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Mediating effect of post-stroke depression between activities of daily living and health-related quality of life: meta-analytic structural equation modeling. Qual Life Res 2023; 32:331-338. [PMID: 35972616 DOI: 10.1007/s11136-022-03225-9] [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] [Accepted: 07/30/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Stroke survivors face various problems that affect their health-related quality of life (HRQoL). Reduced activities of daily living (ADL) may contribute to post-stroke depression (PSD) and low HRQoL, and depression might be associated with low HRQoL. However, these relationships are not well known. This study aimed to analyze correlations among ADL, PSD, and HRQoL in stroke survivors and further explore the mediating role of PSD between ADL and HRQoL. METHODS This study utilized meta-analytic structural equation modeling (MASEM) on systematically searched articles from six electronic databases, namely PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (China), Wanfang database (China), and SinoMed (China), from inception up to July 31, 2021. Two researchers independently assessed study eligibility, and data from the eligible studies were encoded and assessed for quality. MASEM was utilized to examine correlations among ADL, PSD, and HRQoL, with an estimation of a pooled correlation matrix under a random-effects model. The matrix was directly fitted to a structural equation model using webMASEM. RESULTS In total, 8580 articles were screened, and data from 27 studies involving 33 effect sizes were used in the MASEM analysis. Correlations among the three variables were significant (both P < 0.01). Furthermore, PSD partially mediated the correlation between ADL and HRQoL (β = 0.24, 95% confidence interval 0.15-0.30). CONCLUSIONS The findings suggest that both decreased ADL and PSD may reduce HRQoL, while a decrease in ADL tends to cause depression after stroke. Therefore, ADL and PSD reductions should be improved to achieve better HRQoL of stroke survivors. Future studies should continue to discuss other factors affecting HRQoL to achieve optimal recovery in stroke survivors.
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Almeida ILGID, Oliveira LFLD, Figueiredo PHS, Oliveira RDDB, Damasceno TR, Silva WT, Oliveira LFFD, Ávila MR, Lima VP, Lages ATC, Mediano MFF, Rocha MOC, Costa HS. The health-related quality of life in patients with Chagas disease: the state of the art. Rev Soc Bras Med Trop 2022; 55:e0657. [PMID: 35293550 PMCID: PMC8932319 DOI: 10.1590/0037-8682-0657-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/15/2022] [Indexed: 12/30/2022] Open
Abstract
Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.
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Affiliation(s)
| | | | - Pedro Henrique Scheidt Figueiredo
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil.,Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Rafael Dias de Brito Oliveira
- Universidade Federal de Minas Gerais, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Belo Horizonte, MG, Brasil
| | - Thayrine Rosa Damasceno
- Universidade Federal de Minas Gerais, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Belo Horizonte, MG, Brasil
| | - Whesley Tanor Silva
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil
| | | | - Matheus Ribeiro Ávila
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Vanessa Pereira Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil.,Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Ana Thereza Chaves Lages
- Universidade Federal de Minas Gerais, Curso de Pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | | | - Manoel Otávio Costa Rocha
- Universidade Federal de Minas Gerais, Curso de Pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Henrique Silveira Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil.,Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
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Fong TCT, Lo TLT, Ho RTH. Indirect effects of social support and hope on quality of life via emotional distress among stroke survivors: A three-wave structural equation model. Front Psychiatry 2022; 13:919078. [PMID: 35966472 PMCID: PMC9365992 DOI: 10.3389/fpsyt.2022.919078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Stroke survivors are prone to functional impairments and reduced quality of life (QoL). This study examined the mediating role of social support and hope in the relationships between functional impairment, emotional distress, and QoL. METHODS A total of 188 stroke survivors in Hong Kong completed assessments on functional impairment, social support, and hope at baseline, with follow-up measurements of emotional distress at 2 months and QoL at 8 months. Structural equation modeling with bootstrapping was used to analyze the direct and indirect effects of functional impairment on emotional distress and QoL via the mediating factors of social support and hope. RESULTS The partial cascading model provided an adequate fit to the data. Functional impairment had significant negative direct effects on hope and physical QoL and social support had significant positive direct effects on hope and physical QoL. Social support had a significant positive indirect effect on physical QoL via hope and perceived stress and on psychosocial QoL via hope and depression. Functional impairment and hope had a significant negative interaction effect on perceived stress. CONCLUSION The findings support a mediating role for hope in the relationship between social support and QoL in stroke survivors. The protective effect of hope on perceived stress was stronger among patients with greater functional impairment.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Temmy L T Lo
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rainbow T H Ho
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Baldoni NR, Quintino ND, Alves GCS, Oliveira CDL, Sabino EC, Ribeiro ALP, Cardoso CS. Quality of life in patients with Chagas disease and the instrument used: an integrative review. Rev Inst Med Trop Sao Paulo 2021; 63:e46. [PMID: 34161552 PMCID: PMC8216686 DOI: 10.1590/s1678-9946202163046] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/08/2021] [Indexed: 01/06/2023] Open
Abstract
Chagas disease (CD) is a neglected tropical highly morbid disease that can have a negative impact on the quality of life (QoL). The purpose of this study was to conduct an integrative review to analyze the QoL of patients with CD in the chronic phase of the disease, as well as the instruments used and the effect of different interventions. The review was carried out based on the criteria and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guideline (PRISMA) using the PubMed, Scopus, Web of Science and Science Direct databases. An analysis of the reference list of the included articles was also carried out. Publications in all languages have been included. Two independent reviewers selected the eligible articles and extracted the data. A total of 1,479 articles were identified, and after applying the inclusion criteria 18 articles were included. Four different instruments were used to assess QoL and the most used was the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) [33.3% (n = 6)]. Investigations involving intervention showed a positive impact on the patients' QoL, and the Environment domain had the lowest score. Heterogeneity of instruments and lack of methodology standardization for assessing QoL was observed. QoL proved to be an important indicator for the planning and monitoring of patients with CD, however it is suggested that the instruments for its assessment should be the ones recommended by the validation studies. This process will allow the comparison of data between investigations.
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Affiliation(s)
| | | | | | | | - Ester Cerdeira Sabino
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
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Topological reorganization of the default mode network in patients with poststroke depressive symptoms: A resting-state fMRI study. J Affect Disord 2020; 260:557-568. [PMID: 31539693 DOI: 10.1016/j.jad.2019.09.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/02/2019] [Accepted: 09/08/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study mapped the topological configuration of the default mode network (DMN) in patients with depressive symptoms after acute ischemic stroke. METHODS The study sample comprised 63 patients: 36 with poststroke depressive symptoms (PSD) and 37 without PSD matched according to age, gender and the severity of stroke. PSD was defined by a cutoff of ≥ 7 on the 15-item Geriatric Depression Scale (GDS). Resting-state functional magnetic resonance imaging (fMRI) was used to examine functional connectivity (FC) to reconstruct the DMN. Network based statistics estimated the FC differences of the DMN between the PSD and non-PSD groups. Graph theoretical approaches were used to characterize the topological properties of this network. RESULTS The study sample mainly comprised patients with mild to moderate stroke. A widespread hyper-connected configuration of the functional DMN was characterized in PSD group. The orbital frontal, dorsolateral prefrontal, dorsal medial prefrontal and, ventromedial prefrontal corticis, the middle temporal gyrus and the inferior parietal lobule were the functional hubs related to PSD. The nodal topology in inferior parietal lobule and superior frontal gyrus, overlapping with dorsal medial prefrontal and, ventromedial prefrontal cortices, tended to be functionally integrated in patients with PSD. After False Discovery Rate correction, no significant difference between the PSD and non-PSD groups was found with respect to the global and nodal metrics of the DMN. However, the correlations between these altered network metrics and severity of PSD were lacking. LIMITATIONS The diagnosis of PSD was based on the GDS score rather than established with a structured clinical interview. CONCLUSIONS The DMN in PSD was functionally integrated and more specialized in some core hubs such as the inferior parietal lobule and dorsal prefrontal cortex. The configuration of the subnetwork like DMN may be more essential in the pathogenesis of PSD than single stroke lesions.
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Nunes HJM, Queirós PJP. Patient with stroke: hospital discharge planning, functionality and quality of life. Rev Bras Enferm 2017; 70:415-423. [DOI: 10.1590/0034-7167-2016-0166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/20/2016] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Stroke still causes high levels of human inability and suffering, and it is one of the main causes of death in developed countries, including Portugal. Objective: analyze the strategies of hospital discharge planning for these patients, increasing the knowledge related to hospitalhome transition, discharge planning processes and the main impact on the quality of life and functionality. Method: integrative literature review using the PICOD criteria, with database research. Results: 19 articles were obtained, using several approaches and contexts. For quality of life, the factors related to the patient satisfaction with care and the psychoemotional aspects linked with functionality are the most significant. Conclusion: during the hospitalization period, a careful hospital discharge planning and comprehensive care to patients and caregivers - in particular the functional and psychoemotional aspects - tend to have an impact on the quality of life of patients.
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Forsyth CJ. "I Cannot Be Worried": Living with Chagas Disease in Tropical Bolivia. PLoS Negl Trop Dis 2017; 11:e0005251. [PMID: 28099488 PMCID: PMC5242422 DOI: 10.1371/journal.pntd.0005251] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/13/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Chagas disease (CD) profoundly affects the social and emotional dimensions of patients' lives, and disproportionately impacts poor, marginalized populations in Latin America. Biomedical treatment for CD fails to reach up to 99% of the people affected, and in any case seldom addresses the emotional health or socioeconomic conditions of patients. This study examines patient strategies for coping with CD in the department of Santa Cruz, Bolivia. METHODOLOGY In this ethnographic study, semistructured interviews took place from March-June 2013 with 63 patients who had previously tested positive for CD. During the fieldwork period, participant observation was conducted and patient family members, providers, community members, and public health officials were consulted. PRINCIPAL FINDINGS Patients often experienced emotional distress when diagnosed with CD, yet were generally unable to find biomedical treatment. Respondents stressed the need to avoid powerful emotions which would worsen the impact of CD symptoms. To manage CD, patients embraced a calm state of mind, described in Spanish as tranquilidad, which partially empowered them to return to a normal existence. CONCLUSIONS In the perceived absence of biomedical treatment options, patients seek their own means of coping with CD diagnosis. Rather than fatalism or resignation, patients' emphasis on maintaining calm and not worrying about CD represents a pragmatic strategy for restoring a sense of normalcy and control to their lives. Programs focused on treatment of CD should remain mindful of the emotional and social impact of the disease on patients.
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Affiliation(s)
- Colin J. Forsyth
- Department of Anthropology University of South Florida 4202 E. Fowler Avenue, SOC 107 Tampa, FL, United States of America
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van 't Noordende AT, Kuiper H, Ramos AN, Mieras LF, Barbosa JC, Pessoa SMF, Souza EA, Fernandes TA, Hinders DC, Praciano MMA, van Brakel WH. Towards a toolkit for cross-neglected tropical disease morbidity and disability assessment. Int Health 2016; 8 Suppl 1:i71-81. [PMID: 26940312 DOI: 10.1093/inthealth/ihw006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are a group of often chronic and disabling infectious conditions, closely related to poverty and inequities. While it is estimated that millions of people are affected, accurate and internationally comparable data about NTD-related morbidity and disability are lacking. Therefore we aimed to develop and pilot a toolkit to assess and monitor morbidity and disability across NTDs. METHODS A cross-sectional, non-random survey design with a mixed methods approach was used. We conducted a literature review on existing tools to assess and monitor disability, followed by a Delphi study with NTD experts to compile a prototype toolkit. A first-phase validation study was conducted in Northeast Brazil among people with Chagas disease, leishmaniasis, leprosy and schistosomiasis. RESULTS Instruments included were the clinical profile, WHODAS, P-scale, SRQ, WHOQOL-BREF and WHOQOL-DIS. Most questions in the various instruments were readily understood with the exception of the WHOQOL-BREF, where additional explanations and examples were often needed. The respondents were very appreciative of the instruments and found it valuable to have the opportunity to talk about these aspects of their condition. CONCLUSIONS Our findings support the acceptability and relevance of five of the six instruments tested and the concept of a cross-NTD toolkit.
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Affiliation(s)
| | | | - Alberto N Ramos
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | - Jaqueline C Barbosa
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Sarah M F Pessoa
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Eliana A Souza
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Thayse A Fernandes
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Duane C Hinders
- Netherlands Leprosy Relief, Brazil Programme, Fortaleza, Ceará, Brazil
| | | | - Wim H van Brakel
- Netherlands Leprosy Relief, Amsterdam, Netherlands Disability Studies, Department of Metamedica, VU Medical Centre Amsterdam, Netherlands
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Nunes MCP, Kreuser LJ, Ribeiro AL, Sousa GR, Costa HS, Botoni FA, de Souza AC, Gomes Marques VE, Fernandez AB, Teixeira AL, da Costa Rocha MO. Prevalence and risk factors of embolic cerebrovascular events associated with Chagas heart disease. Glob Heart 2016; 10:151-7. [PMID: 26407510 DOI: 10.1016/j.gheart.2015.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 07/07/2015] [Accepted: 07/16/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patients with Chagas disease are at increased risk for stroke that may result in major clinical disability and death. Identification of risk factors involved in the genesis of thromboembolic events related to this disease may lead to improved therapeutic decision making and outcomes. OBJECTIVES This study sought to assess the prevalence of ischemic cerebrovascular events (ICE) among patients with Chagas heart disease and to identify the risk factors associated with cardioembolism in this population. METHODS This study involved 330 patients, 193 were men (58%), with a mean age of 49 ± 12 years with Chagas disease classified in the chronic cardiac form of the disease. Comprehensive echocardiography was performed to search a substrate for cardioembolic events, especially apical aneurysm and intracavitary thrombus. RESULTS Most of the patients were classified as New York Heart Association classes I or II (75%) with mean left ventricular (LV) ejection fraction of 39 ± 14%. Sixty-seven patients had a previous ICE with the overall prevalence of 20%. Apical aneurysms were detected in 128 patients (39%), whereas LV mural thrombi were found in 48 patients (15%). In multivariate analysis including the potential predictors of ICE, apical aneurysm (adjusted odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.11 to 4.34; p = 0.024) and LV thrombus (adjusted OR: 2.43, 95% CI: 1.09 to 5.42; p = 0.030) emerged as important determinants of ICE, after adjusting for anticoagulation therapy. CONCLUSIONS In a selected population referred to a tertiary center for Chagas disease that included patients with different severities of cardiac involvement, the prevalence of ICE was 20%. The presence of apical aneurysm and intracavitary thrombus were independently associated with ICE, after adjustment for other risk factors for stroke.
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Affiliation(s)
- Maria Carmo P Nunes
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | | | - Antonio Luiz Ribeiro
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Giovane Rodrigo Sousa
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Henrique Silveira Costa
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Antonio Botoni
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline Cristina de Souza
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vitoria Emilia Gomes Marques
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Antonio Lucio Teixeira
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Manoel Otávio da Costa Rocha
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Sousa GR, Costa HS, Souza AC, Nunes MCP, Lima MMO, Rocha MODC. Health-related quality of life in patients with Chagas disease: a review of the evidence. Rev Soc Bras Med Trop 2016; 48:121-8. [PMID: 25992924 DOI: 10.1590/0037-8682-0244-2014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/13/2015] [Indexed: 11/21/2022] Open
Abstract
Chagas disease (ChD), a neglected tropical disease caused by infection with the parasite Trypanosoma cruzi (T. cruzi), remains a serious public health issue in Latin America and is an emerging disease in several non-endemic countries, where knowledge of the condition and experience with its clinical management are limited. Regionally, the disease is the major cause of disability secondary to tropical diseases in young adults. Health-related quality of life (HRQoL) impairment is common in patients with ChD, especially in those with Chagas dilated cardiomyopathy, the most severe manifestation of the disease, which frequently leads to heart failure. The aim of this review was to conduct a literature search for studies that have evaluated the determining factors of HRQoL in ChD patients. We included cross-sectional, case-control, cohort, and experimental studies, as well as clinical trials that evaluated the HRQoL in ChD patients aged 18 to 60 years and are presenting an explicit description of statistical analysis. Using a combination of keywords based on Descriptors in Health Sciences (DeCS) and Medical Subject Headings (MeSH) for searches in PubMed and the Scientific Electronic Library Online (SciELO), 148 studies were found. After exclusions, 12 studies were selected for analysis. Three main findings were extracted from these studies: 1) cardiac involvement is associated with a worse HRQoL in ChD patients; 2) HRQoL is associated with the patients' functional capacity; and 3) simple and inexpensive therapeutic measures are effective for improving HRQoL in ChD patients. Hence, ChD patients' functional capacity, the effectiveness of non-surgical conservative treatment, and cardiac involvement are important determining factors for the HRQoL in ChD patients.
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Affiliation(s)
- Giovane Rodrigo Sousa
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Henrique Silveira Costa
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Aline Cristina Souza
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Carmo Pereira Nunes
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Márcia Maria Oliveira Lima
- Departamento de Fisioterapia, Faculdade Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Manoel Otávio da Costa Rocha
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Effects of Mobility-Enhancing Nursing Intervention in Patients with MS and Stroke: Randomised Controlled Trial. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2015; 2015:785497. [PMID: 27347547 PMCID: PMC4897267 DOI: 10.1155/2015/785497] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 02/05/2015] [Indexed: 01/29/2023]
Abstract
Background. Multiple sclerosis (MS) or stroke causes functional impairment which can have a major impact on patients' life. Objectives. This RCT investigated the effect of a new nursing intervention (Mobility Enhancing Nursing Intervention—MFP) designed to improve rehabilitation outcomes. Method. The study took place in a rehabilitation clinic in Switzerland. One hundred forty participants diagnosed with MS, stroke, and brain injuries were randomly assigned to control group (CG = standard care) or intervention group (IG). The IG combined standard care with 30 days of MFB. MFP placed patients on a mattress on the floor and used tactile-kinaesthetic stimulation to increase spatial orientation and independency. Outcomes were functionality (Extended Barthel Index, EBI), quality of life (WHOQoL), and fall-related self-efficacy (FES-I). Results. There was a significant main effect of the intervention on functionality (EBI-diff/day mean = 0.30, versus mean = 0.16, P = 0.008). There was also a significant main effect on QoL (WHOQoL-diff mean = 13.8, versus mean = 5.4, P = 0.046). No significant effect was observed on fall-related self-efficacy. Conclusions. The positive effect of MFP on rehabilitation outcomes and quality of life suggests that this specialized nursing intervention could become an effective part of rehabilitation programs. The study was approved by the Ethics Committee of St. Gallen (KEK-SG Nr. 09/021) and registered at ClinicalTrial.gov NCT02198599.
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Assessment of the source of ischemic cerebrovascular events in patients with Chagas disease. Int J Cardiol 2014; 176:1352-4. [DOI: 10.1016/j.ijcard.2014.07.266] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 07/27/2014] [Accepted: 07/28/2014] [Indexed: 11/20/2022]
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Pedroso VSP, Souza LCD, Teixeira AL. Síndromes neuropsiquiátricas associadas a acidentes vasculares encefálicos: revisão de literatura. JORNAL BRASILEIRO DE PSIQUIATRIA 2014. [DOI: 10.1590/0047-2085000000021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Revisar as principais síndromes neuropsiquiátricas associadas ao acidente vascular encefálico (AVE), suas características clínicas, impacto sobre a recuperação dos pacientes, tratamento, suas possíveis relações com a fisiopatologia dos AVE e, quando possível, contextualizá-las à realidade brasileira. Métodos Foram realizadas buscas nas bases de dados PubMed/MedLine e SciELO/Lilacs com os termos “stroke” e “cerebrovascular disease” em combinações com “neuropsychiatry”, “neuropsychiatric disorders”, “psychiatry”, “psychiatric disorders”, “depression”, “anxiety” e “dementia”, com ênfase nos últimos dez anos. Resultados Foram revisadas as síndromes neuropsiquiátricas pós-AVE, incluindo depressão, ansiedade, transtorno da expressão emocional involuntária, labilidade emocional, irritabilidade, raiva, reação catastrófica, apatia, demência, mania e psicose, de acordo com os objetivos propostos. Conclusão É notória a escassez de informações sobre o manejo terapêutico das complicações neuropsiquiátricas secundárias aos AVE, especialmente diante do impacto em saúde pública representado pelas doenças cerebrovasculares. Com a evolução da abordagem precoce a esses pacientes e o consequente aumento de sua sobrevida, o aprofundamento do conhecimento sobre o desenvolvimento e o tratamento dos transtornos neuropsiquiátricos parece ter maior potencial para melhorar o desfecho e a qualidade de vida dos indivíduos que sofreram AVE.
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