Quality of life under the COVID-19 quarantine

The Effect of COVID-19 on Quality of Life: A Community-Based Study in Türkiye

OBJECTIVE

The purpose of this study was to analyze the impact of COVID-19 on the quality of life of individuals who received psychological treatment compared to those who did not.

METHODS

The survey method was used to collect data. The questionnaire consisted of questions that elicit the personal characteristics of the participants and the COVID-19-Impact on Quality of Life Scale (COV19-QoL). A total of 480 individuals aged 18 years or older were administered the questionnaires in Türkiye. The data obtained from the survey was analyzed using the SPSS 26 software package.

RESULTS

The results showed that the effect of COVID-19 on quality of life differed significantly depending on whether the participants received psychological treatment or not.

CONCLUSIONS

It was concluded that individuals who received psychological treatment had a higher impact of COVID-19 on their quality of life. The findings are discussed concerning the relevant literature on theoretical and practical implications.

Does self-compassion buffer the impact of fear of COVID-19 on health-related quality of life for people living with HIV?

Extant literature has consistently documented the adverse impact of fear of COVID-19 on the health-related quality of life (HRQoL) of people living with HIV (PLWHIV), as they are more prone to being infected with this deadly disease than the normal population. However, studies on the mechanism that could mitigate this adverse impact are lacking. We investigated whether self-compassion could buffer the negative impact of fear of COVID-19 on HRQoL among PLWHIV. Utilizing a cross-sectional design, 241 outpatients (41.5% male, 58.5% female) from two Nigerian healthcare facilities were conveniently sampled. Results showed that heightened fear of COVID-19 was associated with poorer HRQoL across four domains. Unexpectedly, self-compassion neither predicted HRQoL nor buffered the impact of fear of COVID-19 on HRQoL. Practical interventions should prioritize reducing fear of COVID-19 and addressing broader psycho-social factors to enhance HRQoL in this vulnerable population.

Safety and Effectiveness of Multisite Transcutaneous Spinal Cord Stimulation Combined With Activity-Based Therapy When Delivered in a Community Rehabilitation Setting: A Real-World Pilot Study

OBJECTIVE

The primary aim of this study was to preliminarily evaluate the safety and efficacy of multisite transcutaneous spinal cord stimulation (tSCS) combined with activity-based therapy (ABT) in individuals with chronic spinal cord injury (SCI) when delivered in a community-based neurorehabilitation center.

MATERIALS AND METHODS

Ten participants were enrolled in a nonrandomized pilot trial. Participants completed 120 sessions of tSCS + ABT focused on recovery of upper extremity, trunk, and lower extremity function dependent on their neurologic level of injury. NeuroRecovery Scale (NRS), Berg Balance Scale (BBS), pinch and grasp force, and Graded and Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) were obtained at baseline and every 20 sessions. International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), quality of life, spasticity, and respiratory measures were assessed at baseline and after 40 and 120 sessions. Nonparametric testing with post hoc correction was used to assess improvements in outcomes.

RESULTS

Median improvements (median [interquartile range]) in NRS-total (Δ1.5 [1.0, 2.0]), NRS-trunk (Δ2.0 [1.2, 3.1]), and BBS scores (Δ2.0 [0, 4.5]) were significant after 120 sessions of tSCS-ABT (all p < 0.013). In the cervical cohort, median improvements in NRS-upper extremity (Δ2.1 [0.6, 2.5]), GRASSP-Sensibility (δ1.0 [0.0, 1.5]), Prehension ability (δ2.0 [1.0, 5.5]), and Prehension performance (Δ10.0 [7.5, 13.5]) were significant (all p < 0.05). Post hoc comparisons revealed continued improvements with an increased number of sessions. There were no significant improvements in the ISNCSCI motor and sensory scores as a group; however, three individuals showed improved American Spinal Injury Association Impairment Scale classifications, with four individuals also indicating changes in the neurologic level of injury. No improvements were noted in other exploratory outcomes.

CONCLUSIONS

Combined tSCS + ABT facilitated functional recovery after chronic SCI. Improvements required ≥60 tSCS-ABT sessions, with further exposure to tSCS facilitating continued improvement. These findings indicate that prolonged training with tSCS-ABT can be an effective neuromodulatory intervention for individuals with SCI.

CLINICAL TRIAL REGISTRATION

The Clinicaltrials.gov registration number for the study is NCT04132596.

Association between job insecurity and health-related quality of life: The moderator effect of social support in the workplace

Background: Employee job insecurity negatively affects health outcomes, with limited research on the moderating role of workplace social support. Objective: This study examines the relationship between job insecurity and health-related quality of life among medical representatives, exploring the moderating effect of social support at work. Method: Cross-sectional data from 391 Turkish medical representatives during the pandemic were analyzed using correlation, logistic regression, and moderation analysis with SPSS for Windows and Hayes' Process Macro. Results: 73.4% of the participants were male, with a mean age of 38.3 ± 6.7 years. According to multiple logistic regression analyses adjusted for age and gender, quantitative and qualitative job insecurity negatively [OR = 1.02 (95% CI = 1.00-1.03)] and social support positively [OR = 0.96 (95% CI = 0.95-0.98)] affected health-related quality of life. There was a moderately significant correlation between health-related quality of life and quantitative job insecurity, qualitatively job insecurity and social support in the workplace (r = -0.430, r = -0.477, r = 0.494), respectively. The moderating effect analysis has revealed that receiving social support in the workplace alleviates and reduces the negative impact of job insecurity on the health-related quality of life of employees. Social support in the workplace received by employees mitigates and reduces the negative impact of job insecurity on their health-related quality of life. Conclusion: Social support in the workplace plays an important role in buffering the negative consequences of job insecurity. According to this research, it is important to improve social support in the workplace to prevent negative health-related quality of life outcomes among medical representatives experiencing job insecurity.

The relationship of race, ethnicity, gender identity, sex assigned at birth, sexual orientation, parental education, financial hardship and comorbid mental disorders with quality of life in college students with anxiety, depression or eating disorders

BACKGROUND

Previous studies showed that comorbidity and demographic factors added to burden on health-related quality of life (HRQoL). Only one study explored the relationship between HRQoL and comorbidity in college students with mental disorders, leaving generalizability of findings uncertain. Less is known about the association of demographics on HRQoL. This study investigated HRQoL based on demographics and comorbidity among college students with mental disorders.

METHODS

Participants were students (N = 5535) across 26 U.S. colleges and universities who met criteria for depression, generalized anxiety, panic, social anxiety, post-traumatic stress, or eating disorders based on self-report measures. ANOVA and linear regressions were conducted.

RESULTS

Overall, female, minoritized (gender, sexual orientation, race, or ethnicity), and lower socioeconomic status students reported lower HRQoL than male, heterosexual, White, non-Hispanic, and higher socioeconomic status peers. After accounting for comorbidity, differences in physical HRQoL based on sex assigned at birth and gender were no longer significant. For mental HRQoL, only gender and sexual orientation remained significant. A greater number of comorbidities was associated with lower HRQoL regardless of demographic group.

LIMITATIONS

The non-experimental design limits causal inference. The study focused on univariable associations without examining potential interactions between demographic factors. Future research should explore structural factors like discrimination.

CONCLUSION

Results suggested that increased comorbidities placed an additional burden on HRQoL and that certain demographic groups were more vulnerable to HRQoL impairment among students with mental disorders. Findings suggest the need for prevention of disorders and their comorbidity and implementing tailored interventions for specific student subgroups with increased vulnerability.

The IMPACT Survey: the humanistic impact of osteogenesis imperfecta in adults

BACKGROUND

The IMPACT Survey explored the humanistic, clinical, and economic burden of osteogenesis imperfecta (OI) on individuals with OI, their families, caregivers, and wider society. Two previous publications report research methodology, initial insights of the survey, and cost of illness of OI. Here, we present data on the impact of OI on the quality of life (QoL) of adults with OI and explore potential drivers of this impact.

METHODS

The IMPACT Survey was an international mixed methods online survey in eight languages (fielded July-September 2021), aimed at adults (aged ≥ 18 years) or adolescents (aged 12-17 years) with OI, caregivers (with or without OI) of individuals with OI, and other close relatives. Survey domains included demographics, socioeconomic factors, clinical characteristics, treatment patterns, QoL, and health economics. We conducted a descriptive analysis of the QoL data, as well as exploratory regression analyses to identify drivers of impact of OI on QoL (independent associations between patient characteristics and the impact on QoL).

RESULTS

1,440 adults with OI participated in the survey. The proportion who reported an impact of OI on their QoL across individual areas in the physical, socioeconomic, and mental well-being domains ranged between 49 and 84%. For instance, 84% of adults reported an impact of OI on the types of leisure activities they could do and 74% on the type of job they could do. More severe self-reported OI and higher fracture frequency were consistently identified as drivers of OI's impact on QoL. The proportion of adults who reported worrying about different aspects of their lives due to their OI, such as mobility loss, future fractures, and ageing, ranged between 31 and 97%.

CONCLUSION

IMPACT provides insights into the humanistic burden of OI on adults, revealing that OI has a substantial impact on the QoL of adults. OI severity and fracture frequency were consistently identified as drivers of impact on QoL across all domains. Understanding these drivers may aid in identifying areas for targeted interventions, such as fracture prevention.

Trends in changes of family functioning during different phases of the pandemic - findings across four population-based surveys between 2020 to 2023 in Germany

BACKGROUND

The COVID-19 pandemic and the associated measures have had a significant impact on millions of individuals and families worldwide. Although cross-sectional studies have demonstrated the considerable burden placed on families during the pandemic, trends over different phases of the pandemic including later stages and using population-based samples is scarce.

OBJECTIVE

In this study, we aimed to assess trends in family functioning across four population-based surveys between December 2020 and March 2023 using a repeated cross-sectional design. The surveys were conducted using a similar sampling strategy and measures. We included individuals residing in a household with at least one minor below the age of 16.

RESULTS

The most notable changes across surveys over time were related to quality of life. While 54.3% of respondents reported a decline in quality of life during the winter of 20/21 compared to pre-pandemic levels, this was observed in only 22.6% of participants during the spring of 23. The proportion of respondents who indicated a deterioration in their relations with their children also decreased during the pandemic. While 9.9% of respondents reported a deterioration in their relationship with their children during the winter of 20/21 in comparison to the initial phase of the pandemic, this was reported by only 5.2% in the spring 23. The relationship with one's partner and health status exhibited minimal fluctuations. Mental health problems were associated with a decline in quality of life, health status and relationships with children and partners compared to pre-pandemic levels at all time points. Moreover, lower income levels were associated with poorer relationship quality with the partner in the most recent wave.

CONCLUSIONS

Our findings demonstrate significant improvements in family functioning since the onset of the pandemic, indicating that individuals and families in our sample were generally adapting well. However, a subgroup of the population still reports suboptimal family functioning compared to before the pandemic. Psychosocial care and social policy support for families are needed.

Findings from a randomized controlled trial of Metacognitive Reflection and Insight Therapy for people with schizophrenia: Effects on metacognition and symptoms

BACKGROUND

Research has suggested that people diagnosed with schizophrenia experience challenges in their abilities to reflect upon themselves, others and their actions in the world. One emerging approach to addressing these forms of subjective disturbance is Metacognitive Reflection and Insight Therapy (MERIT).

AIMS

In this study, a randomized delayed trial was conducted to assess the effects of MERIT upon metacognition, psychiatric symptoms and quality of life.

MATERIALS AND METHODS

Following recruitment and randomization, data from 54 adults diagnosed with schizophrenia were analysed.

RESULTS

Findings included significant interaction effects between group (immediate intervention or waiting condition) and time (pre- and post intervention) with regard to the metacognition general score and its domain of mastery, as well as with regard to negative, positive and cognitive symptoms.

DISCUSSION

Participating in MERIT seems to improve one's ability to use reflective knowledge to cope with psychological challenges and to improve, or at least maintain, level of symptomatology.

CONCLUSIONS

These findings are discussed within the framework of agency as an important aspect of recovery.

Balance and Health-Related Quality of Life After 1 Year of COVID-19 Social Restriction Measures: A Cross-Sectional Study in Two Samples from Spain

BACKGROUND

The COVID-19 pandemic significantly impacted the well-being of the general population. However, more information is needed regarding the relationship between participation-related outcomes. This study aimed to analyze the impact of the pandemic on occupational balance (OB) and health-related quality of life (HRQoL) before and after social restrictions and to explore their relationship with COVID-19 diagnosis.

METHODS

We conducted a study among individuals diagnosed with COVID-19, assigning a healthy control group with the same sociodemographic characteristics using the EQ-5D-5L and the Occupational Balance Questionnaire (OBQ).

RESULTS

The final sample size consisted of 61 participants in the COVID-19 diagnosis group (50.8% male; mean age 34.6 ± 14.17 years) and 57 healthy participants (50.8% male; mean age 33.7 ± 13.77 years). There were no differences in the sociodemographic variables between the groups. Significant differences were found between groups both before the pandemic and 1 year after confinement measures in HRQoL and OBQ (p < 0.005). The regression model indicated significant associations (p < 0.001) between HRQoL and both current OB and COVID-19 diagnosis. However, the OBQ scores from before the pandemic did not show a significant association with HRQoL (p = 0.336).

CONCLUSIONS

In conclusion, social restrictions from the COVID-19 pandemic negatively impacted HRQoL in our sample even 1 year after confinement, with COVID-19 diagnosis and occupational imbalance predicting worse outcomes, highlighting the need for targeted interventions not only for the current situation but also for possible future public health crises.

COVID-19 and self-reported health of the Norwegian adult general population: A longitudinal study 3 months before and 9 months into the pandemic

The COVID-19 pandemic had a global impact on daily lives, and this study aimed to assess the effects on broader aspects of health in the general population of Norway. This population-based cohort study assessed changes in health of the Norwegian general population from 3 months before to 9 months during the COVID-19 pandemic. Sampling was based on the results of Norwegian surveys designed for collecting general population norms for health measurement instruments. In December 2019, 12,790 randomly selected adults aged ≥18 years received a postal questionnaire. The 3,200 respondents received a similar follow-up postal questionnaire including the EQ-5D-5L, PROMIS-29 instruments, and questions about respondents having or having had COVID-19. Score changes were compared to estimates for the minimal important change (MIC) and age-related change. Association of instrument change scores with baseline characteristics, health problems, and having had COVID-19 was determined using multivariable linear regression. Of 3101 respondents with unchanged addresses, 2423 (78.1%) responded to the second survey. For all respondents, EQ VAS and PROMIS-29 scores for 6 of 8 domains were slightly poorer (p<0.01) than before COVID-19, and the mean change was below the MIC. In multivariable analyses, the greatest number of poorer outcomes were associated with being female, 18-29 years, or ≥80 years of age (p<0.01); > MIC for ≥ 80 years of age and EQ-5D index, PROMIS-29 physical function and social participation. Respondents who had COVID-19 had poorer outcomes for PROMIS-29 social participation (> MIC). Those reporting COVID-19 in their partner/family and not themselves, had poorer outcomes for PROMIS-29 anxiety and social participation. About 9 months into the COVID-19 pandemic, EQ-5D-5L and PROMIS-29 domain scores showed slightly poorer health in the Norwegian adult general population compared to 1 year earlier in the same respondents. The overall changes were less than expected for age-related change. Relatively poor outcomes defined as important, included general health and social participation for the elderly, and the latter for those having had COVID-19. In conclusion, this study found no evidence for a decline in important aspects of adult general population health in Norway that might be attributed to the pandemic at approximately 9 months.

Personality and Health-Related Quality of Life of Older Chinese Adults: Cross-Sectional Study and Moderated Mediation Model Analysis

Background

Personality has an impact on the health-related quality of life (HRQoL) of older adults. However, the relationship and mechanisms of the 2 variables are controversial, and few studies have been conducted on older adults.

Objective

The aim of this study was to explore the relationship between personality and HRQoL and the mediating and moderating roles of sleep quality and place of residence in this relationship.

Methods

A total of 4123 adults 60 years and older were from the Psychology and Behavior Investigation of Chinese Residents survey. Participants were asked to complete the Big Five Inventory, the Brief version of the Pittsburgh Sleep Quality Index, and EQ-5D-5L. A backpropagation neural network was used to explore the order of factors contributing to HRQoL. Path analysis was performed to evaluate the mediation hypothesis.

Results

As of August 31, 2022, we enrolled 4123 older adults 60 years and older. Neuroticism and extraversion were strong influencing factors of HRQoL (normalized importance >50%). The results of the mediation analysis suggested that neuroticism and extraversion may enhance and diminish, respectively, HRQoL (index: β=-.262, P<.001; visual analog scale: β=-.193, P<.001) by increasing and decreasing brief version of the Pittsburgh Sleep Quality Index scores (neuroticism: β=.17, P<.001; extraversion: β=-.069, P<.001). The multigroup analysis suggested a significant moderating effect of the place of residence (EQ-5D-5L index: P<.001; EQ-5D-5L visual analog scale: P<.001). No significant direct effect was observed between extraversion and EQ-5D-5L index in urban older residents (β=.037, P=.73).

Conclusions

This study sheds light on the potential mechanisms of personality and HRQoL among older Chinese adults and can help health care providers and relevant departments take reasonable measures to promote healthy aging.

The relationship between healthcare access and change in health-related quality-of-life among the general population of five countries during the COVID-19 pandemic

PURPOSE

To determine whether (1) healthcare access at onset of the pandemic and (2) age, gender, socioeconomic status (SES), and pre-existing health status were associated with change in health-related quality-of-life (HRQoL) during the COVID-19 pandemic. The study includes a general population sample of five countries.

METHODS

An online questionnaire was administered to respondents from Greece, Italy, the Netherlands, the UK, and the US at the onset of the COVID-19 pandemic between April 22nd and May 5th of 2020, and 1 year later between May 23rd and June 29th of 2021. The questionnaire included questions on demographic background, health status, and HRQoL. The primary outcome was change in HRQoL as measured by the EQ-5D-5L instrument. Specifically, the EQ-5D-5L index and EQ VAS were used. Healthcare access was quantified with regard to the respondent's ease of getting an appointment, waiting time, and opportunity to contact the provider and during analysis dichotomized into "sufficient" versus "insufficient". Linear regression analysis was performed with change in HRQoL as dependent variable and background variables as independent variables.

RESULTS

In total, 6,765 respondents completed the second questionnaire. 19.8% of total respondents reported insufficient healthcare access. Respondents with insufficient healthcare had both more improved and deteriorated HRQoL compared to respondents with sufficient healthcare, whose HRQoL remained unchanged. We did not find significant interactions between age, gender, SES and/or chronic disease status with healthcare access at onset of the COVID-19 pandemic.

CONCLUSION

Healthcare access was not associated with cumulative differences in change in HRQoL over a 1-year period in strata of age, gender, SES, and chronic disease status.

Perceived health-related quality of life in people living with HIV co-infected with SARS-CoV-2 in France

PURPOSE

We aimed to assess health-related quality of life (HRQL) and its correlates among people living with HIV/AIDS (PLWHA) co-infected with SARS-CoV-2 in France.

METHODS

This cross-sectional was study conducted among PLWHA co-infected with SARS-CoV-2. HRQL was measured using the four dimensions of the PROQOL-HIV scale. Factors associated with each dimension were identified using linear regression.

RESULTS

mean (SD) scores for HRQL dimensions: 76.7 (± 21.1) for Physical Health and Symptoms (PHS), 79.2 (± 23.6) for Social Relationships (SR), 67.3 (± 27.4) for Mental and Cognitive (MC), and 83.9 (± 16.5) for Treatment Impact (TI). Employment status and COVID-19 knowledge were associated with higher PHS score, while blood transfusion-acquired HIV, CDC HIV, hospital discharge instructions, and self-reported symptoms were associated with lower PHS score. Couple status was associated with higher SR score, whereas, hospital discharge instructions, CDC HIV stage C, drug injection-acquired HIV, self-reported symptoms, and COVID-19 vulnerability perception were associated with lower SR score. Employment status and French birth were associated with higher MC score, while female sex, detectable HIV viral load, hospital discharge instructions, COVID-19 vulnerability perception, smoking, and self-reported symptoms were associated with lower MC score. French birth and homosexual/bisexual relationships-acquired HIV were associated with higher TI score, while detectable HIV viral load, psychiatric disorders, and self-reported symptoms were associated with lower TI score CONCLUSION: Among PLWHA co-infected with SARS-CoV-2, the scores of HRQL were impaired, particularly in the MC dimension. Findings underscore the multidimensional nature of HRQL, with notable variations across different dimensions. Understanding these correlates is crucial for tailored interventions aimed at improving the well-being of this population.

Examining the Trajectory of Health-Related Quality of Life among Coronavirus Disease Patients

BACKGROUND

Recent studies have reported a reduction in health-related quality of life (HR-QoL) among post-coronavirus disease 2019 (COVID-19) patients. However, there remains a gap in research examining the heterogeneity and determinants of HR-QoL trajectory in these patients.

OBJECTIVE

To describe and identify factors explaining the variability in HR-QoL trajectories among a cohort of patients with history of COVID-19.

DESIGN

A prospective study using data from a cohort of COVID-19 patients enrolled into a registry established at a health system in New York City.

PARTICIPANTS

Participants were enrolled from July 2020 to June 2022, and completed a baseline evaluation and two follow-up visits at 6 and 12 months.

METHODS

We assessed HR-QoL with the 29-item Patient Reported Outcomes Measurement Information System instrument, which was summarized into mental and physical health domains. We performed latent class growth and multinomial logistic regression to examine trajectories of HR-QoL and identify factors associated with specific trajectories.

RESULTS

The study included 588 individuals with a median age of 52 years, 65% female, 54% White, 18% Black, and 18% Hispanic. We identified five physical health trajectories and four mental health trajectories. Female gender, having pre-existing hypertension, cardiovascular disease, asthma, and hospitalization for acute COVID-19 were independently associated with lower physical health. In addition, patients with increasing body mass index were more likely to experience lower physical health over time. Female gender, younger age, pre-existing asthma, arthritis and cardiovascular disease were associated with poor mental health.

CONCLUSIONS

We found significant heterogeneity of HR-QoL after COVID-19, with women and patients with specific comorbidities at increased risk of lower HR-QoL. Implementation of targeted psychological and physical interventions is crucial for enhancing the quality of life of this patient population.

Estimating the Health-Related Quality of Life Benefit of Prophylactic Treatment for COVID-19 in Immunocompromised People: A Multimethod Valuation Study

Background: Pre-exposure prophylaxis (PrEP) for COVID-19 provides additional protection, beyond vaccines alone, for individuals who are immunocompromised (IC). This may reduce the need for preventative behavioral modification, such as shielding-a behavioral restriction limiting an IC individual to minimize face-to-face interactions and/or crowded places. Therefore, PrEP may improve psychosocial well-being and health-related quality of life (HRQoL) for individuals with IC conditions. Objective: To estimate the potential HRQoL and utility benefit of PrEP for prevention of COVID-19 in individuals with IC conditions who may not have an adequate response of full vaccination (and therefore are at "highest risk" of severe COVID-19) that can be used in future economic evaluations of preventative therapies against COVID-19. Methods: Vignettes describing HRQoL associated with 2 pre-PrEP states (shielding and semi-shielding behavioral restrictions) and a post-PrEP state were developed from a literature review and tested through interviews with clinicians (n = 4) and individuals with IC conditions (n = 10). Vignettes were valued by a general population sample (N = 100) using a visual analog scale (VAS), time trade-off (TTO), and EQ-5D-5L. A sample of individuals with IC conditions (n = 48) valued their current HRQoL and a post-PrEP vignette using VAS and EQ-5D-5L. Results: Individuals with IC conditions reported a mean current EQ-5D-5L score of 0.574, and 0.656 for post-PrEP based on the vignette. PrEP would lead to behavior changes for 75% (30/40) of individuals with IC conditions and an emotional benefit for 93% (37/40) of individuals with IC conditions. Mean values from the general population valuation based on EQ-5D-5L ranged from 0.606 ("shielding") to 0.932 ("post-PrEP"). Conclusion: This study quantified the expected health state utility benefit of reduced psychosocial burden and behavioral restriction. PrEP would potentially result in a utility gain between 0.082 and 0.326, dependent on valuation approach and expected change in behavioral restrictions, leading to improvements in daily activities and emotional well-being.

Dealing with the challenges of the pandemic - results of a population-based survey during the second year of the COVID-19 pandemic contrasting benefits and burden

BACKGROUND

The pandemic and the associated consequences have been ongoing stressors with severe impacts on the population and particularly on families. Research focusing on groups dealing well with the challenges of the pandemic is scarce. Here, we aimed to identify groups being well-adjusted during the pandemic and associated predictors.

METHODS

A representative sample of the German population (N = 2,515, 51.6% women, 50.09 years), and a subsample of persons with children or adolescents under the age of 18 (N = 453, 60.3% women, 40.08 years) was assessed from July to October 2021. As huge differences in coping with the pandemic are seen, cluster analysis was performed.

RESULTS

Persons in the "well-adjusted cluster" were characterized by higher quality of life, better coping with the pandemic and lower burden of the pandemic. The family subsample well-adjusted cluster was characterized by lower pandemic-associated burden, lower parental stress compared to before the pandemic and a better relationship with the child. Fewer mental health symptoms and less pandemic-associated negative impact on career predicted membership of the well-adjusted cluster in both samples. An interaction between mental health symptoms and the negative impact of COVID-19 on the career was found.

CONCLUSIONS

Our results underscore the importance of mental health and work-related factors for coping with the pandemic.

A network analysis of the interrelationships between depression, anxiety, insomnia and quality of life among fire service recruits

Background

Research on the mental health and quality of life (hereafter QOL) among fire service recruits after the end of the COVID-19 restrictions is lacking. This study explored the network structure of depression, anxiety and insomnia, and their interconnections with QOL among fire service recruits in the post-COVID-19 era.

Methods

This cross-sectional study used a consecutive sampling of fire service recruits across China. We measured the severity of depression, anxiety and insomnia symptoms, and overall QOL using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), Insomnia Severity Index (ISI) questionnaire, and World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. We estimated the most central symptoms using the centrality index of expected influence (EI), and the symptoms connecting depression, anxiety and insomnia symptoms using bridge EI.

Results

In total, 1,560 fire service recruits participated in the study. The prevalence of depression (PHQ-9 ≥ 5) was 15.2% (95% CI: 13.5-17.1%), while the prevalence of anxiety (GAD-7 ≥ 5) was 11.2% (95% CI: 9.6-12.8%). GAD4 ("Trouble relaxing") had the highest EI in the whole network model, followed by ISI5 ("Interference with daytime functioning") and GAD6 ("Irritability"). In contrast, PHQ4 ("Fatigue") had the highest bridge EI values in the network, followed by GAD4 ("Trouble relaxing") and ISI5 ("Interference with daytime functioning"). Additionally, ISI4 "Sleep dissatisfaction" (average edge weight = -1.335), which was the central symptom with the highest intensity value, had the strongest negative correlation with QOL.

Conclusion

Depression and anxiety were important mental health issues to address among fire service recruits in the post-COVID-19 era in China. Targeting central and bridge symptoms identified in network analysis could help address depression and anxiety among fire service recruits in the post-COVID-19 era.

Epidemiologic and clinical updates on viral infections in Saudi Arabia

In the past two decades, the world has witnessed devastating pandemics affecting the global healthcare infrastructure and disrupting society and the economy worldwide. Among all pathogens, viruses play a critical role that is associated with outbreaks due to their wide range of species, involvement of animal hosts, easily transmitted to humans, and increased rates of infectivity. Viral disease outbreaks threaten public health globally due to the challenges associated with controlling and eradicating them. Implementing effective viral disease control programs starts with ongoing surveillance data collection and analyses to detect infectious disease trends and patterns, which is critical for maintaining public health. Viral disease control strategies include improved hygiene and sanitation facilities, eliminating arthropod vectors, vaccinations, and quarantine. The Saudi Ministry of Health (MOH) and the Public Health Authority (also known as Weqayah) in Saudi Arabia are responsible for public health surveillance to control and prevent infectious diseases. The notifiable viral diseases based on the Saudi MOH include hepatitis diseases, viral hemorrhagic fevers, respiratory viral diseases, exanthematous viral diseases, neurological viral diseases, and conjunctivitis. Monitoring trends and detecting changes in these viral diseases is essential to provide proper interventions, evaluate the established prevention programs, and develop better prevention strategies. Therefore, this review aims to highlight the epidemiological updates of the recently reported viral infections in Saudi Arabia and to provide insights into the recent clinical treatment and prevention strategies.

The Psychosocial Impact of the COVID-19 Pandemic on Italian Families: The Perception of Quality of Life and Screening of Psychological Symptoms

Throughout the COVID-19 period, families were forced to stay indoors, adapting to online schooling, remote work, and virtual social engagements, inevitably altering the dynamics within households. There was a notable increase in mental health challenges in terms of anxiety and depression in children and adolescents. This study intended to explore the psychosocial effects of the COVID-19 pandemic on Italian families by adopting self- and proxy-report questionnaires on anxiety, anger, and health-related quality of life. The results showed that approximately 20% obtained a clinical anxiety score and only 10% obtained a clinical anger score. There was a difference in the perception of the quality of life reported by the child and that perceived by the parent. A stepwise regression model showed that total anxiety scores were predicted by sex, quality of life scores from the parents' self-report version, and the total anger score. Another stepwise regression model identified physiological and social anxiety as the best predictors that impact quality of life. Parental well-being actively influences the well-being of children, so it is fundamental to implement preventive programs and promote child well-being by providing parents the most adequate support possible.

The impact of depressive and anxious symptoms on quality of life in adults on the autism spectrum

Quality of life (QoL) is lower in adults on the autism spectrum (AS) compared with typically developing (TD) adults. In this context, recent studies have examined the role of depression and anxiety in reducing QoL in AS adults. The aim of this study was to (1) replicate these findings of lower QoL and (2) assess the negative influence of depressive and anxious symptoms on QoL in an adult AS (N = 86) and TD (N = 87) German sample with a broad age range (18-70 years). For this, we used questionnaires that have been validated for the AS and TD population: the World Health Organization Quality of Life Brief Version, the Autism-Specific QoL items, and the Hospital Anxiety and Depression Scale. We replicated previous findings and extended them to autism-specific QoL. Our AS sample had lower QoL compared with the TD adults. However, depressive symptoms were the largest contributor to lower QoL in both samples, more so than group membership and anxious symptoms. We conclude that interventions to improve QoL in AS adults should specifically target depressive symptoms and for this, improvements to the diagnostic process and treatment of depression in AS are necessary.

Lived experiences of COVID-19 disease: a qualitative meta-synthesis

Background

During the COVID-19 pandemic, various aspects of human life were changed around the world. The present study aimed to provide a systematic review of the available evidence on lived experiences of the COVID-19 pandemic.

Methods

This is a systematic review of the meta-synthesis type. Evidence from studies from 2019 to 2021 was used. Keywords of lived experiences, experiences, people, nation, patients, community, COVID-19, corona, and corona disease were searched in PubMed, Science Direct, Web of Science, and Cochrane databases. The Newcastle-Ottawa scale was used to evaluate the quality of articles. A qualitative meta-synthesis was performed by a researcher based on a three-step meta-synthesis method described by Thomas and colleagues. MAXQDA 10 was used for data analysis. The present study is based on the guidelines for Enhancing transparency in reporting the meta-synthesis of qualitative research (ENTREQ). The reliability of this study had a Kappa coefficient of 0.660 with a consistency rate of 98.766%.

Results

Finally, the data from 11 articles were analyzed. The main and sub-themes obtained in this study included negative aspects (chaos, hustle associated, dualities, bad body, value decay, seclusion, psychological challenges) as well as positive aspects (opportunities arising from the individual, family, and social stability).

Conclusion

Problems of life during COVID-19 should be considered as part of the COVID-19 pandemic care program. Individual assessments should normally be considered in a public health crisis. It is recommended to conduct serious, in-depth, and practical research in this field.

The quality of life impact of the COVID-19 pandemic and lockdowns for people living with multiple sclerosis (MS): evidence from the Australian MS Longitudinal Study

PURPOSE

People living with multiple sclerosis (PwMS) in metropolitan Victoria, Australia, experienced a 112-day, COVID-19-related lockdown in mid-2020. Contemporaneously, Australian PwMS elsewhere experienced minimal restrictions, resulting in a natural experiment. This study investigated the relationships between lockdowns, COVID-19-related adversity, and health-related quality of life (HRQoL). It also generated health state utilities (HSU) representative of changes in HRQoL.

METHODS

Data were extracted from Australian MS Longitudinal Study surveys, which included the Assessment of Quality of Life-Eight Dimensions (AQoL-8D) instrument and a COVID-19 questionnaire. This COVID-19 questionnaire required participants to rank their COVID-19-related adversity across seven health dimensions. Ordered probits were used to identify variables contributing to adversity. Linear and logit regressions were applied to determine the impact of adversity on HRQoL, defined using AQoL-8D HSUs. Qualitative data were examined thematically.

RESULTS

N = 1666 PwMS (average age 58.5; 79.8% female; consistent with the clinical presentation of MS) entered the study, with n = 367 (22.0%) exposed to the 112-day lockdown. Lockdown exposure and disability severity were strongly associated with higher adversity rankings (p < 0.01). Higher adversity rankings were associated with lower HSUs. Participants reporting major adversity, across measured health dimensions, had a mean HSU 0.161 (p < 0.01) lower than participants reporting no adversity and were more likely (OR: 2.716, p < 0.01) to report a clinically significant HSU reduction. Themes in qualitative data supported quantitative findings.

CONCLUSIONS

We found that COVID-19-related adversity reduced the HRQoL of PwMS. Our HSU estimates can be used in health economic models to evaluate lockdown cost-effectiveness for people with complex and chronic (mainly neurological) diseases.

The relationship between spiritual health and quality of life among COVID-19 patients with long-term complications in the post-coronavirus era

Objective

COVID-19 has varied manifestations and can cause complications that affect quality of life. Spiritual health may be a source of adaptation for these patients. This study investigated the relationship between spiritual health and quality of life among COVID-19 patients with long-term complications in the post-coronavirus era.

Participants/methods

This study enrolled 475 COVID-19 patients through convenience sampling from medical facilities located in the Central Province of Iran. Data collection occurred between November 2022 and July 2023. A demographic checklist was utilized to ascertain the presence of potential COVID-19 complications. Patients exhibiting at least one long-term complication of COVID-19 were classified into the group with complications, while those without such complications were categorized into the group without complications. Subsequently, spiritual health and quality of life were assessed utilizing Paloutzian and Ellison's Spiritual Well-Being Scale and the 36-item Short Form Health Survey (SF-36), respectively. Statistical analysis was conducted using SPSS-20.

Results

The mean scores of spiritual well-being and quality of life for participants without COVID-19 complications were 70.87 ± 22.44 and 61.30 ± 18.33, respectively. In contrast, the mean spiritual health scores and quality of life for participants with COVID-19 complications were 41.20 ± 12.49 and 33.66 ± 1.46, respectively. Moreover, spiritual well-being was positively associated with quality of life among COVID-19 patients (p < 0.05).

Conclusion

This study indicates that COVID-19 complications can impair patients' spiritual health and quality of life, leaving them vulnerable and distressed. However, patients with higher spiritual health can cope better and enjoy a higher quality of life, despite challenges. Therefore, this study highlights the importance of addressing the spiritual needs of patients with COVID-19 complications and providing them with adequate support and care.

Deterioration in Quality of Life among COVID-19 Survivors: Population-Based Cohort Study

We aimed to examine the prevalence of, and factors associated with, quality of life (QOL) worsening among coronavirus disease 2019 (COVID-19) survivors. This population-based retrospective cohort study used data from the Korea Disease Control and Prevention Agency and the National Health Insurance Service in South Korea. A total of 325,666 COVID-19 survivors were included in this study. Among them, 106,091 (32.6%) survivors experienced worsening QOL after COVID-19. Specifically, 21,223 (6.5%) participants experienced job loss, 94,556 (29.0%) experienced decreased household income, and 559 (0.2%) acquired new disabilities. In the multivariable logistic regression model, living in rural areas (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 1.01, 1.04; p = 0.009), intensive care unit admission (OR: 1.08, 95% CI: 1.02, 1.15; p = 0.028), and increase in self-payment by 100 USD (OR: 1.02, 95% CI: 1.02, 1.02; p < 0.001) were associated with increased QOL worsening after COVID-19. Old age (OR: 0.99, 95% CI: 0.98, 0.99; p < 0.001), first vaccination (OR: 0.89, 95% CI: 0.86, 0.93; p < 0.001), and second vaccination (OR: 0.95, 95% CI: 0.93, 0.96; p < 0.001) were associated with decreased QOL worsening after COVID-19. Approximately one-third of COVID-19 survivors in South Korea who were admitted to hospitals or monitoring centers experienced QOL worsening.

Improving immersive experiences in virtual natural setting for public health and environmental design: A systematic review and meta-analysis of randomized controlled trials

In recent years, virtual reality (VR) technology has emerged as a powerful tool in the field of therapeutic landscapes. For hospitalized patients or individuals with limited mobility, VR provides highly personalized therapy by simulating authentic natural environments within a safe, convenient, and engaging setting. This study investigated the effectiveness of immersing patients in virtual natural environments for health recovery and compared the varying impacts of different types of landscapes on patients' recovery levels. The aim was to complement traditional medical approaches and enhance environmental design in the field of public health. Researchers systematically reviewed databases (January 2018 to August 2, 2023) to identify randomized controlled trials comparing the efficacy of virtual nature immersion with other treatments. The inclusion/exclusion criteria were established based on the population, intervention, comparison, outcomes, study design, and other aspects (expanded PICO) framework. The Cochrane tool was employed to assess the risk of bias. Meta-analysis was conducted by pooling the mean differences with a 95% confidence interval. Among 30 trials, a total of 2123 patients met the inclusion criteria, with 15 studies included in the meta-analysis. 30 trials met the criteria. Results show significant improvements in pain, anxiety, fear, and some physiological indicators with virtual nature-based treatments. On the other hand, natural scenes incorporating blue and green elements have been applied more extensively and have shown more significant effects. In comparison to conventional methods, this study strongly advocates that virtual reality environments are a crucial tool in bridging the gap between patients and nature, demonstrating their potential to reshape medical interventions and improve environmental design in the field of public health.

Quality of life of patients with hip fracture was better during the COVID-19 period than before, an ancillary study from the HiFIT multicenter study

Background

The COVID-19 pandemic had a global impact on people life, notably because of lockdown periods. This could particularly affected patients suffering from hip fracture, who could have been more isolated during these periods. We aim at evaluating the impact of the COVID-19 period (including lockdown periods) on quality of life (QOL) in older adult patients 90 days after a surgery for a hip fracture.

Subject and methods

Ancillary study of the prospective randomized controlled HiFIT study. We compared the QOL measured at 90 days after a hip fracture surgery using the EuroQOL-5 dimensions 3 levels (EQ-5D), the Perceived Quality of life (PQOL) and the Instrumental Activities of Daily Living (IADL) in patients included in the Hifit study before and during the COVID-19 pandemic.

Results

The characteristics of the 161 patients included before and of the 213 included during the COVID period (including 122 (57%) during COVID with containment periods and 91 (43%) during COVID without containment periods) were similar (mean age 84 ± 10 years; 282 (75%) women). The majority (81%) of the patients alive at 90 days had returned to their previous place of residence in both periods. During the COVID period, EQ-5D showed better patient pain/discomfort and anxiety/depression levels. The PQOL happiness was not different, with around 81% of the patient being "happy" or "very happy" during the two periods and the IADL was also similar during the two periods. In the multivariate analysis odd ratios of having poorer outcomes were increased before COVID for pain/discomfort (OR 2.38, 95%CI [1.41-4.15], p = 0.001), anxiety (OR 1.89 [1.12-3.21], p = 0.017) and mobility (1.69 [1.02-2.86], p = 0.044).

Conclusion

Patient's quality of life measured using different scales was not altered during the COVID period compared to before COVID, 90 days after a hip fracture. Surprisingly, the Pain/Discomfort and Anxiety dimensions of the EQ-5D questionnaires were even better during the COVID period.Clinical trial registration:https://clinicaltrials.gov/ (NCT02972294).

The effect of a prosocial environment on health and well-being during the first COVID-19 lockdown and a year later

The outset of the COVID-19 pandemic was characterized by prolonged periods of chronic stress and social isolation. While studies have investigated the changes to well-being (WB) during this period, the impact of the social environment on long-term physical and mental health requires further study. This study aimed to assess the factors influencing WB and health outcomes, with the hypothesis that a positive social environment would play a significant immediate and long-term role in improving WB and preventing the effects of anxiety associated with the pandemic. At time point 1 (April 2020), an Israeli sample of 206 participants (84% female, mean age 31.5) responded to traditional questionnaires assessing mental health and social support. Factors affecting WB were assessed within subjects during the first COVID-19 lockdown for 6 weeks using a daily survey (Beiwe phone application). A year later, in May 2021, at time point 2, the initial questionnaires were readministered to a subset of the same participants (N = 94). We found that anxiety during the first lockdown adversely affected WB and predicted health and WB deterioration a year later. In contrast, a high quality of social relationships was associated with better short- and long-term WB, and mitigated the adverse effects of anxiety. Daily activities, including physical activity, meditation, and romantic relations, were also positively associated with WB during the first lockdown but did not have long-term effects. In summary, our study underscores the enduring health advantages of a positive social environment, particularly during stressful periods. These results have implications for health policymakers: programs which support individuals with high anxiety and low support, by integrating them into community-based interventions, promise to enhance well-being (WB) and health, as well as to fortify the community as a whole.

TVET programme and health-related quality of life among low-income populations during the COVID-19 pandemic in Malaysia

Introduction

Education improves the economy and quality of life. The availability of skilled education in Malaysia is not restricted to the younger generation but is available to people of all ages, including those with low incomes.

Methods

This study used the EuroQol 5-Dimension 5-Level (EQ- 5D-5L) tool during the COVID-19 pandemic to examine relationships between socio-demographics, knowledge, and attitudes towards education and outcomes of health-related quality of life (HRQOL). Between September and October 2020 and January and February 2021, a cross-sectional study using a multi-stage sampling technique was carried out.

Results

A total of 1,997 adults participated, with a mean age of 45.17 (SD 14.113). In total, 74.9% had good knowledge, while 59.8% had a positive attitude towards skill education. In univariate analyses, the EQ-5D-5L score was related to age, income, education level, marital status, employment status, financial strain level, and knowledge and attitude towards skilled education. Generalised linear model analyses demonstrated that lower EQ-5D-5L scores were associated with older age, financial constraints, and a negative attitude towards skills education. However, additional adjustments for knowledge and attitude towards skills education show only an increase in age and financial strain was significant.

Conclusion

The findings suggest that appropriate strategies be implemented to increase low-income populations' knowledge and attitude towards skill education. Improving education may improve the quality of life for this vulnerable group. Additionally, a qualitative study can be conducted to determine the barriers to low-income households participating in skilled education to fill in the knowledge gap.

Quality of life and family management of paediatric chronic condition amidst the COVID-19 pandemic

PURPOSE

This study aimed to describe the perception of parents of children/adolescents with chronic conditions of their quality of life and family functioning during the COVID-19 pandemic and explore how the COVID-19 pandemic affected family management of children/adolescents' chronic conditions.

DESIGN AND METHODS

A total of 237 parents of children/adolescents with chronic conditions participated in this cross-sectional study. Data were collected through an online questionnaire using the Paediatric Quality of Life Inventory™ Family Impact Module and an open-ended question about the impact of the pandemic on the family management of the paediatric chronic condition.

RESULTS

The Total Score of PedsQL™ FIM was slightly higher than the midpoint of the scale (M = 60.27; SD = 19.04), and the impact of the pandemic on the family's management of the chronic condition was perceived by 30% of parents as high or moderate. Statistically significant differences were found between parents who reported a high or moderate impact of the pandemic and those reporting little or no impact of the pandemic regarding parental quality of life and family functioning (t (233) = 8.13, p = .00, Cohen's d = 1.14). Two themes emerged from the analysis of the open-ended question: Impact on the child/adolescent and Impact on the family.

CONCLUSIONS

Parents of children/adolescents with chronic conditions reported an average quality of life, and the COVID-19 pandemic significantly impacted the family management of chronic conditions.

PRACTICE IMPLICATIONS

These results highlight the importance of developing interventions to support families in complex situations and contexts, targeting family functioning, family quality of life, and emotional management.

The Impact of the COVID-19 Pandemic on Real-world Functioning in Adult Cochlear-implant Users

Hypothesis

As a result of COVID-19 lockdowns and the associated effects on the auditory-social environments of cochlear-implant (CI) users, we expected that adult CI users would report a decrease in real-world communication abilities, a decrease in social isolation, and a decrease in quality of life (QOL) from pre- to post-pandemic.

Background

The COVID-19 pandemic brought many changes to the environments in which adults with CIs interact and communicate. However, the impact of these changes on CI users' real-world functioning is not well understood. This study investigated the impact of the COVID-19 pandemic on real-world communication abilities, social isolation, and CI-related QOL in adult CI users.

Methods

Fourteen adult CI users completed self-report questionnaires assessing communication abilities, social isolation, and CI-related QOL at time points before and after the onset of the COVID-19 pandemic. Responses at the 2 time points were compared to evaluate changes in CI users' real-world functioning.

Results

Adult CI users showed a significant decrease in self-reported communication ability and a nonsignificant decline in CI-related QOL from before to during COVID-19. However, a nonsignificant trend of a decline in social isolation was also observed in adult CI users.

Conclusion

Findings showed a decrease in self-reported communication abilities and, to a lesser extent, CI-related QOL, suggesting that changes to the auditory-social environment brought on by the COVID-19 pandemic may have negatively impacted communication abilities in real-world, challenging environments. Yet, the potential decrease in social isolation suggests that these changes may have had an overall positive effect on social interaction, potentially with close family and friends in well-controlled environments. Assessing changes in real-world functioning in the same CI users from both before and during the COVID-19 pandemic provided a unique glimpse into how changes in the auditory-social environment may impact outcomes in adult CI users.

Impact of COVID-19 Infection on Health-Related Quality of Life in the Japanese Population: A Large Health-Insurance-Based Database Study

Evidence for acute or long-term coronavirus disease 2019 (COVID-19) infection is relatively limited. We aimed to evaluate the impact of COVID-19 infection on health-related quality of life (HRQoL) in the Japanese population. Eligible study participants were 13,365 employees and their dependents who answered questionnaires at baseline and 18 months later and who had at least 6 months of continuous enrolment before and after baseline. Of the 711 study participants who developed COVID-19 infection, 29.0% reported a decline in HRQoL, whereas 25.2% of uninfected participants reported a decline. The adjusted odds ratios (95% confidence intervals) for the association between COVID-19 infection and declines in HRQoL in the age categories of less than 30 years, 30s, 40s, 50s, and 60 years or higher were 0.54 (0.15-1.92), 1.70 (1.03-2.81), 1.14 (0.82-1.57), 1.05 (0.77-1.42), and 0.87 (0.46-1.64), respectively. This study demonstrates a differential association between COVID-19 infection and declines in HRQoL by age group. A 1.7-fold increase in the odds of negative changes in HRQoL was observed in only those in their 30s. Further studies are needed to elucidate differences in the impact of COVID-19 infection on HRQoL between younger people such as those in their 30s and the older population.

The impact of long COVID on health-related quality of life in patients 6 months after discharge with severe COVID-19

This study investigates the relationship between long COVID and health-related quality of life (HRQOL) in patients discharged for 6 months. It included 192 patients with a history of severe COVID-19 and 192 patients with a history of non-severe COVID-19 patients that were selected through quota sampling methods from the Medical Care Monitoring Center (MCMC) of hospitals in Shiraz, Iran, in 2020. Phone-based interviews were conducted to collect data using the short form of the 12-item health-related quality of life (SF-12) questionnaire. Descriptive statistics, including mean (standard deviation) and frequency (percentage), were utilized. Statistical tests, such as the chi-squared test, independent samples t-test, Fisher's exact test, and multiple linear regression models were performed. Statistical analysis was performed using SPSS software version 24, with a significance level of 0.05. Among 384 patients, 79.95% were married, with a mean age of 53.95 years. The majority of patients in both groups were male (57.81% in the severe group and 51.04% in the non-severe group). Patients with severe COVID-19 had significantly lower quality of life scores compared to those with non-severe COVID-19 (p < 0.001, 34.45 [SD = 6.59] versus 39.64 [SD = 5.07]). Furthermore, multiple linear regression analysis indicated that severe COVID-19 inducts a significant negative effect on HRQOL in patients after adjustment of confounders (p < 0.001, B =  - 4.84). Patients with severe COVID-19 had lower HRQOL compared to those with a non-severe level. It is necessary to consider implementing policies aimed at providing social, psychological, or medical support to improve the HRQOL of patients with a history of severe COVID-19.

Quality of Life in Adolescents and Young Adults with Cleft Lip and Palate with and Without Speech Therapy During COVID-19

OBJECTIVE

Cleft-related speech concerns can affect the quality of life (QOL) in patients with cleft lip and palate (CLP). During the coronavirus disease 2019 (COVID-19), in-person speech therapy (ST) was restricted due to fear of getting infected. This study aimed to compare QOL in patients with CLP with and without ST during the pandemic.

DESIGN

Cross-sectional Study.

SETTING

CLP team at Tehran University of Medical Sciences (TUMS).

PATIENTS/PARTICIPANTS

Thirty-six CLP subjects with a mean age of 17.33 ± 4 years participated in two groups, including with and without ST. Fifteen subjects had cleft palate only (CPO) and others had CLP.

INTERVENTIONS

ST group received at least 10 ST sessions, and group without ST didn't receive ST during COVID-19.

MAIN OUTCOME MEASURE(S)

A virtual link of demographic and QOL adolescent cleft (QoLAdoCleft) questionnaires were sent to fill out. Results were extracted and transferred to SPSS.

RESULTS

Total and subscales' scores of QoLAdoCleft were lower in ST group than without ST but differences between them weren't statistically significant (P > .05). Furthermore, according to cleft type, there weren't any statistically significant differences in total, physical, and social subscales of QoLAdoCleft (P > .05); however, psychological subscale in CLP had a higher significant score than CPO (P < .05).

CONCLUSIONS

QOL was weak in all patients with CLP, and receiving/not receiving ST couldn't make noticeable differences between them. It seems; COVID-19 pandemic can have an adverse effect on these results. Also, subjects with CLP had weaker psychological than CPO due to negative psychosocial feedback related to Orofacial deformities received from society.

Arts therapies for mental disorders in COVID-19 patients: a comprehensive review

Background and objective

The COVID-19 global pandemic has necessitated the urgency for innovative mental health interventions. We performed a comprehensive review of the available literature on the utility and efficacy of arts therapies in treating mental health problems, with special emphasis on their deployment during the COVID-19 pandemic, aiming to provide some evidence for the application of this therapy.

Methods

The potential studies were systematically sourced from five authoritative databases: PubMed, Embase, the Cochrane Library, Web of Science, and the CNKI database. The evaluation of these studies was conducted based on stringent criteria, including validity, suitability, therapeutic potential, and consistency. Each piece of included literature was meticulously scored in accordance with these criteria, thus ensuring the inclusion of only the most robust studies in this review. The data from these Randomized Controlled Trials (RCTs) were carefully extracted using the PICO(S) framework, ensuring a comprehensive and systemic approach to data collection. In order to emphasize the variability in the effects of differing arts therapies on COVID-19-induced psychiatric disturbances, the sourced literature was systematically categorized and scrutinized based on distinct modalities.

Results

Out of the 7,250 sourced articles, 16 satisfied the inclusion conditions. The therapies were predominantly meditation (n = 7), supplemented by individual studies on color therapy (n = 3), music therapy (n = 2), and single studies on horticultural therapy, dance therapy, mindfulness and music therapy, and yoga and music therapy (n = 4 collectively). These various forms of arts therapies had a positive short to medium-term impact on the mental health of COVID-19 patients. Besides improving patients' physical and mental health, these therapies can also be employed to mitigate mental health issues among healthcare professionals.

Conclusion

The COVID-19 pandemic has profound and long-lasting implications for public mental health. Diverse forms of arts therapies are potentially effective in addressing related psychiatric symptoms. The integration of artificial intelligence might further enhance the efficacy and scalability of arts therapies in future implementations.

EQ-5D-5L Portuguese population norms

OBJECTIVES

The EQ-5D-5L is a generic preference-based quality-of-life measure for which the corresponding Portuguese population value set was only recently developed. This study sought to establish EQ-5D-5L population norms for Portugal and to identify significant relationships with sociodemographic variables.

METHODS

The research was based on a representative sample of Portugal's general population (n = 1006) aged 18 or older. The sample was stratified by gender, age group, and geographical region. The respondents were interviewed by telephone and asked to value their own state of health using both the EQ-5D-5L description system and the EuroQol-Visual Analogue Scale (EQ VAS).

RESULTS

The estimated mean EQ-5D-5L index for Portugal's general population is 0.887 (standard error [SE] = 0.0051), and the EQ VAS score was estimated as 76.0 (SE = 0.640). One-third of the population reported being in the best health state (11111). Women, individuals 70 years old or more and people with low education or a chronic disease reported a lower EQ-5D-5L index score (p < 0.001). Residents in the Azores and the Algarve reported higher health utility scores.

CONCLUSIONS

The EQ-5D-5L Portuguese population norms obtained can be used as reference scores. These norms are consistent with other countries' population norms. The findings facilitate clinical, economic, and policy decision-making processes and provide a fuller understanding of the Portuguese population's health-related quality of life.

Navigating the Shifts: Retrospective Analysis of Alcohol Consumption and its Predictors Across Pre-Pandemic, Lockdown, and Post-Pandemic Eras in Poland

BACKGROUND Alcohol consumption is a serious health risk that affects both physical and mental health. It is one of the major risk factors in the development of non-communicable diseases. The aim of this study was to perform a retrospective analysis of alcohol consumption patterns, determine of predictors of alcohol addiction, and attempt to distinguish and compare the profiles of participants differentiated in terms of their preferences in the pre-pandemic, lockdown, and post-pandemic periods. MATERIAL AND METHODS A retrospective study was conducted with a computer-assisted web interview on a representative sample of Polish citizens. Primary outcomes were sociodemographic and COVID-19-related variables, preferences regarding the type and location of consumed alcohol, reasons for drinking, severity of addiction symptoms, loneliness, quality of life, and health level. RESULTS During the lockdown period, the percentage of people declaring abstinence increased, as well as people who, according to the Alcohol Use Disorders Identification Test (AUDIT) cut-off points, could be diagnosed with probable alcohol dependence. The strongest predictors of the severity of addiction symptoms were preferences regarding the type and place of alcohol consumption, with a high percentage of explained variance (>50%). The analysis of profiles differentiated in terms of the preferred type of alcohol consumed allowed for the identification of 7 different profiles, which differed in terms of AUDIT score, loneliness, quality of life, and level of health. CONCLUSIONS Patterns of alcohol consumption changed during the pandemic. Alcohol-related preferences are important from the public health perspective.

Impact of the COVID-19 pandemic on well-being and quality of life of patients with alpha-1-antitrypsin deficiency

BACKGROUND

Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder characterized by mutations in the SERPINA1 gene, primarily affecting the lungs and liver. The COVID-19 pandemic has raised questions about the susceptibility of individuals with AATD to COVID-19 and whether patients with rare lung disease might experience increased stress-related symptoms and mental health challenges. This study aims to investigate the impact of the COVID-19 pandemic on the quality of life of individuals living with AATD.

METHODS

The study enrolled participants from the German registry for individuals with AATD. Questionnaires were sent to the 1250 participants, and a total of 358 patients were included in the analysis. The primary objective was to examine the influence of sociodemographic and disease-related factors on the occurrence of stress-related symptoms. This was accomplished through correlation and regression analyses. We also investigated the role of baseline quality of life (QoL), as measured by the St. George's Respiratory Questionnaire (SGRQ), as a mediator of this relationship.

RESULTS

Stress-related symptoms were predicted by young age, female gender, psychological disorders, and a history of exacerbations of lung disease, as determined by multiple regression analysis. QoL as measured by the SGRQ mediated the relationship between poor lung function, stress, and a decline in overall well-being.

CONCLUSION

The presented data demonstrate that the COVID-19 pandemic significantly affects the psychological well-being of patients with rare diseases, leading to increased levels of anxiety and stress. Disease-related factors can exacerbate stress manifestations, especially when compounded by sociodemographic and contextual factors. Thus, our study emphasizes the crucial role of taking these factors into account when managing individuals with AATD in pandemic situations.

Serially mediated effects of psychological inflexibility on quality of life of refugees in Uganda during coronavirus pandemic

The unexpected outbreak and rapid spread of COVID-19 necessitated radical and stringent control measures, consequently changing how people live globally. To vulnerable populations like refugees, who were already living a disrupted life, the outbreak of COVID-19 and accompanying control measures complicated their living conditions and drastically affected their mental health and, consequently, their quality of life. The current study aimed to test whether psychological inflexibility was a factor in lowering the quality of life of refugees in Uganda during the COVID-19 pandemic. The study further examines whether the effects of psychological inflexibility on quality of life were serially mediated by avoidance coping, perceived threat, adherence to COVID-19 control measures, and general mental health states. The study was conducted among refugees living in Kampala city suburbs and Bidibidi refugee settlement in Uganda. Data was collected using a survey questionnaire during the partial reopening of the economy in mid-2020, after the first lockdown. The analysis assesses a serial mediation model of the effects of psychological inflexibility on the quality of life of refugees through avoidance coping, perceived threat, adherence to COVID-19 control measures, and mental health using PROCESS Macro. The study involved 353 participants. Our analyses revealed that psychological inflexibility was negatively associated with the perceived threat, adherence, and quality of life. Psychological inflexibility was positively associated with avoidance coping and poor mental health. The data supported all hypothesized mediation paths. These findings support literature suggesting that psychological inflexibility is a maladaptive attribute that thwarts positive coping and behavior adjustment in times of crisis. Consequently, psychological inflexibility can worsen mental health problems and quality of life, especially in populations such as refugees in low-income countries who live in precarious conditions. Incorporating interventions that reduce psychological inflexibility in crisis management efforts can help refugees maintain good psychological functioning and quality of life.

Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life

PURPOSE

Post-Covid-19 syndrome is defined as the persistence of symptoms beyond 3 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The most common symptoms include reduced exercise tolerance and capacity, fatigue, neurocognitive problems, muscle pain and dyspnea. The aim of our work was to investigate exercise capacity and markers of subjective wellbeing and their independent relation to post-COVID-19 syndrome.

PATIENTS AND METHODS

We examined a total of 69 patients with post-COVID-19 syndrome (23 male/46 female; age 46±12 years; BMI 28.9±6.6 kg/m2) with fatigue and a score ≥22 in the Fatigue Assessment Scale (FAS). We assessed exercise capacity on a cycle ergometer, a 6-minute walk test, the extent of fatigue (FAS), markers of health-related quality of life (SF-36 questionnaire) and mental health (HADS).

RESULTS

On average the Fatigue Assessment Scale was 35.0±7.4 points. Compared with normative values the VO2max/kg was reduced by 8.6±5.8 ml/min/kg (27.7%), the 6MWT by 71±96 m (11.9%), the health-related quality of life physical component score by 15.0±9.0 points (29.9%) and the mental component score by 10.6±12.8 points (20.6%). Subdivided into mild fatigue (FAS score 22-34) and severe fatigue (FAS score ≥35), patients with severe fatigue showed a significant reduction of the 6-minute walk test by 64±165 m (p<0.01) and the health-related quality of life physical component score by 5.8±17.2 points (p = 0.01). In multiple regression analysis age (β = -0.24, p = 0.02), sex (β = 0.22, p = 0.03), mental (β = -0.51, p<0.01) and physical (β = -0.44, p<0.01) health-related quality of life and by trend the 6-minute walk test (β = -0.22, p = 0.07) were associated with the FAS.

CONCLUSION

Patients with post-COVID-19 syndrome show reduced maximal and submaximal physical performance as well as limitations in quality of life, particularly pronounced in the physical components. These results are essentially influenced by the severity of fatigue and implicating the need for targeted treatments.

The relationship between the COVID-19 anxiety and self-efficacy of patients undergoing hemodialysis: a cross-sectional study

BACKGROUND

The spread of the COVID-19 increased anxiety and stress among patients undergoing hemodialysis. Unpleasant experiences in the lives of these patients reduced their quality of life. Self-efficacy is an effective factor that can improve the quality of life of patients undergoing hemodialysis. Therefore, this study aimed to investigate the relationship between the COVID-19 anxiety and self-efficacy in patients undergoing hemodialysis.

METHODS

This cross-sectional, descriptive and analytical study used purposive sampling to select 110 patients undergoing hemodialysis in Sirjan from October to late November 2021. Demographic and clinical information questionnaire, the Corona Disease Anxiety Scale, and the General Self-Efficacy Scale were used to collect data. Data were analyzed using SPSS25. A significance level < 0.05 was considered.

RESULTS

The results showed that the mean score of COVID-19 anxiety was 13.14 ± 7.38, which was lower than the midpoint of the questionnaire. The mean self-efficacy score was 57.72 ± 9.68, with 73.8% (N = 79) of the participants having high self-efficacy and 26.2% (N = 28) having moderate self-efficacy. We found no significant relationship between self-efficacy and the COVID-19 anxiety (P = 0.31), as well as between self-efficacy and the psychological dimension of the corona disease anxiety scale (P = 0.96), but we observed a negative, poor and significant relationship between self-efficacy and its physical dimension (P = 0.048).

CONCLUSIONS

Patients undergoing hemodialysis showed low anxiety and high self-efficacy. No significant relationship was found between COVID-19 anxiety and self-efficacy, but a weak correlation was observed with the physical dimension of anxiety. Increasing self-efficacy through patient education and support can improve outcomes and reduce hospitalizations for these patients.

Prevalence of COVID-19 fear and its association with quality of life among fire service recruits after ceasing the dynamic zero-COVID policy in China

Background

In December 2022, China terminated its dynamic zero-COVID policy. To date, however, no research has been conducted upon mental health issues and their relationship with quality of life (hereafter QoL) among fire service recruits since the dynamic zero-COVID policy ended. This study explored fear of COVID-19 (FOC) prevalence and correlates as well as its network structure and interconnections with QoL among fire service recruits.

Methods

A cross-sectional survey design was used to assess fire service recruits in Beijing and Sichuan, Guangxi and Guizhou provinces of China between February 13 and 16, 2023. Fear of COVID-19 was measured using the Fear of COVID-19 Scale, depression was assessed with the Patient Health Questionnaire, anxiety was examined using the Generalized Anxiety Disorder scale, and QOL was evaluated with the World Health Organization Quality of Life-brief version. Univariate and multivariate analyses were used to explore correlates of COVID-19 fear. Network analysis assessed the structure of fear of COVID-19 and its associations with QoL.

Results

A total of 1,560 participants were included in this study. The overall prevalence of fear of COVID-19 was 38.85% (n = 606; 95% CI = 36.42-41.32%). Being afraid of COVID-19 was significantly related to depression (OR = 1.084; p < O.OO1) and physical fatigue (OR = 1.063; p = 0.026). Fire service recruits with more fear of COVID-19 had lower QOL (F = 18.061 p < 0.001) than those with less fear of COVID-19 did. The most central symptoms included FOC6 ("Sleep difficulties caused by worry about COVID-19"), FOC7 ("Palpitations when thinking about COVID-19") and FOC2 ("Uncomfortable to think about COVID-19"). The top three symptoms negatively associated with QoL were FOC4 ("Afraid of losing life because of COVID-19"), FOC6 ("Sleep difficulties caused by worry about COVID-19") and FOC2 ("Uncomfortable to think about COVID-19").

Conclusion

Over one-third of fire service recruits reported fear of COVID-19 after China's dynamic zero-COVID policy had terminated. Poorer QoL was related to fear of COVID-19. Targeting core symptoms of the fear network structure could help improve the physical and mental health of fire service recruits during public health crises.

The Prevalence of COVID-19 Fog and the Impact on Quality of Life After SARS-CoV-2 Infection (QoL-COVID): A Cross Sectional Study

INTRODUCTION

Coronavirus has an impact on both the physical and mental health of individuals. The literature regarding the patient's health status post-SARS-CoV-2 is still scarce with limited data on the prevalence of residual symptoms and quality of life (QoL) after the infection. The aim of this study was to understand the impact of SARS-CoV-2 on patient QoL, and remaining symptoms.

MATERIAL AND METHODS

Single center cross-sectional study of patients who had been admitted to our COVID-19 ward between March 2020 and March 2021. By applying a QoL questionnaire (EQ-5D-5L) we assessed the overall sample, at three time points and in different groups of patients: those admitted to the intensive care unit (ICU) and the elderly.

RESULTS

A total of 125 participants were included in our study. Most patients who were admitted had a severe course of disease (51%), with 22% of admissions to the ICU, with 8% requiring prone ventilation, 10% experiencing thrombotic complications and 18% of nosocomial infections throughout the admission. As for persistent symptoms related with COVID-19 fog, the most frequent were fatigue (57%), memory loss (52%) and insomnia (50%). Regarding QoL, the average decrease was 0.08 ± 0.2 in the index and 8.7 ± 19 in the Visual Analogue Scale (VAS). The QoL index decrease correlated with age, chronic obstructive pulmonary disease, asthma and heart failure, and all persistent symptoms, significantly. QoL VAS correlated significantly with fatigue, mood changes, difficulty concentrating and memory loss. The decrease in QoL and the persistent symptoms remained overall stable over the three time points. The ICU group showed no statistically significant difference in QoL, but the most frequently persistent symptoms were mood changes and attention disturbances. However, the elderly experienced a worsening in QoL expressed by index (0.69 ± 0.3 vs 0.8 ± 0.2, p-value = 0.01).

CONCLUSION

A decrease in QoL was observed following SARS-CoV-2 infection, correlating with both chronic conditions and persistent symptoms. The lack of difference through time points of both QoL and persistent symptoms suggests a long-standing effect.

Impact of COVID-19 on Lifestyle: A Sample of Iranian Older Adults

The COVID-19 pandemic and prolonged quarantine affect the health behaviors of older adults. We investigated the changes in older adults' lifestyles during the pandemic in a sample of 1020 people aged 60 years old and over in Tehran. The results revealed that the COVID-19 pandemic had a positive impact on nutritional behaviors and social support while having a negative impact on physical activity and anxiety in older adults. Due to the greater deterioration of health behaviors among unmarried older adults, low socio-economic status, and COVID-19 inpatients, policymakers must pay attention to interventions to promote healthy lifestyles.

Quantifying COVID-19 policy impacts on subjective well-being during the early phase of the pandemic: A cross-sectional analysis of United States survey data from March to August 2020

To stop the spread of COVID-19, a number of public health policies and restrictions were implemented during the pre-vaccination phase of the pandemic. This study provides a quantitative assessment of how these policies impacted subjective well-being (SWB) in the United States over a 6-month period spanning March to August 2020. We study two specific research objectives. First, we aim to quantify the impacts of COVID-19 public health policies at different levels of stringency on SWB. Second, we train and implement a conditional inference tree model for predicting individual SWB based both on socio-demographic characteristics and policies then in place. Our results indicate that policies such as enforcing strict stay-at-home requirements and closing workplaces were negatively associated with SWB, and that an individual's socio-demographic characteristics, including income status, job, and gender, conditionally interact with policies such as workplace closure in a predictive model of SWB. Therefore, although such policies may have positive health implications, they also have secondary environmental and social implications that need to be taken into account in any cost-benefit analysis of such policies for future pandemic preparedness. Our proposed methodology suggests a way to quantify such impacts through the lens of SWB, and to further advance the science of pandemic preparedness from a public health perspective.

Health and well-being of the Portuguese citizens: impacts of the COVID-19

BACKGROUND

COVID-19 pandemic placed unprecedented pressure on societies and healthcare systems around the world. Over the last years, measures imposed in almost all countries dealing with the pandemic sent the entire world into an extensive crisis and thus into a deep global recession. Since the outbreak began, many European countries have faced three/four waves of pandemic. Portugal has mainly dealt with three waves (March/April'2020; October/November'2020; January/February'2021), the third being the deadliest one. The purpose of this article is to provide evidence on the impact of the COVID-19 on health-related quality of life (HRQol) and well-being (W-B) of Portuguese citizens. It aims to (i) characterize these outcomes during the COVID-19 pandemic; (ii) compare them to pre-COVID-19 Portuguese population; and (iii) identify the social determinants that may affect these outcomes during the COVID-19 pandemic.

METHODS

This study used data from a survey that collected data on HRQoL, W-B, satisfaction with life, economic and labour impacts, access to healthcare, mental and physical health, amongst others. The survey was implemented by telephone to a representative random sample of 1,255 respondents from the general adult Portuguese population, stratified by sex, age group and region. Data was collected during the end of the second national lockdown. For comparison purposes, we have also used two other representative databases from the general Portuguese population: (i) data from before the pandemic (n = 1,006); and (ii) data from a survey conducted during the first lockdown, (n = 904).

RESULTS

Looking at health and access to healthcare, 4% of citizens had their surgeries postponed or cancelled because of COVID-19, more than a quarter had medical appointments or complementary exams postponed or cancelled, with 7% over 65 years old with surgeries cancelled or postponed and 32% medical appointments. COVID-19 pandemic also impacted negatively on the HRQoL of citizens, especially in the first lockdown. Half of the respondents reported feeling nervous, anxious, or on edge, about 45% of citizens felt sad or depressed. Sleeping problems were reported for almost 39% of citizens, and loneliness is reported by 29% of citizens. For about 70-85% of citizens, these feelings were more so than before the pandemic. Citizens with fair/strong economic stability were the most economically affected by the pandemic.

CONCLUSIONS

We provided evidence on the impact of COVID-19 on health and W-B of Portuguese citizens. Their health was worse than before the pandemic and the access to healthcare was highly affected.

Quality of life in families under quarantine: a cross-sectional study in seven countries during the first outbreak of COVID-19

Background

The COVID-19 pandemic has disrupted human well-being worldwide in unforeseen ways. In early 2020, the spread of the virus left its mark on every affected country, impacting mental health by limiting daily activities and causing fatalities amidst public health strategies to mitigate its impact. The influence of COVID-19 on the quality of life (QoL) may vary between countries, underscoring the need to examine its effects on individuals and families during the mandatory home quarantine. We aimed to assess the QoL of individuals and families during home isolation by COVID-19 lockdown.

Methods

A cross-sectional study was conducted from February to May 2020. We included adult partners (≥18 years) of families from Brazil, Colombia, Spain, Japan, Peru, Russia, and Venezuela. Using the 26-item World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire we assess the impact of COVID-19 on their partner/family member's QoL.

Results

The survey was completed by 466 participants (mean age = 38.59 ± 13.75 years; females = 298) and 76% worked mostly as health professionals from South America (69.2%), Europe (18.4%), and Asia (12.4%). The WHOQOL-BREF mean score from 38.38 ± 11.55 (range = 22.8-43.4). The average quality of life in South America (41.9 ± 1.2) was significantly higher than that of European countries (30.9 ± 11.5) (p = 0.002). The social relations dimension was the only one with values close to 100 (mean = 83.3) in 6/7 evaluated countries, where only Spain had a low score (41 ± 33.12). Women had a slightly lower quality of life than men, but it was not significant (40.2 ± 8.8 vs. 41.5 ± 9.9, p = 0.354), while we found differences in the overall QoL between young and older, and by employment type (p < 0.05). According to family structure, we found differences on QoL between nuclear and siblings' families (p = 0.024).

Conclusion

Families from seven countries of three continents reported poor QoL during the first outbreak of COVID-19. The pandemic scenario has dramatically weakened the QoL in 3/4 dimensions, where social relationships have remained high. It is important to fully address the impact of this reduced QoL on families after several waves of infection and to provide comprehensive support in the post-COVID future.

Quality of life of a healthy polish population due to sociodemographic factors during the COVID-19 pandemic - a cross-sectional study

Introduction

The quality of life should be studied in every person, both among the sick and healthy. Sociodemographic factors affect the level of the perceived quality of life (QoL), and especially in the situation of the COVID-19 pandemic, which forced the enforcement of certain behaviours in society, such as social distancing, as well as introduced panic and fear for one's own health and life. The main aim of the study was to assess the quality of life in the group of people without the disease, to assess the impact of sociodemographic factors on QoL during the pandemic.

Material and method

3,511 healthy people were included in the study. The inclusion criteria of the study were: age of respondents over 18 years, no continuously administered medicaments, no diagnosed chronic diseases and no treatment in specialist clinics as well as lack of positive COVID-19 test in 4 weeks before the examination. The SF-36 questionnaire was used to assess the quality of life. The student's t-test and intergroup comparisons were used in 7 age groups. Factors such as age, gender, place of residence, education, civil status, employment status, smoking, and physical activity were assessed.

Results

The lowest average QoL level in the studied population was recorded in the Mental Component Summary (MCS) dimension (X = 47.9;Cl:47.6-48.3). A high correlation between age and the SF-36 spheres was noted in the following spheres: physical functioning (PF), role physical (RP), Physical Component Summary (PCS), and ILQ (p < 0.001). The highest chance of a better QoL in the PCS dimension among men was recorded in the 30-39 age group (OR = 3.65;Cl:1.13-11.79). In the group of people over 50 years of age living in the village, there was a greater chance of a better QoL in the PCS dimension in each age group. Practicing physical activity was significantly more often conditioned by a higher chance of developing a better QoL (p < 0.05). In the group of people ≥80 years of age, there was a greater than 4 times higher chance of developing a better quality of life in terms of MCS among physically active people (OR = 4.38;Cl:1.62-11.83).

Conclusion

With age, QoL decreases among people with disabilities. Men are more likely to assess their health better. A better QoL among women occurs at age 80 and later. A higher level of education often determined a significantly higher level of QoL felt. The practising of recreational physical activity and the lack of smoking habit determined a higher level of QoL more often. Smoking provided a greater chance of a better QoL in ILQ in the group of people ≥80 years.

The Effects of Exercise Training on Exercise Capacity and Vascular Function after Transcatheter Aortic Valve Implantation-A Pilot Study

Transcatheter aortic valve implantation (TAVI) improves event-free survival in patients with severe aortic stenosis, but patients' exercise capacity remains poor after the procedure. Therefore, we sought to compare the effects of a supervised center-based exercise training program and unsupervised exercise routine on exercise capacity and vascular function in patients after TAVI. Patients were randomized to either center-based exercise training (12-24 sessions of combined aerobic and low-weight resistance training twice weekly for 8-12 weeks) or an unsupervised home-based exercise routine (initial appraisal with detailed recommendations and monthly follow-up). Exercise capacity (cardiopulmonary testing) and vascular function (ultrasonographic measurement of flow-mediated vasodilation (FMD) and arterial stiffness) were assessed at the baseline and after the study period. We included 23 patients (mean age of 81 years, 61% women), with higher-than-expected drop-out rates (41%) because of the coronavirus-19 pandemic outbreak. Exercise capacity improved over time, irrespective of the intervention group: 0.09 mL/min/kg increase in peak oxygen uptake (95% CI [0.01-0.16]; p = 0.02), 8.2 Watts increase in workload (95% CI [0.6-15.8]; p = 0.034), and 47 s increase in cumulative exercise time (95% CI [5.0-89.6]; p = 0.029). A between-group difference in change over time (treatment effect) was detected only for FMD (4.49%; 95% CI [2.35; 6.63], p < 0.001), but not for other outcome variables. Both supervised and unsupervised exercise training improve exercise capacity and vascular function in patients after TAVI, with supervised exercise training possibly yielding larger improvements in vascular function, as determined by FMD.

Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection

BACKGROUND

Understanding the impact of the COVID-19 crisis on health involves conducting longitudinal studies to evaluate the inequalities that may have been exacerbated by the pandemic. The purpose of this study was to estimate differences in physical and mental health derived from the COVID-19 pandemic, beyond SARS-CoV-2 infection, in the Spanish general population according to the participants' level of education; and to assess the evolution of these differences from June 2020 (just after the lockdown) to nine months later (February-March 2021).

METHODS

This is a longitudinal prospective study of a representative sample of non-institutionalized Spanish adults, through computer-assisted telephone interviews. Mobility, self-care, usual activities, pain/discomfort and anxiety/depression problems were measured with EQ-5D-5L. Prevalence ratio (PR) between high and low education levels and adjusted PR were estimated by Poisson regression models. Analyses were stratified by gender.

RESULTS

A total of 2,000 participants answered both surveys. Individuals with low level of education reported more health problems in both genders, and absolute inequalities remained quite constant (mobility and self-care problems) or decreased (pain/discomfort and anxiety/depression problems). The greatest relative inequalities were observed just after the lockdown, with age-adjusted PR ranging from 1.31 (95%CI 1.08-1.59) for women and 1.34 (95%CI 1.05-1.69) for men in pain/discomfort to 2.59 (95%CI 0.98-6.81) for women and 4.03 (95%CI 1.52-10.70) for men in self-care; aPR decreased after nine months for most dimensions.

CONCLUSIONS

Prevalence of health problems increased during the COVID-19 pandemic in all education groups, but the increase was higher in women and men with a high level of education, suggesting that its impact appeared later in this group. Further analysis on the role of governmental economic aid given to vulnerable people might shed light on this evolution.

Gastrointestinal quality of life and bowel function in adults born with anorectal malformation and hirschsprung disease

PURPOSE

To assess the quality of life and disease-specific functioning of adults with anorectal malformations (ARM) or Hirschsprung disease (HD) compared to healthy reference scores.

METHODS

Patients with the diagnosis of ARM or HD from the Adult Colorectal Research Registry completed the Short Form 36 Health Survey (SF-36), the Gastrointestinal Quality of Life Index (GIQoLI), and the Bowel Function Score (BFS) between October 2019 and August 2022. One-sample Wilcoxon test compared the results to reported healthy references with a significance level of < 0.05.

RESULTS

The response rate was 67%. All three surveys were completed by 133 adults with a slight preponderance of males (51%). Median age was 31 years, 117 were born with ARM and 16 with HD. All subgroups had significantly lower BFS than healthy references. ARM patients scored significantly lower than the healthy reference population when assessed for GIQoL. All showed significant impairment with the mental component summary (MCS) of SF-36. Patients with a successful bowel management had significantly higher scores on all three questionnaires than those with fecal accidents.

CONCLUSION

Our results emphasize the importance of a successful bowel management and its impact on the quality of life and bowel function. Long-term follow-up is recommended with attention to mental health.