemic and its associated circumstances had adversely affected patients with chronic diseases. This study aimed to assess the health-related quality of life (QoL), and identify its psychological and clinical correlates in patients with diabetes mellitus (DM) during pandemic in Egypt. Materials and methods: A cross-sectional study, using a convenience sampling technique, was conducted among patients with DM who were recruited from Zagazig University endocrinology outpatient clinics, Sharkia Province, Egypt from June 30 to September 29, 2020. A total of 200 consecutive patients were interviewed using a semistructured demographic and clinical checklist, the fear of COVID-19 scale (FCV-19S), the Hospital Anxiety and Depression Scale (HADS), and the short form 36 (SF-36) health survey. Results: Poor physical and mental QoL was reported in 64% and 62% of patients with DM, respectively. Female gender, increased mean arterial pressure (MAP), associated physical comorbidities, and depressive symptoms were associated with lesser odds of physical QoL (OR 0.46, 0.96, 0.29, and 0.88, respectively). Besides, female gender, associated physical comorbidities, fear of COVID-19 virus infection (FCV), and depressive symptoms were associated with lesser odds of mental QoL (OR 0.41, 0.36, 0.91, and 0.84, respectively). The FCV was inversely correlated with all items of SF-36 among patients. Conclusion: QoL, either physical or mental, was adversely affected among patients with DM during pandemic. FCV was negatively correlated with all QOL domains. Longitudinal studies are warranted to explore the long-term effect of pandemic on the physical and mental well-being of patients with DM. [ABSTRACT FROM AUTHOR]

Objective: Smell and taste defects adversely affect both physical and mental health. The Short Form (SF)-36 Health Survey is a widely used tool for the quality of life (QoL) assessment. The aim of this study was to investigate the impact of smell and taste disorders on QoL in Thais using the SF-36 Health Survey (Thai version). Methods: This retrospective chart review included the patients with smell and taste disorders that attended our clinic during 2011 to 2016. Smell ability was evaluated by phenyl ethyl alcohol odor detection threshold, and smell discrimination and identification tests. Taste ability was evaluated by electrogustometry, regional testing, and modified taste strips. SF-36 was used to assess QoL. Results: Three hundred fifty-five patients were included in the final analysis. The mean age was 50.8±15.5 years, and 64.2% were female. Most patients (78.59%) had smell disorder only, 15.78% had taste disorder only, and 5.63% had both disorders. Specific to taste disorders, QoL was significantly lower in the patient group than in healthy population for the following 6 domains: physical function, role-physical, bodily pain, general health, vitality, and role-emotional (all p<0.05). Conclusion: The four major causes of smell and taste disorders are nasal/sinonasal diseases, idiopathic causes, post-URI, and head trauma. Women are more often affected than men. Although smell and taste disorders both adversely affect physical and mental health, the taste disorders cause more adverse effect. An assessment tool that is specific to smell and taste disorders may facilitate more detailed elucidation of the effect of these conditions on QoL. [ABSTRACT FROM AUTHOR]

Background: Coronary artery bypass grafting (CABG) is the best treatment option for coronary heart disease. It improves survival and quality of life (QOL) for patients with multivessel coronary artery disease and those with more advanced coronary artery disease, left ventricular dysfunction, or diabetes. The purpose of this study is to measure the QOL among patients after CABG surgery and its associated factors. Materials and Methods: A cross-sectional study was conducted in a cardiothoracic centre in Malaysia involving 184 respondents. A pretested, self-administered questionnaire which included the validated SF-36 Health Survey was filled by respondents who met the inclusion and exclusion criteria. Non parametric test was used to identify factors associated with QOL among the respondents. Significance level was set at 0.05. Result: The total number of respondents was 184 with response rate of 100%. From the analysis, the mean(SD) score of the eight domains of SF-36 ranges between 58.8(25.4) and 82.7(23.5), where the lowest score was physical functioning domain while the highest score was bodily pain and social functioning domain. The mean(SD) age of respondents was 59.86(8.17). Majority of respondents were male (82.6%), Malay (43.5%), Muslims (45.1%), married (85.9%), received minimal primary education (96.7%) and retired/unemployed (48.9%). Age, gender, religion, educational level and employment status, showed to have significant association with at least one domain of QOL including physical component score (PCS) and mental component score (MCS) with statistical significant set at P<0.05. Conclusion: Quality of life scores showed to be higher compared to coronary artery disease patients. Several sociodemographic characteristics (employed, married, high education level) were associated with good quality of life domains among the respondents. [ABSTRACT FROM AUTHOR]

Objective: The Sf-36 is the most widely used instrument to measure health-related quality of life (HRQoL) with the most convincing evidence of both internal consistency and test–retest reliability. In addition, it is appropriate for use among elderly and minority groups like migrants. The aim of this study is to investigate and compare the reliability and the factorial structure of the Sf-36 in a sample of elderly migrants and natives. The hypothesis is that the construct (the HRQoL consisting of eight dimensions correlated with two components) is the same for elderly Turkish migrants, Polish migrants and German natives. This means that the Sf-36 model shows good psychometric properties and model invariance for the three groups investigated in this study. Methods: The Sf-36 v.2 was forward and backward translated to Turkish and Polish. In this cross-sectional study, interviews were conducted with a sample of elderly migrants from Turkey (n = 100), from Poland (n = 103) and a sample of elderly German natives (n = 101). All data were entered and analysed using SPSS version 21 and AMOS Graphics. Cronbach’s α was used to analyse the reliability of the Sf-36. Multi-group confirmatory factor analysis (MGCFA) and structural equation modelling (SEM) were used for the Sf-36 model invariance testing. Results: The reliability of the Sf-36 was good to excellent for all Sf-36 dimensions (α > 0.7) except for General Health (0.55) in the Polish group. Multi-group confirmatory factor analysis (MGCFA) showed non-invariance between the three groups (CMIN: 180.172, df: 51, CMIN/df: 3.533, p

Background. With the improvement in survival rates after lung transplantation, concern has arisen about evaluating quality of life (QoL). This multicenter cross-sectional study aimed at describing QoL and identifying factors associated with it. Methods. We assessed QoL in 129 lung transplant recipients from 5 centres in Italy, during scheduled followup visits, using the SF-36, GHQ and St George’s respiratory questionnaires (SGRQ). Results. The SF-36 elicited impaired QoL in the physical, but not in the mental domains (PCS=44; MCS=53). The GHQ identified 29 patients (23%) with psychological discomfort and the SGRQ scores were significantly better than those of patients with chronic respiratory disease. On multivariate analysis, exertional dyspnea was an independent predictor of the PCS (adjusted Δ -6.3 (p5. Conclusions. The study identified exertional dyspnea as the main determinant of QoL as measured both by SF36 (PCS) and GHQ. Other objective measures contributed only to the PCS. Thus, the SF-36 (PCS) and GHQ were useful in identifying patients who needed treatment not only for complications but also psychological support and continued physical rehabilitation.

BACKGROUND: Low back pain (LBP) is one of the most common health complaints, with lifetime prevalence rates as high as 84%. The Oswestry Disability Index (ODI) is often the measure of choice for LBP in both research and clinical settings and, as such, has been translated into 29 languages and dialects. Currently, however, there is no validated version of Hebrew-translated ODI (ODI-H). OBJECTIVE: To examine the psychometric properties of the ODI-H. METHODS: Cross-culturally appropriate translation into Hebrew was conducted. A convenience sample of 115 participants (Case Group) with LBP and 68 without LBP (Control Group) completed the ODI-H, SF-36 Health Survey, and two Visual Analog Scales (VAS). RESULTS: Internal consistency was α = 0.94 and test-retest reliability for 18 participants repeating the ODI-H was 0.97. No floor or ceiling effects were noted for Cases, although there was a floor effect for the Control Group. Scores were significantly different for the two groups, indicating discriminant validity. Concurrent validity was reflected by significant correlations with SF-36 scores, particularly the Physical Functioning and Bodily Pain subscales (-0.83 and -0.79, respectively) and with the VAS (0.84 and 0.79). CONCLUSIONS: The ODI-H is a valid and reliable measure of low back pain-related disability for the Hebrew-speaking public. [ABSTRACT FROM AUTHOR]

Purpose: The structural equation modeling (SEM) approach for detection of response shift (Oort in Qual Life Res 14:587-598, 2005. doi: 10.1007/s11136-004-0830-y ) is especially suited for continuous data, e.g., questionnaire scales. The present objective is to explain how the SEM approach can be applied to discrete data and to illustrate response shift detection in items measuring health-related quality of life (HRQL) of cancer patients.Methods: The SEM approach for discrete data includes two stages: (1) establishing a model of underlying continuous variables that represent the observed discrete variables, (2) using these underlying continuous variables to establish a common factor model for the detection of response shift and to assess true change. The proposed SEM approach was illustrated with data of 485 cancer patients whose HRQL was measured with the SF-36, before and after start of antineoplastic treatment.Results: Response shift effects were detected in items of the subscales mental health, physical functioning, role limitations due to physical health, and bodily pain. Recalibration response shifts indicated that patients experienced relatively fewer limitations with "bathing or dressing yourself" (effect size d = 0.51) and less "nervousness" (d = 0.30), but more "pain" (d = -0.23) and less "happiness" (d = -0.16) after antineoplastic treatment as compared to the other symptoms of the same subscale. Overall, patients' mental health improved, while their physical health, vitality, and social functioning deteriorated. No change was found for the other subscales of the SF-36.Conclusion: The proposed SEM approach to discrete data enables response shift detection at the item level. This will lead to a better understanding of the response shift phenomena at the item level and therefore enhances interpretation of change in the area of HRQL. [ABSTRACT FROM AUTHOR]

Background: At the time of initial diagnosis, only 15-20% of patients with pancreatic cancer present with a resectable disease. Patients with pancreatic cancer face a poor prognosis. Progression-free survival and overall survival rates are very limited, so it is important to develop concepts to improve the quality of life for their remaining lives.Methods/design: The proposed trial is a randomized controlled intervention study. After pancreatic resection, the intervention group (cohort A, n = 30 patients) will take part in an intensified physiotherapy program consisting of endurance and muscle force exercises. The control group (cohort B, n = 30 patients) will take part in standard physiotherapy. Both groups will receive dietary counseling and, if necessary, substitution for endocrine/exocrine pancreatic insufficiency. Quality of life will be evaluated using the Short Form-8 Health Survey and the European Organization for Research and Treatment of Cancer QLQ-C30/QLQ-PAN26 questionnaires.Discussion: The aim of this study is to investigate whether intensive physiotherapy improves the quality of life of patients after pancreatic resection. If the results for the intervention group are positive, a multicenter study should be performed with appropriate statistical power. The progressive postresection program includes a structured follow-up after pancreatic resection. In this study, all patients will undergo abdominal computed tomography for follow-up 6 and 12 months postoperatively.Trial Registration: German Clinical Trials Register DRKS00006786. Date of registration 1 October 2014. [ABSTRACT FROM AUTHOR]

Background: A major goal of much aging-related research and geriatric medicine is to identify early changes in health and functioning before serious limitations develop. To this end, regular collection of patient-reported outcome measure (PROMs) in a clinical setting may be useful to identify and monitor these changes. However, existing PROMs were not designed for repeated administration and are more commonly used as one-time screening tools; as such, their ability to detect variation and measurement properties when administered repeatedly remain unknown. In this study we evaluated the potential of the RAND SF-36 Health Survey as a repeated-use PROM by examining its measurement properties when modified for administration over multiple occasions.Methods: To distinguish between-person (i.e., average) from within-person (i.e., occasion) levels, the SF-36 Health Survey was completed by a sample of older adults (N = 122, M age  = 66.28 years) daily for seven consecutive days. Multilevel confirmatory factor analysis (CFA) was employed to investigate the factor structure at both levels for two- and eight-factor solutions.Results: Multilevel CFA models revealed that the correlated eight-factor solution provided better model fit than the two-factor solution at both the between-person and within-person levels. Overall model fit for the SF-36 Health Survey administered daily was not substantially different from standard survey administration, though both were below optimal levels as reported in the literature. However, individual subscales did demonstrate good reliability.Conclusions: Many of the subscales of the modified SF-36 for repeated daily assessment were found to be sufficiently reliable for use in repeated measurement designs incorporating PROMs, though the overall scale may not be optimal. We encourage future work to investigate the utility of the subscales in specific contexts, as well as the measurement properties of other existing PROMs when administered in a repeated measures design. The development and integration of new measures for this purpose may ultimately be necessary. [ABSTRACT FROM AUTHOR]

This was a longitudinal health-related quality of life (HRQoL) study conducted among smear positive pulmonary tuberculosis (PTB) patients at the chest clinic of Penang General Hospital between March 2010 and February 2011. Primary objective of this study was to propose an appropriate statistical method in analysing longitudinal HRQoL data. Eligible patients (i.e., a case of new smear positive PTB, literate and 18 years and above) were asked to self-complete the SF-36v2 questionnaire at the start of the treatment, after the intensive phase and at the end of the treatment. The mean physical component summary (PCS) and mental component summary (MCS) scores, ranging from 47 to 53, were considered equivalent to the general population norms. Repeated measures ANOVA (with single imputations) and linear mixed model were used to analyse the data. The study's findings indicated compromised health among the study participants even at the end of treatment. In repeated measures ANOVA analysis, level of education, diabetes, being alcoholic and cough with sputum were the significant predictors of PCS, whereas none of the covariates explained a significant variance in the MCS scores. In linear mixed model, ethnicity, marital status, being a smoker, productive cough and ≥3 TB-related symptoms were the significant predictors of PCS. Similarly, covariates such as ethnicity, hypertension, being a smoker, monthly income ≥1,000 Malaysian Ringgit and ≥3 TB-related symptoms significantly explained variance in the MCS scores. According to different findings obtained from both methods and the limited assumption in applying repeated measures ANOVA, linear mixed model was preferred to analyse this data. [ABSTRACT FROM AUTHOR]

Background and aims: No studies have been published regarding the results of lumbar spine surgery in a population-based setting in Finland. Our objective was to investigate functional capacity and quality of life after lumbar spine surgery in a population-based cohort in Northern Finland, focusing on working-age patients. Methods: This was a cross-sectional postal survey. Three questionnaires (a self-made questionnaire, the Oswestry Low Back Disability Questionnaire and the SF-36) were sent the patients aged 18-65 years, who had undergone lumbar spine surgery due to disc herniation, instability or spinal stenosis in the Oulu University Hospital between June 2005 and May 2008. Results: The postal survey was sent to 814 patients, of whom 537 patients (66%) replied. Of these, 361 (67%) underwent disc surgery, 85 (16%) stabilizing surgery and 91 (17%) decompression. Pain was absent or present only occasional in 51% in the disc surgery group, whereas it was present daily in 59% in the stabilizing surgery group and in 58% in the decompression group (P < 0.001). Axial pain was slightly more intense than radicular pain. Pain was milder in the disc surgery group compared with the stabilizing surgery and decompression groups: mean (SD) axial pain with 0-10 NRS was 4.0 (2.3), 4.7 (2.4) and 4.8 (2.3) respectively (P = 0.002) and radicular pain 3.5 (2.6), 4.2 (2.8), 4.5 (2.6) respectively (P < 0.001). The total ODI score (mean, SD) was 20 (17) in the disc surgery group, 35 (17) in the stabilizing surgery group and 32 (17) in the decompression group (P < 0.001). The physical dimension sum score from the SF-36 was 42 (11) in the disc surgery group and 34 (10) in the stabilizing surgery and decompression groups (P < 0.001). Mental sum scores did not vary significantly between the groups. Conclusions and Implications: Outcome was good after lumbar disc operations but less favourable after stabilizing surgery and decompression regarding pain, functional capacity and quality of life. Implications. This study offers important information about outcome after lumbar spine surgery in Oulu University Hospital. It also brings out that in Finland we need systematic national spine register, with accurate pre-and postoperative data. [ABSTRACT FROM AUTHOR]

Informal carers represent a substantial proportion of the population in many countries and health is an important factor in their capacity to continue care-giving. This study investigated the impact of care-giving on the mental and physical health of informal carers, taking account of contextual factors, including family and work. We examined health changes from before care-giving commenced to 2 and 4 years after, using longitudinal data from the Household Income and Labour Dynamics in Australia survey. The sample comprised 424 carers and 424 propensity score-matched non-carers. Health was self-assessed, measured with the SF-36 Health Survey Mental Health (MH) and Physical Functioning (PF) scales. Care-giving was classified as non-carer, low (<5 hours/week), moderate (5-19 hours/week) and high (20 or more hours/week). PF and MH change scores were regressed on baseline scores, care-giving, covariates (including work, family and socio-demographic characteristics) and interactions to identify impacts for subgroups. The physical and mental health impacts differed by gender, and care-giving hours and carer work hours were important contextual factors. Deterioration in both PF and MH was worse for females after 2 years and deterioration in MH was worse for males after 4 years. Among carers aged 40-64 years, there was a 17-point decline in PF (P = 0.009) and a 14-point decline in MH (P < 0.0001) after 2 years for female high caregivers working full-time and 9.3 point improvement (P = 0.02) for non-working male high caregivers. Change was not significant for non-carers. The study found that not all carers suffer adverse health impacts; however, the combination of high levels of care-giving with workforce participation can increase the risk of negative physical and mental health effects (particularly in female carers). Working carers providing high levels of care represent a vulnerable subgroup where supportive and preventive services might be focused. [ABSTRACT FROM AUTHOR]

To validate short-form-36 health survey (SF-36) with specific scoring algorithm obtained in a large sample of Chilean older people and to associate quality of life in this sample with social and health related factors. A cross-sectional study on 2,143 community-living subjects aged 60-92 years (33 % men and 67 % women) conducted in Santiago, Chile. Scores in 8 scales of SF-36-physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH)-, were calculated. Factor analysis was used to extract two principal factors and logistic regression model was applied to estimate its association with socio-demographic and health variables. The internal consistency of scales was high (Cronbach's alpha 0.86-0.87). Factor analysis retained two factors: mental (MCS) and physical (PCS) components accounting for 65.3 % of total variance (55.3 and 10.0 % respectively). High correlations (0.61-0.94) between MCS and MH, V, RE and SF were obtained. PCS correlated highest (0.72-0.86) with RP, PF and BP. Self-perceived symptoms of depression (GDS-15 ≥5) was the main variable explaining low scores in both MCS and PCS (adjusted OR = 26.9; 95 % CI: 15.3-47.2; OR = 3.4; 95 % CI: 2.1-5.5, respectively). We have demonstrated the reliability and validity of SF-36 questionnaire to evaluate health related quality of life, reporting Chilean-Specific factor score coefficients for MCS and PCS based in national Chilean means and standard deviations for older people. After adjusting by age and gender, the main predictors of low health related QoL in Chilean older people were self-perceived symptoms of depression, the presence of two or more chronic diseases and illiteracy. Important gender inequalities were observed in all of these results, being consistently less favorable in women than in men. [ABSTRACT FROM AUTHOR]

Objectives Restless legs syndrome ( RLS) has a high prevalence in the general population. Treatment with intrathecal morphine has been shown to be successful in a small number of patients. Our aim was to quantify the effect on RLS-related symptoms, health and quality of life in three patients treated with intrathecal morphine. Materials and Methods Three patients with medically refractory RLS received an implanted pump for delivery of intrathecal morphine. Severity of RLS and self-assessed health were rated using the International Restless Legs Syndrome Study Group ( IRLSSG) rating scale and the Short Form health survey ( SF-36). Assessments were made preoperatively and after 6 months of follow-up. Results Preoperatively two patients had very severe RLS, scoring 35 and 36 on the IRLSSG rating scale, and one patient had severe RLS (score, 26). All three patients were free of symptoms of RLS post-operatively and also at the 6-month follow-up. The daily doses of intrathecal morphine ranged from 73 to 199 µg. Results from the SF-36 health survey showed that all three patients had a better physical health compared to before surgery. Conclusion Intrathecal morphine may be efficient in the treatment for medically refractory RLS. All three patients became completely free of symptoms, and there was also improvement in self-perceived overall health. [ABSTRACT FROM AUTHOR]

Objective : To carry out both an objective and subjective assessment of the facial esthetics, clinical outcome, and quality of life evaluation in 25 OSAS patients treated with telegnathic surgery. Methods : Patients were analyzed using AHI, Legan and Burstone and airway cephalometric analysis for the objective study together with youthful and esthetic perception and SF-36 health surveys for the subjective part. Results : Facial convexity, nasolabial and lower face-throat angle, upper lip protrusion, and vertical height-depth ratio improved the facial and neck esthetics, while the maxillary and mandibular prognathism increased. Eighty-eight percent considered an esthetic change on their facial profile and 52% a more youthful profile. FS-36 survey (pre- 48.86 and post-surgery 71.74) and AHI (pre- 41.32 and post-surgery 7.80) scores improved significantly. Discussion : Results after telegnathic surgery were both esthetically and clinically satisfactory. The FS-36 survey should be considered for monitoring treatment in OSAS patients.

Abstract: Objective: To evaluate the perception of health-related quality of life (HRQoL) in Portuguese patients with narcolepsy, and to compare the results to normative data. Methods: Fifty-one narcoleptic adults (26M, 25F), aged between 18 and 80years (mean=43.35, SD=15.32), were included in the final analysis of a multicentric cross-sectional study. The Medical Outcome Study – 36 Item Short-Form Survey (SF-36) was used to assess quality of life, and the Beck Depression Inventory (BDI) was used for self-assessment of depression. Results: Several HRQoL domains were significantly lower than National surveys, except physical function and bodily pain (p between 0.000 and 0.006). SF-36 presented the lowest score in vitality (39.93). Deterioration was significantly higher in role physical (p =0.006), vitality (p =0.011), and mental health (p =0.008) in women, and in physical function (p =0.003) and bodily pain (p =0.045) in elderly subjects. Those with higher literacy had better physical function (p =0.046). Conclusion: HRQoL is significantly deteriorated in narcoleptics, affecting all dimensions (except physical function and bodily pain) when compared with the general Portuguese population. The results are consistent with studies of narcolepsy in other countries in demonstrating the profound impact of this disorder on quality of life. [Copyright &y& Elsevier]

Background: Total knee arthroplasty (TKA) is often associated with a severe local inflammatory reaction which, unless controlled, leads to persistent pain up to one year after surgery. Standard and accelerated rehabilitation protocols are currently being implemented after TKA, but no consensus exists regarding the long-term effects. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has been demonstrated to exert an anti-inflammatory effect, to promote early functional recovery and to maintain a positive long-term effect in patients undergoing joint arthroscopy. The aim of this study was to evaluate whether PEMFs can be used to limit the pain and enhance patient recovery after TKA. Methods: A prospective, randomized, controlled study in 30 patients undergoing TKA was conducted. Patients were randomized into experimental PEMFs or a control group. Patients in the experimental group were instructed to use I-ONE stimulator 4hours/day for 60 days. Postoperatively, all patients received the same rehabilitation program. Treatment outcome was assessed using the Knee Society Score, SF-36 Health-Survey and VAS. Patients were evaluated pre-operatively and one, two, six and 12 months after TKA. Joint swelling and Non Steroidal AntiInflammatory Drug (NSAID) consumption were recorded. Comparisons between the two groups were carried out using a two-tail heteroschedastic Student's t-test. Analysis of variance for each individual subject during the study was performed using ANOVA for multiple comparisons, applied on each group, and a Dunnet post hoc test. A p value<0.05 was considered statistically significant.Results: Pre-operatively, no differences were observed between groups in terms of age, sex, weight, height, Knee-Score, VAS, SF-36 and joint swelling, with the exception of the Functional Score. The Knee-Score, SF-36 and VAS demonstrated significantly positive outcomes in the I-ONE stimulated group compared with the controls at follow-ups. In the I-ONE group, NSAID use was reduced and joint swelling resolution was more rapid than in controls. The effect of I-ONE therapy was maintained after use of the device was discontinued. Conclusions: The results of the study show early functional recovery in the I-ONE group. I-ONE therapy should be considered after TKA to prevent the inflammatory reaction elicited by surgery, for pain relief and to speed functional recovery.Trial registration: Current Controlled Trials ISRCTN10526056 [ABSTRACT FROM AUTHOR]

Objectives. The Medical Outcome Survey short-form 36 (SF-36) is widely used in studies of PsA. We test the fundamental scaling assumptions for the validity of SF-36 eight scales and two summary scores in PsA. [ABSTRACT FROM PUBLISHER]

Objective: The SF-36 Health Survey (SF-36) is a general instrument used to assess health-related quality of life (HRQL). The purpose of this study is to describe self-reported information on health and the quality of life among cancer outpatients during chemotherapy treatment and to compare it with the baseline sample drawn from the general Spanish population. Methods: A randomised sample of 583 cancer outpatients completed the questionnaire. Using a cross-sectional analysis of the SF-36 data, standardised scores were used to compare patients with comparative Spanish baseline data. Other health-related concerns (gender, age, site of cancer) were also analysed. Results: The patients showed acceptable levels on HRQL and no significant differences were found between the oncology patients compared with the general population for any of the SF-36 domains. The older patients had scores significantly lower in physical functioning (p<0.01) and physical role (p<0.05). The results identified lower HRQL ratings among women compared with men on all the scales except general health. In relation to the location of the cancer, patients with genitourinary tumours scored statistically lower (p<0.05) on bodily pain in the SF-36 domain compared with patients with gastrointestinal tumours. Conclusions: Although more studies are needed, the SF-36 allows us to describe the HRQL of cancer outpatients during chemotherapy treatment compared with the general population. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

To evaluate the psychometrics of the SF-36 Health Survey among Turkish and Moroccan ethnic minority populations in the Netherlands and to compare the results to those based on the indigenous Dutch population. Data were derived from the Second Dutch National Survey of General Practice. In total, SF-36 data were available for 409 Turkish, 377 Moroccan, and 9,628 Dutch respondents. Language subgroup analyses were performed for the Turkish ( n = 162) and Moroccan-Arabic ( n = 52) versions of the SF-36. Psychometric properties were evaluated by descriptive statistics, factor analysis, internal consistency estimates, known-group comparisons, and differential item function (DIF) analysis. Low levels of missing SF-36 data were observed across all groups. Confirmatory factor analysis supported the hypothesized SF-36 scale structure for the Dutch and Turkish group, but high correlations between the MH and VT factors were observed in the Moroccan group. All Cronbach’s alpha coefficients were above 0.70, except for the Vitality scale in the Moroccan group and the Vitality and Social Functioning scales in the Moroccan-Arabic language subgroup. Known-groups validity was found across samples using age, sex, education, and comorbidity as grouping variables, but not marital status. Some evidence for DIF was found in both ethnic group samples. The results generally support the use of the SF-36 for general population research among Turkish and Moroccan ethnic minorities in the Netherlands. Additional studies are needed to confirm the psychometrics of the questionnaire when used among these populations in other Western European countries. [ABSTRACT FROM AUTHOR]

Objective To compare the two higher order factor structures of the Short-Form 36 (SF-36) Health Survey, using exploratory factor analytic methods and structural equation modeling (SEM). Methods Two population data sets were used. A stratified representative sample ( n = 1,005) of the Greek general population was approached for interview. This survey containing the SF-36 was used to obtain component score coefficients from principal components analysis and orthogonal rotation. These coefficients were then used in the second data set ( n = 1,007) of the Greek adult general population to compute scores for the physical component summary and the mental component summary of the SF-36. The second data set was also used to obtain factor scores for physical and mental health measures, applying SEM. Results Exploratory factor analysis supported the existence of two principal components that are the basis for summary physical and mental health measures. SEM showed that models assuming that physical and mental health are correlated provided a better fit to the data than models assuming independence between physical and mental health. However, all eight dimensions of SF-36 should be included in the construction of summary scores. Conclusions These results confirm the multidimensional structure of the SF-36, the correlational equivalence between standard summary measures and SEM-based second-order factor scores, and underscore the feasibility of multinational comparisons of health status using this instrument. [ABSTRACT FROM AUTHOR]

▪ Abstract Objectives: Although long-term opioid therapy for chronic nonmalignant pain (CNMP) is widely accepted, it is controversial as to whether long-term benefits outweigh detrimental side effects. This study examines the effect of long-term opioid therapy on quality of life in terms of both physical and mental health in patients with CNMP. Methods: We retrospectively studied a cohort of patients with CNMP. With informed consent, data were collected prior to and at 6–36 months after the institution of opioid therapy in 67 patients with CNMP. The Short Form 36 (SF-36) health survey was used to compare self-reported measures of health-related quality of life in nine subscales. Visual analog scale (VAS) for pain intensity scores, disability status, and ability to return to work were also assessed. The pre- and post-therapy parameters were compared. Results: The average scores of self-reported quality of life improved significantly in eight out of the nine parameters in the SF-36 after at least 6 months of opioid therapy. The increase in reported scores was statistically significant for physical functioning, physical role, bodily pain, general health, validity, social functioning, emotional role, and mental health. No significant changes were observed in reported health transition, VAS pain scores, disability status, or return to work. Conclusions: We conclude that judicious use of opioid therapy may lead to improvement in perceived quality of life and certain aspects of functional capacity and daily activities in a highly selected group of patients with CNMP who have not responded to other therapeutic modalities for over 6 months. ▪ [ABSTRACT FROM AUTHOR]

Objectives: The SF-36® Health Survey (Version 2; SF-36) was evaluated among older Vietnamese Americans to determine whether underlying dimensions of physical and mental health were similar to those of other groups in the United States. Method: Field testing of participants from senior centers. Results: The study provided support for the reliability and validity of the SF-36. Structural equation modeling provided confirmation of physical and mental health factors. However, the factor loadings for the SF-36 scales were more consistent with previous results from Asian countries than the typical pattern observed in the United States. Discussion: As the older populations in the United States become more diverse, it is important to have standardized health-related quality of life measures. However, the conceptualization of physical and mental health and associations among different scales may be different for Asian immigrants than for other groups. Thus, the interpretation of the SF-36 scores needs to account for cultural differences. [ABSTRACT FROM AUTHOR]

Objectives: This prospective study aimed to investigate the quality of life of workers in a steel factory. Methods: The study group was composed of 16 male workers with tinnitus and 30 ears. Fifteen male workers without tinnitus and 30 ears were included into the control group. Workers were evaluated by questionnaire, pure-tone audiometry, and the SF-36 Health Survey. In the study group, tinnitus loudness levels (TLLs) were found. Results: In the study group, the domains general mental health and role limitations owing to emotional problems were significantly lower than in the control group. Older age, industrial noise exposure over a long period, higher noise exposure during work. and hearing loss secondary to occupational noise caused workers to experience higher TLLs. Earheadings protected workers more than earplugs, and TLLs were lower. Important factors that affect workers' quality of life are maximum exposed noise levels, daily and total noise exposure time, and exposure to continuous noise. Occupational noise-induced tinnitus mainly causes emotional disability rather than physical disability. Emotionally impaired QOL results may be due to tinnitus-related psychological problems. Conclusion: Workers should have knowledge about the hazardous effects of noise. Periodic health checkups and regular seminars have great importance. Workers must be aware of other ototoxic factors, such as medications and noisy music. In the future, researchers should develop a screening method to detect those with a more hereditary affinity to hearing loss. [ABSTRACT FROM AUTHOR]

Background. Lumbar disc disease is a very common condition with a substantial socioeconomic impact. Studies have shown the importance of a multilevel assessment of this disease, as its course is influenced by many factors. Most follow-up studies use the degree of physical impairment to measure the outcome of a certain treatment. This remains unsatisfactory, as physical impairment itself seems to be influenced by the social, psychological and personal condition of a patient. We believe that an overall quality of life assessment is required to evaluate success of treatment. The SF-36 questionnaire seemed appropriate, as it provides consistent data of a patient’s overall health status. To ensure measurement of disability due to back pain we combined the SF-36 with the NASS (North American Spine Society) questionnaire, an instrument specific for lumbar spine disorders. Method. One year after the last outpatient consultation in our neurosurgical clinic, a SF-36 questionnaire was sent to 636 patients with conservatively treated lumbar disc disease. We used the Mann Whitney Test to compare patient’s data with a standard group. The demographics of the standard group were matched with the study cohort. Findings. A total of 486 patients (66.5% males and 33.5% females), mean age 49 years (range 21–82 years), returned the questionnaire. The SF-36 data was usable in 76.4% of the patients. Statistical testing reported a significant impact of the disease on all 8 items of the SF-36 questionnaire. The “Role Functioning – Physical (RF)” item was the most, the “Mental Health (MH)” item the less affected. No statistical difference was found between males and females regarding the impact on single items. The NASS scores were also affected suggesting that lumbar back disorder was the influencing factor for the low SF-36 scores. Conclusions. Besides impairment in the execution of daily physical tasks, patients with lumbar disc disease also showed a significant impact on the “Mental Health (MH)” item. Early SF-36 assessment could identify subjects with high probability of prolonged recovery and development of chronic pain syndromes. In these patients, an early rheumatologic, rehabilitative and psychiatric treatment might be the key to improve their coping abilities and should become an integral part of the treatment strategy. [ABSTRACT FROM AUTHOR]

Background: Cleaning and kitchen employees have an increased risk of suffering from occupational dermatoses. Prevention including improving individual skin care and skin protection behavior, health education, optimizing diagnostics and therapy as well as avoidance of occupational skin disease (BK 5101) is important. Patients and methods: Participants in the courses were patients suspected of having an occupational skin disease. Besides socio-demographic and diseaserelated data, health-related quality of life (QL) was measured using the SF-36 and Skindex-29. One year later all participants were interviewed by telephone about the course of their skin disease. Results: Out of 212 participants, 84.0 % were female. The mean age was 41.6 (SD = 10.8) years.168 patients (79.2 %) suffered from hand dermatitis,with irritant contact dermatitis being the predominant diagnosis (46.2 %,n = 98).One year later 65.4 % (n = 85) of the patients interviewed still suffered from hand der-matitis.9.2 % (n = 12) had meanwhile quit their job due to the skin disease.QL was impaired in all age groups being lower with increasing age of the patients. Conclusions: The follow-up confirmed the positive impact of the skin protection courses on patients' skin disease and well-being. Occupational skin diseases impair health-related quality of life in these professions but disease severity does not seem to play a key role. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To determine the effect on quality of life and cost effectiveness of specialist nurse early supported discharge for women undergoing major abdominal and/or pelvic surgery for benign gynaecological disease compared with routine care. Study design: Randomised controlled trial comparing specialist nurse supported discharge with routine hospital care in gynaecology. The SF-36, a generic health status questionnaire, was used to measure women''s evaluation of their health state before surgery and at 6 weeks after surgery. A further questionnaire scoring patient symptoms, milestones of recovery, information given and satisfaction, was administered prior to discharge from hospital and at 6 weeks thereafter. Setting: Gynaecology service at the Western Infirmary Glasgow, part of North Glasgow University, NHS Trust. Participants: One hundred and eleven women scheduled for major abdominal or pelvic surgery for benign gynaecological disease. Main outcome measures: SF-36 health survey questionnaire baseline scores were reported before surgery and at 6 weeks follow-up. Complications, length of hospital stay, readmission, information on discharge support and satisfaction of women were recorded at discharge from hospital and at 6 weeks follow-up. A cost consequence analysis was conducted based on the perspective of the NHS. Results: The addition of a specialist nurse to routine hospital care in gynaecology significantly reduced the post-operative length of hospital stay p =0.001, improved information delivery and satisfaction of women. The specialist nurse supported discharge group was associated with significantly lower total costs to the NHS than routine care resulting principally from the difference in the cost of the post-operative length of stay. Conclusions: Women undergoing major abdominal and pelvic surgery were discharged home earlier with provision of support from a specialist gynaecology nurse. The results of this study suggest that duration of hospital stay can be shortened by the introduction of a specialist nurse without introducing any adverse physical and psychological effects. This process of care is associated with receipt of information on health and lifestyle issues and maintenance of high levels of patient satisfaction and demonstrates the effectiveness of the specialist nurse role in the provision of health information for women. Earlier hospital discharge at 48h after major abdominal and pelvic surgery is an acceptable, cost effective alternative to current routine practice in the absence of further randomised evidence. [Copyright &y& Elsevier]

Objective: To assess quality of life in patients with oropharyngeal carcinoma after primary surgery and postoperative irradiation. Study Design: Retrospective chart review and patient response to the Short Form 36 (SF-36) Health Survey and the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35 questionnaires. Setting: A tertiary care university hospital. Results: One hundred sixty-nine patients with oropharyngeal carcinoma underwent primary surgery followed by postoperative irradiation between January 1997 and February 2002. Eighty-eight disease-free survivors were identified in September 2002 and included in this study. The questionnaires were completed by 34 patients (39% completion rate), Median follow-up was 2.3 years (range 0.5-4.9 years). In oropharyngeal carcinoma patients, five scales of the SF-36 showed significantly reduced scores in comparison with the normal German population: physical functioning, role functioning--physical, general health, social functioning, and role functioning--emotional. Posttreatment scores from the literature fell within the 95% confidence interval of our data except one out of fifteen scales of the EORTC QLQ-C30 questionnaire and six out of eighteen scales of the EORTC QLQ H&N35 questionnaire. The comparison of our data with data from the reviewed literature produced similar results. Conclusions: General quality of life was reduced in our oropharyngeal carcinoma patients, Primary surgery and postoperative irradiation demonstrated similar results in different studies. [ABSTRACT FROM AUTHOR]

Aim: To examine the efficiency of α1-blocker treatment on disease-specific and generic quality of life (QOL) in men with clinically diagnosed benign prostatic hyperplasia (BPH), the improvement of QOL scores with International prostate symptom score (I-PSS) and Rand Medical Outcomes Study 36-item Health Survey (SF-36) was prospectively analyzed. Methods: A total of 68 newly diagnosed patients with symptomatic BPH that satisfied all inclusion and none of the exclusion criteria were prospectively recruited. All patients received 0.2 mg/day of tamsulosin for 12 weeks. All patients underwent pretreatment documentation of lower urinary tract symptoms (LUTS) and assessment of symptom-specific QOL. Symptoms and general health-related QOL (HRQOL) were assessed using the I-PSS and SF-36, respectively. Also, other objective variables, such as prostate volume, maximal urinary flow and postvoid residual urine volume, were evaluated. Results: After 12 weeks, decrease in I-PSS was 27% compared with baseline (from 16.4 ± 7.18 to 11.9 ± 7.56). All questionnaires in the I-PSS showed improvement after tamsulosin treatment and the I-PSS QOL score was improved from 4.51 ± 1.14 to 3.17 ± 1.38 ( P < 0.0001) at 12 weeks after tamsulosin administration. In intragroup comparisons of HRQOL scores with age-gender adjusted SF-36 Japanese national norms, three SF-36 subscales (bodily pain, BP; social function, SF; and mental health, MH) were worse in the BPH group aged over 70 years, while younger BPH groups aged <70 had better mean SF-36 physical function (PF) scores compared with age-gender adjusted Japanese national norms. In the BPH group with a prostatic volume ≥20 mL, three mean SF-36 scales (BP, SF and MH) were significantly improved after tamsulosin treatment. It is noteworthy that these SF-36 subscales were identical to those observed to worsen in the older BPH group compared to Japanese national norms. Conclusions: Treatment with tamsulosin for symptomatic BPH patients is associated with significant improvement in the generic HRQOL, in addition to disease-specific QOL and symptoms, at 3 months after drug administration. In particularly, for generic HRQOL with SF-36, tamsulosin treatment can efficiently improve three mean SF-36 subscales (BP, SF and MH) that are decreased in older BPH patients. [ABSTRACT FROM AUTHOR]

Abstract: Psychobiological effects associated with a progressive body weight loss may help to improve the understanding of psychological barriers to weight loss. We hypothesized that a moderate body weight loss (about 10% of initial body weight) is accompanied with some negative psychological impact. Four questionnaires [SF-36 Health Survey, Three-Factor Eating Questionnaire (TFEQ), Beck Depression Inventory (BDI) and Pittsburgh Sleep Quality Index (PSQI)] were administered at each phase of a body weight loss program that consisted of a supervised diet and exercise clinical intervention to 11 obese men (mean BMI=33.4 kg/m2, mean age=38 yr). The three phases investigated were: 1) at the beginning of the intervention (baseline); 2) after 5±1 kg body weight loss (Phase 1); and 3) after 10±1 kg body weight loss (Phase 2). Using the SF-36 Health Survey, physical and mental health were shown to be significantly improved at Phase 1 (p &#60;0.05). The TFEQ showed that cognitive dietary restraint increased (p &#60;0.001), and both disinhibition (p &#60;0.05) and susceptibility to hunger (p &#60;0.05) were significantly reduced at both Phase 1 and 2 compared to baseline. Depression as measured by the BDI significantly increased at Phase 2 (p &#60;0.05) compared to baseline and Phase 1. However, the mean BDI scores observed remained below the cut-off point for likely clinical significance. Finally, the PSQI showed that sleep quality was significantly improved at Phase 1 compared to baseline (p &#60;0.01). Altogether, these results suggest that a substantial improvement in the psychobiological profile occurs with a 5-kg weight loss (Phase 1) but that with additional weight loss (Phase 2) a small, but significant increase in depression occurred and seems to be associated with the increase in rigid restraint of eating. However, prospective studies with a larger sample are needed to confirm and deepen these results. [Copyright &y& Elsevier]

Abstract: Background: In order to determine the magnitude of the short- or medium-term effects of tobacco use on the health-related quality of life (HRQOL) of smokers and ex-smokers, and to compare them with the estimated long-term effects reported in other studies, a cross-sectional epidemiological study was designed. Methods: A representative study of the general population over 14 years of age was conducted in the western health area of Valladolid, Spain. HRQOL was evaluated using the SF-36 Health Questionnaire. Differences in HRQOL among smokers, non-smokers, and former smokers were determined. Standardized scores from the general population and long-term effects of tobacco exposure were compared. Results: Former smokers had a better HRQOL than smokers and non-smokers on the emotional dimensions, especially “vitality” and “role emotional”, while differences between the groups on the physical and emotional dimensions did not reach statistical significance. Smokers displayed deterioration in “bodily pain”, “general health”, “vitality”, “social function”, and “role emotional”, while deterioration in ex-smokers only occurred in “bodily pain” and “general health.” The variable package/year was correlated with “general health.” Conclusions: Short- and medium-range effects of tobacco consumption on HRQOL cannot be demonstrated with the SF-36 Health Questionnaire in the general Spanish population, whereas long-term effects can. [Copyright &y& Elsevier]

The aims of this study were 1) to translate the Dizziness Handicap Inventory (DHI) into Chinese and to validate it and 2) to use the Chinese DHI and the Chinese (Hong Kong) Short Forni-36 Health Survey (Chinese [HK] SF-36) to evaluate the quality of life (QoL) of patients with chronic dizziness. Seventy-one patients with 6 months of dizziness due to vestibular dysfunction were evaluated initially, 7 days later (n = 49), and after 7 months of medical treatment (n = 17). The Chinese DHI has been shown to retain good test-retest reliability (intraclass correlation coefficient range, 0.64 to 0.87) and internal consistency (Cronbach a coefficient > 0.7) as compared to the original DHI and has a moderate responsiveness (0.54). We find the Chinese DHI to be a valid tool for evaluation of QoL of Chinese patients with dizziness. Low mean scores on the Chinese DHI and Chinese (HK) SF-36 signify that chronic dizziness has a considerable impact on the QoL of these patients. [ABSTRACT FROM AUTHOR]

Introduction: Dorsal stabilisation has represented the standard procedure for the treatment of burst fractures of the thoracolumbar spine for a long time, but in the last few years the combined dorsoventral stabilisation has gained in significance due to its higher mechanical stability. However, there are no data yet available indicating whether the patients benefit from the combined operation with regard to their postoperative quality of life and what the advantages are in comparison with the dorsal procedures. Therefore, the question was researched in the framework of a matched-pairs analysis of patients suffering from an unstable fracture of the thoracolumbar transition. Materials and methods: From a consecutive series of patients treated in our clinic between 1995 and 2000, 10 patients with combined and 10 patients with a purely dorsal stabilisation were selected and included in the study. Their quality of life was summed up in retrospect with the SF-36 questionnaire. The X-rays were analysed, and the Cobb angle as well as the sagittal index were calculated. Only patients with burst fractures of the thoracolumbar transition without accompanying co-morbidity and neuro- logical deficits were included in the study. Both of the treated groups were matched with regard to sex, age and radiological patterns of injury. Results: Patients who had undergone only a dorsal stabilisation showed a significant of the examination (0.88±0.02 postoperative vs 0.77±0.03 at 4 years postoperatively, p=0.01). In the group of patients treated with the combined therapy, there was no statistically relevant loss of correction with regard to the sagittal vertebral profile. The SF-36 questionnaire showed a reduced quality of life in both groups compared with an age-referenced norm population, especially concerning the parameters of bodily health. No statistically relevant difference was observed between the two groups. Further, there was no statistically relevant association between the parameters of the SF-36 and the clinical and radiological data. After performing several regression analyses it could be shown that the patient's mental health is a strong predictor of the postoperative vitality (r=0.803, p<0.01). However, none of the remaining parameters was able to predict the postoperative quality of life. Conclusion: The patients in this study showed a reduced quality of life, independent of the method of surgical treatment. Although better radiological results could be seen for the combined procedure, regarding the postoperative quality of life no advantage could be proved compared with the dorsally stabilized patients. Furthermore, there was no relation between the radiological results and the quality of life parameters. Therefore, it can be assumed that the injury itself seems to be the main cause of the decreased quality of life after a burst fracture of the thoracolumbar transition. [ABSTRACT FROM AUTHOR]