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Aim: Real-world evidence on the management of hemorrhoidal disease (HD) is limited. This international study collected clinical practice data on the effectiveness of conservative treatments for acute HD on symptoms and quality of life (QoL), providing perspectives of treatment modalities from different continents. Patients & methods: The 4-week observational prospective CHORALIS study involved adult outpatients consulting for spontaneous complaints of hemorrhoids (graded using Goligher classification) and prescribed conservative treatments according to usual clinical practice. Assessments were: anal pain/discomfort (visual analog scale [VAS]), other signs/symptoms (patient questionnaire), Patient Global Impression of Change (PGI-C) questionnaire and disease-specific QoL (HEMO-FISS-QoL questionnaire). Results: Of 3592 participants, 3505 were analyzed (58.4% male; age 40.5 ± 13.7 years; history of HD in 48.4%; 72.1% Goligher grade I and II). Pain and discomfort were the most common symptoms. Most treatments were venoactive drugs (VADs; 90.9%), particularly micronized purified flavonoid fraction (MPFF; 73.7%) and diosmin (14.6%). All VAD-based therapies improved signs/symptoms (number/intensity/frequency of pain, discomfort, bleeding, swelling, itching and soiling) and QoL. MPFF was associated with a significantly greater proportion of patients with no symptoms (48.8 vs diosmin 34.4%, p < 0.001), pain disappearance (69.7 vs diosmin 52.8%, p < 0.001), treatment impact at 1 week rated on PGI-C as 'very much better' (30.5 vs diosmin 17.9%, p < 0.001) and shorter times to improvement (mean ± SD 3.9 ± 1.5 days vs diosmin 4.2 ± 1.7 days). Conclusion: In this prospective real-world study of patients with acute HD, conservative therapies consisting mainly of VADs, including MPFF, improved the clinical signs and symptoms of disease, as well as QoL. This study evidence supports clinical advantages associated with VADs, mostly MPFF, for effectively managing acute HD.

We aimed to assess the mental health of adults living in Ukraine one year after onset of the Russo-Ukrainian war, along with quality of life and coping strategies. Quota sampling was used to collect online survey data from 2364 adults aged 18-79 years living in Ukraine from April 5, 2023 to May 15, 2023. Among adults living in Ukraine, 14.4 % had probable post-traumatic stress disorder (PTSD), another 8.9 % had complex PTSD (CPTSD), 44.2 % had probable depressive disorder, 23.1 % had anxiety disorder and 38.6 % showed significant loneliness. In adjusted models, the number of trauma events experienced during the war showed a dose-response association with PTSD/CPTSD and was associated with depressive disorder and anxiety disorder. Quality of life domains, particularly physical quality of life, were negatively associated with PTSD/CPTSD, depressive disorder, anxiety disorder, and number of trauma events. Maladaptive coping was positively associated with depressive disorder, anxiety disorder, PTSD/CPTSD and loneliness. All quality of life domains were positively associated with using adaptive coping strategies. Mental health disorders are highly prevalent in adults living in Ukraine one year into the war. Policy and services can promote adaptive coping strategies to improve mental health and quality of life for increased resilience during war., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)

For assessing health-related quality of life in patients with chronic wounds, the Wound-QoL questionnaire has been developed. Two different versions exist: the Wound-QoL-17 and the Wound-QoL-14. For international and cross-cultural comparisons, it is necessary to demonstrate psychometric properties in an international study. Therefore, the aim of this study was to test both questionnaires in a European sample, using item response theory (IRT). Participants were recruited in eight European countries. Item characteristic curves (ICC), item information curves (IIC) and differential item functioning (DIF) were calculated. In both questionnaires, ICCs for most items were well-ordered and sufficiently distinct. For items, in which adjacent response categories were not sufficiently distinct, response options were merged. IICs showed that items on sleep and on pain, on worries as well as on day-to-day and leisure activities had considerably high informational value. In the Wound-QoL-14, the item on social activities showed DIFs regarding the country and age. The same applied for the Wound-QoL-17, in which also the item on stairs showed DIFs regarding age. Our study showed comparable results across both versions of the Wound-QoL. We established a new scoring method, which could be applied in international research projects. For clinical practice, the original scoring can be maintained., (© 2024 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

The Wound-QoL assesses the impact of chronic wounds on patients' health-related quality of life (HRQoL). A 17-item and a shortened 14-item version are available. The Wound-QoL-17 has been validated for multiple languages. For the Wound-QoL-14, psychometric properties beyond internal consistency were lacking. We aimed to validate both Wound-QoL versions for international samples representing a broad range of European countries, including countries for which validation data had yet been pending. Patients with chronic wounds of any aetiology or location were recruited in Austria, Lithuania, the Netherlands, Poland, Slovakia, Spain, Switzerland and Ukraine. Psychometric properties were determined for both Wound-QoL versions for the overall sample and, if feasible, country-wise. We included 305 patients (age 68.5 years; 52.8% males). Internal consistency was high in both Wound-QoL-17 (Cronbach's α: 0.820-0.933) and Wound-QoL-14 (0.779-0.925). Test-retest reliability was moderate to good (intraclass correlation coefficient: 0.618-0.808). For Wound-QoL-17 and Wound-QoL-14, convergent validity analyses showed highest correlations with global HRQoL rating (r = 0.765; r = 0.751) and DLQI total score (r = 0.684; r = 0.681). Regarding clinical data, correlations were largest with odour (r = -0.371; r = -0.388) and wound size (r = 0.381; r = 0.383). Country-wise results were similar. Both Wound-QoL versions are valid to assess HRQoL of patients with chronic wounds. Due to its psychometric properties and brevity, the Wound-QoL-14 might be preferrable in clinical practice where time is rare. The availability of various language versions allows for the use of this questionnaire in international studies and in clinical practice when foreign language patients are being treated., (© 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Age-related sarcopenia, resulting from a gradual loss in skeletal muscle mass and strength, is pivotal to the increased prevalence of functional limitation among the older adult community. The purpose of this meta-analysis of individual patient data is to investigate the difference in health-related quality of life between sarcopenic individuals and those without the condition using the Sarcopenia Quality of Life (SarQoL) questionnaire. A protocol was published on PROSPERO. Multiple databases and the grey literature were searched until March 2023 for studies reporting quality of life assessed with the SarQoL for patients with and without sarcopenia. Two researchers conducted the systematic review independently. A two-stage meta-analysis was performed. First, crude (mean difference) and adjusted (beta coefficient) effect sizes were calculated within each database; then, a random effect meta-analysis was applied to pool them. Heterogeneity was measured using the Q-test and I 2 value. Subgroup analyses were performed to investigate the source of potential heterogeneity. The strength of evidence of this association was assessed using GRADE. From the 413 studies identified, 32 were eventually included, of which 10 were unpublished data studies. Sarcopenic participants displayed significantly reduced health-related quality of life compared with non-sarcopenic individuals (mean difference = -12.32; 95 % CI = [-15.27; -9.37]). The model revealed significant heterogeneity. Subgroup analyses revealed a substantial impact of regions, clinical settings, and diagnostic criteria on the difference in health-related quality of life between sarcopenic and non-sarcopenic individuals. The level of evidence was moderate. This meta-analysis of individual patient data suggested that sarcopenia is associated with lower health-related quality of life measured with SarQoL., Competing Interests: Declaration of competing interest B.C., B.O., and R.J.Y. are shareholders of the SarQoL sprl. However, they never received any financial compensation for this role. The other authors declare they have no competing interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: Aim: To evaluate and compare the functional outcomes and quality of life in distal rectal cancer patients after low anterior resection with the formation of a transverse double-fold reservoir (TDFR) and without it., Patients and Methods: Materials and Methods: The retrospective study enrolled 80 patients with distal rectal cancer: 40 patients who underwent low anterior resection with the formation of a TDFR, and 40 patients with the formation of a colorectal anastomosis (control group). The follow-up period was 10-60 months, with a median follow-up of 36 months after primary surgery. Functional outcomes were assessed at 3, 6, 12, and 24 months after stoma closure using anal manometry, balloonometry, and questionnaires including LARS Score, Wexner, and FIQL., Results: Results: The 5-years overall survival rate was comparable in main and control groups (85% and 79%, respectively). Rectal sensitivity threshold, urge to defecate and maximum tolerated volume were higher in the TDFR group at 3, 6, and 12 months post-operatively. Manifestations of low anterior resection syndrome (LARS) were more frequently observed in the control group. Quality of life, as assessed by the FIQL questionnaire, was significantly better in the TDFR group. The internal sphincter function was better preserved in the TDFR group, in contrast to control group., Conclusion: Conclusions: The TDFR formation in patients with distal rectal cancer after low anterior resection leads to improved anal continence within 12 months postoperatively, reduction of LARS manifestations, and enhancement of quality of life for patients while maintaining oncological radicality.

Objective: The aim: To work out the predictive system that can help to determine the group of patients to whom the hemodynamic surgery of varicose disease, CHIVA, is beneficial., Patients and Methods: Materials and methods: Results of examination and treatment of 58 patients of the main group who underwent hemodynamic surgery and 65 patients of the comparison group who underwent stripping. Patients of both groups were evaluated in the preoperative period using an evaluation scale, and divided into three subgroups depending on the scores: 5- 8, 9 - 11, and 12 - 15 points., Results: Results: The best treatment results with the lowest number of relapses were obtained in the subgroup of patients with low scores on the prognostic scale (5-8 points) after hemodynamic treatment and in the subgroup of patients with a high the number of points (12 -15 points) after the classic stripping (p < 0.05). The same subgroups received more improvement in the quality of life of patients according to CIVIQ 20 (p < 0.001). The subgroup of patients with a high number of points (12 -15 points) after the stripping received significantly more reduction in scores VCSS (p < 0,01)., Conclusion: Conclusions: Comprehensive assessment of factors such as the anamnestic duration of the disease, the diameter of the great saphenous vein, the presence of skin complications, dilated varicose collaterals and previous surgical treatment using a prognostic preoperative assessment score allows the surgeon to be more clearly guided in choosing the optimal method of treatment for each patient and achieve the best treatment results.

Objective: The aim: To identify the main problems in the quality of life of patients with gastric cancer to optimize health care for them., Patients and Methods: Materials and methods: The sociological study was performed by surveying 404 patients with gastric cancer usage questionnaires EORTC QLQ-C30 and QLQ-STO22. Calculations were performed according to the EORTC QLQ-C30 Scoring Manual and QLQ-STO22. The analysis of three main indicators was performed: functional scale, symptom scale and quality of life scale., Results: Results: The quality of life of gastric cancer patients amounted to 51.80±11.35 on a 100-point scale. According to the QLQ-C30 functional scale, the psy¬cho-emotional sphere (59.62±12.91), social functioning (66.42±13.48) are the most impressive in patients. According to the results obtained in the QLQ-C30 symptoms scale, gastric cancer patients were most concerned about financial difficulties (57.18±12.45) and fatigue with a score of 50.12±10.86 on a 100-point scale. According to the QLQ-STO22 symptom scale in the study of patients, anxiety (59.07±12.46) and hair loss (56.97±11.78) amounted to the highest scores., Conclusion: Conclusions: Given the low quality of life of gastric cancer patients, they need psychological support, which is aimed at adapting to the manifestations of the disease and should be a mandatory component in the development of models or strategies for providing medical care to cancer patients. Standardized psychological care should be organized at all stages of diagnosis, treatment and rehabilitation in all institutions that provide treatment to gastric cancer pa¬tients. It is also important to develop and implement a comprehensive program to support gastric cancer patients in interaction with society, family and work.

Objective: The aim: The research is devoted to the analysis of theoretical and empirical determinants of formation of structural components of an active life position of modern elderly people., Patients and Methods: Materials and methods: Psychodiagnostic techniques were selected as tools for data collection. Experiment participants were people aged 65-72 years old (total number - 78 people). Data processing was done by means of the computer program SPSS 21.0., Results: Results: The psychological features of the formation of elderly people's active life position were determined by the fact that more than 50% of respondents had an average level of cognitive development, more than 60% demonstrated a low level of emotional-volitional component and more than 50% were at medium level of motivational-behavioural component. Most respondents' high level of cognitive component development does not correlate with a high level of emotional-volitional component development. The leading role in the formation of elderly people's active life position is played by the motivational-behavioural component., Conclusion: Conclusions: Based on the theoretical and empirical research of the issue of formation of elderly people's active life position, three structural components of the phenomenon under study were identified: cognitive, emotional-volitional and motivational-behavioural. The results of the experiment suggest that most respondents had medium-low levels of active life position. The main determinant of the elderly people's reduced vitality is their low level of emotional-volitional component development. The research outcomes allowed us to track the dependence of the level of active life position on the motivational-behavioral component.

Objective: The aim of the study was on the basis of the study of clinical manifestations and mechanisms of the formation of disorders of psychological adaptation among the combatants, to develop the principles and program of their medical and psychological rehabilitation., Patients and Methods: Materials and methods: The study was attended by 153 people at the sanatorium and resort stage of treatment, of which 98 people were combatants and 55 people were civilians. The study used a set of methods aimed at the study of emotional disorders (HDRS, BDI, Spielberger Scale, "Asthenic state scale"), individual psychological features (Multilevel personal questionnaire "Adaptability," Test questionnaire G. Shmishek, K. Leonhard), features of psychosocial functioning (Mississippian scale of PTSD-military version) and quality of life (WHOQOL-BREF)., Results: Results: At the stage of sanatorium treatment of combatants is important readaptation to peaceful living conditions. A clinical and psychological analysis of combatants showed that the presence of experienced state of subjective distress and emotional disorder leads to a decrease in the productivity of adaptation to a stressful event. The stress factor disrupted the integrity of the micro-social network of combatants and their system of social support and social values, with the prevailing sense of inability to overcome problems and build plans. A detailed analysis of the nature of depressive and anxiety manifestations was carried out, which allowed to determine the predictors of the violation of adaptation in combatants. Thus, on the basis of the study of clinical manifestations and mechanisms of the formation of disorders of psychological adaptation among the participants of hostilities, the principles of their medical and psychological rehabilitation at the sanatorium and resort stage of treatment are developed., Conclusion: Conclusions: The peculiarities of stress response in combatants as a component of personal potential play a role in the formation of predictors of psychological adaptation disorders among combatants. Psychological intervention at the tertiary stage of rehabilitation (sanatorium-resort) should be targeted, taking into account individual-psychological characteristics (preventors) and psychosocial factors (predictors).

Objective: The aim: To assess the impact of dental status on the quality of life of the adult population in the presence of periodontal disease in combination with musculoskeletal dysfunction in patients with dental anomalies and deformities., Patients and Methods: Materials and methods: To study this goal, we examined 283 patients who complained of an aesthetic defect of the dentition, combined with the presence of joint pain and periodontal disease of varying severity., Results: Results: received a complete analysis of factors that significantly affected the quality of life of patients with a lot of diseases of the oral cavity., Conclusion: Conclusions: Oral health deficiencies reduce the quality of life of our patients, and the treatment significantly changes its quality depending on age, sex and method. But the best results in achieving positive changes in the quality of life of the patient dentists can expect only by conducting a comprehensive treatment.

Objective: The aim is to investigate if the overweight (OW) and obesity (OB) impact on the quality of life (QOL) of children with bronchial asthma (BA)., Patients and Methods: Materials and methods: The study included 73 children aged 7 - 17, with moderate BA. Depending on the body mass index, patients were divided into the three clinical groups: normal body weight (NW) - 30 children, OW - 28 children and OB - 15 children. QOL was conducted by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). The statistical processing was carried out using the IBM SPSS Statistics Base (version 22) and EZR version 1.32. Results were considered statistically significant when p<0.05., Results: Results: Children with BA and OB had statistically lower QOL than children with BA and NW in all PAQLQ domains. The Kruskal-Wallis H-test revealed a statistically significant difference between the different weight groups of children with BA both for the general QOL: H(2) = 37.51, p<0.001and for each rating scale separately. Pairwise comparisons using Steel-Dwass test indicated that scores of NW were observed to be significantly different from those of OW and OB for rating Activity and Symptoms scales (p<0.001)., Conclusion: Conclusion: Comorbid OW and OB reduce the specific QOL of children with BA. In assessing the effectiveness of specific approaches to treating BA in children with OW and OB, an assessment of the QOL of children should be added to the traditional common clinical and laboratory assessment.

Objective: Introduction: Increased blood pressure is major risk factors for morbidity and mortality from coronary heart disease, stroke and heart failure. Special studies have shown that women in perimenopause are a category of high risk of cardiovascular diseases and complications developing. The aim of research was to study the effects of cimicifuga racemosa on the hemodynamics parameters and quality of life in perimenopausal women with arterial hypertension., Patients and Methods: Materials and methods: The research involved 78 symptomatic perimenopausal women with arterial hypertension (AH) and menopausal syndrome (MS) and 30 hypertensive women with AH without MS manifestations as a control group. After prescription to all patients standard antihypertensive therapy, all women with AH and MS were randomized into 2 groups - the research group (40 patients) and the comparison group (38 patients). Cimicifuga racemosa extract BNO 1055 added to standard treatment of the research group, patients of comparison group and group of hypertensive women without MS continued receiving standard antihypertensive therapy. Before randomization and 8 weeks after prescribing therapy, ambulatory blood pressure monitoring (ABPM) and quality of life (QoL) evaluation were made., Results: Results: After treatment, according to ABPM measurements there was a significant decrease of day and night systolic and diastolic blood pressure, more pronounced in the research group who received cimicifuga racemosa. Data of systolic blood pressure variability per day and night in research group were significantly reduced to normal values, in comparison group was just systolic blood pressure variability decrease. After 8 weeks treatment QoL improved in the all study groups, but the most pronounced effect was observed in a group of patients who received of cimicifuga racemosa with a standard antihypertensive treatment., Conclusion: Conclusions: The data have shown positive effects of cimicifuga racemosa on the hemodynamics parameters and quality of life in perimenopausal women with arterial hypertension.

End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed., (Copyright © 2015. Published by Elsevier Ireland Ltd.)