1
|
Rajpurohit S, Musunuri B, Mohan PB, Bhat G, Shetty S. Health-related Quality of Life in Patients With Liver Cirrhosis: A Randomized Study. J Clin Exp Hepatol 2024; 14:101433. [PMID: 38873593 PMCID: PMC11166871 DOI: 10.1016/j.jceh.2024.101433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/19/2024] [Indexed: 06/15/2024] Open
Abstract
Background/Aims Health-related quality of life (HRQoL) relates to how people perceive illness and treatment affects their physical health, emotional health, functional status, and social position. Along with clinical goals, HRQoL is significant. Therefore, the present study evaluates the effect of patient counseling and education on HRQoL of cirrhotic patients. Methods This prospective study was conducted in a tertiary care center of coastal Karnataka, Kasturba Medical College, Manipal, Karnataka from October 2022 with a three-month follow-up. Patients with a confirmed diagnosis of liver cirrhosis visiting the outpatient department of age ≥18 were enrolled in the study and divided on the basis of compensated and decompensated cirrhosis. Patients were randomized into two groups i.e., case and control in compensated and decompensated group through the envelop method of randomization. The case group received patient education and counseling along with standard medical therapy. CLDQ was used to evaluate HRQoL scores on baseline and after the third month. Results A total of 104 patients were enrolled with a mean age of 53.49 ± 11.25, with most being male (80.7%). Out of 104, 60 and 44 had compensated and decompensated cirrhosis. Case and control groups did not differ significantly on baseline. However, on follow-up, the compensated group showed significant improvement in abdominal symptoms, fatigue, and emotional functions. Meanwhile, the decompensated group showed significant improvement in activity, emotional function, and worry domain of CLDQ. Higher MELD scores were the significant factor associated with lower HRQoL scores. Conclusion Patient education and counseling positively impacted the fatigue, emotional, and worry domain of the CLDQ. Hence, the present study recommends making an effort to promote patient counseling and education via leaflets or videos.
Collapse
Affiliation(s)
- Siddheesh Rajpurohit
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Balaji Musunuri
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Pooja B. Mohan
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ganesh Bhat
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shiran Shetty
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
2
|
Gazder DP, Parvez SS, Gazder NP, Muqtadir J. Health-Related Quality of Life Assessment for Liver Cirrhosis Patients at a Tertiary Care Hospital in Karachi, Pakistan. Cureus 2024; 16:e53766. [PMID: 38465018 PMCID: PMC10922217 DOI: 10.7759/cureus.53766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/12/2024] Open
Abstract
Background The global health challenge of cirrhosis affects millions of individuals. Still, there is a notable lack of research on the health-related quality of life (HRQOL) of cirrhosis patients, especially in specific regions. This study aims to assess the impact of cirrhosis on HRQOL, including factors influencing it in a tertiary care setting in Pakistan. Methodology A cross-sectional study was conducted on a cohort of 115 patients diagnosed with cirrhosis, confirmed on imaging. HRQOL was measured using the short-form 36 (SF-36) survey. Furthermore, socioeconomic factors and self-rated health perceptions regarding HRQOL were recorded. Factors Influencing HRQOL domains in liver cirrhosis patients were also analyzed. Results Among 115 liver cirrhosis patients, 63.5% (N=73) were aged 40-60 years, and 73.9% (N=85) lived primarily in urban areas. HRQOL assessments highlighted moderate disability in physical functioning (62.6 ± 26.5) and notable impacts on mental health, emotional well-being, and bodily pain. Statistical analysis demonstrated the complexity of factors influencing HRQOL. Physical functioning was significantly associated with a higher Child-Turcotte-Pugh class, diabetes mellitus, hypertension, smoking status, and family monthly income (p-value < 0.05). While the duration of liver cirrhosis showed a significant association with bodily pain (p < 0.05). Additionally, residence status with social well-being (p-value = 0.01), and family monthly income with vitality (p-value < 0.05). Conclusion Our study in Pakistan highlights significant impacts on the HRQOL of liver cirrhosis patients, affecting physical function, mental health, emotional well-being, and bodily pain. Factors influencing HRQOL include liver disease severity, comorbidities, and socio-economic status. Recommendations include educational programs and specialized nursing care to address diverse challenges. The findings stress the importance of a personalized approach to patient care, urging urgent, targeted efforts to improve the health-related standard of life for cirrhotic patients.
Collapse
Affiliation(s)
- Darayus P Gazder
- Gastroenterology and Hepatology, Ziauddin University, Karachi, PAK
| | | | | | | |
Collapse
|
3
|
Teshome E, Hailu W, Adane A, Belayneh Melese E, Abebaw Angaw D, Tarekegn GE. Clinical and individual factors of quality of life of chronic liver disease patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia 2022. Medicine (Baltimore) 2023; 102:e35425. [PMID: 37960830 PMCID: PMC10637558 DOI: 10.1097/md.0000000000035425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/05/2023] [Indexed: 11/15/2023] Open
Abstract
Chronic liver disease (CLD) may be a major cause of morbidity and mortality worldwide, as well as a reduction in health-related quality of life. In Ethiopia, however, little is known about the effect of CLD on quality of life. The purpose of this study was to evaluate CLD patients' health-related quality of life and associated factors. A cross-sectional study was carried out on 227 CLD patients who were being followed up on at the University of Gondar specialized hospital between January 2022 and February 2022. To assess health-related quality of life, the chronic disease Questionnaire was used. Epi-Data version 4.6 was used to enter data, and SPSS version 25 was used for all statistical analysis. To identify factors associated with the outcome variable, a linear regression model was used. Patients with CLD had significantly lower mean scores in all domains of health-related quality of life. Hepatitis B virus treatments and a college education or higher have a positive effect on all domains of health-related quality of life. Upper gastrointestinal bleeding, spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), and ascites were a clinical related factors significantly associated with poor health-related quality of life in simple linear regression. In this study setting, all dimensions of health-related quality of life of patients with CLD were compromised. Antiviral treatment for HBV infection, beta-blocker treatment, and the presence of complications such as ascites were all found to be significantly related to health-related quality of life. This necessitates going above and beyond standard treatments to improve patients' quality of life with CLD.
Collapse
Affiliation(s)
- Eliud Teshome
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Workagegnehu Hailu
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aynishet Adane
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Belayneh Melese
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekegn
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
4
|
Singh S, Taneja S, Roy A, Rathi S, De A, Verma N, Premkumar M, Duseja A, Dhiman RK, Singh V. Simple bedside tests of muscle strength and function correlate with computed tomography-skeletal muscle index for assessment of sarcopenia in cirrhosis. Indian J Gastroenterol 2023; 42:379-387. [PMID: 37222972 DOI: 10.1007/s12664-023-01338-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 12/30/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Sarcopenia assessment can be done by skeletal muscle index (SMI) or bedside tests such as handgrip strength (HGS) and gait speed (GS). GOALS This study evaluated the correlations of HGS and GS with SMI, health-related quality of life (HRQOL) and cognition and assessed them as predictors of mortality. STUDY As many as 116 outpatients with cirrhosis were included in this prospective cohort study. Assessment for sarcopenia was done by SMI, HGS and GS. HRQOL was assessed using the chronic liver disease questionnaire (CLDQ) and fatigue severity scale (FSS). Cognition was assessed by mini-mental state examination (MMSE). Correlations of HGS and GS with SMI, HRQOL and cognition were analyzed. Area under the curve (AUCs) were calculated to compare them as predictors of mortality. RESULTS Alcoholic liver disease (47.4%) was the commonest etiology of cirrhosis followed by hepatitis C (12.9%). Sarcopenia was diagnosed in 64 (55.2%) patients. A strong correlation was seen between SMI and HGS (ρ = 0.78) and GS (ρ = 0.65). AUCs of GS (0.91 (95% confidence interval [CI], 0.85-0.96) was maximum, followed by HGS (95% CI, 0.86 [0.78-0.93] and SMI [95% CI, 0.8 0.71-0.88]) in predicting mortality (p > 0.05). CLDQ (3.2 vs. 5.6, p < 0.01) and MMSE scores (24.3 vs. 26.3, p < 0.01) were lower, whereas FSS score (5.7 vs. 3.1, p < 0.01) was higher in patients with sarcopenia. CLDQ (ρ = 0.83) and MMSE (ρ = 0.73) showed the strongest correlation with HGS, whereas FSS correlated well (ρ = 0.77) with GS. CONCLUSIONS Bedside tests of muscle strength and function, including HGS and GS, correlate strongly with SMI for sarcopenia assessment and prediction of mortality in patients with cirrhosis.
Collapse
Affiliation(s)
- Surender Singh
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
| | - Akash Roy
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Sahaj Rathi
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Arka De
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Nipun Verma
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - R K Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Virendra Singh
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| |
Collapse
|
5
|
Jelić I, Mihajlović G, Mihajlović F, Minić N, Ratinac M, Pantović-Stefanović M. COPD and Depression Analysis in Regard to Obstructive Pulmonary Levels. Healthcare (Basel) 2023; 11:healthcare11081175. [PMID: 37108009 PMCID: PMC10138090 DOI: 10.3390/healthcare11081175] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Depression symptoms take place recurrently in patients suffering from COPD. This study aims to assess the effects of antidepressant therapy in patients with COPD and a depressive disorder in relation to COPD levels. The study population consisted of N = 87 patients diagnosed with COPD, according to the GOLD criteria, and a depressive disorder. All of the patients were subjected to clinical and psychiatric exploration according to psychiatric assessment instruments, which was followed by SSRI therapy for the duration of 8 weeks. The main methods used were descriptive statistics and analysis of variance. The results showed a different distribution of depressive symptoms at a different stage of COPD by FEV1 (χ2 = 30.47, df = 6, p < 0.01) and by mMRC (χ2 = 34.6, df = 6, p < 0.01). After the application of SSRIs, there was a significant improvement in HDRS scores in all stages of COPD by FEV1 (χ2 = 251.62, df = 9, p < 0.01) and by mMRC (χ2 = 919.17, df = 9, p < 0.01). This study contributes to the improvement in the quality of life of patients by the targeted application of SSRI therapy and, therefore, more precise and better overall treatment results.
Collapse
Affiliation(s)
- Ivana Jelić
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Goran Mihajlović
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Clinic of Psychiatry, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
| | - Filip Mihajlović
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Nataša Minić
- Clinic of Psychiatry, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
| | - Miloš Ratinac
- Clinic of Pulmonology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
| | - Maja Pantović-Stefanović
- Faculty of Medicine, Department of Psychiatry, University of Belgrade, 11000 Belgrade, Serbia
- Clinic of Psychiatry, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| |
Collapse
|
6
|
Su WC, Chen TT, Yang SS, Shih LN, Liu CK, Wang CC, Wu CH. The effect of a pay-for-performance program on health-related quality of life for patients with hepatitis in Taiwan. Health Qual Life Outcomes 2022; 20:130. [PMID: 36064530 PMCID: PMC9446742 DOI: 10.1186/s12955-022-02038-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 06/13/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose Chronic viral hepatitis is a major global public health problem. The guidelines suggest the long-term performance of regular ongoing liver examinations to monitor liver inflammation and screen for hepatocellular carcinoma. However, the effects of regular liver examinations on health-related quality of life (HRQoL) have not been adequately evaluated. Therefore, this study evaluated the effects of regular ongoing examinations on the quality of life of patients with hepatitis.
Methods A cross-sectional study was conducted from October to December 2016 in four hospitals in northern Taiwan. A hepatitis pay-for-performance (P4P) program was launched in 2010 to ensure that hepatitis patients have regular ongoing liver examinations. The study group consisted of patients who joined and stayed in the program for more than one year. The study assessed HRQoL utilizing the five-level version of the EuroQol-5 Dimension (EQ-5D-5L) and the EuroQoL visual analog scale (EQ-VAS). The responses for the EQ-5D-5L in hepatitis patients were transformed into the EQ-5D index according to the Taiwanese population’s value set. Sociodemographic and clinical characteristics were collected by questionnaire, and descriptive statistics were presented. A two-part model and generalized linear model with a Poisson distribution and a log link function, respectively, were used to examine the associations of the EQ-5D index and EQ-VAS score with participation in the hepatitis P4P program. We applied propensity score weighting with inverse probability weighting to control for selection bias. Results In all, 508 patients (aged 57.6 ± 11.6 years; 60.8% male) were enrolled in this study. The mean (standard deviation, SD) reported EQ-5D index and EQ-VAS scores were 0.93 (0.12) and 75.1 (13.8), and the median (interquartile range, IQR) values were 1 (0.108) and 80 (15), respectively. The study group had a moderately significantly higher EQ-VAS score (mean ratio = 1.029, P < 0.001). However, the differences in the EQ-5D index scores between the study and control groups were not significant. Conclusion Patients with hepatitis partially benefited from receiving hepatitis P4P in Taiwan, which featured regular ongoing liver examinations, in that their EQ-VAS scores were enhanced but not their EQ-5D index scores.
Collapse
Affiliation(s)
- Wei-Chih Su
- Department of Gastroenterology, Buddhist Tzu Chi Medical Foundation, Taipei Tzu-Chi Hospital, New Taipei City, Taiwan.,Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Tsung-Tai Chen
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Sien-Sing Yang
- Liver Unit, Cathay General Hospital Medical Center, Taipei, Taiwan.,School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Ling-Na Shih
- Lo-Sheng Sanatorium Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.,Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Chih-Kuang Liu
- Department of Urology, Fu-Jen Catholic University Hospital, New Taipei City, Taiwan.,Graduate Institute of Business Administration and College of Medicine, Fu-Jen, Catholic University, New Taipei City, Taiwan
| | - Chia-Chi Wang
- Department of Gastroenterology, Buddhist Tzu Chi Medical Foundation, Taipei Tzu-Chi Hospital, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chien-Hsien Wu
- Lo-Sheng Sanatorium Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan. .,Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
| |
Collapse
|
7
|
Cunha-Silva M, Neto FLP, de Araújo PS, Pazinato LV, Greca RD, Secundo TML, Imbrizi MR, Monici LT, Sevá-Pereira T, Mazo DF. EncephalApp Stroop Test validation for the screening of minimal hepatic encephalopathy in Brazil. Ann Hepatol 2022; 27:100543. [PMID: 34571266 DOI: 10.1016/j.aohep.2021.100543] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/24/2021] [Accepted: 05/04/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES The EncephalApp Stroop Test was developed to more easily diagnose minimal hepatic encephalopathy (MHE). A cut-off of >274.9sec (ONtime+OFFtime) reached a 78% sensitivity and 90% specificity in the validation study, but it has been poorly studied in Brazil. We aim to analyze the usefulness of this diagnostic method and to describe a cut-off value to screen MHE in Brazil. METHODS In this cross-sectional and single-center study, three positive psychometric tests defined the diagnosis of MHE as the gold standard. We evaluated gender, age, education, familiarity with smartphones, etiology of cirrhosis, Child-Pugh/MELD scores, and previous hepatic encephalopathy (HE). Healthy controls and patients without HE were compared for the task validation. The Chi-square and Mann-Whitney tests, logistic regression analysis, and ROC curves were used for statistical evaluation. RESULTS We included 132 patients with cirrhosis (61% male) and 42 controls (62% male) around 51y. Sixty-three were diagnosed with MHE on psychometric tests and 23 had clinical HE. Viral hepatitis (38%) was the major etiology of cirrhosis. The median MELD was 10 and Child-Pugh A was more frequent (70%). There was no significant difference in test results between controls and patients without HE. There was also no influence of gender, age, education, and familiarity with smartphones in the test results. Child-Pugh A was associated with MHE (p=0.0106). A cut-off of >269.8sec (ONtime+OFFtime) had an 87% sensitivity and 77% specificity to detect MHE (p=0.002). CONCLUSION This is a valid and reliable tool for screening MHE. However, optimal cut-off values need to be validated locally.
Collapse
Affiliation(s)
- Marlone Cunha-Silva
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil.
| | - Fernando L Ponte Neto
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Priscila S de Araújo
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Lucas V Pazinato
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Raquel D Greca
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Tirzah M L Secundo
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Marcello R Imbrizi
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Leonardo T Monici
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Tiago Sevá-Pereira
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil
| | - Daniel F Mazo
- Division of Gastroenterology (Gastrocentro), University of Campinas (Unicamp), Campinas, Brazil; Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, University of São Paulo School of Medicine (FMUSP), Sao Paulo, Brazil
| |
Collapse
|
8
|
D'Alessandro MCDO, Gomes AD, Morais JF, Mizubuti YGG, Silva TAD, Fernandes SM, Mendes LL, Correia MITD, Generoso SDV. SHORT-TERM EFFECT OF WHEY PROTEIN SUPPLEMENTATION ON THE QUALITY OF LIFE OF PATIENTS WAITING FOR LIVER TRANSPLANTATION: A DOUBLE BLINDED RANDOMIZED CLINICAL TRIAL. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2021; 34:e1596. [PMID: 34669886 PMCID: PMC8521869 DOI: 10.1590/0102-672020210002e1596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/10/2021] [Indexed: 11/29/2022]
Abstract
Background:
Chronic liver disease is associated with malnutrition that negatively impacts a patient’s health-related quality of life (HRQoL).
Aim:
To evaluate the short-term effect of whey protein supplementation on the HRQoL and nutritional and functional status of patients waiting for liver transplantation.
Methods:
This was a double-blind randomized clinical trial with patients waiting for liver transplantation who were randomized into two groups: WP (whey protein supplementation) and the control (casein supplementation). Both groups received 40 g (20 g in the morning and 20 g in the evening) for 15 days. Nutritional and functional status were evaluated. Energy balance was calculated as the difference between energy intake (24-hour recall) and total energy expenditure (assessed by indirect calorimetry). The chronic liver disease questionnaire was used to assess HRQoL. All measurements were performed before and after the intervention.
Results:
Fifty-six patients were evaluated. Malnutrition was present in 56.9%, and it was directly associated with a poor HRQoL (p<0.05). No improvement on the nutritional and functional status was observed, in either group after protein supplementation. HRQoL improved after WP and casein supplementation, with no differences between groups (p>0.05). Patients who met protein requirements and had a positive energy balance demonstrated a higher HRQoL score (4.9, p<0.05), without between-group differences.
Conclusion:
Malnutrition substantially reduces HRQoL. Short-term WP or casein supplementation improved similarly the HRQoL.
Collapse
Affiliation(s)
| | - Amanda Dias Gomes
- Pharmacy School/Food of Science Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Jéssica França Morais
- Nursing School, Department of Nutrition/Nutrition and Health Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Thales Antônio da Silva
- Pharmacy School/Food of Science Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Silvia Mauricio Fernandes
- Faculty of Medicine, Department of Surgery/Surgery and Ophthalmology Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Larissa Loures Mendes
- Nursing School, Department of Nutrition/Nutrition and Health Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Simone de Vasconcelos Generoso
- Nursing School, Department of Nutrition/Nutrition and Health Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
9
|
Gazineo D, Godino L, Bui V, El Mouttaqi L, Franciosi E, Natalino A, Ceci G, Ambrosi E. Health-related quality of life in outpatients with chronic liver disease: a cross-sectional study. BMC Gastroenterol 2021; 21:318. [PMID: 34364363 PMCID: PMC8349052 DOI: 10.1186/s12876-021-01890-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 07/25/2021] [Indexed: 01/16/2023] Open
Abstract
Background The symptoms and complications related to chronic liver disease (CLD) have been shown to affect patient well-being. Currently there is limited research data on how CLD severity may affect both health-related quality of life (HRQOL) and the development of depressive symptoms in CLD patients. Moreover, the ongoing advances in CLD treatment, and its effect on HRQOL, highlight the need for further studies. Therefore, the aim of the present study was to evaluate if the CLD severity may affect the HRQOL and the development of depressive symptoms. Methods A cross-sectional study was conducted. Patients with CLDs were identified at their regular visits to the outpatient clinic of the Sant’Orsola-Malpighi Hospital in Bologna, between September 2016 and July 2017. HRQOL was measured with Short Form 12 (SF-12) and Nottingham Health Profile (NHP) questionnaires; depressive symptoms were measured with Beck Depression Inventory-II (BDI). CLD severity was measured using the MELD score and the sample was stratified into five classes according to it. Group comparisons were conducted using the Kruskal–Wallis test. Results Two hundred and fifty-four patients were included. Mean age was 62.84 years (SD 11.75) and 57.9% were male. Most participants were affected by compensated cirrhosis (140.2%) and chronic hepatitis (40.2%), with a disease duration ≥ 5 years (69.3%). Regarding the MELD score, 67.7% of patients belonged to Class I, 29.9% to Class II, and 2.4% to Class III. There were not patients belonging to the Classes IV and V. No statistically significant differences were found in all SF-12 and NHP domains between the MELD classes, except for CLD impact on sexual life and holidays (p = 0.037 and p = 0.032, respectively). A prevalence rate of 26% of depressive symptoms was reported, no statistically significant differences were found in BDI-II total scores between the three MELD classes. Conclusions All domains of HRQOL and depression were altered in CLDs patients, nevertheless CLD severity was not confirmed as an affecting factor for HRQOL.
Collapse
Affiliation(s)
- Domenica Gazineo
- Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, Italy
| | - Lea Godino
- Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, Italy
| | - Virna Bui
- Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, Italy
| | - Latifa El Mouttaqi
- Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, Italy
| | | | | | - Grazia Ceci
- Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, Italy
| | - Elisa Ambrosi
- Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie 8, Istituti Biologici Blocco B, 37134, Verona, Italy.
| |
Collapse
|
10
|
Ozawa N, Sato K, Sugimura A, Maki S, Tanaka T, Yamamoto K, Ito T, Ishizu Y, Kuzuya T, Honda T, Ishigami M, Fujishiro M, Ishikawa T, Ando S. Quality of Life in patients with nonalcoholic fatty liver disease: Structure and related factors focusing on illness uncertainty. Jpn J Nurs Sci 2021; 18:e12415. [PMID: 33709507 DOI: 10.1111/jjns.12415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 12/22/2022]
Abstract
AIM Patients with nonalcoholic fatty liver disease (NAFLD) have a low quality of life (QOL) and illness uncertainty. This study examined the structure of QOL and associated factors, including illness uncertainty, among individuals with NAFLD. METHODS A cross-sectional survey was conducted using a self-administered questionnaire for outpatients with NAFLD. QOL was measured using the Short Form-8. Dietary habits, physical activity level, illness uncertainty, health locus of control, and knowledge of NAFLD were assessed. Path analysis was used to study the associated factors of QOL and their structure, including uncertainty of disease. RESULTS Path analysis of 168 NAFLD patients indicated that a high Physical Component Summary score on the Short Form-8-representing physical QOL-was predicted by a body mass index <25 kg/m2 and high educational level. A high Mental Component Summary score-representing mental QOL-was predicted by being male, good dietary habits, low illness uncertainty, and presence of consultants. The model showed satisfactory goodness-of-fit without being rejected by the chi-square test (goodness-of-fit index = .947, adjusted goodness-of-fit index = .917, comparative fit index = .967, root mean square error of approximation = 0.023). CONCLUSIONS Nurses need to work closely with NAFLD patients as consultants, providing adequate information about the causes, treatments, and dietary habits, and focusing on the individual's perception of health. This could reduce illness uncertainty and contribute to the improvement of QOL.
Collapse
Affiliation(s)
- Naoki Ozawa
- Department of Nursing, Doctoral Course, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuki Sato
- Nursing for Advanced Practice, Division of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayumi Sugimura
- Nursing for Advanced Practice, Division of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Taku Tanaka
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenta Yamamoto
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takanori Ito
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoji Ishizu
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Teiji Kuzuya
- Department of Gastroenterology and Gastroenterological Oncology, Fujita Health University, Japan
| | - Takashi Honda
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masatoshi Ishigami
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Ishikawa
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shoko Ando
- Nursing for Advanced Practice, Division of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
11
|
Machado JÚnior PAB, Ziliotto RD, Ferreira APVN, Buson TM, Couto CMD, Pissaia Junior A. USE OF THE STROOP ENCEPHALAPP FOR COVERT HEPATIC ENCEPHALOPATHY SCREENING IN CIRRHOTIC PATIENTS IN SOUTHERN BRAZIL. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:399-403. [PMID: 33237215 DOI: 10.1590/s0004-2803.202000000-73] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Covert hepatic encephalopathy (CHE) is difficult to detect due to the lack of easily applicable screening tools. The Stroop EncephalApp is a smartphone application already validated for CHE screening. However, its applicability to the Brazilian population is not known. OBJECTIVE To estimate the prevalence of CHE and evaluate the use of Stroop EncephalApp in a cirrhotic population in Brazil. METHODS In this cross-sectional study, we evaluated 99 patients previously diagnosed with liver cirrhosis in a Private Hospital in Curitiba/PR. Patients were initially submitted to the mini mental state examination (MMSE) to exclude individuals with dementia. After, the Psychometric Hepatic Encephalopathy Score (PHES) test was performed and lastly, the Stroop EncephalApp test. Results were adjusted for age, sex and education levels to evaluate the accuracy of the app on detecting the disease, comparing its results with the gold standard method (PHES). Patients with one or more of the following were excluded: dementia, inadequate MMSE score, illiteracy, color blindness, history of drugs/alcohol abuse within the past 3 months and previous or actual episodes of encephalopathy. The statistical analysis was performed by SPSS 2.0 and the significance adopted by 5%. RESULTS We included 82 individuals in the final analysis. Among these patients, 29 were diagnosed with CHE by the PHES test (35.36% prevalence) and 28 of those obtained equal diagnosis by the Stroop EncephalApp (96.6% sensitivity). A total of 53 patients obtained negative results for CHE by PHES, while the Stroop test classified 27 of them as having the disease. In the multivariate analysis, high levels of education were associated with better performance during the tests. No significant relationship was observed between age and sex with the probability of diagnosing CHE through the PHES test.
Collapse
Affiliation(s)
| | - Rafaela Deneka Ziliotto
- Pontifícia Universidade Católica do Paraná (PUCPR), Escola de Medicina, Curitiba, PR, Brasil
| | | | - Thiago Mesquita Buson
- Pontifícia Universidade Católica do Paraná (PUCPR), Escola de Medicina, Curitiba, PR, Brasil
| | | | - Alcindo Pissaia Junior
- Pontifícia Universidade Católica do Paraná (PUCPR), Escola de Medicina, Curitiba, PR, Brasil.,Hospital Nossa Senhora das Graças (HNSG), Serviço de Hepatologia, Curitiba, PR, Brasil
| |
Collapse
|
12
|
Pradhan RR, Kafle Bhandari B, Pathak R, Poudyal S, Anees S, Sharma S, Khadga P. The Assessment of Health-Related Quality of Life in Patients With Chronic Liver Disease: A Single-Center Study. Cureus 2020; 12:e10727. [PMID: 33145133 PMCID: PMC7599056 DOI: 10.7759/cureus.10727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Aim The aim of this study was to investigate the factors affecting health-related quality of life (HRQOL) in Nepalese patients with chronic liver disease (CLD). Methods In this study, HRQOL was measured with validated Nepali versions of the short-form 36 (SF-36) survey. Socioeconomic factors, etiology, laboratory parameters, disease severity, and self-rated health perceptions on HRQOL were recorded for analysis. Results Sixty CLD patients were enrolled in the study. The following HRQOL scores were obtained: physical functioning (PF) (34.4 ±26.7), role limitation due to physical health (RLPH) (7.5 ±17.8), role limitation due to emotional problems (RLEP) (27.7 ±38.2), energy or fatigue (E/F) (38.5 ±21.5), emotional well-being (EWB) (57.7 ±22.8), social functioning (SF) (55.2 ±23.5), pain (44.8 ±30.3), and general health (GH) (38.2 ±17). Employed status and higher annual family income had a positive impact on HRQOL. Ascites and abnormal upper gastrointestinal endoscopic findings were associated with poor health status perceptions. More severe disease (higher Child-Pugh class) was associated with lower HRQOL scores. A significant negative correlation between the model for end-stage liver disease (MELD) score and HRQOL domains was observed (p: <0.05). Age, gender, religion, education, and duration of the diagnosis of CLD had no effect on HRQOL of CLD patients. Conclusion HRQOL in patients with CLD was lower than that in the general population. Unemployed status, low annual family income, ascites, abnormal upper gastrointestinal endoscopic findings, and higher Child-Pugh class and MELD scores were important factors that adversely affected HRQOL.
Collapse
Affiliation(s)
- Ravi R Pradhan
- Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL
| | | | - Rahul Pathak
- Gastroenterology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, NPL
| | - Sagar Poudyal
- Gastroenterology, KIST Medical College, Kathmandu, NPL
| | - Shahbaz Anees
- Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL
| | - Sashi Sharma
- Gastroenterology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, NPL
| | - Prem Khadga
- Gastroenterology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, NPL
| |
Collapse
|
13
|
Abstract
OBJECTIVES Patients with cirrhosis experience a worsened quality of life; this may be quantified by the use of health-related QoL (HRQoL) constructs, such as the chronic liver disease questionnaire (CLDQ) and EuroQoL Group-visual analog scale (EQ-VAS). In this multicenter prospective study, we aimed to evaluate HRQoL as a predictor of unplanned hospital admission/early mortality, identify HRQoL domains most affected in cirrhosis, and identify predictors of low HRQoL in patients with cirrhosis. METHODS Multivariable logistic regression was used to determine independent association of HRQoL with primary outcome and identify predictors of low HRQoL. HRQoL was also compared with population norms. RESULTS In this cohort of 402 patients with cirrhosis, mean model for end-stage liver disease was 12.5 (4.9). More than 50% of the cohort had low HRQoL, considerably lower than population norms. HRQoL (measured by either CLDQ or EQ-VAS) was independently associated with the primary outcome of short-term unplanned hospitalization/mortality. Every 1-point increase in the CLDQ and every 10-point increase in the EQ-VAS reduced the risk of reaching this outcome by 30% and 13%, respectively. Patients with cirrhosis had lower HRQoL scores than population norms across all domains of the CLDQ. Younger age, female sex, current smoker, lower serum albumin, frailty, and ascites were independently associated with low CLDQ. DISCUSSION Patients with cirrhosis experience poor HRQoL. HRQoL is independently associated with increased mortality/unplanned hospitalizations in patients with cirrhosis and could be an easy-to-use prognostic screen that patients could complete in the waiting room before their appointment.
Collapse
|
14
|
Chiu E, Marr K, Taylor L, Lam L, Stapleton M, Tandon P, Raman M. Malnutrition Impacts Health-Related Quality of Life in Cirrhosis: A Cross-Sectional Study. Nutr Clin Pract 2019; 35:119-125. [PMID: 30806489 DOI: 10.1002/ncp.10265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To explore the influence of nourishment state measured by various nutrition assessment tools (NATs) on health-related quality of life (HRQoL) in a pretransplant population with cirrhosis. METHODS We collected demographic, nutrition assessment, and disease specific data on 81 patients. HRQoL was measured with the Short-Form 36 and divided into 8 subscales. Significant relationships between NATs and HRQoL were examined using independent sample t-tests, χ2 analyses, correlations, and multiple and logistic regression adjusted for age and gender. RESULTS Study mean age was 54.2 years (SD 10.4 years), and 57% were male. Subjective Global Assessment (SGA) was significantly related to all HRQoL subscales, except bodily pain and mental health. In the adjusted regression models, general health, vitality, and social functioning were all significantly lower in patients with poorer nutrition status measured using SGA (adjusted R2 = 11%, β = -0.34, p < 0.01; adjusted R2 = 8%, β = -0.27, P < 0.05; and adjusted R2 = 12%, β = -0.38, P < 0.01, Q4 respectively). Physical functioning improved as hand grip strength increased (adjusted R2 = 20%, β = 0.36, P < 0.01). MELDNa demonstrated a significant negative relationship with role-emotional (adjusted R2 = 3%, β = 0.25, P < 0.05), and mid-arm circumference did not demonstrate any significant relationships with HRQoL. CONCLUSIONS Malnutrition assessed by SGA is associated with lower HRQoL in patients with cirrhosis. Future research should identify if nutrition interventions can effectively improve HRQoL in cirrhosis patients.
Collapse
Affiliation(s)
- Elaine Chiu
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kaleb Marr
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lorian Taylor
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Louisa Lam
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Health Services, Calgary, Alberta, Canada
| | - Melanie Stapleton
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Puneeta Tandon
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
15
|
Kim HJ, Chu H, Lee S. Factors influencing on health-related quality of life in South Korean with chronic liver disease. Health Qual Life Outcomes 2018; 16:142. [PMID: 30021601 PMCID: PMC6052687 DOI: 10.1186/s12955-018-0964-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/02/2018] [Indexed: 01/12/2023] Open
Abstract
Background The objective of this study was to determine health-related quality of life (HRQoL) among chronic liver disease (CLD) subjects in South Korea using EuroQol five-dimension questionnaire (EQ-5D). Method The sample consisted of 139 subjects with CLD from the sixth Korean National Health and Nutrition Examination Survey (KNHNES VI). Data were analyzed using SPSS program for descriptive statistics, t-test, ANOVA, Scheffe’s test and hierarchical multiple regression. Results Results indicated that marital status (P < 0.01), occupation (P < 0.01), basic livelihood security recipient status (P < 0.05), hepatocellular carcinoma (P < 0.05), subjective health status (P < 0.01), and depression (P < 0.001) were significant predictors of HRQoL. Health behaviors (alcohol intake, sleep duration) variables were insignificant. Conclusion In conclusion, marital status, occupation, basic livelihood security recipient status (BLSRS), hepatocellular carcinoma (HCC), subjective health status (SHS), and depression were confirmed to be factors affecting the HRQoL. We should be provide to continuous monitoring and education of adequate alcohol intake for patients with CLD. Findings of this study might be used to develop community based health programs and policies for CLD.
Collapse
Affiliation(s)
- Hyun Jin Kim
- Department of Quality Improvement, Hanyang University Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Hyeonsik Chu
- Hanyang Cell Therapy Center, Hanyang University Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Seonhye Lee
- Department of Nursing, Gyeongnam National University of Science and Technology, 33, Dongjin-ro, Jinju-si, Gyeongsangnam-do, 52725, Republic of Korea.
| |
Collapse
|
16
|
Patient Views on Advance Care Planning in Cirrhosis: A Qualitative Analysis. Can J Gastroenterol Hepatol 2018; 2018:4040518. [PMID: 30079330 PMCID: PMC6069582 DOI: 10.1155/2018/4040518] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 02/20/2018] [Indexed: 02/07/2023] Open
Abstract
AIM To investigate patient experiences and perceptions of advance care planning (ACP) process in cirrhosis. METHODS Purposive sampling was used to identify and recruit participants (N = 17) from discrete patient groups: compensated with no prior decompensation, decompensated and not yet listed for transplant, transplant wait listed, medical contraindications for transplant, and low socioeconomic status. Review and discussion of local ACP videos, documents, and experiences with ACP occurred in two individual interviews and four focus groups. Data were analyzed using inductive content analysis including iterative processes of open coding, categorization, and abstraction. RESULTS Three overarching categories emerged: (1) lack of understanding about disease trajectories and ACP processes, (2) roles of alternate decision makers, and (3) preferences for receiving ACP information. Most patients desired advanced care-planning conversations before the onset of decompensation (specifically hepatic encephalopathy) with a care provider with whom they had a trusting, preexisting relationship. Involvement of the alternate decision makers was of critical importance to participants, as was the use of direct, easy to understand patient education tools that address practical issues. CONCLUSION Our findings support the need for early advance care planning in the outpatient setting. Outpatient clinicians may play a key role in facilitating these discussions.
Collapse
|
17
|
Horváth G, Keleti T, Makara M, Ungvari GS, Gazdag G. Effect of hepatitis C infection on the quality of life. Perspect Psychiatr Care 2018. [PMID: 29528505 DOI: 10.1111/ppc.12269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To assess the quality of life (QoL) of patients with hepatitis C infection (HCI) and its correlations with demographic and clinical variables. DESIGN AND METHODS QoL and depressive symptoms were evaluated with the validated rating instruments of the 36-item short form (SF-36) generic health survey and the second version of the self-rated Beck depression inventory (BDI-II) in a cross-sectional design and correlated with basic demographic and clinical variables, including the Fibroscan score, which indicates the severity of liver impairment. FINDINGS A cohort of 60 HCI patients who participated in the study scored lower than the general population on all domains of the SF-36. In the multivariate correlation analysis, only the physical functioning domain of the SF-36 showed a significant correlation with age, gender, and BD-II and Fibroscan scores. IMPLICATIONS FOR CLINICAL PRACTICE QoL is lower for patients who are older, female, and have depressive symptoms. Progression of hepatic cirrhosis is associated with lower QoL in the physical domain.
Collapse
Affiliation(s)
- Gergely Horváth
- Hungarian Drug Focal Point, National Center for Epidemiology, Budapest, Hungary
- School of Doctoral Studies, Semmelweis University, Budapest, Hungary
| | - Teodóra Keleti
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Mihály Makara
- Hepatology Outpatient Clinic, Szent István and Szent László Hospitals, Budapest, Hungary
| | - Gabor S Ungvari
- Notre Dame University Australia, Perth, Australia
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Gábor Gazdag
- 1st Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc Hospital, 1204 Budapest, Koves ut 1, Hungary
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| |
Collapse
|
18
|
Warsi I, Younus A, Rasheed A, Ahmed J, Mahida H, Hashmi R, Qureshi A. Oral health-related quality of life in patients with upper gastrointestinal and hepatic disorders in Pakistan: validation of the Oral Health Impact Profile-14 in the Urdu language. BDJ Open 2018; 4:17036. [PMID: 30057791 PMCID: PMC5944343 DOI: 10.1038/s41405-018-0002-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/01/2018] [Accepted: 02/05/2018] [Indexed: 12/16/2022] Open
Abstract
Introduction The Oral Health Impact Profile (OHIP-14) has been used extensively to measure the impact of oral disease on oral health-related quality of life (HRQoL) but has not been validated in the Urdu language or tested in gastroenterology. Aims To validate the OHIP-14 for use in Pakistan and its ability to assess oral health in patients with upper gastrointestinal (GI) and hepatic disorders. Design Multicentre, cross-sectional. Setting Four major tertiary care hospitals. Methods The OHIP-14 was tested for reliability and validity in 700 patients referred for oesophago-gastro-duodenoscopic (OGD) investigation of the symptoms of upper GI or hepatic disease. Socio-demographic details and oral examination findings (for oral lesions and DMFT) were recorded. Results The mean (±standard deviation) total OHIP-14 score (range 0–56) was estimated to be 23.38 ± 10.47, indicating a significant impact of upper gastrointestinal and hepatic disorders on oral health. The reliability coefficient of the OHIP-14 was above 0.7 threshold, and the tool had good internal consistency (α = 0.83). When associated with worsening DMFT (decayed, missed, and filled teeth) index value, the highest correlations (p < 0.01) were detected with functional limitation (rs = 0.234), physical disability (rs = 0.230), and psychological discomfort (rs = 0.221). Conclusion The OHIP-14 is a precise and valid instrument for assessing oral-HRQoL in a gastroenterological setting amongst Pakistani population.
Collapse
Affiliation(s)
- Ibrahim Warsi
- 1Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Anjum Younus
- 2Department of Community Dentistry, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Abdur Rasheed
- 3Department of Research, Dow University of Health Sciences, Karachi, Pakistan
| | - Javeria Ahmed
- 1Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Hafsa Mahida
- 4Ziauddin College of Dentistry, Ziauddin University Hospital, Karachi, Pakistan
| | - Rimsha Hashmi
- Department of Operative Dentistry, Rehmat Memorial Dental Hospital, Abbottabad, Pakistan
| | - Ambrina Qureshi
- 2Department of Community Dentistry, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| |
Collapse
|
19
|
GuimarãesSá AM, Ferreira PAM, Souza MT, Nascimento GC, da Silva Pereira Damianse S, de Carvalho Rocha VC, dos Santos Faria M, de Souza Paiva Ferreira A. Higher Income and Integration into the Workforce Are the Main Factors Associated with Quality of Life in Acromegalic Patients in Northeastern Brazil. Int J Endocrinol 2018; 2018:6135080. [PMID: 29681935 PMCID: PMC5848138 DOI: 10.1155/2018/6135080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/14/2017] [Accepted: 01/10/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To identify the factors associated with quality of life in patients with acromegaly with follow-up at the referral service in neuroendocrinology of the state of Maranhão, northeast Brazil. METHODS The Acromegaly Quality of Life Questionnaire (Acro-QoL) was used. Factors independently associated with quality of life were identified using multivariate linear regression, with p values < 0.05 considered significant. RESULTS The multivariate linear regression analysis indicated a positive association between being integrated into the job market and quality of life scores in the overall domain (β = 0.288, p = 0.003), psychological domain (β = 0.291, p = 0.032), and personal relationship domain (β = 0.314, p = 0.019). We also observed a positive association with income and the quality of life scores in all domains as follows: overall domain (β = 0.037, p = 0.003), physical domain (β = 0.988, p = 0.001), psychological domain (β = 0.342, p = 0.008), physical appearance domain (β = 0.270, p = 0.049), and personal relationship domain (β = 0.315, p = 0.012). CONCLUSION For patients with acromegaly living in one of the least developed regions of Brazil, integration into the job market and a higher income were associated with a better quality of life.
Collapse
Affiliation(s)
- Adriana Maria GuimarãesSá
- Graduate Program in Public Health, Department of Public Health, The Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | | | | | - Gilvan Cortês Nascimento
- Presidente Dutra University Hospital of The Federal University of Maranhão (HUUPD-UFMA), São Luís, MA, Brazil
| | | | | | - Manuel dos Santos Faria
- Graduate Program in Child and Adult Health, Department of Medicine, UFMA, São Luís, MA, Brazil
| | | |
Collapse
|
20
|
Alt Y, Grimm A, Schlegel L, Grambihler A, Kittner JM, Wiltink J, Galle PR, Wörns MA, Schattenberg JM. The Impact of Liver Cell Injury on Health-Related Quality of Life in Patients with Chronic Liver Disease. PLoS One 2016; 11:e0151200. [PMID: 26990427 PMCID: PMC4798400 DOI: 10.1371/journal.pone.0151200] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/24/2016] [Indexed: 12/20/2022] Open
Abstract
Background Patients with chronic liver disease often suffer from unspecific symptoms and report severe impairment in the quality of life. The underlying mechanisms are multifactorial and include disease-specific but also liver related causes. The current analysis evaluated the association of hepatocellular apoptosis in non-viral chronic liver disease and health-related quality of life (HRQL). Furthermore we examined factors, which influence patient's physical and mental well-being. Methods A total of 150 patients with non-infectious chronic liver disease were included between January 2014 and June 2015. The German version of the Chronic Liver Disease Questionnaire (CLDQ-D), a liver disease specific instrument to assess HRQL, was employed. Hepatocellular apoptosis was determined by measuring Cytokeratin 18 (CK18, M30 Apoptosense ELISA). Results Female gender (5.24 vs. 5.54, p = 0.04), diabetes mellitus type II (4.75 vs. 5.46, p<0.001) and daily drug intake (5.24 vs. 6.01, p = 0.003) were associated with a significant impairment in HRQL. HRQL was not significantly different between the examined liver diseases. Levels of CK18 were the highest in patients with NASH compared to all other disease entities (p<0.001). Interestingly, CK18 exhibited significant correlations with obesity (p<0.001) and hyperlipidemia (p<0.001). In patients with cirrhosis levels of CK18 correlated with the MELD score (r = 0.18, p = 0.03) and were significantly higher compared to patients without existing cirrhosis (265.5 U/l vs. 186.9U/l, p = 0.047). Additionally, CK18 showed a significant correlation with the presence and the degree of hepatic fibrosis (p = 0.003) and inflammation (p<0.001) in liver histology. Finally, there was a small negative association between CLDQ and CK18 (r = -0.16, p = 0.048). Conclusion Different parameters are influencing HRQL and CK18 levels in chronic non-viral liver disease and the amount of hepatocellular apoptosis correlates with the impairment in HRQL in chronic non-viral liver diseases. These findings support the role of liver-protective therapies for the improvement of the quality of life in chronic liver disease.
Collapse
Affiliation(s)
- Yvonne Alt
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Anna Grimm
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Liesa Schlegel
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Annette Grambihler
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jens M. Kittner
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Peter R. Galle
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Marcus A. Wörns
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jörn M. Schattenberg
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- * E-mail:
| |
Collapse
|