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Hair cortisol concentration (HCC) and a questionnaire were used as indicators of chronic stress status and quality of life (QoL), respectively, in cats. To date, there has been limited research on the simultaneous application of both indicators in unwell cats. Our aim was to evaluate HCC and questionnaire data obtained from a healthy cat cohort ( n  = 61) and cat cohorts with either chronic kidney disease (CKD) ( n  = 78) or suspected feline infectious peritonitis (FIP) ( n  = 24). Furthermore, we also investigated the correlation between HCC and clinical pathological data. For this study, hair from the abdomen of cats was collected and analyzed for HCC using a commercial ELISA kit. Owners also completed a questionnaire, from which average-item-weighted-impact-scores (AWISs) were calculated. Cats with late-stage-CKD (median, HCC = 330.15 pg/mg, AWIS = -0.43) presented with a significantly higher HCC ( p  < 0.01) and a significantly lower AWIS ( p  < 0.01) than cats with early-stage-CKD (HCC = 183.56 pg/mg, AWIS = 1.08). Similarly, there were significant differences in both HCC ( p  < 0.001) and AWIS ( p  < 0.001) between cats with suspected FIP (HCC = 896.27 pg/mg, AWIS = -1.97) and healthy cats (HCC = 181.24 pg/mg, AWIS = 1.24). The degree of consistency between the HCC results and the questionnaire results reminds us that the severity of a chronic disease or the presence of a life-threatening disease can significantly increase stress and thus can affect the QoL of cats.

In December 2019, COVID-19 broke out in Wuhan, China, affecting the mental health and quality of life (QoL) of its inhabitants. This study aimed at investigating the factors associated with anxiety and QoL in the Wuhan populace during the COVID-19 pandemic. An online questionnaire survey was carried out during July 6-10, 2020. The questionnaire collected information on demography, anxiety, QoL, and social-environmental support. The main statistical methods included descriptive statistics, independent-samples t-test, one-way analysis of variance, and multivariate regression analysis. In total, 226 participants were recruited. The findings showed that females, elderly, middle-income, poor health status, shortage of medical supplies, and insufficient basic commodities were associated with anxiety significantly. Multiple regression analysis indicated that social-environmental support was significantly related to anxiety. Higher social-environmental support was significantly associated with a higher QoL. Our findings showed that the social-environmental support may reduce anxiety and improve the QoL for those living in an area heavily affected by the pandemic., (© 2021 John Wiley & Sons Ltd.)

Background: Nutritional status could affect functional capacity and reduce quality of life in patients with stroke. Although the associations between nutritional status, basic activities of daily living (BADL)/Instrumental ADL, and quality of life (QOL) in older people have been identified, the relationships have not yet been examined in patients with stroke, using the full Mini Nutritional Assessment (MNA) or MNA-short form (MNA-SF)., Objective: This study aimed to examine the relationship between nutritional status (using full MNA and MNA-SF), comprehensive ADL function, and QOL in patients with stroke., Methods: Eighty-two patients with ischemic stroke participated in this cross-sectional design study. Each participant was assessed with the full MNA, MNA-SF, comprehensive ADL function (including Barthel Index and Frenchay Activities Index), and WHO Quality of Life Questionnaire (WHOQOL-BREF) once., Results: The MNA-SF was only significantly correlated with the comprehensive ADL function (rho = 0.27, p = 0.013), whereas, the full MNA was found to be significantly correlated with the comprehensive ADL function and WHOQOL-BREF (rho = 0.24, p = 0.029 and rho = 0.30, p = 0.005, respectively). The MNA-SF was a significant predictor of comprehensive ADL function, accounting for 44% of the variance. The full MNA was the only significant predictor of the WHOQOL-BREF, explaining 17% of the variance., Conclusions: This study has revealed a relationship between nutritional status, comprehensive ADL function, and QOL among patients with stroke. Patients with stroke with better nutritional status had higher ADL function as well as better QOL. The MNA-SF was useful in predicting comprehensive ADL, whereas, the full MNA could be used to predict QOL. Knowledge and evidence of the association and predictive power of the MNA-SF and full MNA could guide clinicians to choose tools for assessing the nutritional status of patients with stroke more effectively.

Background & Objective: Malnutrition is one of commonly issues in patients with stroke. The Mini Nutritional Assessment (MNA) is a widely used measure for assessing nutritional status in patients with stroke. A nutritional measure with acceptable test-retest reliability allows clinicians to consistently assess patients' nutritional status. Knowledge of the relationship between nutritional status and quality of life (QOL) could guide clinicians to improve QOL in patients with stroke more effectively. This study aimed to examine test-retest reliability of the MNA and its relationship with QOL in patients with stroke., Methods: Fifty-nine patients participated in the test-retest reliability study and the correlation between the MNA and WHO Quality of Life-BREF (WHOQOL-BREF) study. A repeated-assessments design (1 week apart) was used to examine the test-retest reliability of the MNA., Results: The intraclass correlation coefficient for the MNA was 0.91. The minimal detectable change and percentage of minimal detectable change for the MNA were 2.1 and 8.2%, respectively. The MNA was positively associated with the QOL (r = 0.32; p = 0.013). The result of linear regression analysis shows that after controlling for age, sex and activities of daily living functions, only the MNA was significantly associated with the WHOQOL-BREF (r2 = 0.104; p = 0.008)., Conclusions: The MNA has satisfactory test-retest reliability that is useful for repeatedly assessing the nutritional status of patients with stroke. The MDC of the MNA has acceptable random measurement error which is useful for determining whether the change score of a patient is outside the range of random measurement error. Future studies that recruit stroke patients in the acute stage is needed to further examine the relationship between the nutritional status and QOL., Competing Interests: The authors have declared that no completing interests exist.

Aim: To determine characteristics of rheumatoid arthritis (RA) patients in Korea using disease-modifying anti-rheumatic drugs (DMARDs) for at least 6 months, and to identify factors associated with poor health-related outcomes., Method: A total of 2000 RA patients aged > 20 years, treated with DMARDs for at least 6 months, and signed informed consent, were enrolled in this non-interventional, multicenter, cross-sectional observational study from December 2012 to June 2013. Health-related quality of life (HRQoL) was measured using EuroQuol 5D (EQ-5D) and functional disability was measured using the Korean Health Assessment Questionnaire (KHAQ). Univariate and multivariate linear regression analyses were used to determine the association between patient characteristics and patient-reported outcomes (PROs)., Results: Of all RA patients, 84% were female, patients with low Disease Activity Score of 28 joints erythrocyte sedimentation rate (DAS-28-ESR < 3.2) was 54%, while moderate (DAS-28-ESR 3.2-5.1) and high disease activity score (DAS-28-ESR > 5.1) were 38% and 7.6%, respectively. Mean EQ-5D index score and KHAQ score were 0.6 ± 0.28 and 0.7 ± 0.67, respectively. In multivariate analysis with both PROs, average HRQoL and functional disability score appeared to be worse in persons with older age compared to younger age (P < 0.001), and worse in females compared to males (P < 0.001). Compared to patients having lower DAS (< 3.2), those with moderate and highest DAS (3.2-5.1 and > 5.1) had worse outcome measures (P < 0.001)., Conclusion: In this study, higher DAS was one of the most influential factors for poor PROs among all other factors. Therefore, we could suggest appropriate treatment approaches according to DAS along with other significantly associated factors with PROs in the early stage of RA., (© 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Purpose: To examine the associations among quality of work life, nurses' intention to leave the profession, and nurses leaving the profession., Design: A prospective study design was used., Methods: Participants were 1,283 hospital nurses with a purposive sampling in Taiwan. The self-reported questionnaire consisted of three questionnaires: the Chinese version of the Quality of Nursing Work Life scale, an intention-to-leave profession questionnaire, and a demographic questionnaire. Records of nurses leaving the profession were surveyed 1 year later. Data were analyzed by descriptive statistics and inferential statistics., Findings: As many as 720 nurses (56.1%) had tendencies to leave their profession. However, only 31 nurses (2.5%) left their profession 1 year later. Nurses' intention to leave the profession mediated the relationship between the milieu of respect and autonomy, quality of work life, and nurses leaving the profession., Conclusions: The milieu of respect and autonomy describing the quality of work life predicts the nurses' intention to leave the profession, and together these predict nurses leaving the profession., Clinical Relevance: This study illustrates that nurse managers could provide effective interventions to ameliorate the milieu of respect and autonomy aspect of quality of work life to prevent nurses from leaving their profession., (© 2017 Sigma Theta Tau International.)

Objective: Health-related quality of life (HRQOL) in patients with fibromyalgia (FM) is lower than in patients with other chronic diseases and the general population. Although various factors affect HRQOL, no study has examined a structural equation model of HRQOL as an outcome variable in FM patients. The present study assessed relationships among physical function, social factors, psychological factors, and HRQOL, and the effects of these variables on HRQOL in a hypothesized model using structural equation modeling (SEM)., Methods: HRQOL was measured using SF-36, and the Fibromyalgia Impact Questionnaire (FIQ) was used to assess physical dysfunction. Social and psychological statuses were assessed using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Arthritis Self-Efficacy Scale (ASES), and the Social Support Scale. SEM analysis was used to test the structural relationships of the model using the AMOS software., Results: Of the 336 patients, 301 (89.6%) were women with an average age of 47.9±10.9 years. The SEM results supported the hypothesized structural model (χ2 = 2.336, df = 3, p = 0.506). The final model showed that Physical Component Summary (PCS) was directly related to self-efficacy and inversely related to FIQ, and that Mental Component Summary (MCS) was inversely related to FIQ, BDI, and STAI., Conclusions: In our model of FM patients, HRQOL was affected by physical, social, and psychological variables. In these patients, higher levels of physical function and self-efficacy can improve the PCS of HRQOL, while physical function, depression, and anxiety negatively affect the MCS of HRQOL., Competing Interests: The authors have declared that no competing interests exist.

Aim: To examine the relationships between quality of work life (QWL) and nurses' intention to leave their unit (ITLunit), organisation (ITLorg) and profession (ITLpro)., Background: The high turnover rate among nurses presents a major challenge to health care systems across the globe. QWL plays a significant role in nurses' turnover., Methods: A descriptive cross-sectional survey design was conducted via purposive sampling of 1283 hospital nurses and administering the Chinese version of the Quality of Nursing Work Life scale (C-QNWL), a three-ITL-type scale questionnaire, and a demographic questionnaire for individual- and work-related variables. Descriptive data, correlations, and ordinal regression models were analyzed., Results: QWL predicted ITLpro and ITLorg better than ITLunit. Three QWL dimensions (work arrangement and workload, nursing staffing and patient care, and work-home life balance) were significantly predictive of all three ITL measures. However, the dimension of teamwork and communication was only predictive for ITLunit, not for ITLorg and ITLpro., Conclusions: Different patterns of QWL dimensions are predictive of ITLunit, ITLorg, and ITLpro., Implications for Nursing Management: The study provides important information to nurse administrators about the aspects of QWL that most commonly lead nurses to leave their units, organisations, and even the profession itself., (© 2013 John Wiley & Sons Ltd.)

In this study, we developed and tested the psychometric properties of the Chinese-version Quality of Nursing Work Life Scale along seven subscales: supportive milieu with security and professional recognition, work arrangement and workload, work/home life balance, head nurse's/supervisor's management style, teamwork and communication, nursing staffing and patient care, and milieu of respect and autonomy. An instrument-development procedure with three phases was conducted in seven hospitals in 2010-2011. Phase I comprised translation and the cultural-adaptation process, phase II comprised a pilot study, and phase III comprised a field-testing process. Purposive sampling was used in the pilot study (n = 150) and the large field study (n = 1254). Five new items were added, and 85.7% of the original items were retained in the 41 item Chinese version. Principal component analysis revealed that a model accounted for 56.6% of the variance with acceptable internal consistency, concurrent validity, and discriminant validity. This study gave evidence of reliability and validity of the 41 item Chinese-version Quality of Nursing Work Life Scale., (© 2014 Wiley Publishing Asia Pty Ltd.)

Background: Patient education is a critical component of asthma management. Limited data from longitudinal research studies are available from Taiwan to show the effect of asthma education on knowledge and health-related quality of life (HRQOL) in asthma patients., Purpose: This study was designed to determine the effectiveness of an asthma education program on asthma general knowledge and HRQOL in Taiwanese patients with asthma during a 6-month follow-up period., Methods: One hundred eighteen patients were recruited using purposive sampling, 42 of whom were enrolled in an asthma education program and 76 of whom received routine care. Measurements were completed at baseline and at 1, 3, and 6 months after enrollment. Over the 6 months of follow-up, asthma knowledge was measured using the Chinese language version of the asthma general knowledge questionnaire for adults, whereas HRQOL was measured using the St. George's Respiratory Questionnaire (SGRQ)., Results: Asthma knowledge increased significantly in the intervention group as compared with the comparison group (p < .001), and Group x Month interaction effects were found. Total SGRQ mean score and the three subscales showed no significant differences between intervention and comparison groups. However, overall SGRQ trends and subscale scores for both groups decreased significantly through the first, third, and sixth months., Conclusions and Implications for Practice: We observed an increase in asthma general knowledge but no significant improvement in HRQOL using an asthma structured-education program.

Background: The early stage of the COVID‐19 pandemic was a critical time for increasing loneliness, especially for older people. However, there is insufficient existing research on associated interventions and their effectiveness. Aim: This study aimed to investigate the effectiveness of an 8‐week online interactive course on the loneliness, depression, social support, and quality of life (QOL) of older adults in the community during the COVID‐19 pandemic. Methods: A single‐blind randomized controlled trial was conducted to collect data from a community in Taiwan. Eighty‐nine participants recruited from long‐term care institutions were randomly divided into an experimental group (n = 44) and a control group (n = 45). Participants in the experimental group received an 8‐week (Monday to Friday) intensive online interactive course, whereas those in the control group watched 8 weeks (Monday to Friday) of unidirectional online video programs. Results: Significant differences were observed in the UCLA Loneliness Scale and in both the psychological health and social relationship domains of the WHO Quality of Life‐BREF Scale. In other words, compared with those in the control group, participants in the experimental group experienced more significant improvements in the state of their loneliness as well as QOL in the psychological health and social relationship domains (without the physical health/environment domains) after taking the online interactive course. Conclusions: The results of this study showed that the 8‐week online interactive course could effectively improve the loneliness, the psychological health domain, and the social relationship domain of the QOL of the older adults of a particular community during the ongoing pandemic. Geriatr Gerontol Int 2023; 23: 91–97. [ABSTRACT FROM AUTHOR]

In December 2019, COVID‐19 broke out in Wuhan, China, affecting the mental health and quality of life (QoL) of its inhabitants. This study aimed at investigating the factors associated with anxiety and QoL in the Wuhan populace during the COVID‐19 pandemic. An online questionnaire survey was carried out during July 6–10, 2020. The questionnaire collected information on demography, anxiety, QoL, and social‐environmental support. The main statistical methods included descriptive statistics, independent‐samples t‐test, one‐way analysis of variance, and multivariate regression analysis. In total, 226 participants were recruited. The findings showed that females, elderly, middle‐income, poor health status, shortage of medical supplies, and insufficient basic commodities were associated with anxiety significantly. Multiple regression analysis indicated that social‐environmental support was significantly related to anxiety. Higher social‐environmental support was significantly associated with a higher QoL. Our findings showed that the social‐environmental support may reduce anxiety and improve the QoL for those living in an area heavily affected by the pandemic. [ABSTRACT FROM AUTHOR]

Musculoskeletal disorders may affect labor efficiency, cause disability, impair one's work ability, and lower one's quality of life. This consequently leads to a larger expenditure of medical resources. We aimed to design easy-to-open assistive devices for pneumatic tube systems to improve ergonomics and reduce musculoskeletal complaints of workers. We followed a design control process, including designs of motors, gears, sensors, and V-shaped connecting rods. Efficacy was evaluated by examining risks based on job strain index, user satisfaction, and musculoskeletal complaints of operators before and after the system's implementation on a Nordic musculoskeletal questionnaire. We designed three assistive devices: two semiautomatic and one automatic. Each semiautomatic device costs about 300 US dollars and required space of 10 × 18 × 38 c m 3 . The automatic device costs about 3000 US dollars and required space of 28 × 38 × 50 c m 3 . The job strain index score decreased from 36 (very high risk) to 3 (low risk) with the semiautomatic devices and to 0 with the automatic device. Musculoskeletal complaints in the neck and upper limbs were reduced, with a significantly higher satisfaction rate for female operators. Our novel design of an automatic cap opening device for a pneumatic tube system was effective in improving ergonomics and reducing musculoskeletal complaints. [ABSTRACT FROM AUTHOR]

Background: Robot-assisted therapy (RT) is a widely used intervention approach to enhance motor recovery in patients after stroke, but its effects on functional improvement remained uncertain. Neuromuscular electrical stimulation (NMES) is one potential adjuvant intervention approach to RT that could directly activate the stimulated muscles and improve functional use of the paretic hand. Methods: This was a randomized, double-blind, sham-controlled study. Thirty-nine individuals with chronic stroke were randomly assigned to the RT combined with NMES (RT + ES) or to RT with sham stimulation (RT + Sham) groups. The participants completed the intervention 90 to 100 minutes/day, 5 days/week for 4 weeks. The outcome measures included the upper extremity Fugl-Meyer Assessment (UE-FMA), modified Ashworth scale (MAS), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale 3.0 (SIS). All outcome measures were assessed before and after intervention, and the UE-FMA, MAL, and SIS were reassessed at 3 months of follow-up. Results: Compared with the RT + Sham group, the RT + ES group demonstrated greater improvements in wrist flexor MAS score, WMFT quality of movement, and the hand function domain of the SIS. For other outcome measures, both groups improved significantly after the interventions, but no group differences were found. Conclusion: RT + ES induced significant benefits in reducing wrist flexor spasticity and in hand movement quality in patients with chronic stroke. Trial Registration: ClinicalTrials.gov. NCT01655446. [ABSTRACT FROM AUTHOR]

Background: The Barthel Index (BI) assesses actual performance of activities of daily living (ADL). However, comprehensive assessment of ADL functions should include two other constructs: self-perceived difficulty and ability. Objective: The aims of this study were to develop two BI-based Supplementary Scales (BI-SS), namely, the Self-perceived Difficulty Scale and the Ability Scale, and to examine the construct validity of the BI-SS in patients with stroke. Method: The BI-SS was first developed by consultation with experts and then tested on patients to confirm the clarity and feasibility of administration. A total of 306 participants participated in the construct validity study. Construct validity was investigated using Mokken scale analysis and analyzing associations between scales. The agreement between each pair of the scales’ scores was further examined. Results: The Self-perceived Difficulty Scale consisted of 10 items, and the Ability Scale included 8 items (excluding both bladder and bowel control items). Items in each individual scale were unidimensional (H≥0.5). The scores of the Self-perceived Difficulty and Ability Scales were highly correlated with those of the BI (rho = 0.78 and 0.90, respectively). The scores of the two BI-SS scales and BI were significantly different from each other (p<.001). These results indicate that both BI-SS scales assessed unique constructs. Conclusions: The BI-SS had overall good construct validity in patients with stroke. The BI-SS can be used as supplementary scales for the BI to comprehensively assess patients’ ADL functions in order to identify patients’ difficulties in performing ADL tasks, plan intervention strategies, and assess outcomes. [ABSTRACT FROM AUTHOR]

Purpose The Frenchay Activities Index (FAI) is a frequently used measure that assesses instrumental activities of daily living (IADL). However, the measurement properties of the FAI are largely unknown for patients with traumatic limb injuries. The purpose of this study was to examine the measurement properties of a Chinese version of the FAI, including score distribution, internal consistency, construct validity, predictive validity, and responsiveness in patients with traumatic limb injuries. Methods We performed a secondary data analysis, primarily using non-parametric item response theory, on a data set. The FAI and the World Health Organization Quality of Life Assessment (WHOQOL-BREF) were administered via telephone interview to a cohort of patients at 3, 6, and 12 months after injury. Totals of 342 patients' data (at 3 months after injury), 1,010 patients' data (6 months), and 987 patients' data (12 months) were available for analysis. Results After the deletion of 5 items (i.e., travel outings, gardening, household/car maintenance, reading books, and gainful work), the 10-item revised FAI (R-FAI) formed a unidimensional construct. The R-FAI exhibited a unidimensional construct at each of the 3 time points. The R-FAI had sufficient score distribution, internal consistency, predictive validity, and responsiveness in patients with limb injuries. Conclusions Our results support the conclusion that the R-FAI has satisfactory measurement properties. The R-FAI is useful for assessing IADL in patients with limb injuries. [ABSTRACT FROM AUTHOR]