Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population

Chronic Pain and Pain Belief in Active Military Personnel: a Cross-sectional Study

Background

Chronic pain (CP) and mental disorders are common among active military personnel (AMP) due to their potential exposure to various physical and psychological stressors.

Aim

The aim of this study was to evaluate pain perception and beliefs regarding their pain among AMP suffering from CP using self-reported measures, and to understand the development and persistence of pain in AMP.

Methods

Sixty male AMP outpatients suffering CP were included. All participants completed the following forms and questionnaires: Oswestry Disability Index(ODI), Visual Analogue Scale(VAS), Neck Disability Index(NDI), Bournemouth Questionnaire for neck(BQN), International Physical Activity Questionnaire(IPAQ), Hospital Anxiety and Depression Index(HADS), 36-item Short Form Survey(SF-36), Automatic Thoughts Questionnaire(ATQ), and Pain Belief Questionnaire(PBQ).

Results

The mean age of the participants was 22.85±3.50 years, the median duration and frequency of pain were 12 months and 14.5 days in a month, respectively. The median of ODI scores was 26; three of patients were evaluated as crippled while 8 patients had severe disability. The HADS and PBQ-psychological scores were high in the patient group. Positive correlations were found between pain frequency and the ODI, VAS, NDI and PBQ-psychological scores. Relationships were also shown between PBQ-psychological and the VAS and ATQ scores. Correlations between ODI scores and ATQ scores were also revealed.

Conclusions

Our results suggest that, in addition to the organic basis of pain, there is strong evidence for significant contribution from the psychological characteristics and pain-related beliefs of the patients. Physicians may choose a multi-dimensional perspective in the diagnosis and treatment of pain, especially in patients suffering from CP.

Quality of Life of Older People Receiving Home Health Care Services: An Example From Turkey

Advanced age, restrictions on daily life activities, increased disability, and chronic diseases negatively affect the quality of life of older individuals. The aim of the present study was to investigate the quality of life of older patients receiving home health care services (HHCS) in Samsun province, Turkey. The population of this cross-sectional study comprised 489 individuals aged 65 years and older. Patient selection was performed using the stratified randomized sampling method. A total of 183 patients were included in the study. Data were collected using a questionnaire and face-to-face interviews. The Mann-Whitney U and Kruskal–Wallis tests were used in the statistical evaluation of data, and significance was regarded as p < .05 for all tests. Some 75.4% of the patients were women, and the average age was 82 years. Eighty-three percent of the participants were semi-dependent or completely dependent in the activities of daily living (ADL); however, in the instrumental activities of daily living (IADL), 96.0% were semi-dependent or completely dependent. The quality of life of the older people receiving HHCS was identified as low both in the physical and mental health components. However, physical quality of life was statistically higher in men, in graduates of primary school or above, and in patients with no decubitus ulcers compared with the others. We found that the older individuals receiving HHCS had a lower quality of life due to their chronic diseases and high dependency compared with the general population and their contemporaries.

The effect of parathyroidectomy on quality of life in primary hyperparathyroidism: evaluation with using sf-36 and phpqol questionnaire

Quality of life (QoL) typically improves with a parathyroidectomy (PTx) in cases of primary hyperparathyroidism (PHPT), but the effect of surgery on QoL is not yet fully understood. This study evaluated the impact of PTx on health-related QoL (HRQoL). Patients who underwent PTx for PHPT between January 2016 and December 2019 were asked to complete the 36-Item Short Form Health Survey (SF-36) and the Primary Hyperparathyroidism Quality of Life (PHPQoL) questionnaire before surgery and 1 year later. A 5-point Likert scale was used: negative responses received a lower score and positive responses scored high. Forty-one of 50 patients completed the questionnaires before and 12 months after the surgery. The median patient age was 64 years (min-max: 32-83 years). In the study group, 33 were female, and 8 were male. The SF-36 results indicated that significant improvements had been observed in all 8 domains a year after surgery, particularly in the physical functioning and role, general health, energy, and mental health scales. The PHPQoL scores also improved significantly after PTx (p < 0.05). The improvement in the physical and mental health components was 50% and 76%, respectively. In conclusion, this study demonstrated that PTx for PHPT improved QoL.

Life quality change after inflatable penile prosthesis implantation

PURPOSE

It was aimed to evaluate the changes in quality of life in patients with erectile dysfunction (ED) after inflatable penile prosthesis implantation.

MATERIAL AND METHODS

Forty-one patients who underwent to an inflatable penile prosthesis implantation surgery due to ED were included in the study. The age of the patients, the indications for surgery, and the type of prosthesis implanted were recorded. All patients were implanted two-piece inflatable (AMS Ambicor™) or three-piece inflatable (AMS 700™) prostheses. A 36-item short form (SF-36) was used to assess the life quality of patients. The scores obtained from these forms were recorded and used to compare the preoperative and postoperative quality of life of the patients.

RESULTS

The mean age of the patients was 59.9 (38-78) years. The mean follow-up was 25.1 (12-39) months. A three-piece inflatable penile prosthesis was implanted in 11 (26.8%) of the 41 patients and the others were implanted with a two-piece inflatable penile prosthesis. Average SF-36 scores were increased significantly after surgery in all groups.

CONCLUSIONS

Inflatable penile prosthesis implantation is one of the most satisfactory treatment methods of ED and our study shows that with this treatment the patients can be provided a significant improvement in life quality.

Comparison of the Effects of Four Treatment Techniques Commonly Used in Ureteral Stone Treatment on Patients' Daily Physical Functioning: An Observational Randomized-Controlled Study

Objective: To investigate the effect of four different techniques used in the treatment of ureteral stones on patients' daily physical functioning (PF) and quality of life (QoL). Materials and Methods: Patients who underwent ureterorenoscopy (URS)-with or without Double-J stenting (DJS)-and extracorporeal shock wave lithotripsy (SWL) were divided into four groups: Group I: SWL (n = 29), Group II: URS (n = 43), Group III: URS +4.8F DJS (n = 39), Group IV: URS +6F DJS (n = 42), and Group V: Control (n = 30). Short Form-36 (SF-36) was administered to each participant both preoperatively and 14 days after operation. Based on the SF-36 results, the changes in patients' PF and QoL were evaluated. Results: Ureteral stone treatment was performed in 202 patients. Of these, 153 patients who underwent an effective SWL or URS procedure in the first attempt were included in the study. Success rates in the first session were 53.7% (29/54) and 83.8% (124/148) for SWL and URS, respectively (p < 0.001). All the four groups were similar with regard to age, gender, body mass index, stone size, preoperative PF, and QoL. However, although postoperative PF, role limitations due to physical health, and energy/fatigue scores were similar in Group I, III, and IV, they were significantly higher in Group II. No major complication associated with SWL or URS occurred in any patient. However, in Group 2, DJS was inserted in three (7.7%) patients in the early postoperative period (within the first 48 hours) due to renal colic attacks secondary to ureterovesical junction mucosal edema. Conclusion: URS without DJS seems to be the most advantageous technique in the treatment of ureteral stones in terms of daily PF and QoL. However, it should be noted that patients undergoing URS may require postoperative emergency stenting, although rarely.

Impacts of combined osteopenia/osteoporosis and sarcopenia on balance and quality of life in older adults

OBJECTIVE

Combined osteopenia/osteoporosis and sarcopenia is a major public health problem for old adults. In this study, we aimed to evaluate the impacts of combined osteopenia/osteoporosis with sarcopenia on balance and quality of life in patients older than 65 years.

METHODS

In this sudy, 77 patients with sarcopenia, who were older than 65 years, were included. The diagnosis of sarcopenia was made according to the diagnostic criteria developed by The European Working Group on Sarcopenia in Older People (EWGSOP). Bone densitometry was performed to screen for osteoporosis or osteopenia. The balance was assessed with the anterior-posterior stability index (APSI), medial-lateral stability index (MLSI), and the general stability index (OSI), which were calculated using a Biodex Stability System device (BSS). The quality of life was assessed using SF-36.

RESULTS

Patients with sarcopenia were included in this study. Of them, 40 had osteoporosis and 37 had osteopenia. The measures of balance and the OSI, APSI, and MLSI values were low in both groups of patients, but they were statistically significantly lower in the sarcopenia with osteoporosis group compared to the sarcopenia with osteopenia group (p=0.01; p=0.002; p=0.04, respectively). The quality of life was lower in all sub-categories of SF-36, excluding the mental health when sarcopenia was accompanied by osteoporosis compared to the joint occurrence of sarcopenia with osteopenia (p<0.05).

CONCLUSION

Our study suggests that the joint occurrence of osteoporosis with sarcopenia is associated with a risk of balance loss, a decrease in quality of life, and a potentially increased fracture risk in older adults.

Comparison of Quality of Life Before and After Septoplasty With Short Form-36

The authors aimed to evaluate quality of life after septal surgery with Short Form-36 survey, and the effectiveness of the survey. Nasal symptoms (nasal obstruction, facial pain, catarrh), and general quality of life (using the Turkish version of the Short Form-36 questionnaire) were assessed preoperatively and at 1st and 6th postoperative months. Acoustic rhinometry and rhinomanometry were assessed preoperatively and at 6th postoperative month. Data from 78 patients were analyzed. This prospective clinical study was conducted on patients complaining of nasal obstruction with nasal septal deviation. Seventy-eight patients were included in the study. Fourty-two patients (53.8%) were male and 36 patients (46.2%) were female. At 1st postoperative month, nasal obstruction, facial pain and catarrh scores significantly improved in all, 46, 18 patients, respectively (P < 0.0001). At 6th postoperative month, scores nonsignificantly worsened by 1 point in 12, 6, 12 patients, respectively. Nasal volume significantly increased and total resistance significantly decreased at 6th month (P < 0.0001). Compared to preoperative values, all items except social function and bodily pain significantly increased at 1st postoperative month. Compared to values at 1st postoperative month, only bodily pain score decreased at 6th postoperative month. One patient presented with septal perforation. Septoplasty is a well-established technique to reduce nasal obstruction and improve quality of life. SF-36 may be used as a reliable measure of changes in quality of life after septal surgery.

Psychometric validation of a Saudi Arabian version of the sf-36v2 health survey and norm data for Saudi Arabia

Background

Adaptation of a patient-reported outcomes survey into a new language requires careful translation procedures as well as qualitative and quantitative psychometric testing. This study aimed to evaluate the basic psychometric properties of the new Saudi Arabian SF-36v2 and establish norm data for Saudi Arabia.

Methods

Translation and adaptation of the SF-36v2 used standard methodology. Psychometric validation included two stages: 1) A qualitative study (n = 100) explored the components of health and health-related quality of life considered important in Saudi Arabia and evaluated the content validity of the SF-36v2 in Saudi Arabia, and 2) A quantitative study (n = 6166) evaluated the basic psychometric properties of the Saudi SF-36v2 and established norm data for Saudi Arabia. Comparison with US general population data (n = 4040) evaluated differential item function (DIF) and cross-national differences.

Results

The qualitative study supported the content validity of the Saudi SF-36v2. Cognitive debriefing identified only few and minor problems. Psychometric analyses supported item convergence within scales and differentiation across scales of the SF-36v2. Scale level exploratory factor analyses did not support the typical distinction between physical health and mental health components. Internal consistency reliability was satisfactory for all scales except the social function scale (alpha = 0.67). Cross-national DIF was identified for 9 items. In the Saudi general population, the average vitality score was lower for women (− 2.71 points) compared to men. For men, older age groups scored lower on the physical function scale (− 3.31) and the physical health component (− 3.06). For women, older age groups scored lower on the role physical (− 3.72), bodily pain (− 3.66), and vitality (− 2.32) scales as well as the physical health component (− 3.52). Compared to the 2009 United States general population, and after adjusting for age, gender, and differential item function, persons in Saudi Arabia had lower average scores for the physical function (− 3.10), role physical (− 4.75), social function (− 4.23), role emotional (− 5.67), and mental health (− 4.82) scales, as well as the mental health component (− 4.57).

Conclusion

This Saudi normative study of patient reported outcomes supported the validity and reliability of the new Saudi SF-36v2 and found cross-national differences with the USA.

Caregiver Burden, Quality of Life and Related Factors in Family Caregivers of Dementia Patients in Turkey

This study aimed to evaluate caregiver burden and quality of life (QoL) and their predictors in family caregivers of dementia patients. A descriptive cross-sectional survey was carried out with a sample of 102 patients and their family caregivers. The Caregiver Burden Inventory (CBI) and Short Form-12 (SF-12) were used to collect data. CBI mean score was 37.97 ± 21.30. Mean scores of SF-12 sub-domains varied between 36.02 and 77.94 and were significantly lower as compared to normative means of the general population, excluding only the physical health subdomain. Among several patient and caregiver-related correlations, the number of medications and worse cognitive function of the patient, caregiver's age and having limited space at home were found as predictors of burden, whereas caregiver's chronic disease and having a limited space were predictors of QoL. Also, the burden and QoL were correlated. This study demonstrated a high burden and low QoL in dementia caregivers. In societies where caregivers are mostly informal such as that in Turkey, supportive systems should be established.

Sports participation and quality of life in individuals with visual impairment

BACKGROUND

The positive effects of sports participation on health can be an important issue for rehabilitation of visually impaired individuals.

AIMS

Our aim was to determine the relationship between sports participation and quality of life in individuals with visual impairment.

METHODS

The study included 100 athletes who participated in national games for people with visual impairment and 100 subjects who did not participate in sports as the control group. The two groups were matched according to age, gender, visual acuity and visual field. The Short-Form Health Survey (SF-36) was applied for assessment of quality of life.

RESULTS

All subjects had best corrected visual acuity less than 6/60 and/or visual field less than central 10 degrees in radius in the better eye. The sociodemographic characteristics of the study and control groups were similar except the level of education being higher in the athlete group and level of income higher in the control group. All of the SF-36 scores were higher among athletes compared to controls. Duration of sports activities (years) was positively correlated with Physical Functioning score. There were no significant relations between SF-36 scores and weekly sports participation time (hours). Athletes who had visual loss at an earlier age had better scores in Physical Functioning and Role Limitations due to Physical Problems.

CONCLUSIONS

Sports activities had positive relationships with all domains of the quality of life in individuals with visual impairment. Thus, appropriate sports activities would increase the success of rehabilitation programs and their quality of life.

Subcostal Transversus Abdominis Plane Block for Laparoscopic Sleeve Gastrectomy, Is It Worth the Time?

BACKGROUND

Obesity is a complex and multifactorial disease whose incidence has increased, making it a serious public health issue. Laparoscopic sleeve gastrectomy (LSG) is one of the most common surgical procedures that is chosen for bariatric surgery. Decreasing postoperative pain in these patients which will increase patients' compliance and quality of life will lead to better surgical results. This study aims to compare the effectiveness of trocar site infiltration versus bilateral subcostal transversus abdominis plane block (TAP) in controlling postoperative pain in patients.

METHODS

Forty-five consecutive patients who have undergone LSG in xxx General Surgery Department have been enrolled in the study. Patients were divided into two groups according to the surgeon's choice. The first group underwent TAP block, while the second group underwent trocar site infiltration. Patients' pain was recorded via visual analogue scale (VAS) in postoperative periods.

RESULTS

Twenty-nine female (69%) and 13 (31%) male patients were included in the study. Median age was 41 (18-58) and median BMI was 48 (41.1-68). When the VAS values were compared, in the TAPB group, 6th hour resting and coughing pain was statistically significantly less. Other VAS values measured while resting, coughing, and post-mobilization did not show significant differences. There were no significant differences between the groups' tramadol use.

CONCLUSIONS

After LSG, TAP block and trocar site infiltration yield similar pain control. Due to the faster application and fewer side effects, we concluded that trocar site infiltration should be the intervention of choice in controlling postoperative pain in LSG.

Automated Remote Monitoring for Peritoneal Dialysis and Its Impact on Blood Pressure

Introduction: Peritoneal dialysis (PD) provides a safe, home-based continuous renal replacement therapy for patients. The adherence of the patients to the prescribed dialysis fluids cannot always be monitored by physicians. Remote monitoring automated peritoneal dialysis (RM-APD) can affect patients’ compliance with treatment and, thus, clinical outcomes. Objective: We aimed to evaluate the clinical outcomes of patients with a remote access program. Methods: This was an observational study. We analyzed the effect of RM-APD on treatment adherence, dialysis adequacy, and change in blood pressure control, sleep quality, and health-related quality of life during the 6 months of follow-up. Results: A total of 15 patients were enrolled in this study. It was found that there was a significant decrease (99 ± 19 vs. 89 ± 11 mm Hg) in mean arterial blood pressure of patients, and a considerable increase in Kt/V was observed in the sixth month after the RM-APD switch (2.11 ± 0.4 vs. 2.25 ± 0.5). A significant increase was found when comparing the 3-month and 6-month ultrafiltration amounts before RM-APD and the ultrafiltration amount within 6 months after RM-APD (800 mL [500–1,000] and 752 mL [490–986] vs. 824 mL [537–1,183]). The daily antihypertensive pill need (4 [0–7] vs. 2 [0–6]) and alarms received from the device decreased (from 4 [3–8] to 2 [0–3]) at the sixth month of the switch. There was no significant change in sleep quality and health-related quality of life within 6 months. Conclusion: This study showed that treatment adherence and ultrafiltration amounts of patients increased with the use of RM-APD, as well as better blood pressure control with fewer antihypertensive drugs.

Large Fibre Neuropathy: Part of Fibromyalgia or Coexisting Entity?

Zielsetzung Ziel dieser Studie ist es, die Inzidenz von Large Fibre Neuropathy (LFN) bei Fibromyalgie (FM) -Patienten mit peripheren Neuropathie-Beschwerden zu untersuchen und den Einfluss von LFN und FM auf Schmerzen, Lebensqualität, Schlafqualität, Behinderung, und depressive Symptome.

Methoden Zwischen Juni 2018 und Februar 2019 wurden insgesamt 104 Patienten (67 Frauen, 37 Männer; Durchschnittsalter: 52,21±9,53 Jahre; Spanne 31–74 Jahre) mit der Diagnose FM in die Studie eingeschlossen. Die Patienten wurden in 2 Gruppen eingeteilt: Gruppe 1, einschließlich Patienten mit Polyneuropathie (PNP) (n=48) und Gruppe 2, einschließlich Nicht-PNP-Patienten (n=54). Gruppe 1 wurde auch weiter in 2 Untergruppen als sensorische PNP (n=28) und sensomotorische PNP (n=20) unterteilt. Alle Patienten wurden anhand der Visual Analog Scale (VAS), des Fibromyalgia Impact Questionnaire (FIQ), des Short Form-36 (SF-36), des Pittsburgh Sleep Quality Index (PSQI) und des Beck Depression Inventory (BDI) bewertet.

Ergebnisse Es gab keinen statistisch signifikanten Unterschied in den demografischen Merkmalen zwischen den Gruppen (p>0,05). Es gab einen statistisch signifikanten Unterschied in den VAS-, SF-36-, BDI-, FIQ- und PSQI-Werten zwischen Gruppe 1 und Gruppe 2 (p<0,05). Es gab keinen statistisch signifikanten Unterschied in den VAS-, SF-36-, BDI-, FIQ- und PSQI-Werten zwischen den sensorischen und sensomotorischen PNP-Gruppen (p>0,05).

Schlussfolgerungen Unsere Studienergebnisse zeigen, dass FM mit LFN die Schmerzen, die Lebensqualität, die Schlafqualität, die Behinderung und die depressiven Symptome negativ beeinflusst, gegenüber denjenigen ohne LFN, was auf die Bedeutung des Neuropathiemanagements bei FM-Patienten hinweist.

Cross-cultural adaptation and validation of the Turkish version of Centrality of Pain Scale in patients with fibromyalgia syndrome

AIM

The purpose of this study was to perform a cross-cultural adaptation of the Turkish version of the Centrality of Pain Scale (COPS) and to evaluate its psychometric properties in patients with fibromyalgia syndrome (FMS).

METHODS

Centrality of Pain Scale was translated and culturally adapted according to guidelines. Clinical and demographic data of the patients were recorded. In addition to the Turkish version of the COPS (COPS-TR), fibromyalgia impact questionnaire (FIQ), Pain Catastrophizing Scale (PCS), Brief Pain Inventory-Short Form (BPI-SF), Beck Depression Inventory (BDI), Generalized Anxiety Disorder 7-item (GAD-7) scale and Short Form-36 were applied. Internal consistency and test-retest methods were used for reliability analysis. Convergent validity was assessed by analyzing the correlations between COP-TR and functional parameters. Divergent validity and responsiveness were also evaluated.

RESULTS

One hundred and four patients (90 female and 14 male) were included. The mean age was 44 years. Good internal consistency (α = .84) and high test-retest reliability (intraclass correlation coefficient = 0.95) were determined. Highest correlations were detected between COPS-TR and BPI-SF pain interference score (r = .64), COPS-TR and PCS (r = .61). There was no significant correlation with non-functional parameters (body mass index, disease duration). It showed high responsiveness (effect size and standardized response mean were 1.66 and 1.94, respectively). The patients filled out COPS-TR in 2 minutes.

CONCLUSIONS

COPS-TR is a reliable and valid instrument that shows good psychometric properties. It can be used in clinical practice and scientific research.

The Impact of Auricular Vagus Nerve Stimulation on Pain and Life Quality in Patients with Fibromyalgia Syndrome

The purpose of this study is to evaluate the impact of auricular vagus nerve stimulation, applied in conjunction with an exercise treatment program, on pain and life quality in patients with fibromyalgia syndrome (FMS). To achieve the study objectives, 60 female patients between the ages 18 and 50, with diagnosed FMS according to the American College of Rheumatology (ACR) 2010 diagnostic criteria, were randomly divided into 2 groups of 30. The first group was assigned 20 sessions of a home-based exercise program, while the second group was assigned 20 sessions of auricular vagus nerve stimulation and 20 sessions of a home-based exercise program. Patients were assessed before and after the treatments using the Visual Analog Scale (VAS) for pain, Beck Depression Scale for depression, Beck Anxiety Scale for anxiety, Fibromyalgia Impact Questionnaire (FIQ) for functional evaluation, and Short Form-36 (SF-36) for life quality. In this randomized controlled trial, comparisons within the groups revealed that both groups had statistically significant improvements in pain, depression, anxiety, functionality, and life quality scores (p < 0.05), while comparisons across the groups revealed that the group experiencing the vagus nerve stimulation had no statistically significant differences between the baseline scores, except for those of SF-36's subparameters of physical function, social functionality, and pain. In fact, comparisons across the groups after the interventions revealed that the group experiencing the vagus nerve stimulation had better scores but not statistically significant. From analysis of this data, we observed that vagus nerve stimulation in FMS treatment did not give additional benefit together with exercise, except for three subparameters of SF-36. It was identified that further studies which separately investigate the effects of vagus nerve stimulation and exercise on FMS with longer follow-up periods and an increased number of patients are needed.

Physical Activity and Health-Related Quality of Life in People With Back Pain: A Population-Based Pooled Study of 27,273 Adults

BACKGROUND

To investigate the association between moderate- to vigorous-intensity physical activity (MVPA) and health-related quality of life (HRQoL) in people with back pain.

METHODS

The sample comprised adults aged 16 years and older who participated in the Welsh Health Survey (2011-2015). The HRQoL was evaluated using the 36-item short form. Participants were categorized into 4 groups based on minutes per week of MVPA: inactive (no MVPA), insufficiently active (<150 min/wk), sufficiently active (≥150 and <300 min/wk), and very active (≥300 min/wk). The authors investigated the association between MVPA and HRQoL using generalized linear models and multiple linear regression.

RESULTS

Of the 74,578 adults in the survey cohorts, 27,273 participants diagnosed with back pain were included in the analyses. Consistent direct curvilinear associations between MVPA and HRQoL were demonstrated for all 36-item short form domains (P < .001), in both the minimally and fully adjusted models, with the highest scores observed for sufficiently active and very active participants. Compared with the inactive group, those who were insufficiently active; sufficiently active; and very active had an average difference of 6.31 (95% confidence interval, 5.70-6.92), 7.72 (95% confidence interval, 7.04-8.41), and 8.00 (95% confidence interval, 7.12-8.89) points in the overall HRQoL, respectively.

CONCLUSION

The authors found a consistent direct curvilinear association between MVPA and HRQoL.

The Study of Validity and Reliability of the SPOFIA Scale in Patients With Postoperative Breast Cancer

Introduction and aim:

This study investigates the validity and reliability of the Subjective Perception of Post-Operative Functional Impairment of the Arm (SPOFIA) scale in patients with postoperative breast cancer.

Materials and methods:

Research was designed as a methodological type. Required permissions were taken from the ethics committee, relevant institutions, and researchers who developed the SPOFIA scale. Data were collected as a research in Kocaeli University hospital, between November 2017 and October 2018. For the Turkish SPOFIA scale’s validity, data were collected from 142 patients. In the study, Patient Information Form, SPOFIA, and 36-item Short-Form Health Survey (SF-36) Quality-of-Life Questionnaire were used. In the analysis of data, descriptive statistical methods were used, and in the analysis of the validity of the scale, test-retest and Cronbach alpha reliability coefficient was used.

Results:

As a result of the analysis, we obtained Kendall W = 0.107, P > 0.05; correlation with SF-36 was P < .05, reliability studies test-retest analysis was P > .05, and Cronbach alpha reliability coefficient was 0.739. It was determined that the SPOFIA scale was valid and reliable for Turkish patients and that the subjective findings of the patients could be used as individual follow-up in longitudinal monitoring.

Conclusions:

As a result, it was determined that the SPOFIA scale was reliable in the patient follow-up of breast cancer women.

The impact of hereditary angioedema on quality of life and family planning decisions

Objective

Hereditary angioedema is a serious disease with unpredictable attacks. It has an impact on patients’ health-related quality of life. This study aimed to assess the quality of life of the hereditary angioedema patients and to investigate the relationship between quality of life and demographic, clinical, laboratory, and psychiatric parameters.

Method

A semistructured face-to-face interview, Hamilton depression rating scale, and Hamilton anxiety rating scale were performed by a psychiatrist. Participants completed Medical Outcomes Study Short Form-36, Revised Form of the Multidimensional Scale of Perceived Social Support, Anxiety Sensitivity Index-3, and Adult Separation Anxiety Questionnaire. Patients’ complement results were recorded, and clinical data obtained by interview were cross-checked from patients’ files.

Results

In 33 hereditary angioedema patients, subscales of the Study Short Form-36, except for physical functioning, vitality, and mental health were significantly lower compared with population norms. Quality of life scores were found to be correlated with depression, anxiety, anxiety sensitivity, separation anxiety, perceived social support, perceived discrimination, perceived limitation, treatment naïve C1-Inhibitor function, and C1q level. Physical role functioning scores were better in the patients using attenuated androgens (p = 0.006, t = −3.027). Hereditary angioedema contributed to the marital problems and childbearing decisions of the patients.

Conclusion

Hereditary angioedema results in significant impairment in quality of life of the patients and has an impact on family life and life style of the patients. In case of depressive and/or anxiety symptoms, patients should be referred to psychiatrists for better quality of life. Higher levels of C1-inhibitor function and C1q seem to correlate with better quality of life; these needs to be further studied.

Identifying variables in relation to health-related quality of life among married women of reproductive age in Sivas Turkey

A cross-sectional study was performed to identify the factors associated with health-related quality of life (HRQoL) among 1,236 married Turkish women aged 15-49 years, in the urban area of Sivas, between January and July 2017. Multiple logistic regression analyzes showed that being unemployed [adjusted odds ratio (AOR) = 1.73, 95% confidence interval (CI) = 1.18-2.25], and having an unsatisfying sexual life (AOR = 1.54, 95% CI = 1.17-2.03), a chronic illness (AOR = 1.66, 95% CI = 1.27-2.17), more than three children (AOR = 1.38, 95% CI = 1.03-1.86), and experienced domestic violence (AOR = 2.15, 95% CI = 1.55-2.98) were associated with worse mental HRQoL. Having less than a high school education (AOR = 2.00, 95% CI = 1.33-3.02), a chronic illness (AOR = 2.49, 95% CI = 1.88-3.30), a history of abortion (AOR = 1.59, CI = 1.09-2.31), and experienced domestic violence (AOR = 1.71, 95% CI = 1.21-2.40) were associated with worse physical HRQoL. These findings suggest that health care providers or policy makers should pay special attention to unemployed women who are less educated, have more than three children and those having unsatisfied sexual lives, chronic illness, domestic violence experience and abortion history to enhance their HRQoL.

SF-36 normative values according to level of functioning in older women

PURPOSE

The 36-item Medical Outcome Study Short Form (SF-36) survey measures health-related quality of life. Age and disease-specific normative values have been published, but a focus on level of functioning may be more meaningful in case of multimorbidity. We estimated normative values for Australian women aged 79-90 years according to levels of functioning.

METHODS

Data were from 6127 (aged 79-84 in 2005) and 3424 (aged 85-90 in 2011) participants in the Australian Longitudinal Study on Women's Health. Surveys included the SF-36 and information on housing. Record linkage to assessment data for access to the national program for aged care support was used to obtain information on participants' need for assistance with 10 activities. Normative values were calculated for physical component (PCS), mental component (MCS), and subscale scores for subsamples defined by types of assistance needed.

RESULTS

At the ages of 79-84, the mean (95% confidence interval) PCS and MCS values for women not any needing assistance were 37.5 (37.2-37.9) and 53.0 (52.8-53.3) compared to 29.0 (27.8-30.2) and 45.9 (44.4-47.4) for women needing any assistance. At ages 85-90, the corresponding PCS values were 34.9 (34.5-35.4) vs. 28.2 (27.4-29.0) and the corresponding MCS values were 53.2 (52.8-53.6) vs. 48.7 (47.8-49.6). Values were higher for participants living in the community or retirement village vs. nursing homes/hostels. The PCS, MCS and 8 subscale values decreased as the need for assistance with more basic activities increased.

CONCLUSIONS

These normative values facilitate meaningful interpretation of SF-36 scores from the perspective of level of functioning.

Functional outcomes and quality of life in adult ipsilateral femur and tibia fractures

Objective

The aim of our study is to evaluate the functional outcomes and quality of life in adult ipsilateral femur and tibia fractures.

Methods

26 patients (21 male, 5 female; mean age 30 years, range: 18 to 66) treated for adult ipsilateral femur and tibia fractures were evaluated retrospectively. For femur fractures, intramedullary nails were used in 15 patients (12 antegrade, 3 retrograde), plate in 11 patients (10 locked-plate, and 1 blade-plate with a 95 degree angle). For tibia fractures, locked-plate were used in 13 patients, intramedullary nails in 9 patients, external fixator in 3 patients and multiple screws in 1 patient. According to Blake and McBryde classification, 17 fractures were type I, 9 fractures were type II (7 type 2A and 2 type 2B). The functional outcomes were evaluated by Karlström and Olerud criteria, and quality of life was evaluated by Short Form-36. The mean follow-up duration was 4.4 years (range: 1.1 to 7.3 years).

Results

The functional outcomes were excellent in 6 patients, good in 8 patients, acceptable in 6 patients and poor in 6 patients. The mean values of quality of life scales were; physical function: 64.8, physical role limitation: 60.5, pain: 68.2, general health: 63.3, vitality: 58.4, social function: 68.2, emotional role limitation: 62.7, and mental health: 65.8.

Conclusion

Adult ipsilateral femur and tibia fractures are severe injuries and adversely affect the quality of life and functional outcomes. The quality of life scales should be used along with functional outcome scores in evaluating these injuries.

The translational potential of this article

Adult ipsilateral femur and tibia fractures cause severe morbidity. Functional outcomes and quality of life scales should be used together to evaluate these fractures. Karlström and Olerud criteria for functional outcomes and Short Form-36 scales for quality of life are suitable methods to evalute these fractures.

Effects of bariatric surgery on knee osteoarthritis, knee pain and quality of life in female patients

OBJECTIVES

Bariatric surgery is an effective intervention for severe obesity and associated comorbidities. We compared symptoms, joint space and life quality of morbidly obese patients with symptomatic knee osteoarthritis before and after bariatric surgery.

METHODS

34 patients with knee osteoarthritis were evaluated with standing anteroposterior and lateral radiography, medial and lateral joint distances of the knees, Visual Analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire and the Short Form 36 (SF-36) before and 6 months after surgery.

RESULTS

Mean patient age was 48.53±6.91 years. Mean body mass index was 46.97±6.04 kg/m² and 34.41±5.62 kg/m² before and after surgery, respectively. SF-36 subscales were significantly higher after surgery (p<0.05), while mean VAS values and WOMAC scores were significantly lower postoperatively (p<0.001). Right knee medial and left knee lateral joint distance measurements were significantly higher postoperatively (p<0.05). BMI change, in linear regression analysis had no significant effect on VAS, WOMAC, SF-36 and knee lateral and medial joint distance measurements.

CONCLUSIONS

Although bariatric surgery might improve pain, life quality and functionality of knee osteoarthritis in early period, improvement is not directly related to weight loss amount.

Effect of interleukin-1 antagonists on the quality of life in familial Mediterranean fever patients

BACKGROUND

Familial Mediterranean fever (FMF) patients suffer from chronic complications of disease such as AA amyloidosis, chronic arthritis, and spondylitis. Reduced quality of life (QoL) is a feature of chronic diseases but it is also impaired in patients with FMF. Despite the regular use of colchicine at a maximal dose, about 10% of patients do not respond well or resistant to colchicine (crFMF). IL-1 inhibitors have been shown to be effective in controlling attacks in crFMF patients. Herein, we aimed to investigate QoL changes of crFMF patients with IL-1 inhibitors.

METHODS

All patients were prospectively monitored for the frequency, duration, severity of attacks, patient global assessments (Visual Analog Scale; VAS), and laboratory features. Either anakinra or canakinumab was used as IL-1 antagonist treatments. Demographic information, MEFV gene mutations, attack characteristics, and previous treatments were registered. Short form-36 (SF-36) quality of life scale was implemented by the interviewer for evaluating the QoL before and 3 months after the treatment.

RESULTS

A total of 44 patients were included in this study. Striking improvements were detected in frequency, duration, and VAS severity of attacks (p < 0.001). In the comparison of pre- and post-treatment, SF-36 sub-components significant improvements were observed on physical function, role limitation due to physical difficulty, role limitation due to emotional problem, energy, emotional well-being, social function, pain, general health, and health change.

CONCLUSIONS

In conclusion, IL-1 antagonists prevent attacks and improve QoL of crFMF.

Evaluation of quality of life in patients undergoing surgery for benign prostatic hyperplasia

INTRODUCTION

Benign prostatic hyperplasia (BPH) is one of the most common diseases in the world and also one of the most common causes of urinary complaints that occur with increasing age. Thus, BPH should be addressed with surgical procedures. To contribute to the relevant literature, the present study aims to investigate the effects of surgical therapies for BPH on the patients quality of life.

MATERIALS AND METHODS

This study included 120 patients who underwent surgery for BPH at a Training and Research Hospital. The short-form health survey (SF-36) was administered to the patients before the surgery and at three months after the surgery. Eight parameters of the SF-36 and mental (MCS) and physical (PCS) component summary scores were calculated. The Student's t-test, Wilcoxon, and chi-square test were used in the statistical analysis.

RESULTS

When the eight parameters within the SF-36 health questionnaire were examined separately, the findings showed that patients quality of life increased significantly with respect to physical functioning, social functioning, and role limitations because of emotional problems , vitality, bodily pain, general health perceptions, and mental health domains three months after surgery (p < .001). The PCS and MCS significantly increased after surgery (p < .001).

CONCLUSION

The SF-36 questionnaire results showed that a significant improvement in the patients quality of life was observed in patients who underwent surgery for BPH. Our findings suggest that SF-36 could be considered a reliable evaluation test to be used in the patients with BPH after surgery.

Effects of whole body vibration training on isokinetic muscular performance, pain, function, and quality of life in female patients with patellofemoral pain: a randomized controlled trial

OBJECTIVES

To investigate the effects of whole body vibration (WBV) training on isokinetic muscular performance, pain, function, and quality of life in patients with patellofemoral pain (PFP).

METHODS

Forty women with PFP were included in this study and assigned to either a WBV group that received WBV training plus home exercise or a control group that performed home exercise only. A supervised WBV training was performed in 24 sessions on a synchronous vertical vibration platform three times a week for eight weeks. The home exercise program in the control group was identical to that in the WBV group. Isokinetic measurements were performed at baseline and post-treatment. In addition, patients were assessed after 6 months using a visual analog scale (VAS), Kujala Patellofemoral Score (KPS), and Short Form-36 (SF-36).

RESULTS

Total work of knee extensors and VAS improved significantly post-treatment in the WBV group compared to the control group (P=0.041, P=0.003, respectively). However, there was no significant difference between groups at the 6-month follow-up (P>0.05).

CONCLUSIONS

The present findings recommended that eight weeks of WBV training plus home exercise can more effectively reduce pain and improve the endurance of the knee extensors than that of home exercise of patient with PFP.

Application of the short form of quality of life instrument version 2 in a large population of Tehran

Background: Quality of life (QoL) is now considered as a key indicator in health studies. Therefore, this study was conducted to evaluate QoL in the general population of Tehran (capital of Iran) using SF-12v2 questionnaire and determine some factors associated with it.

Methods: This was part of a large population-based cross sectional study conducted in Tehran, Iran, in 2011. Participants were selected from all districts of Tehran using multistage cluster random sampling method. Data were collected using the Iranian version of the SF12v2 questionnaire. Linear regression model was used to assess the independent effect of surveyed variables of the study population on their QoL. P< 0.05 was considered statistically significant.

Results: Overall, 30 809 individuals over the age of 20 from 22 urban districts were included in this study and evaluated by SF-12v2 questionnaire. The mean age of the study population was 44.5±15.9, and most of them were female (19 967 (64.8%)). The total mean score of SF-12v2 was 60.4 and the lowest and highest mean scores were observed in GH (46.9±26.5) and MH subscales (64.1±24.7), respectively. It was also observed that District 3 of Tehran had the highest mean score (65.2±18.7) in the total QoL and District 12 had the lowest mean score (56.6±18.7), respectively. The results of multiple linear regression model showed that sex, age, education, household size, presence of chronic disease in family, having insurance, smoking, and marital status were significantly related to most subscales and two summary components of QoL.

Conclusion: The results of this study showed that the surveyed population of Tehran had a relatively moderate QoL, but it changed from district to district. It was also observed that age and education of the study population were important variables in relation to QoL.

Regulation of Dietary Habits: The effect of losing weight on quality of life

OBJECTIVE

This study aimed to investigate the effects of regulation of nutritional habits on quality of life by applying Short Form (SF-36) Quality of Life Scale.

METHODS

SF-36 was administered through face-to-face interviews to a total of 129 individuals (112 female, 17 male) aged 18-65 years. Anthropometric measurements, body mass index, and waist circumference measurement were undertaken simultaneously. The changes in weight, body mass index, waist circumference measurement, and SF-36 scores were compared at baseline and three months after modification of dietary habits.

RESULTS

At three months after the regulation of dietary habits, a statistically significant decrease was found in weight, body mass index, and waist circumference measurements (p<0.05). Overall improvement was observed in all the quality of life parameters assessed with SF-36, and among them, the sub-scales of general health, bodily pain and vitality were statistically significant (p<0.05). The improvement in these sub-scale scores was similar to the literature.

CONCLUSION

The individuals who lost weight through adopting healthy dietary habits had increased SF-36 scores, indicating the positive effect of regulating diet on their quality of life.

Is it Possible to Recover Cardiac Functions After Total Knee Arthroplasty?

Background

Patients suffering from knee osteoarthritis lead a less active life than their healthy peers. It is well known that insufficient physical activity is the most common cause of chronic diseases. However, there is not enough research to enlighten the effect of increased functional capacity on cardiac functions after Total Knee Arthroplasty (TKA). This study aimed to investigate whether the orthopedic surgeons can predict that the patients will be healthier after TKA in terms of cardiac functions or not?

Methods

109 patients who underwent TKA were prospectively followed for one year. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and short form 36 (SF-36) surveys, BMI measures, average step count per day, the six-minute walking test (6MWT), the Five-Times-Sit-to-Stand Test (FTSST) and Doppler echocardiography were performed both in the preoperative and postoperative period.

Results

After TKA, there was a substantial improvement in terms of WOMAC and SF36 survey scores. The average step count increased from 2199.6±690.8 steps/day to 4124.3±1638.8 steps/day. 6MWT and FTSST improved significantly as well. The average brisk walking time was 174.23±95.11 minutes/week. The means of early and late mitral inflow velocity ratios (E/A and Em/Am ratios) increased from 0.71±0.12 to 0.77±0.13 and from 0.66±0.13 to 0.76± 0.15 at the first year follow-up visit, respectively (p<0.001).

Conclusion

In the first year, objective physical capacity measures increased together with the expected improvements in disease-specific and generic measures. After TKA, left ventricular diastolic functions may be considered to have recovered in the light of the healing signs via echocardiography.

Validity and Reliability of Visual Analog Scale Foot and Ankle: The Turkish Version

The present study tested the reliability and validity of the Turkish version of the visual analog scale foot and ankle (VAS-FA) among healthy subjects and patients with foot problems. A total of 128 participants, 65 healthy subjects and 63 patients with foot problems, were evaluated. The VAS-FA was translated into Turkish and administered to the 128 subjects on 2 separate occasions with a 5-day interval. The test-retest reliability and internal consistency were assessed with the intraclass correlation coefficient and Cronbach's α. The validity was assessed using the correlations with Turkish versions of the Foot Function Index, the Foot and Ankle Outcome Score, and the Short-Form 36-item Health Survey. A statistically significant difference was found between the healthy group and the patient group in the overall score and subscale scores of the VAS-FA (p < .001). The internal consistency of the VAS-FA was very good, and the test-retest reliability was excellent. Adequate to good correlations were found between the overall VAS-FA score and the Foot Function Index, Foot and Ankle Outcome Score, and Short-Form 36-item Health Survey scores in the healthy and patient groups both. The Turkish version of the VAS-FA is sensitive enough to distinguish foot and ankle-specific pathologic conditions from asymptomatic conditions. The Turkish version of the VAS-FA is a reliable and valid method and can be used for foot-related problems.

The Impact of Fibromyalgia on Disability, Anxiety, Depression, Sleep Disturbance, and Quality of Life in Patients with Migraine

Introduction

The aim of the present study was to assess the impact of fibromyalgia (FM) comorbidity on disability, anxiety, depression, sleep disturbance, and quality of life in patients with migraine.

Methods

Eighty-six consecutive migraine patients (age, 35.4±10.3 years; 69 women and 17 men) were enrolled in the study. The headache characteristics of the patients were recorded. FM was diagnosed based on the 1990 American College of Rheumatology classification criteria for the diagnosis of FM. All patients were asked to complete selfreport questionnaires, including the Fibromyalgia Impact Questionnaire (FIQ), Headache Impact Test (HIT-6), Migraine Disability Assessment Questionnaire (MIDAS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the 36- Item Short Form Survey (SF-36) to assess their pain-related disability, migraine-related disability, depression, anxiety, sleep disturbance, and quality of life.

Results

Of the migraine patients, 28 (32.6%) met the criteria for FM. Migraine patients with FM showed significantly increased migraine frequency and BDI, BAI, and PSQI scores and decreased quality of life scores for all eight domains of the SF-36 compared to patients with migraine alone, whereas the mean HIT-6 and MIDAS values did not differ between the groups. FIQ score showed statistically significant positive correlations with BDI, BAI, PSQI, and MIDAS scores and with headache frequency (p<0.001, r=0.657; p<0.001, r=0.730; p<0.001, r=0.754; p=0.005, r=0.300; p=0.008, r=0.286, respectively); FIQ score showed negative correlations with scores for all domains of the SF-36. In multivariate linear regression analysis, BDI, BAI, and PSQI scores independently predicted FIQ score.

Conclusion

Our study results demonstrate the significant impact of FM comorbidity on anxiety, depression, sleep disturbance, and quality of life in this population. FM evaluation and treatment should be considered in the routine care of patients with migraine to globally improve the patient's quality of life.

Neuropathic pain: is it an underestimated symptom in systemic sclerosis?

Pain is one of the most common symptoms in systemic sclerosis (SSc) patients, yet not considered in the assessment of disease severity. This study aimed to investigate the frequency of neuropathic pain (NP) and to evaluate its interference with the quality of life (QoL) in SSc patients. Diffuse and Limited SSc patients diagnosed by American College of Rheumatology 2013 criteria were included in the study. Pain was evaluated with Visual Analogue Scale (VAS); presence of NP was screened with The Leeds Assessment of Neuropathic Symptoms and Signs (LANNS) questionnaire; disease activity was evaluated with modified Medsger Severity Scale (MSS) and QoL with short-form 36 (SF-36). One hundred twenty patients were included in the study (mean age 53.64 ± 11.44 years, female/male 83.3-16.7%). Total pain frequency was found 69.2% and NP was 35.9% in the entire patient group. Pain was most frequently seen in wrist-hand (50.6%) and ankle-foot (43.4%) regions; albeit, NP rates were highest in face (94.4%), lower leg (87.5%), and hip-thigh (78.6%) regions. SF-36 scores were significantly lower in patients with NP than the patients without NP (P < 0.05). The most associated factors with NP were MSS score for muscle involvement and drug consumption of the patient. According to our results, high frequency of NP is seen in SSc patients, and NP is associated with low QoL. Differential diagnosis of NP is important to consider right treatment options and accurate management of pain in all rheumatologic diseases including SSc.

Quality of life and influencing factors of coal miners in Xuzhou, China

Background

Coal industry is one of the national pillar industries in China. A large number of coal miners are exposed to various occupational hazards, which might cause occupational disease. The aim of the study was to assess the quality of life (QOL) of coal miners in Xuzhou, China and explore influencing factors to QOL of coal miners.

Methods

Six hundred and twelve underground miners and 354 ground workers in one of coal mines of Xuzhou were enrolled in our study. The 36-item Short-Form Health Survey (SF-36) questionnaires were applied to evaluate the QOL of coal miners. Multivariate stepwise regression analysis was used to assess the potential impact factors on QOL.

Results

The score of role limitations due to physical health problems (RP) dimension in underground miners was significantly lower than that of ground workers (P=0.005). Multivariate stepwise regression analysis showed that longer job tenure for dust exposure significantly lower coal miners' RP score. Comparing with normal populations, our subjects scored lower in both the physical health components (PHC) and the mental health components (MHC), and many factors accounted for it including job tenure for dust exposure, chronic disease, medical insurance, etc.

Conclusions

QOL of coal miners has been affected. Some measures might be taken by enterprise and coal miners themselves to protect the health of coal miners and improve their quality of life.

Family Physician-Led Group Visits for Lifestyle Modification in Women with Weight Problems: A Pilot Intervention and Follow-Up Study

OBJECTIVE

Lifestyle modification requires extensive information sharing and counseling. However, one-on-one primary care consultations are lacking to cover all necessary components due to time constraints. This preliminary study aims to investigate the feasibility and effects of lifestyle-changing intervention by family physician-led group visits (GVs) on weight management in overweight and obese women.

METHODS

60 volunteers fulfilling the inclusion criteria were enrolled. Baseline and 6th month assessments consisted of anthropometric measurements, SF-36 Health Survey, blood variables, exercise test, and resting metabolic rate. Weight maintenance was controlled at the 12th month.

RESULTS

Although weight loss among participants varied, the mean body weights were significantly decreased by 8.2% in full-attenders (n = 30). A significant increase in HDL-cholesterol and decreases in heart rate and blood pressure were found. SF-36 summary scales were significantly improved. Weight change was moderately correlated with exercise duration, compliance to diet, and baseline mental component score. It was determined that 62.5% of the participants either lost or maintained body weight at the 12th month.

CONCLUSION

Significant weight loss and quality of life improvement was achieved in this pilot study. GVs may be a promising alternative to primary care consultations for obesity management; however, the high dropout level and diverse outcomes need further assessment.

The quality of life analysis of knee prosthesis with complete microprocessor control in trans-femoral amputees

Objective

The aim of this study was to analyze the patient demographics, etiology of limb loss as well as reporting SF-36 scores for microprocessor prosthesis users in Turkish population.

Methods

We reviewed 72 patients (61 male and 11 female; mean age: 37.7 ± 10.7) with uni-lateral, above knee amputation and a history of regular and microprocessor prosthesis use. All patients were called back for a last follow-up and they were asked to fill a self-administered general health status questionnaire (SF-36).

Results

According to the SF-36 results; physical component score (PCS) score was 46 ± 7.3 and mental components summary (MCS) score was 46.5 ± 9.1. These scores have statistical similarity with Turkish healthy controls, except SF (social functioning) sub-dimension. PCS score for women microprocessor users were significantly lower than men (43.3 vs. 48.7, p = 0.03), but MCS scores were similar in between genders (46 vs. 48.2, p = 0.13). Conventional prostheses usage time was positively correlated with physical function (PF) scores (r = 0.322, p = 0.010). Microprocessor prosthesis usage time was negatively correlated with role limitations due to emotional problem (RE) scores (r = −0,313, p = 0.009).

Conclusion

The quality of life surveys were showed that the loss of an extremity have higher physical and psychological impact on women's physical scores. Overall, SF-36 results were similar in microprocessor using amputee's and Turkish normal controls.

Level of evidence

Level IV, therapeutic study.

Interplay among pain intensity, sleep disturbance and emotion in patients with non-specific low back pain

Background

Low back pain (LBP) is the most common problem worldwide. There are several negative consequences of LBP, such as sleep disorders, work leave, disability, depression, anxiety, and poor quality of life. In this study, we designed to evaluate the prevalence of sleep disturbance in patients with non-specific LBP(NSLBP), and cross-correlation among sleep disorder, anxiety, depression and pain intensity in patients with NSLBP.

Aim

In this study, we designed to evaluate the prevalence of sleep disturbance in patients with NSLBP, and cross-correlation among sleep disorder, anxiety, depression and pain intensity in patients with NSLBP.

Methods

A cross-sectional self-assessment questionnaire survey was carried out in an outpatient clinic. Anonymous assessments were used to characterize the presence of NSLBP, PSQI, VAS, SF-36 form, ODI, BAI and BDI. Cross-correlation among the severity of NSLBP and sleep disturbance, anxiety, depression and life quality were evaluated.

Results

Patients with NSLBP have a higher incidence of sleep disorder, anxiety and depression, and higher ODI scores than healthy people without LPB (P < 0.01). NSLBP patients with sleep disorders have more severe anxiety, depression, an increased VAS score and poor daily living (P < 0.05). NSLBP patients with anxiety have declined sleep quality, poor daily living, decreased work and social skills, and increased LBP severity (P < 0.05). NSLBP patients with depression have declined sleep quality, poor daily living, decreased work and social skills (P < 0.05). Significant associations were found between the severity of NSLBP and sleep disorders, anxiety and ODI scores.

Conclusion

Psychological and social factors play an important role in the development of NSLBP. NSLBP leads to sleep disorders, which decrease the sleep quality and increase the unpleasant emotions and memories in return; these can exacerbate the severity of LBP, with the cycle repeating to form a vicious circle.

Prevalence of Psychiatric Comorbidity in Symptomatic Gastroesophageal Reflux Subgroups

BACKGROUND

Limited data exist regarding the psychosocial aspects of gastroesophageal reflux disease (GERD). Some GERD subgroups, such as functional heartburn and hypersensitive esophagus, might show different psychiatric comorbidities than others.

AIM

We aimed to evaluate the psychiatric comorbidities of GERD subgroups using a cross-sectional design.

METHODS

A group of GERD patients at a tertiary outpatient clinic were evaluated via upper GIS (gastrointestinal system) endoscopy, esophageal manometry, and 24-h impedance-pH monitoring. Thirty-nine patients diagnosed with erosive reflux disease, 44 with non-erosive reflux disease, 20 with functional heartburn, 11 with hypersensitive esophagus, and 44 healthy controls participated. Psychiatric diagnoses were made using the Structured Clinical Interview for Diagnostics and Statistical Manual of Mental Disorders IV. Psychometric measurements of the patients were performed using the Somatosensory Amplification Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Short-Form 36. Healthy controls were evaluated with the same psychometric scales except for the Short-Form 36.

RESULTS

All of the GERD subgroups were significantly more depressed than the control group. Depressive disorders were significantly more prevalent in the functional heartburn group than in the non-erosive reflux disease and erosive reflux disease groups. The trait anxiety level of the functional heartburn group was significantly higher than those of the control and non-erosive reflux disease groups. The quality of life scores of the GERD subgroups were significantly lower than the population standards.

CONCLUSIONS

Depressive disorders were frequently comorbid in the GERD subgroups studied (30-65 %). It is essential to consider the high prevalence rates of comorbid depression when managing GERD.

Determinants of Health Care Services Utilization among First Generation Afghan Migrants in Istanbul

There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. One hundred and fifty-five Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.

Disabled children's functionality and maternal quality of life and psychological status

BACKGROUND

Physiotherapy is being provided for different disabled groups in pediatric rehabilitation centers. The quality of life (QOL) and psychological status of the mothers of these children is affecting their compliance in the rehabilitation period. The aim of this study was therefore to assess the relationship between disability level of individuals receiving rehabilitation and maternal QOL, psychological status and influencing factors.

METHODS

One hundred and twenty-six disabled children and their mothers were included in this cross-sectional study. Demographic information was noted. Child motor level was assessed using the Gross Motor Function Classification System and the level of independency in activities of daily living (ADL) was assessed with the Katz ADL scale. Maternal QOL was assessed with the 36-item Short Form (SF-36), and psychological status with the Beck Depression Inventory (BDI). SPSS 18.0 was used to analyze data.

RESULTS

Mean maternal age was 36.46 ± 7.2 years. Of the children, 67.5% had physical problems, 16.7% had mental problems, 7.9% had autism, 4.8% had hyperactivity, and 3.2% had hearing and speaking problems. Mild depression was detected in mothers (mean BDI score, 11.27 ± 8.1). There was no correlation between child disability level and maternal QOL and depression (P > 0.05). Maternal BDI score was negatively correlated with all SF-36 subscale scores (P < 0.001 for all parameters).

CONCLUSION

The SF-36 subscale scores of mothers of disabled children were decreased compared with Turkish community norms. Psychological support of mothers of children in the rehabilitation period may positively affect this period.

Autoimmunity affects health-related quality of life in patients with Hashimoto's thyroiditis

Hashimoto's thyroiditis (HT) is the most common endocrine disorder leading to hypothyroidism. HT is characterized by the presence of elevated circulating antibodies, especially anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg). In our study, we aimed to reveal the effects of autoimmunity on health-related quality of life of euthyroid HT patients. Patients who were admitted to the Adnan Menderes University Outpatient Clinic were enrolled. The medical records of the patients were surveyed and their demographical data were collected. By using communication data, the patients were invited to our clinic, to inform them about our study and to fill out the health-related quality of life questionnaire. A total of 84 euthyroid HT patients older than 18 years who completed the short form-36 questionnaire, were enrolled. As all patients were euthyroid, there was a significant negative correlation between each domain score and the antibody levels, individually. Patients who had higher anti-TPO and anti-Tg levels had significantly lower quality of life domain scores (p < 0.001). There was statistically no significant correlation between the antibody levels and thyroid function tests (p > 0.05). Additionally, all dimension scores were significantly higher both in the anti-Tg and anti-TPO negative groups, indicating a better quality of life than that in the antibody positive groups. Our study revealed that higher thyroid antibody levels were negatively correlated with life quality scores. Thus, patients who had higher anti-TPO and anti-Tg levels had significantly lower quality of life domain scores. We believe that apart from hypothyroidism, a high antibody level was one of the contributing factors for the development of HT-associated symptoms, leading to a lower quality of life. Other probable contributing factors such as selenium deficiency, thyroid hormone fluctuation, and disease awareness should keep in mind.

Evaluation of Health-Related Quality of Life among Tuberculosis Patients in Two Cities in Yemen

Background

The health-related quality of life (HRQoL) of Tuberculosis (TB) patients is important because it directly influences the outcome of TB patients in several aspects. The current study aims to evaluate and to find the factors influencing the HRQoL of TB patients in two major TB-prevalent cities (Taiz and Alhodidah) in Yemen.

Methods

A prospective study was conducted, and all TB patients meeting the HRQoL criteria were asked to complete the HRQoL SF-36 survey. The records of TB patients were examined for disease confirmation, and a follow-up was consequently performed for patients during treatment between March 2013 and February 2014 in Taiz and Alhodidah Cities. HRQol scores were calculated by using QM scoring software version 4.5, in which the physical component score (PCS) and mental component score (MCS) were obtained. The scores obtained between 47–53 normal based score (NBS) were considered equivalent to the US normal score. Low scores indicate the poor health situation of TB patients

Results

A total of 243 TB patients enrolled in the study at the beginning of the treatment. A total of 235 and 197 TB patients completed the questionnaire at the end of the intensive phase (I.P.) and continuation phase (C.P.), respectively. The final dropout rate was 16.2%. The mean PCS and MCS scores at the beginning of treatment were low, thus showing the poor health situation of TB patients. The mean PCS scores at the beginning of treatment, end of I.P., and end of treatment were (36.1), (44.9), and (48), respectively. Moreover, the mean MCS score at the beginning of treatment, end of I.P., and end of treatment were (35.1), (42.2), and (44.3), respectively. The result shows that significant increases are observed at the end of I.P. for PCS and MCS because of the treatment and slight changes at the end of C.P. Despite this finding, the MCS score remains below the normal range (47), thus indicating a significant risk of depression among TB patients. Furthermore, general linear repeated measure ANOVA was performed for selected variables, to examine the changes of PCS and MCS over time. It was found that Alhodiah city, chewing khat habit, stigmatization, and duration of treatment more than six months were greatly associated with low mean MCS score of TB patient, indicating great risk of depression which may result in poor treatment outcome.

Conclusion

TB patients in Yemen were found to have poor QoL, with a significant likelihood of depression. Highly risk depression was found among TB patients in Alhodiah city, khat chewers, stigmatization and having a duration of treatment more than 6 months. Therefore, additional efforts should be made to improve their QoL because it may affect the final clinical outcome of patients.