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Item Short Form Health Survey (item + short_form_health_survey)
Selected AbstractsThe safety and tolerability of duloxetine in depressed elderly patients with and without medical comorbidityINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2007T. N. Wise Summary Aim and methods:, The impact of medical comorbidity on the efficacy and tolerability of duloxetine in elderly patients with major depressive disorder (MDD) was investigated in this study. Data were obtained from a multicentre, randomised, double-blind, placebo-controlled study in 311 patients with MDD aged 65,89. The primary outcome measure was a prespecified composite cognitive score based on four cognitive tests: (i) Verbal Learning and Recall Test; (ii) Symbol Digit Substitution Test; (iii) 2-Digit Cancellation Test and (iv) Letter-Number Sequencing Test. Secondary measures included the Geriatric Depression Scale (GDS), 17-Item Hamilton Depression Scale (HAMD17), Clinical Global Impression-Severity (CGI-S) Scale, Visual Analogue Scale (VAS) for pain and 36-Item Short Form Health Survey (SF-36). Tolerability measures included adverse events reported as the reason for discontinuation and treatment-emergent adverse events (TEAEs). The consistency of the effect of duloxetine vs. placebo comparing patients with and without medical comorbidity (vascular disease, diabetes, arthritis or any of these) was investigated. Results:, Overall, duloxetine 60 mg/day demonstrated significantly greater improvement compared with placebo for the composite cognitive score, GDS and HAMD17 total scores, CGI-Severity, HAMD17 response and remission rates, and some of the SF-36 and VAS measures. There were few significant treatment-by-comorbidity subgroup interactions for these efficacy variables, or for adverse events reported as the reason for discontinuation and common TEAEs. Conclusions:, The present analyses suggested that the efficacy of duloxetine on cognition and depression in elderly patients, and its tolerability, were not largely affected by the comorbidity status. These results further support the use of duloxetine in elderly patients with MDD. [source] Prevalence of depression and anxiety in hospitalized chronic obstructive pulmonary disease patients and their quality of life: a pilot studyASIA-PACIFIC PSYCHIATRY, Issue 3 2009Herng Nieng Chan MBBS MMed (Psychiatry) Abstract Introduction: There is a high prevalence of psychiatric comorbidities in patients with Chronic Obstructive Pulmonary Disease (COPD). It has been reported that if left untreated, the psychiatric comobidities can lead to poorer quality of life. The present study was initiated to investigate the prevalence of major depressive disorder, generalized anxiety disorder and panic disorder in hospitalized COPD patients and their quality of life. Methods: The Patient Health Questionnaire (PHQ) of the Primary Care Evaluation of Mental Disorders (PRIME-MD) was administered to screen an opportunistic sample of COPD patients admitted to a general hospital for the abovementioned psychiatric disorders. The Medical Outcomes Study (MOS) 36-Item Short Form Health Survey (SF-36) was utilized to assess quality of life. Results: Fifty-one patients were analyzed. The prevalence of major depressive disorder in this sample on screening was 7.8% (95% CI 2.2,18.9) and that of anxiety disorders (generalized anxiety disorder and panic disorder) was 5.9% (95% CI 1.2,16.2). The quality of life of COPD patients with psychiatric comorbidities in the present study was severely impaired in seven of the eight domains measured by the SF-36. Discussion: Despite the small sample size of COPD patients, the prevalence of psychiatric comorbidities was not insignificant. The present study showed that the quality of life of hospitalized COPD patients with psychiatric illnesses was significantly lowered. Treatment of COPD should include addressing psychosocial issues. [source] The relationship of pain and health-related quality of life in Korean patients with Parkinson's diseaseACTA NEUROLOGICA SCANDINAVICA, Issue 6 2009J. H. Roh Background,,, Parkinson's disease (PD) is a chronic progressive neurodegenerative disorder. Increasing attention has been focused on the pain and health-related quality of life (HrQOL) in patients with PD. Objective,,, To evaluate the relationship between pain and the HrQOL in patients with PD. Methods,,, Eighty-two patients with PD were included and classified into two groups according to the presence of pain. The Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale (UPDRS), the Modified Somatic Perception Questionnaire (MSPQ), the Zung Depression Inventory , Self-rating Depression Scale (SDS), the Visual Analogue Scale and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were administered. The factors influencing the pain, HrQOL and parkinsonian manifestations were evaluated. Results,,, The PD with pain group had higher UPDRS part III scores, lower SF-36 scores, higher SDS scores and higher MSPQ scores than the PD without pain group. The presence of pain, high Hoehn and Yahr stage, advanced age and somatic perception were the factors that had a negative effect on the physical component of the HrQOL. Depression and somatic perception were the most important predictive factors for the mental component of the HrQOL. Depression and poor parkinsonian motor abilities were the leading factors contributing to pain. Conclusion,,, Pain and depression were major detrimental factors affecting the physical and mental aspects of the HrQOL respectively. Therefore, the treatment of pain and depression can be important to improve the HrQOL. [source] Parental mental health, education, age at childbirth and child development from six to 18 monthsACTA PAEDIATRICA, Issue 5 2009For-Wey Lung Abstract Aim: To investigate the effect six-month parental mental health has on children's six and 18-month development. Parental covariates of age and education were also analysed. Methods: Through a national random selection, 21 648 babies were selected. Parental self perceived overall mental health was measured using 36-Item Short Form Health Survey (SF-36) and children's development using the Taiwan Birth Cohort Study (TBCS) instrument which measures gross motor, fine motor, language and social dimensions of children's development. Results: Both multiple linear regression and structural equation modeling showed that when the covariates of parental education and age at childbirth were added, the effect parental mental health has on children's development decreases. Additionally, maternal mental health had a more persistent and pervasive effect than paternal mental health. Father's mental health at six months had a delayed effect, in that its influence was seen only with children's development at 18 months. Of the three factors of parental mental health, education and age at childbirth, parental education had the most pervasive and persistent effect on children's development. Conclusion: Although parental mental health has an effect on children's development, parental education and age at childbirth are vital confounding factors, which should be considered in future studies. Clinical health care providers should provide childcare resources and instructions to younger, less educated and parents with mental symptoms. [source] Diabetes Care Protocol: effects on patient-important outcomes.DIABETIC MEDICINE, Issue 4 2010A cluster randomized, non-inferiority trial in primary care Diabet. Med. 27, 442,450 (2010) Abstract Aims, The Diabetes Care Protocol (DCP) combines task delegation, intensification of diabetes treatment and feedback. It reduces cardiovascular risk in Type 2 diabetes (T2DM) patients. This study determines the effects of DCP on patient-important outcomes. Methods, A cluster randomized, non-inferiority trial, by self-administered questionnaires in 55 Dutch primary care practices: 26 practices DCP (1699 patients), 26 usual care (1692 patients). T2DM patients treated by their general practitioner were included. Main outcome was the 1-year between-group difference in Diabetes Health Profile (DHP-18) total score. Secondary outcomes: DHP-18 subscales, general perceived health [Medical Outcomes Study 36-Items Short Form Health Survey (SF-36), Euroqol 5 Dimensions (EQ-5D) and Euroqol visual analogue scale (EQ-VAS)], treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire; DTSQ status) and psychosocial self-efficacy (Diabetes Empowerment Scale Short Form; DES-SF). Per protocol (PP) and intention-to-treat (ITT) analyses were performed: non-inferiority margin , = ,2%. At baseline 2333 questionnaires were returned and 1437 1 year thereafter. Results, Comparing DCP with usual care, DHP-18 total score was non-inferior: PP ,0.88 (95% CI ,1.94 to 0.12), ITT ,0.439 (95% CI ,1.01 to 0.08), SF-36 ,health change' improved: PP 3.51 (95% CI 1.23 to 5.82), ITT 1.91 (95% CI 0.62 to 3.23), SF-36 ,social functioning' was inconclusive: PP ,1.57 (95% CI ,4.3 to 0.72), ITT ,1.031 (95% CI ,2.52 to ,0.25). Other DHP and SF-36 scores were inconsistent or non-inferior. DHP-18 ,disinhibited eating' was significantly worse in PP analyses. For EQ-5D/EQ-VAS, DTSQ and DES-SF, no significant between-group differences were found. Conclusion, DCP does not seem to influence health status negatively, therefore diabetes care providers should not shrink from intensified treatment. However, they should take possible detrimental effects on ,social functioning' and ,disinhibited eating' into account. [source] Original article: Quality of life after esophagectomy and endoscopic therapy for Barrett's esophagus with dysplasiaDISEASES OF THE ESOPHAGUS, Issue 6 2010D. Schembre SUMMARY Esophagectomy (EG) and endoscopic therapy (ET) can eradicate Barrett's esophagus with early neoplasia. Their relative effect on quality of life is unknown. The 36-item Short Form Health Survey (SF-36) and Gastrointestinal Quality of Life Index (GIQLI) questionnaires were sent to all patients who underwent either EG or ET at our institution over the last 9 years. Groups were stratified by age and American Society of Anesthesia (ASA) class. Surveys were sent to 77 patients and completed by 14 EG (50%) and by 28 ET patients (57%). The average time between treatment and survey was 4 years in the ET group and 5 years in the EG group. There were no significant differences in SF-36 scores between EG and ET patients except for superior physical functioning among EG patients 65 and older QOL scores among EG and ET groups were not significantly different than sex age-matched controls. GIQLI scores were similar between ET and EG patients of all ages (P= 0.60). GIQLI scores were higher among younger ET patients than young EG patients (P= 0.049). GIQLI scores also tended to be higher among ASA 1 and 2 ET patients than ASA 1 and 2 EG patients, but this did not reach statistical significance (P= 0.09). EG and ET for early Barrett's neoplasia appear to have similar impact on QOL 1 year or more after treatment compared with age-matched controls. Negative QOL impact appears to be greater for younger patients undergoing EG than for ET. [source] Progression of dysautonomia in multiple system atrophy: a prospective study of self-perceived impairmentEUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2007M. Köllensperger To assess severity and progression of self-perceived dysautonomia and their impact on health-related quality of life (Hr-QoL) in multiple system atrophy (MSA), twenty-seven patients were recruited by the European MSA Study Group (EMSA-SG). At baseline, all patients completed the Composite Autonomic Symptom Scale (COMPASS) and the 36 item Short Form Health Survey (SF-36), and they were assessed using the 3-point global disease severity scale (SS-3) and the Unified MSA Rating Scale (UMSARS). After 6 months follow-up, the self completed COMPASS Change Scale (CCS), the SF-36, SS-3, and UMSARS were obtained. MSA patients showed marked self-perceived dysautonomia at baseline visit and pronounced worsening of dysautonomia severity on the CCS at follow-up. Severity and progression of dysautonomia did not correlate with age, disease duration, motor impairment and overall disease severity at baseline. There were no significant differences between genders and motor subtypes. Baseline COMPASS scores were, however, inversely correlated with SF-36 scores. Progression of self-perceived dysautonomia did not correlate with global disease progression. Hr-QoL scores were stable during follow-up. This is the first study to investigate self-perceived dysautonomia severity in MSA and its evolution over time. Our data suggest that dysautonomia should be recognized as a key target for therapeutic intervention in MSA. [source] Cost-Effectiveness of Preventive Occupational Therapy for Independent-Living Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2002Joel Hay PhD OBJECTIVES: To evaluate the cost-effectiveness of a 9-month preventive occupational therapy (OT) program in the Well-Elderly Study: a randomized trial in independent-living older adults that found significant health, function, and quality of life benefits attributable to preventive OT. DESIGN: A randomized trial. SETTING: Two government-subsidized apartment complexes. PARTICIPANTS: One hundred sixty-three culturally diverse volunteers aged 60 and older. INTERVENTION: An OT group, a social activity group (active control), and a nontreatment group (passive control). MEASUREMENTS: Use of healthcare services was determined by telephone interview during and after the treatment phase. A conversion algorithm was applied to the RAND 36-item Short Form Health Survey to derive a preference-based health-related quality of life index, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio for preventive OT relative to the combined control group. RESULTS: Costs for the 9-month OT program averaged $548 per subject. Postintervention healthcare costs were lower for the OT group ($967) than for the active control group ($1,726), the passive control group ($3,334), or a combination of the control groups ($2,593). The quality of life index showed a 4.5% QALY differential (OT vs combined control), P < .001. The cost per QALY estimates for the OT group was $10,666 (95% confidence interval = $6,747,$25,430). For the passive and active control groups, the corresponding costs per QALY were $13,784 and $7,820, respectively. CONCLUSION: In this study, preventive OT demonstrated cost-effectiveness in conjunction with a trend toward decreased medical expenditures. [source] Effectiveness of mirtazapine for nausea and insomnia in cancer patients with depressionPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2008Sung-Wan Kim md Aims:, The purpose of the present paper was to evaluate the effectiveness of mirtazapine orally disintegrating tablets for nausea and sleep disturbance, which are common and distressing symptoms of cancer. Methods:, This was a 4-week, prospective, open-labeled study of cancer patients. Assessments were performed at baseline and on days 1, 3, 5, 7, 14, and 28. Primary outcome measures were the Clinical Global Impression scale for nausea/vomiting and the Chonnam National University Hospital,Leeds Sleep Evaluation Questionnaire (C-LSEQ) including total amount of night sleep time. The secondary outcome measures consisted of pain items in the 36-item Short Form Health Survey, the Montgomery,Asberg Depression Rating Scale (MADRS), and the EuroQoL (EQ)-5D. Forty-two cancer patients were enrolled. Results:, Those with nausea (n = 28) improved significantly from day 1. The total night sleep time and each item on the C-LSEQ improved from days 1,5. The scores on the MADRS and the depression/anxiety dimension and visual analog scale of EQ-5D improved significantly from the first week. Pain measures also improved from day 1. Exacerbation of sleepiness developed in approximately one-third of subjects during the initial few days, but disappeared gradually. Conclusion:, In the present study mirtazapine rapidly improved nausea, sleep disturbance, pain and quality of life, as well as depression in cancer patients. Mirtazapine may be an effective treatment option in managing cancer patients with multiple distressing symptoms, including nausea and sleep disturbance. [source] Subclinical late cardiac toxicity in childhood cancer survivorsCANCER, Issue 8 2008Impact on self-reported health Abstract BACKGROUND The authors analyzed how self-reported health and self-reported modified New York Heart Association (NYHA) cardiac function scores were related to cardiac systolic function, cardiac risk factors, and cancer treatment history in childhood cancer survivors who reported no symptoms of cardiac disease. METHODS Long-term survivors of pediatric cancer who were treated between 1971 and 1995 (current ages, 16,39.7 years) underwent noninvasive clinical and laboratory cardiac risk evaluation and responded to selected subscales of the Medical Outcomes Study 36-item Short Form Health Survey. Results were compared with survivor history of anthracycline therapy alone or with radiotherapy (n = 127 patients; mean, 10 years after diagnosis) versus no anthracycline therapy (n = 32 patients; mean, 11 years after diagnosis). RESULTS Sex, current age, highest school grade completed, race, age at diagnosis, diagnostic group, years off therapy, fractional shortening (FS), heart rate, and smoking status were found to be independently predictive of self-reported health. Interaction between female sex and higher low-density lipoprotein values and between diagnosis and abnormal FS variably predicted low reported vitality and low reported modified New York Heart Association (NYHA) scores. Echocardiographic findings, cardiac risk factors, and treatment history explained 13% to 28% of the variance in perceived health and self-reported modified NYHA scores. CONCLUSIONS Systolic function and cardiac risk factors were linked to lower self-reported health and NYHA scores even in the absence of clinically evident cardiotoxicity. Cancer 2008. ©2008 American Cancer Society. [source] | |||||||||||||||||||