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Benefits of pulmonary rehabilitation in COPD patients with mild cognitive impairment - A pilot study. Respir Med 2021; 185:106478. [PMID: 34038843 DOI: 10.1016/j.rmed.2021.106478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cognitive impairment might interfere with the efficacy of Pulmonary Rehabilitation (PR) in Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify differential responses to PR between cognitively impaired (CI) and cognitively normal (CN) COPD patients by assessing health status and exercise capacity. METHODS Sixty patients (FEV1: 47 ± 15%) were classified as CI or CN according to the Montreal Cognitive Assessment (MoCA ≤25points) and completed a 3-week inpatient PR program. Cognitive function (neuropsychological battery), health-status (36-Item Short Form Survey [SF-36]), and exercise capacity (6-min walk test [6MWT], cycle-endurance test [CET]) were assessed before and after PR. Responsiveness to PR was estimated by mean change (delta-value [Δ]) and the d-Effect Size (ES). RESULTS Twenty-five COPD patients (42%) presented evidence of mild CI prior to PR. Both, CI and CN patients significantly improved global cognitive function, health status (the majority of SF-36 components), and exercise capacity (6MWT and cycle endurance) in response to PR. Compared to CN, CI patients did not improve SF-36 subdomains of "role emotional" and "bodily pain", and demonstrated a lower magnitude of improvement in 6MWT ([Δ]: 25 m; ES: 0.21) compared to CN ([Δ]: 46 m; ES: 0.54). CONCLUSIONS PR has favorable effects on global cognitive function, health status, and exercise capacity in both CI and CN COPD patients. There was no concrete evidence to indicate interference of cognitive impairment to PR effectiveness.
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Chockalingam A. Home-Based Arm Cardiac Rehabilitation in Disabled Veterans: A Pilot Study. MISSOURI MEDICINE 2021; 118:387-392. [PMID: 34373676 PMCID: PMC8343626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
One of the cornerstones of treatment after acute coronary syndromes is cardiac rehabilitation (CR). However, traditional CR remains underused in the United States due to comorbidities and geographical limitations. To evaluate feasibility and safety of our individually tailored CR program, we evaluated twelve weeks of tele-monitored home-based arm ergometer and weight training exercises in seven Veterans. Prior to beginning our CR program, all Veterans underwent an arm ergometer stress test and training in the proper techniques for arm exercises and weight training. Seattle Angina Questionnaire (SAQ) and the MacNew Heart Disease Health-related Quality of Life (MacNew) questionnaire were administered at the beginning and conclusion of the program. Six patients completed the study. One withdrew due to generalized weakness. There were no adverse events during the study period. There was a perceived improvement in heart disease related global (4.47 to 4.61), physical, emotional, and social well-being by the MacNew questionnaire. The SAQ showed improvement in physical limitation, angina frequency, treatment satisfaction, and overall quality of life (36.1 to 51.7) after completion of our tailored CR program. There was a decrease in average blood pressure and patients were able to exercise seven minutes longer and workload increased eight additional watts. This pilot study demonstrates the safety and feasibility of a home-based arm cardiac rehabilitation program. These tailored programs may improve quality of life in coronary artery disease patients with disabilities.
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Agreement between the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) interview and a paper-administered adaption. BMC Med Res Methodol 2020; 20:80. [PMID: 32276603 PMCID: PMC7149856 DOI: 10.1186/s12874-020-00961-9] [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] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) is a prevalent face-to-face interview method for measuring quality of life by integrating respondent-generated dimensions. To apply this method in clinical trials, a paper-administered alternative would be of interest. Therefore, our study aimed to analyze the agreement between the SEIQoL-DW and a paper questionnaire version (SEIQoL-PF/G). METHODS In a crossover design, both measures were completed in a random sequence. 104 patients at a heart surgery hospital in Germany were randomly assigned to receive either the SEIQoL-DW or the SEIQoL-PF/G as the first measurement in the sequence. Patients were approached on their earliest stable day after surgery. The average time between both measurements was 1 day (mean 1.3; SD 0.8). Agreement regarding the indices, ratings, and weightings of nominated life areas (cues) was explored using Bland-Altman plots with 95% limits of agreement (LoA). Agreement of the SEIQoL indices was defined as acceptable if the LoA did not exceed a threshold of 10 scale points. Data from n = 99 patients were included in the agreement analysis. RESULTS Both measures led to similarly nominated cues. The most frequently nominated cues were "physical health" and "family". In the Bland-Altman plot, the indices showed a mean of differences of 2 points (95% CI, - 1 to 6). The upper LoA showed a difference of 36 points (95% CI, 30 to 42), and the lower LoA showed a difference of - 31 points (95% CI, - 37 to - 26). Thus, the LoAs and confidence intervals exceeded the predefined threshold. The Bland-Altman plots for the cue levels and cue weights showed similar results. The SEIQoL-PF/G version showed a tendency for equal weighting of cues, while the weighting procedure of the SEIQoL-DW led to greater variability. CONCLUSIONS For cardiac surgery patients, use of the current version of the SEIQoL-PF/G as a substitute for the SEIQoL-DW is not recommended. The current questionnaire weighting method seems to be unable to distinguish weighting for different cues. Therefore, the further design of a weighting method without interviewer support as a paper-administered measure of individual quality of life is desirable.
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Long-Term Quality of Life Outcomes in Adult Survivors After Anomalous Pulmonary Venous Drainage Repair. Ann Thorac Surg 2019; 110:654-659. [PMID: 31794738 DOI: 10.1016/j.athoracsur.2019.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/14/2019] [Accepted: 10/09/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND We sought to determine the long-term quality of life after repair of anomalous pulmonary venous drainage using the Short Form (SF)-36 questionnaire in adult survivors. METHODS All patients who underwent repair of partial or total anomalous pulmonary venous drainage (PAPVD or TAPVD) and were 18 years of age or older with a current contact number were identified from the hospital database. The mean age of the 101 patients was 26 ± 7 years (range, 18-49) old. Patients completed the SF-36 quality of life questionnaire via telephone. The results of the 8 domains of the SF-36 questionnaire and the derived health state summary score (SF-6-Dimension) were compared against an age-matched Australian population data. RESULTS Compared with Australian population age-matched data, the 18- to 24-year-old TAPVD/PAPVD patients ranked their health higher in 1 of 8 domains; however the SF-6-Dimension scores were similar (0.75 for TAPVD and PAPVD patients vs 0.77 for the Australian population, P = .2). In the 25-50 age group TAPVD/PAPVD patients ranked their health higher in 3 of 8 domains. However the SF-6-Dimension scores were similar to Australian age-matched population (0.78 for TAPVD and PAPVD patients vs 0.77 for the Australian population, P = .51). CONCLUSIONS Young adult survivors after anomalous pulmonary venous drainage repair have similar quality of life outcomes as age-matched Australian control subjects as measured by SF-6-Dimension.
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Andersen KS, Laustsen S, Petersen AK. Correlation Between Exercise Capacity and Quality of Life in Patients With Cardiac Disease. J Cardiopulm Rehabil Prev 2019; 38:297-303. [PMID: 28885281 DOI: 10.1097/hcr.0000000000000281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Patients are referred to exercise-based cardiac rehabilitation (ECR) to increase exercise capacity and health-related quality of life (HRQOL) and thereby reduce risk of morbidity and mortality. The purpose of this study was to examine the correlation between exercise capacity and HRQOL. Furthermore, this study examined whether improvements in HRQOL were directly related to improvements in exercise capacity. METHODS The study included 277 patients participating in ECR. HRQOL was assessed using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), and exercise capacity was measured as peak oxygen uptake ((Equation is included in full-text article.)O2peak) and oxygen uptake ((Equation is included in full-text article.)O2) at the ventilatory threshold (VTh). Patients were examined before and after completion of an 8-wk ECR program. RESULTS Analyses at baseline showed a significant correlation between (Equation is included in full-text article.)O2peak and VTh and physical functioning (PF), role limitations because of physical problems (RP), general health perceptions (GH), vitality (VT), and physical component summary (PCS) on the SF-36; PF was the only dimension showing a moderate correlation (>0.40 Spearman ρ) with (Equation is included in full-text article.)O2peak. The follow-up analyses demonstrated a significant correlation between changes in (Equation is included in full-text article.)O2peak and changes in PF, RP, VT, and MH. Changes in (Equation is included in full-text article.)O2 peak explained 4% of the changes in the PF and VT scores. CONCLUSION The correlations between exercise capacity and HRQOL were weak and varied considerably among patients. The ECR program improved both exercise capacity and HRQOL, but it was not necessarily the same patients who improved both parameters. Therefore, it is recommended to use separate objective measures and patient-reported outcomes when evaluating the effect of ECR.
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Affiliation(s)
- Karoline Stentoft Andersen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark (Ms Andersen and Drs Laustsen and Petersen); Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Dr Laustsen); Centre of Research in Rehabilitation, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Ms Andersen and Drs Laustsen and Petersen)
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Andrianopoulos V, Gloeckl R, Boensch M, Hoster K, Schneeberger T, Jarosch I, Koczulla RA, Kenn K. Improvements in functional and cognitive status following short-term pulmonary rehabilitation in COPD lung transplant recipients: a pilot study. ERJ Open Res 2019; 5:00060-2019. [PMID: 31544112 PMCID: PMC6745414 DOI: 10.1183/23120541.00060-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/20/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) following lung transplantation (LTx) is considered part of the optimal treatment in chronic obstructive pulmonary disease (COPD) for favourable post-operative outcomes. We investigated the effects of a PR intervention in the post-transplant phase with regard to lung function, exercise responses and cognitive function in COPD LTx recipients. METHODS 24 COPD LTx recipients (mean±sd forced expiratory volume in 1 s 75±22% predicted) were assigned to a comprehensive 3-week inpatient PR programme. Changes from PR admission to discharge in lung function variables, 6-min walk test-derived outcomes and cognitive function were assessed and examined for several factors. The magnitude of changes was interpreted by effect size (ES). RESULTS In response to the PR intervention, LTx recipients had improved lung function with regard to diffusing capacity of the lung for carbon monoxide (+4.3%; p=0.012) and static hyperinflation (residual volume/total lung capacity -2.3%; p=0.017), increased exercise capacity (6-min walk test +86 m; p<0.001), and had small to large improvements (ES range 0.23-1.00; all p≤0.34) in 50% of the administered cognitive tests. Learning skills and memory ability presented the greatest benefits (ES composite scores 0.62 and 0.31, respectively), which remained similar after stratification by single or bilateral LTx and sex. CONCLUSIONS PR is an effective treatment for LTx recipients in the post-transplant phase, improving lung function, exercise responses, and domains of cognitive function of learning, memory and psychomotor speed. PR may facilitate the course of post-operative treatment and should be recommended in LTx.
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Affiliation(s)
- Vasileios Andrianopoulos
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Rainer Gloeckl
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Prevention, Rehabilitation and Sport Medicine, Technical University Munich, Munich, Germany
| | - Martina Boensch
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Katharina Hoster
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
| | - Tessa Schneeberger
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
| | - Inga Jarosch
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Rembert A. Koczulla
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
- German Center of Lung Research (DZL), Giessen-Marburg, Germany
| | - Klaus Kenn
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
- German Center of Lung Research (DZL), Giessen-Marburg, Germany
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Tackmann E, Dettmer S. Health-related quality of life in adult heart-transplant recipients—a systematic review. Herz 2018; 45:475-482. [DOI: 10.1007/s00059-018-4745-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/15/2018] [Accepted: 08/09/2018] [Indexed: 02/02/2023]
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Mokhles S, Nuyttens JJME, de Mol M, Aerts JGJV, Maat APWM, Birim Ö, Bogers AJJC, Takkenberg JJM. Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making. BMC Cancer 2018; 18:79. [PMID: 29334910 PMCID: PMC5769349 DOI: 10.1186/s12885-018-3986-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 01/02/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The objective of this study is to investigate the role and experience of early stage non-small cell lung cancer (NSCLC) patient in decision making process concerning treatment selection in the current clinical practice. METHODS Stage I-II NSCLC patients (surgery 55 patients, SBRT 29 patients, median age 68) were included in this prospective study and completed a questionnaire that explored: (1) perceived patient knowledge of the advantages and disadvantages of the treatment options, (2) experience with current clinical decision making, and (3) the information that the patient reported to have received from their treating physician. This was assessed by multiple-choice, 1-5 Likert Scale, and open questions. The Decisional Conflict Scale was used to assess the decisional conflict. Health related quality of life (HRQoL) was measured with SF-36 questionnaire. RESULTS In 19% of patients, there was self-reported perceived lack of knowledge about the advantages and disadvantages of the treatment options. Seventy-four percent of patients felt that they were sufficiently involved in decision-making by their physician, and 81% found it important to be involved in decision making. Forty percent experienced decisional conflict, and one-in-five patients to such an extent that it made them feel unsure about the decision. Subscores with regard to feeling uninformed and on uncertainty, contributed the most to decisional conflict, as 36% felt uninformed and 17% of patients were not satisfied with their decision. HRQoL was not influenced by patient experience with decision-making or patient preferences for shared decision making. CONCLUSIONS Dutch early-stage NSCLC patients find it important to be involved in treatment decision making. Yet a substantial proportion experiences decisional conflict and feels uninformed. Better patient information and/or involvement in treatment-decision-making is needed in order to improve patient knowledge and hopefully reduce decisional conflict.
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Affiliation(s)
- S Mokhles
- Department of Cardio-thoracic Surgery, Erasmus-MC, Room Bd-577, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - J J M E Nuyttens
- Department of Radiation Oncology, Erasmus-MC-Cancer Institute, Rotterdam, The Netherlands
| | - M de Mol
- Department of Pulmonary Disease, Amphia Hospital, Breda, The Netherlands
| | - J G J V Aerts
- Department of Pulmonary Disease, Erasmus-MC, Rotterdam, The Netherlands.,Department of Pulmonary Disease, Amphia Hospital, Breda, The Netherlands
| | - A P W M Maat
- Department of Cardio-thoracic Surgery, Erasmus-MC, Room Bd-577, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Ö Birim
- Department of Cardio-thoracic Surgery, Erasmus-MC, Room Bd-577, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - A J J C Bogers
- Department of Cardio-thoracic Surgery, Erasmus-MC, Room Bd-577, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - J J M Takkenberg
- Department of Cardio-thoracic Surgery, Erasmus-MC, Room Bd-577, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Abe T, Terazawa S, Ito H, Tokuda Y, Fujimoto K, Mutsuga M, Narita Y, Oshima H, Usui A. Clinical outcomes and quality of life after surgery for dilated ascending aorta at the time of aortic valve replacement; wrapping versus graft replacement. NAGOYA JOURNAL OF MEDICAL SCIENCE 2017; 79:443-451. [PMID: 29238100 PMCID: PMC5719203 DOI: 10.18999/nagjms.79.4.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Wrapping and graft replacement are two optional procedures for the treatment of dilated ascending aorta at the time of aortic valve replacement (AVR). Wrapping is considered less invasive. The aim of this study was to compare the short- and long-term clinical outcomes as well as the long-term quality of life in patients undergoing these two procedures.This study enrolled 40 consecutive patients with dilated ascending aorta who had undergone either wrapping (WAA group, n=20) or replacement (RAA group, n=20) of the ascending aorta at the time of AVR. Short-term outcomes, long-term deaths, and aortic events were evaluated, as was quality of life using the SF-36 Short Form. Long-term maximal proximal aortic diameter was also obtained.There were no early deaths in either group. Pump time was shorter, and transfusion (55% vs. 95%, p=0.035) and postoperative atrial fibrillation (5% vs. 30%, p=0.036) rates were lower, in the WAA than in the RAA group. At a mean follow-up of 4.9 years, the overall 5 year survival rates in the WAA and RAA groups were 78.1% and 87.5%, respectively. There were no significant between group differences in SF-36 scores in any subcategory of this survey. Long-term maximal aortic diameter remained stable in both groups. Both surgical interventions for dilated ascending aorta at the time of AVR yield favorable and comparable results in patients with suitable anatomy. Furthermore, we found no differences in quality of life between these procedures.
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Affiliation(s)
- Tomonobu Abe
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sachie Terazawa
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Ito
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Tokuda
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuro Fujimoto
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Mutsuga
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuji Narita
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Oshima
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihiko Usui
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Hamidou Z, Baumstarck K, Chinot O, Barlesi F, Salas S, Leroy T, Auquier P. Domains of quality of life freely expressed by cancer patients and their caregivers: contribution of the SEIQoL. Health Qual Life Outcomes 2017; 15:99. [PMID: 28494773 PMCID: PMC5427569 DOI: 10.1186/s12955-017-0672-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 04/28/2017] [Indexed: 12/13/2022] Open
Abstract
Background The purposes of this study, performed on a large sample of cancer patient-caregiver dyads, were: i) to simultaneously investigate, using an individualized quality of life (QoL) measure (Schedule for the Evaluation of Individual QoL, SEIQoL), the QoL domains freely expressed by cancer patients and their caregivers, and ii) to explore overlapping between the SEIQoL assessment and QoL assessment using traditional instruments. Methods The study employed a cross-sectional design including cancer patients who were going to receive chemotherapy treatment and their caregivers. Quality of life was assessed using condition-specific questionnaires (EORTC QLQ-C30 and CarGOQoL), generic health-related questionnaire (SF-36), and open individualized measure (SEIQoL). Results The final sample included 205 patient-caregiver dyads. From the SEIQoL, Family, Health, and Leisures were the most freely expressed QoL domains by patients and caregivers, but reported with different weights. Love life and financial issues were less spontaneously mentioned. The SEIQoL index was moderately correlated to the condition-specific QoL questionnaires (R lower than |0.40|) and to SF-36 (correlation coefficients: R ranging from 0.17 to 0.31). Conclusion Individualized QoL measures allow individuals to spontaneously express important, non-predefined domains. This study highlights the need to explore QoL using a combination of individualized questionnaires and standardized questionnaires, capturing complementary facets that patients consider important in their life.
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Affiliation(s)
- Zeinab Hamidou
- EA3279, Self-perceived Health Assessment Research Unit, Aix Marseille Université, 27 bd Jean Moulin, Marseille, cedex 05, F-13385, France.,National Clinical research Quality of Life in Oncology Platform, Nancy, France
| | - Karine Baumstarck
- EA3279, Self-perceived Health Assessment Research Unit, Aix Marseille Université, 27 bd Jean Moulin, Marseille, cedex 05, F-13385, France.
| | - Olivier Chinot
- Department of Neuro-Oncology, Assistance Publique Hôpitaux de Marseille, Timone Hospital, 13005, Marseille, France
| | - Fabrice Barlesi
- Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Centre d'Investigation Clinique, 13385, Marseille, France
| | - Sébastien Salas
- Department of adult oncology, Assistance Publique Hôpitaux de Marseille, Timone Hospital, 13005 Marseille, and CRO2, Aix Marseille Université, 13284, Marseille, France
| | - Tanguy Leroy
- Université Lumière Lyon 2, Social Psychology Research Group (GRePS EA 4163), Bron, France
| | - Pascal Auquier
- EA3279, Self-perceived Health Assessment Research Unit, Aix Marseille Université, 27 bd Jean Moulin, Marseille, cedex 05, F-13385, France
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Sciriha A, Lungaro-Mifsud S, Scerri J, Magro R, Camilleri L, Montefort S. Health status of COPD patients undergoing pulmonary rehabilitation: A comparative responsiveness of the CAT and SGRQ. Chron Respir Dis 2017; 14:352-359. [PMID: 29081264 PMCID: PMC5729730 DOI: 10.1177/1479972317694622] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The St. George’s Respiratory Questionnaire (SGRQ) and chronic obstructive pulmonary disease (COPD) assessment test (CAT) are the measures used to assess health status. This study aims to examine the responsiveness of these tools by severity of dyspnoea category in patients with COPD. Forty-nine COPD patients who underwent a 12-week pulmonary rehabilitation (PR) programme were assessed at baseline, 12 weeks and at 28-week follow-up. Patients were categorized into two groups by severity of dyspnoea category (i.e. mild to moderate (modified Medical Research Council (mMRC) 1–2) and severe to very severe (mMRC 3–4)) using the mMRC dyspnoea scale. Effect size (ES) was computed as estimates of responsiveness. The SGRQ demonstrated greater responsiveness by total sample (SGRQ, ES = 0.87; CAT, ES = 0.75) and for the mMRC 3–4 category (SGRQ, ES = 0.91; CAT, ES = 0.76) on completion of PR. At 28-week follow-up, overall comparable responsiveness of the CAT and SGRQ was identified by total sample (SGRQ, ES = 0.75; CAT, ES = 0.74) and by severity of dyspnoea category. The symptom, impact and activity domains of the SGRQ showed good responsiveness, with greater ESs obtained overall for the mMRC 3–4 category. On completion of PR, the SGRQ demonstrates a greater responsiveness with COPD patients, especially in relation to the mMRC 3–4 category, while both the CAT and SGRQ show comparable responsiveness on follow-up.
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Affiliation(s)
- Anabel Sciriha
- 1 Department of Physiotherapy, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Stephen Lungaro-Mifsud
- 1 Department of Physiotherapy, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Josianne Scerri
- 2 Department of Mental Health, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Rosalie Magro
- 3 Department of Medicine, Mater Dei Hospital, Msida, Malta
| | - Liberato Camilleri
- 4 Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - Stephen Montefort
- 5 Department of Medicine, Faculty of Medicine and Surgery; University of Malta, Msida, Malta
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Matlabi H, Ahmadzadeh S. Evaluation of individual quality of life among hemodialysis patients: nominated themes using SEIQoL-adapted. Patient Prefer Adherence 2017; 11:1-9. [PMID: 28031703 PMCID: PMC5179215 DOI: 10.2147/ppa.s117860] [Citation(s) in RCA: 2] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Quality of life (QoL) has become an important issue for patients with chronic renal failure diseases who are permanently undergoing hemodialysis. In this study, an adapted schedule for the evaluation of individual quality of life (SEIQoL-adapted) was used to evaluate QoL among hemodialysis patients, to explore their views about the most important aspects of life satisfaction. METHODS AND RESULTS A multiple approach design and convenience sampling were applied to recruit 53 patients from a hemodialysis unit in Iran. Data were collected through structured interviews and then analyzed using conventional content analysis. A total score for QoL was calculated using scale guideline. The most important aspects of life were health, family, financial status, living conditions, leisure activities, relationships and socializing, religious and spiritual issues, medical knowledge, and therapies or treatments. The calculated mean QoL score was 66.2, indicating a relatively high life satisfaction. Males had higher QoL scores than females in both married and single groups. Moreover, the relationships between the QoL scores and education, job and marital status were not statistically significant. CONCLUSION The SEIQoL-adapted revealed reasonable lay definitions of QoL in a group of patients following chronic renal failure. The patients' views of the aspects of life could be used by health policy makers, clinicians, and caregivers as a reliable guide to the most important priorities for treatment and medical interventions.
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Affiliation(s)
- Hossein Matlabi
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence: Hossein Matlabi, Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Attare Neishabouri St, Tabriz, PO Box 5165665811, Iran, Tel +98 91 41 008927, Fax +98 41 33344731, Email
| | - Sharareh Ahmadzadeh
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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In support of an individualized approach to assessing quality of life: comparison between Patient Generated Index and standardized measures across four health conditions. Qual Life Res 2016; 26:601-609. [DOI: 10.1007/s11136-016-1480-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 01/08/2023]
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El Dib R, Gomaa H, Carvalho RP, Camargo SE, Bazan R, Barretti P, Barreto FC. Enzyme replacement therapy for Anderson-Fabry disease. Cochrane Database Syst Rev 2016; 7:CD006663. [PMID: 27454104 PMCID: PMC6481759 DOI: 10.1002/14651858.cd006663.pub4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Anderson-Fabry disease is an X-linked defect of glycosphingolipid metabolism. Progressive renal insufficiency is a major source of morbidity, additional complications result from cardio- and cerebro-vascular involvement. Survival is reduced among affected males and symptomatic female carriers.This is an update of a Cochrane review first published in 2010, and previously updated in 2013. OBJECTIVES To evaluate the effectiveness and safety of enzyme replacement therapy compared to other interventions, placebo or no interventions, for treating Anderson-Fabry disease. SEARCH METHODS We searched the Cystic Fibrosis and Genetic Disorders Group's Inborn Errors of Metabolism Trials Register (date of the most recent search: 08 July 2016). We also searched 'Clinical Trials' on The Cochrane Library, MEDLINE, Embase and LILACS (date of the most recent search: 24 September 2015). SELECTION CRITERIA Randomized controlled trials of agalsidase alfa or beta in participants diagnosed with Anderson-Fabry disease. DATA COLLECTION AND ANALYSIS Two authors selected relevant trials, assessed methodological quality and extracted data. MAIN RESULTS Nine trials comparing either agalsidase alfa or beta in 351 participants fulfilled the selection criteria.Both trials comparing agalsidase alfa to placebo reported on globotriaosylceramide concentration in plasma and tissue; aggregate results were non-significant. One trial reported pain scores measured by the Brief Pain Inventory severity, there was a statistically significant improvement for participants receiving treatment at up to three months, mean difference -2.10 (95% confidence interval -3.79 to -0.41; at up to five months, mean difference -1.90 (95% confidence interval -3.65 to -0.15); and at up to six months, mean difference -2.00 (95% confidence interval -3.66 to -0.34). There was a significant difference in the Brief Pain Inventory pain-related quality of life at over five months and up to six months, mean difference -2.10 (95% confidence interval -3.92 to -0.28) but not at other time points. Death was not an outcome in either of the trials.One of the three trials comparing agalsidase beta to placebo reported on globotriaosylceramide concentration in plasma and tissue and showed significant improvement: kidney, mean difference -1.70 (95% confidence interval -2.09 to -1.31); heart, mean difference -0.90 (95% confidence interval -1.18 to -0.62); and composite results (renal, cardiac, and cerebrovascular complications and death), mean difference -4.80 (95% confidence interval -5.45 to -4.15). There was no significant difference between groups for death; no trials reported on pain.Only two trials compared agalsidase alfa to agalsidase beta. One of them showed no significant difference between the groups regarding adverse events, risk ratio 0.36 (95% confidence interval 0.08 to 1.59), or any serious adverse events; risk ratio 0.30; (95% confidence interval 0.03 to 2.57).Two trials compared different dosing schedules of agalsidase alfa. One of them involved three different doses (0.2 mg/kg every two weeks; 0.1 mg/kg weekly and; 0.2 mg/kg weekly), the other trial evaluated two further doses to the dosage schedules: 0.4 mg/kg every week and every other week. Both trials failed to show significant differences with various dosing schedules on globotriaosylceramide levels. No significant differences were found among the schedules for the primary efficacy outcome of self-assessed health state, or for pain scores.One trial comparing agalsidase alfa to agalsidase beta showed no significant difference for any adverse events such as dyspnoea and hypertension.The methodological quality of the included trials was generally unclear for the random sequence generation and allocation concealment. AUTHORS' CONCLUSIONS Trials comparing enzyme replacement therapy to placebo show significant improvement with enzyme replacement therapy in regard to microvascular endothelial deposits of globotriaosylceramide and in pain-related quality of life. There is, however, no evidence identifying if the alfa or beta form is superior or the optimal dose or frequency of enzyme replacement therapy. With regards to safety, adverse events (i.e., rigors, fever) were more significant in the agalsidase beta as compared to placebo. The long-term influence of enzyme replacement therapy on risk of morbidity and mortality related to Anderson-Fabry disease remains to be established. This review highlights the need for continued research into the use of enzyme replacement therapy for Anderson-Fabry disease.
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Affiliation(s)
- Regina El Dib
- Institute of Science and Technology, Unesp ‐ Univ Estadual PaulistaDepartment of Biosciences and Oral DiagnosisBotucatuBrazil
| | - Huda Gomaa
- Department of Pharmacy,Tanta Chest Hospital3 Ahmed Kamal Street,TantaGharbiaEgypt112311
| | - Raíssa Pierri Carvalho
- Botucatu Medical School, UNESP ‐ Univ Estadual PaulistaAvenida Camilo Mazoni, 1055 ‐ F23Jardim ParaisoBotucatuSao PauloBrazil18610‐285
| | - Samira E Camargo
- São Paulo State University ‐ UNESPDepartment of Biosciences and Oral Diagnosis777 Francisco Jose LongoSão Jose dos CamposSão PauloSão PauloBrazil12245‐000
| | - Rodrigo Bazan
- Botucatu Medical School, Universidade Estadual Paulista (UNESP)Department of NeurologyDistrict of Rubiao JuniorBotucatu, São PauloBrazil
| | - Pasqual Barretti
- Botucatu Medical School, UNESP ‐ Univ Estadual PaulistaClinical MedicineDistrito de Rubião Junior, s/nBotucatuSão PauloBrazil18618‐900
| | - Fellype C Barreto
- Universidade Católica do ParanáSchool of Medicine PontifíciaRua Imaculada Conceição, 1155CuritibaParanáBrazil80215‐901
- Universidade Federal do Paraná (UFPR)Department of Internal MedicineCuritibaParanáBrazil
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Tingström PR, Kamwendo K, Bergdahl B. Effects of a Problem-Based Learning Rehabilitation Programme on Quality of Life in Patients with Coronary Artery Disease. Eur J Cardiovasc Nurs 2016; 4:324-30. [PMID: 15923147 DOI: 10.1016/j.ejcnurse.2005.04.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2004] [Revised: 03/18/2005] [Accepted: 04/18/2005] [Indexed: 12/11/2022]
Abstract
Background: The aim of cardiac rehabilitation (CR) is not only physical improvement but also increased quality of life (QoL). A CR programme based upon problem based learning (PBL) philosophy was developed, to achieve and apply new knowledge related to coronary artery disease (CAD). The aim of this paper was to evaluate the impact of the PBL programme on QoL. Methods: 207 consecutive patients < 70 years of age with a recent event of CAD were randomised to a PBL group ( n = 104) or a control group ( n = 103). In addition to standard treatment, the PBL patients participated in 13 group sessions during 1 year, where individual learning needs and behavioural changes were focused upon. QoL was measured by the Ladder of Life, Self-Rated Health (SRH), SF 36, and Cardiac Health Profile (CHP). Results: Significant differences between the groups, favouring the PBL patients, were found by global instruments: more optimistic expectations of the future QoL and a better general condition. No differences were found by SRH, SF 36 or subscales of CHP, but QoL increased in both groups during the year. Conclusions: The main outcome was that QoL improved in both groups with some effects favouring the PBL programme.
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Affiliation(s)
- Pia R Tingström
- Department of Medicine and Care, Division of Cardiology, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
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Smith K, Ross D, Connolly E. Investigating Six-Month Health Outcomes of Patients with Angina Discharged from a Chest Pain Service. Eur J Cardiovasc Nurs 2016. [DOI: 10.1016/s1474-51510200041-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Hospital admissions for patients with suspected cardiac chest pain are increasing. The development of a chest pain service allows rapid diagnosis, investigation and treatment. Since the in-patient stay is often short, there is limited time for education and risk factor management. Little is known about the patients' recovery post discharge. This study was completed to investigate the 6-month health outcomes of 57 patients discharged from the chest pain service by measuring cardiovascular symptoms and risk profiles, mood and quality of life, adherence to secondary prevention, morbidity and mortality. The results of this study showed that 58% of the sample still suffered angina, 72% reported breathlessness, and 79% reported lethargy. Assessment of mood showed that 76% suffered from anxiety and 78% depression. Quality of life was impaired. A reduction of cholesterol level was the only significant change in risk factors. Secondary prevention measures showed that there was still room for improvement. Twenty-five percent of the sample was readmitted to hospital due to their cardiac condition. Patients had an average of eight contacts with their general practitioner, four of which were cardiac related. The ongoing symptoms, anxiety and depression and uncorrected risk factors can impact on their recovery. Currently, however, no programme of rehabilitation is available for angina patients, despite the potential for up to 30% of patients suffering a subsequent cardiac event (Ghandi et al., British Heart Journal 73 (1995) 193–198). This study suggests the need to develop, implement and evaluate a CR programme in this client group.
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Affiliation(s)
- Karen Smith
- Department of Cardiology, Ninewells Hospital, Tayside University Hospitals NHS Trust, Dundee, UK
- School of Nursing and Midwifery, University of Dundee, Dundee, UK
| | - Dawn Ross
- Department of Cardiology, Ninewells Hospital, Tayside University Hospitals NHS Trust, Dundee, UK
| | - Elizabeth Connolly
- Medical Admissions Unit, Ninewells Hospital, Tayside University Hospitals NHS Trust, Dundee, UK
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Individualized quality of life of severely affected multiple sclerosis patients: practicability and value in comparison with standard inventories. Qual Life Res 2016; 25:2755-2763. [PMID: 27125955 DOI: 10.1007/s11136-016-1303-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 12/14/2022]
Abstract
PURPOSE Individualized quality of life (QoL) measures differ from traditional inventories in that QoL domains/weights are not predetermined, but identified by the individual. We assessed practicability of the Schedule for the Evaluation of Individual QoL-Direct Weighting (SEIQoL-DW) interview in severely affected multiple sclerosis (MS) patients; the key QoL dimensions identified; and the correlation of the SEIQoL-DW index score with standard patient-reported outcome measures (PROMs). METHODS Participants were people with severe MS who performed the baseline visit of the PeNSAMI trial (ISRCTN73082124). The SEIQoL-DW was administered at the patient's home by a trained examiner. Patients then received the following PROMs: the Core-Palliative care Outcome Scale (Core-POS), the Palliative care Outcome Scale-Symptoms-MS (POS-S-MS), the European Quality of Life Five Dimensions-3L (EQ-5D-3L), and the Hospital Anxiety and Depression Scale (HADS). RESULTS Of 59 enrolled patients, 11 (19 %) did not receive the SEIQoL-DW (and the other PROMs) because of severe cognitive compromise or inability to communicate. SEIQoL-DW administration was completed and deemed valid in all 48 cases (mean age 60 years, 58 % women, median Expanded Disability Status Scale score 8.5). Mean SEIQoL-DW index score was 59.1 (SD 25.5). The most commonly nominated SEIQoL-DW areas were family (94 % of the patients), relationships, and leisure activities (both 65 %). Core-POS and POS-S-MS contained 70 % of the SEIQoL-DW-nominated areas. Nevertheless, correlations between SEIQoL-DW index, Core-POS, and POS-S-MS (and the other PROMs) were negligible. CONCLUSIONS Individualized QoL can be assessed in severely affected MS patients, providing information that is not tracked by the standard inventories Core-POS, POS-S-MS, EQ-5D-3L, and HADS.
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Zacek P, Holubec T, Vobornik M, Dominik J, Takkenberg J, Harrer J, Vojacek J. Quality of life after aortic valve repair is similar to Ross patients and superior to mechanical valve replacement: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:63. [PMID: 27039180 PMCID: PMC4818911 DOI: 10.1186/s12872-016-0236-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 03/23/2016] [Indexed: 11/21/2022] Open
Abstract
Background In patients after aortic valve surgery, the quality of life is hypothesized to be influenced by the type of the valve procedure. A cross-sectional study on the postoperative quality of life was carried out in patients after aortic valve-sparing surgery (with regards to the age of the patient), Ross procedure and mechanical aortic valve replacement. Methods Quality of life was studied in 139 patients after aortic valve surgery divided into four study groups (Y – aortic valve-sparing procedure at the age below 50 years, mean age 36.2 years; O – aortic valve-sparing procedure at the age 50 years and over, mean age 59.2 years; R – Ross procedure, mean age 37.8 years and M – mechanical aortic valve replacement at the age below 50 years, mean age 39.2 years). SF-36 Short Form and valve-specific questionnaires were mailed to the patients after 6 months or later following surgery (median 26.9 months). Results In SF-36, the younger aortic valve repair patients and the Ross patients scored significantly better in 4 of 4 physical subscales and in 2 of 4 mental subscales than the older aortic valve repair and mechanical valve replacement patients. In the valve-specific questionnaire; however, all 3 groups free of anticoagulation (Y, O, and R) displayed greater freedom from negative valve-related concerns. Conclusions Postoperative quality of life is influenced by the type of aortic valve procedure and is negatively linked with mechanical prosthesis implantation and long-term anticoagulation. Aortic valve-sparing strategy should be considered in cases with suitable valve morphology due to favorable clinical results and beneficial impact on the long-term quality of life.
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Affiliation(s)
- Pavel Zacek
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic.
| | - T Holubec
- Department of Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany
| | - M Vobornik
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
| | - J Dominik
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
| | - J Takkenberg
- Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - J Harrer
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
| | - J Vojacek
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
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Thompson DR, Ski CF, Garside J, Astin F. A review of health-related quality of life patient-reported outcome measures in cardiovascular nursing. Eur J Cardiovasc Nurs 2016; 15:114-25. [DOI: 10.1177/1474515116637980] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 02/18/2016] [Indexed: 12/22/2022]
Affiliation(s)
- David R Thompson
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Chantal F Ski
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Joanne Garside
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Felicity Astin
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK
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20
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Predictors of subjective health status 10 years post-PCI. IJC HEART & VASCULATURE 2016; 11:19-23. [PMID: 28616521 PMCID: PMC5441316 DOI: 10.1016/j.ijcha.2016.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 01/21/2016] [Accepted: 03/07/2016] [Indexed: 12/31/2022]
Abstract
Background Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. Methods We included a series of consecutive PCI patients (n = 573) as part of the RESEARCH registry, a Dutch single-center retrospective cohort study. Results These patients completed the 36-item Short-Form Health Survey (SF-36) at baseline and 10 years post-PCI. We found 6 predictors of poor subjective health status 10 years post-PCI: SF-36 at baseline, age, previous PCI, obesity, acute myocardial infarction as indication for PCI, and diabetes mellitus (arranged from most to least numbers of sub domains). Conclusions SF-36 scores at baseline, age, and previous PCI were significant predictors of subjective health status 10 years post-PCI. Specifically, the SF-36 score at baseline was an important predictor. Thus assessment of subjective health status at baseline is useful as an indicator to predict long-term subjective health status. Subjective health status becomes better by optimal medical treatment, cardiac rehabilitation and psychosocial support. This is the first study determining predictors of subjective health status 10 years post-PCI.
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van den Berge JC, Utens EM, Dulfer K, Hartman EM, van Geuns RJ, Daemen J, van Domburg RT. Can anxiety and depression, separately or in combination predict subjective health status 10years post-PCI? Int J Cardiol 2015; 186:57-9. [DOI: 10.1016/j.ijcard.2015.03.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 03/15/2015] [Indexed: 11/17/2022]
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Leung Yinko SSL, Pelletier R, Behlouli H, Norris CM, Humphries KH, Pilote L. Health-related quality of life in premature acute coronary syndrome: does patient sex or gender really matter? J Am Heart Assoc 2014; 3:jah3598. [PMID: 25074696 PMCID: PMC4310372 DOI: 10.1161/jaha.114.000901] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Limited data exist as to the relative contribution of sex and gender on health‐related quality of life (HRQL) among patients with acute coronary syndrome (ACS). This study aims to evaluate the effect of sex and gender‐related variables on long‐term HRQL among young adults with ACS. Methods and Results GENESIS‐PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond‐Premature Acute Coronary SYndrome) is a multicenter, prospective cohort study (January 2009 to August 2013) of adults aged 18 to 55 years, hospitalized with ACS. HRQL was measured at baseline, 1, 6, and 12 months using the Short Form‐12 and Seattle Angina Questionnaire (SAQ) among 1213 patients. Median age was 49 years. Women reported worse HRQL than men over time post‐ACS, both in terms of physical and mental functioning. Gender‐related factors were more likely to be predictors of HRQL than sex. Femininity score, social support, and housework responsibility were the most common gender‐related predictors of HRQL at 12 months. We observed an interaction between female sex and social support (β=0.44 [95% confidence interval, 0.01, 0.88]; P=0.047) for the physical limitation subscale of the SAQ. Conclusions Young women with ACS report significantly poorer HRQL than young men. Gender appears to be more important than sex in predicting long‐term HRQL post‐ACS. Specific gender‐related factors, such as social support, may be amenable to interventions and could improve the HRQL of patients with premature ACS.
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Affiliation(s)
- Sylvie S L Leung Yinko
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Roxanne Pelletier
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Hassan Behlouli
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Colleen M Norris
- Faculties of Nursing, Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (C.M.N.)
| | - Karin H Humphries
- Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (K.H.H.) Providence Health Care Research Institute, St. Paul's Hospital, Vancouver British, Columbia, Canada (K.H.H.)
| | - Louise Pilote
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.) Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada (L.P.)
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Hagell P, Westergren A. The Significance of Importance: An Evaluation of Ferrans and Powers’ Quality of Life Index. Qual Life Res 2013; 15:867-76. [PMID: 16721646 DOI: 10.1007/s11136-005-5467-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2005] [Indexed: 11/25/2022]
Abstract
Ferrans and Powers' Quality of Life Index (QLI) defines and assesses quality of life (QoL) in terms of importance-weighted life satisfaction. This study assessed the value of such weights and explored the relationship between weighted and unweighted (satisfaction only) scores and single-item rated overall life satisfaction (LS) and QoL. Data were collected by a postal survey to 81 Parkinson's disease patients (88% response rate). Correlations between weighted and unweighted QLI scores were >or=0.96, except for one subscale (r ( s ) = 0.85). Item non-response rates ranged between 4.2 and 45.1% and 1.4 and 38% for the weighted and unweighted QLI, respectively. Cronbach's alpha exceeded 0.7 for weighted and unweighted versions of two out of the four subscales and the total score. Scaling success rates were similar for weighted and unweighted scores and did not support the current subscale structure. Unexpectedly, weighted total scores correlated stronger with LS than with QoL, and unweighted scores displayed the opposite pattern. This study found no advantages by using importance-weighted satisfaction scores. The correlational pattern with overall LS and QoL challenges the QLI approach to QoL, although these observations may relate to the use of multiplicative item weights. This study has implications also beyond the QLI regarding, e.g., the use of multiplicative weights and the relationship between life satisfaction and QoL.
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Affiliation(s)
- Peter Hagell
- Division of Gerontology and Caring Sciences, Department of Health Sciences, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden .
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Abstract
BACKGROUND Anderson-Fabry disease is an X-linked defect of glycosphingolipid metabolism. Progressive renal insufficiency is a major source of morbidity, additional complications result from cardio- and cerebro-vascular involvement. Survival is reduced among affected males and symptomatic female carriers. OBJECTIVES To evaluate the effectiveness and safety of enzyme replacement therapy compared to other interventions, placebo or no interventions, for treating Anderson-Fabry disease. SEARCH METHODS We searched 'Clinical Trials' on The Cochrane Library, MEDLINE, EMBASE, LILACS and the Cystic Fibrosis and Genetic Disorders Group's Inborn Errors of Metabolism Trials Register (date of the most recent search: 11 September 2012). The original search was performed in September 2008.Date of the most recent search of the Cystic Fibrosis and Genetic Disorders Group's Inborn Errors of Metabolism Trials Register: 11 September 2012. SELECTION CRITERIA Randomized controlled trials of agalsidase alfa or beta in participants diagnosed with Anderson-Fabry disease. DATA COLLECTION AND ANALYSIS Two authors selected relevant trials, assessed methodological quality and extracted data. MAIN RESULTS Six trials comparing either agalsidase alfa or beta in 223 participants fulfilled the selection criteria.Both trials comparing agalsidase alfa to placebo reported on globotriaosylceramide concentration in plasma and tissue; aggregate results were non-significant. One trial reported pain scores, there was a statistically significant improvement for participants receiving treatment at up to three months, mean difference -2.10 (95% confidence interval (CI) -3.79 to -0.41); at up to five months, mean difference -1.90 (95% CI -3.65 to -0.15); and at up to six months, mean difference -2.00 (95% CI -3.66 to -0.34). There was a significant difference in pain-related quality of life at over five months and up to six months, mean difference -2.10 (95% CI -3.92 to -0.28) but not at other time-points. Neither trial reported deaths.One of the three trials comparing agalsidase beta to placebo reported on globotriaosylceramide concentration in plasma and tissue and showed significant improvement: kidney, mean difference -1.70 (95% CI -2.09 to -1.31); heart, mean difference -0.90 (95% CI -1.18 to -0.62); and composite results (renal, cardiac, and cerebrovascular complications and death), mean difference -4.80 (95% CI -5.45 to -4.15). There was no significant difference between groups for death; no trials reported on pain.Only one trial compared agalsidase alfa to agalsidase beta. There was no significant difference between the groups for any adverse events, risk ratio 0.36 (95% CI 0.08 to 1.59), or any serious adverse events; risk ratio 0.30; 95% CI 0.03 to 2.57). AUTHORS' CONCLUSIONS Six small, poor quality randomised controlled trials provide no robust evidence for use of either agalsidase alfa and beta to treat Anderson-Fabry disease.
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Affiliation(s)
- Regina P El Dib
- Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, Brazil.
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Lü MJ, Zhang HY, Zhang Z, Yang GL. [Measurement of health-related quality of life in coronary heart disease: a review]. ACTA ACUST UNITED AC 2013; 9:1277-85. [PMID: 22152764 DOI: 10.3736/jcim20111201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This paper introduces the development and application of health-related quality of life (HRQOL) scales in research on coronary heart disease (CHD). Currently, the scales for CHD patients have been more systematically developed and widely used in foreign countries, while domestically in China, they are developed successfully but problematically; research in this field has started later and the scales introduced are limited and not suitable for the entire range of domestic CHD patients. Thus, this paper introduces 26 HRQOL scales in research on CHD, including five generic scales, ten disease-specific scales from abroad and eleven scales originating from China. With the deficiency of HRQOL scales, especially that in traditional Chinese medicine and specific scales, this paper analyzes and summarizes the problems existing in development of scales. The authors also provide solutions in order to help the development and application of scales in further studies.
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Affiliation(s)
- Mei-jun Lü
- The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
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Thiel C, Landgrebe K, Knubben E, Nadalin S, Ladurner R, Grasshoff C, Königsrainer A, Schenk M, Thiel K. Contributors to individual quality of life after liver transplantation. Eur J Clin Invest 2013; 43:11-9. [PMID: 23078202 DOI: 10.1111/eci.12007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND With increasing improvements of patient survival after liver transplantation, the focus on outcome measures shifts from survival rate to quality of life. Individual quality of life is crucial to rehabilitate patients after transplantation. Therefore, it is important to identify specific issues that contribute to high individual quality of life. In contrast to the Short form 36 Health Survey (SF-36), the Schedule for the Evaluation of Individual aspects of Quality of Life-direct weighting (SEIQoL-DW) allows patients to name the areas of life, which are important to them. DESIGN In a semi-structured interview style, 71 patients following liver transplant were asked to complete the SEIQoL-DW and the SF-36 in a cross-sectional design. RESULTS We found five quality of life areas that were chosen by more than half of the patients: family, friends, sports, partnership and profession/occupation. Health was only mentioned by 45% of all patients. Individual quality of life did not differ from healthy population. In the SF-36, patients showed normal mental health parameters but reduced physical components. A strong correlation between SEIQoL-DW-Index and the mental component summary of the SF-36 was observed. CONCLUSION In addition to the widely used standardized SF-36, the individual measure SEIQoL-DW shows new aspects concerning the areas of quality of life, which are personally important to the participants. Less than half of our patients mentioned health and the five most nominated areas are not related to health. By focusing on health, the importance of health-related factors is overrated, and the impact of non-medical effects is underrepresented.
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Affiliation(s)
- Christian Thiel
- Department of General, Visceral and Transplant Surgery, Tuebingen University Hospital, Tuebingen, Germany
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Doyle K, Weber E, Atkinson JH, Grant I, Woods SP. Aging, prospective memory, and health-related quality of life in HIV infection. AIDS Behav 2012; 16:2309-18. [PMID: 22246512 DOI: 10.1007/s10461-011-0121-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
HIV infection and older age are each independently associated with lower health-related quality of life (HRQoL) and deficits in prospective memory (PM), which is a distinct aspect of cognition involving the ability to "remember to remember" to do something at a future occasion. The present study investigated associations between PM and HRQoL in 72 older (≥ 50 years) and 41 younger (≤ 40 years) HIV-infected adults. Self-reported PM complaints predicted HRQoL across the entire sample, but there was a significant interaction between performance-based PM and age group on HRQoL, such that lower time-based PM was associated with lower HRQoL only in the younger cohort. Within the younger group, time-based and self-reported PM significantly predicted mental HRQoL independent of other risk factors (e.g. depression). These findings suggest that PM plays a unique role in HRQoL outcomes among younger persons living with HIV infection and support the examination of other age-related factors (e.g. effective use of compensatory strategies) that may regulate the adverse impact of PM on everyday functioning.
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Affiliation(s)
- Katie Doyle
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, San Diego, CA, 92093, USA.
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Obesity, health status, and 7-year mortality in percutaneous coronary intervention: in search of an explanation for the obesity paradox. Int J Cardiol 2012; 167:1154-8. [PMID: 22475846 DOI: 10.1016/j.ijcard.2012.03.105] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 03/07/2012] [Accepted: 03/08/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND Obesity is a growing health problem and is associated with adverse outcomes in coronary artery disease (CAD). However, recent studies have shown better survival in cardiovascular patients with overweight or obesity, which has been referred to as the "obesity paradox". As there is no clear understanding of the phenomenon, we examined the association between body mass index (BMI) and all-cause mortality in patients treated with percutaneous coronary intervention (PCI) at 7-year follow-up, and the potential role of health status in explaining the obesity paradox. METHODS Consecutive PCI patients (72.5% men; mean age 62.0 ± 11.2 years, range [27-90]years) from the Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital (RESEARCH) registry completed the 36-item short-form health survey (SF-36) to assess health status at baseline. Patients were classified into a normal weight, overweight or obesity group. RESULTS The prevalence of normal weight was 34.7% (354/1019), overweight was seen in 45.9% (468/1019) of patients, and 19.3% (197/1019) was obese. After a median follow-up of 7.0 ± 1.7 years, 163 deaths (16.0%) from any cause were recorded. Cumulative hazard functions differed significantly for the obese and overweight group when compared to the normal weight group (log-rank X(2)=6.59, p<0.05). In multivariable analysis, overweight, but not obesity, remained associated with a lower risk for all-cause mortality (HR=0.60, 95%CI [0.42-0.86], p=0.005). Additionally, after adding the 8 health status SF-36 domains to the multivariate model, the association between overweight and mortality remained unchanged. CONCLUSION In our study population overweight, but not obesity, was associated with a lower risk for 7-year mortality in PCI patients. Health status as measured with the SF-36 did not seem to play a role in explaining the obesity paradox.
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Hsu CJ, Chen SY, Su S, Yang MC, Lan C, Chou NK, Hsu RB, Lai JS, Wang SS. The effect of early cardiac rehabilitation on health-related quality of life among heart transplant recipients and patients with coronary artery bypass graft surgery. Transplant Proc 2012; 43:2714-7. [PMID: 21911151 DOI: 10.1016/j.transproceed.2011.04.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 04/19/2011] [Indexed: 01/13/2023]
Abstract
PURPOSE To investigate the effect of an early postoperative outpatient cardiac rehabilitation program to health-related quality of life among heart transplantation recipients (HTR) and patients with coronary artery bypass graft (CABG) surgery. METHODS The study included 45 clinically stable HTR (age: 47 ± 14 years; 36 men, 9 women) and 34 patients with CABG (age: 57.2 ± 12.5 years; 27 men, 7 women). HTR started rehabilitation 70 ± 33 days after transplantation; patients with CABG started training 36 ± 18 days after surgery. Patients participated in a 12-week supervised exercise training program three times per week. Each training session comprised 10 minutes of warm-up, 25 to 30 minutes of cycling or treadmill walking, and 10 minutes of cooldown. The exercise intensity was set at 50% to 80% of peak oxygen uptake (V̇O(2peak)) according to the patient's condition. The health-related quality of life of subjects was evaluated by the Medical Outcomes Trust 36-item health survey (SF-36) at baseline and upon the completion of rehabilitation. RESULTS At baseline, the HTR group showed lower V̇O(2peak) than the CABG group, but the health-related quality of life was similar between the two groups. After training, both groups exhibited an increase of 3.6 mL·kg(-1)·min(-1) in V̇O(2peak) and improvement of physical component in health-related quality of life. The HTR group showed a significant increase of SF-36 scores in physical functioning (59.7 ± 18.9 to 77.0 ± 14.0), physical role (21.1 ± 34.1 to 38.3 ± 37.9), bodily pain (57.4 ± 24.3 to 73.6 ± 21.5), social functioning (63.6 ± 23.4 to 72.8 ± 22.1), emotional role (59.2 ± 43.7 to 76.3 ± 37.4), and mental health (67.1 ± 17.9 to 73.4 ± 14.6). The CABG group only exhibited increased scores in physical functioning (60.0 ± 22.9 to 73.4 ± 18.0), physical role (19.1 ± 24.9 to 27.9 ± 38.3), bodily pain (57.1 ± 20.0 to 70.3 ± 16.1), and social functioning (54.0 ± 21.3 to 69.9 ± 21.1). CONCLUSIONS Early postoperative cardiac rehabilitation significantly improved physical capacity and quality of life among heart transplant recipients and patients with CABG. Additionally, HTR showed greater improvement in health-related quality of life than patients with CABG regardless of lower physical capacity.
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Affiliation(s)
- C-J Hsu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
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Silarova B, Nagyova I, Rosenberger J, Studencan M, Ondusova D, Reijneveld SA, van Dijk JP. Sense of coherence as an independent predictor of health-related quality of life among coronary heart disease patients. Qual Life Res 2012; 21:1863-71. [PMID: 22230964 DOI: 10.1007/s11136-011-0106-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2011] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to determine whether sense of coherence (SOC) at baseline predicts health-related quality of life (HRQoL) at 12-28-month follow-up among patients with coronary heart disease when controlled for sociodemographic and medical variables. METHODS A total of 179 consecutive patients (58.28 ± 6.52 years, 16.8% women) scheduled for coronary angiography (CAG) were interviewed before CAG and 12-28 months after. SOC was measured with the 13-item Orientation to Life Questionnaire. HRQoL was measured using the Short Form Health Survey 36 (SF-36), from which the mental and physical component summaries (MCS, PCS) were calculated. The relationship between SOC and HRQoL was examined using regression analyses. RESULTS SOC proved to be a significant predictor of the MCS-score (B = 0.29; 95% CI = 0.17-0.41) and PCS-score (B = 0.18; 95% CI = 0.06-0.31) when not adjusted for possible confounding sociodemographic and medical variables. After adjustment for sociodemographic and medical variables, SOC remained a predictor of the MCS-score (B = 0.26; 95% CI = 0.14-0.39). SOC also remained a predictor of the PCS-score when controlled for gender, age and family income; however, the association disappeared after adjustment for functional status (B = 0.07; 95% CI = -0.05 to 0.19). CONCLUSIONS SOC is a predictor of mental and physical HRQoL at 12-28-month follow-up, crude and also after adjustment. Patients undergoing CAG with low SOC thus deserve particular attention in regard to the maintenance and improvement of their HRQoL.
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Affiliation(s)
- Barbora Silarova
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Safarik University, Kosice, Slovak Republic.
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Effectiveness of a Pedometer-Based Program Using a Socio-cognitive Intervention on Physical Activity and Quality of Life in a Setting of Cardiac Rehabilitation. Can J Cardiol 2012; 28:27-32. [DOI: 10.1016/j.cjca.2011.09.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 09/28/2011] [Accepted: 09/28/2011] [Indexed: 11/19/2022] Open
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Uysal H, Ozcan Ş. A Turkish Version of Myocardial Infarction Dimensional Assessment Scale (TR-MIDAS): Reliability–Validity Assesment. Eur J Cardiovasc Nurs 2011; 10:115-23. [DOI: 10.1016/j.ejcnurse.2010.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 04/28/2010] [Accepted: 05/24/2010] [Indexed: 11/27/2022]
Affiliation(s)
- Hilal Uysal
- Istanbul University, Florence Nightingale School of Nursing, Medical Nursing Department, Istanbul, Turkey
| | - Şeyda Ozcan
- Istanbul University, Florence Nightingale School of Nursing, Medical Nursing Department, Istanbul, Turkey
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Dueñas M, Ramirez C, Arana R, Failde I. Gender differences and determinants of health related quality of life in coronary patients: a follow-up study. BMC Cardiovasc Disord 2011; 11:24. [PMID: 21619566 PMCID: PMC3125287 DOI: 10.1186/1471-2261-11-24] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 05/27/2011] [Indexed: 01/23/2023] Open
Abstract
Background The role of gender differences in Health Related Quality Life (HRQL) in coronary patients is controversial, so understanding the specific determinants of HRQL in men and women might be of clinical importance. The aim of this study was to know the gender differences in the evolution of HRQL at 3 and 6 months after a coronary event, and to identify the key clinical, demographic and psychological characteristics of each gender associated with these changes. Methods A follow-up study was carried out, and 175 patients (112 men and 63 women) with acute myocardial infarction (AMI) or unstable angina were studied. The SF-36v1 health questionnaire was used to assess HRQL, and the GHQ-28 (General Health Questionnaire) to measure mental health during follow-up. To study the variables related to changes in HRQL, generalized estimating equation (GEE) models were performed. Results Follow-up data were available for 55 men and 25 women at 3 months, and for 35 men and 12 women at 6 months. Observations included: a) Revascularization was performed later in women. b) The frequency of rehospitalization between months 3 and 6 of follow-up was higher in women c) Women had lower baseline scores in the SF-36. d) Men had progressed favourably in most of the physical dimensions of the SF-36 at 6 months, while at the same time women's scores had only improved for Physical Component Summary, Role Physical and Social Functioning; e) the variables determining the decrease in HRQL in men were: worse mental health and angina frequency; and in women: worse mental health, history of the disease, revascularization, and angina frequency. Conclusions There are differences in the evolution of HRQL, between men and women after a coronary attack. Mental health is the determinant most frequently associated with HRQL in both genders. However, other clinical determinants of HRQL differed with gender, emphasizing the importance of individualizing the intervention and the content of rehabilitation programs. Likewise, the recognition and treatment of mental disorders in these patients could be crucial.
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Affiliation(s)
- María Dueñas
- Área de Medicina Preventiva y Salud Pública, Universidad de Cádiz, Spain
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35
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Heradstveit BE, Larsson EM, Skeidsvoll H, Hammersborg SM, Wentzel-Larsen T, Guttormsen AB, Heltne JK. Repeated magnetic resonance imaging and cerebral performance after cardiac arrest—A pilot study. Resuscitation 2011; 82:549-55. [DOI: 10.1016/j.resuscitation.2011.01.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 12/22/2010] [Accepted: 01/17/2011] [Indexed: 10/18/2022]
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36
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Quality of life after aortic valve surgery: replacement versus reconstruction. J Thorac Cardiovasc Surg 2011; 142:e19-24. [PMID: 21450311 DOI: 10.1016/j.jtcvs.2011.02.006] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 01/12/2011] [Accepted: 02/09/2011] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Quality of life has been shown to be influenced by aortic valve replacement, particularly in younger patients. Aortic valve repair is a recent alternative to replacement. We investigated quality of life and anxiety and depression after aortic valve repair and compared with 2 established replacement alternatives, mechanical valve and pulmonary autograft. METHODS In a cross-sectional study, 166 patients (age, 18-45 years) were studied after isolated elective aortic valve surgery. They had undergone aortic valve repair (group I, n = 86), replacement with mechanical prosthesis (group II, n = 41), or pulmonary autograft (group III, n = 39). Assessment was performed by Short Form Health Survey, Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, and valve-specific questions. RESULTS In Short Form Health Survey, groups I and III revealed similar or identical scores better than group II in physical functioning (P = .02), general health (P = .03), and mental health (P = .05). No differences were found in Hospital Anxiety and Depression Scale score. In cardiac anxiety, there was less heart-focused attention in groups I and III than in group II (P = .043, P = .053). In response to valve-specific questions, there were no differences between groups I and III. Interestingly, fear of reoperation was identical in all 3 groups. CONCLUSIONS In young patients after aortic valve surgery quality of life is influenced by type of operation. Although differences are limited, aortic valve reconstruction and pulmonary autograft replacement lead to less long-term alteration from normal values.
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Holzhausen M, Kuhlmey A, Martus P. Individualized measurement of quality of life in older adults: development and pilot testing of a new tool. Eur J Ageing 2010; 7:201-211. [PMID: 28798629 DOI: 10.1007/s10433-010-0159-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Accepted: 08/10/2010] [Indexed: 11/30/2022] Open
Abstract
We describe theoretical background, development, and piloting of a measure for quality of life in older adults that specifically takes into account the subjective perspective. Although quality of life is usually subjectively assessed, normative thresholds for "the good life" are most often set by a third party. The new tool FLQM asks for respondents to name, rate, and weight those domains in life that are most important for their life-satisfaction solely from their own point of view. Construct validity was pilot-tested in two samples of elders (N1 = 44; N2 = 90). Correlations were in the medium range in both studies and support the questionnaire's validity. There were no age or gender differences on total score. However, in Study 1 as well as in Study 2 older subjects named significantly fewer domains than did younger participants. Further, in Study 1 the overall number of distinct domains generated by the participants diminished with age-the "interindividual pool of domains" shrank. Implications of this age-associated narrowing of domainscope are discussed on a background of adaptation theories. Concluding, the new questionnaire seems apt to assess older peoples' quality of life even in a physically very ill population, but needs further testing, especially regarding its reliability. This is currently being undertaken in a larger longitudinal sample to assure psychometric properties.
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Affiliation(s)
| | | | - Peter Martus
- Charité-Universitätsmedizin Berlin, Berlin, Germany
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38
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Brink E, Karlson BW, Hallberg LRM. Health experiences of first-time myocardial infarction: Factors influencing women's and men's health-related quality of life after five months. PSYCHOL HEALTH MED 2010. [DOI: 10.1080/13548500120101522] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Adler E, Resnick B. Reliability and Validity of the Dementia Quality of Life Measure in Nursing Home Residents. West J Nurs Res 2010; 32:686-704. [DOI: 10.1177/0193945909360780] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to test the reliability and validity of the Dementia Quality of Life (DQOL) in a sample of 486 residents from 12 nursing homes in the greater Baltimore area. There was some evidence of validity of the DQOL based on confirmatory factor analysis and Rasch model testing and criterion-related validity. Reliability of the DQOL was somewhat supported in this study based on internal consistency and test—retest reliability. Alpha coefficients and R2 estimations were generally low across all of the subscales. Despite these findings, the subscale scores remained consistent over a 12-month period. The use of the single-item question about QOL may not be an accurate reflection of QOL among nursing home residents. These findings provide additional information about the psychometric properties of the DQOL and offer some recommendations for revisions in the measure to optimally measure QOL in nursing home residents.
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Affiliation(s)
- Efrat Adler
- University of Maryland School of Nursing, Baltimore,
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Tavella R, Air T, Tucker G, Adams R, Beltrame JF, Schrader G. Using the Short Form-36 mental summary score as an indicator of depressive symptoms in patients with coronary heart disease. Qual Life Res 2010; 19:1105-13. [DOI: 10.1007/s11136-010-9671-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2010] [Indexed: 12/11/2022]
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Abstract
BACKGROUND Anderson-Fabry disease is an X-linked defect of glycosphingolipid metabolism. Progressive renal insufficiency is a major source of morbidity, additional complications result from cardio- and cerebro-vascular involvement. Survival is reduced among affected males and symptomatic female carriers. OBJECTIVES To evaluate the effectiveness and safety of enzyme replacement therapy compared to other interventions, placebo or no interventions, for treating Anderson-Fabry disease. SEARCH STRATEGY We searched 'Clinical Trials' on The Cochrane Library, MEDLINE, EMBASE, LILACS and the Cystic Fibrosis and Genetic Disorders Group's Inborn Errors of Metabolism Trials Register (date of the most recent search: 07 April 2010). SELECTION CRITERIA Randomized controlled trials of agalsidase alfa or beta in participants diagnosed with Anderson-Fabry disease. DATA COLLECTION AND ANALYSIS Two authors selected relevant trials, assessed methodological quality and extracted data. MAIN RESULTS Five studies comparing either agalsidase alfa or beta in 187 participants fulfilled the selection criteria.Both trials comparing agalsidase alfa to placebo reported on globotriaosylceramide concentration in plasma and tissue; aggregate results were non-significant. One study reported pain scores, there was a statistically significant improvement for participants receiving treatment at up to three months, mean difference -2.10 (95% confidence interval (CI) -3.79 to -0.41); at up to five months, mean difference -1.90 (95% CI -3.65 to -0.15); and at up to six months, mean difference -2.00 (95% CI -3.66 to -0.34). There was a significant difference in pain-related quality of life at over five months and up to six months, mean difference -2.10 (95% CI -3.92 to -0.28) but not at other time-points. Neither study reported deaths.One of the three trials comparing agalsidase beta to placebo reported on globotriaosylceramide concentration in plasma and tissue and showed significant improvement: kidney, mean difference -1.70 (95% CI -2.09 to -1.31); heart, mean difference -0.90 (95% CI -1.18 to -0.62); and composite results (renal, cardiac, and cerebrovascular complications and death), mean difference -4.80 (95% CI -5.45 to -4.15). There was no significant difference between groups for death; no studies reported on pain. AUTHORS' CONCLUSIONS Five small, poor quality randomised controlled trials provide no robust evidence for use of either agalsidase alfa and beta to treat Anderson-Fabry disease.
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Affiliation(s)
- Regina P El Dib
- Department of Surgery, St. Joseph's Healthcare Hamilton, McMaster University, 50 Charlton Avenue East, Hamilton, ON, Canada, L8N 4A6
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Farquhar M, Ewing G, Higginson IJ, Booth S. The experience of using the SEIQoL-DW with patients with advanced chronic obstructive pulmonary disease (COPD): issues of process and outcome. Qual Life Res 2010; 19:619-29. [PMID: 20224901 DOI: 10.1007/s11136-010-9631-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To report the experience of using the SEIQoL-DW for the measurement of quality of life with patients with advanced COPD and consider its feasibility, acceptability and appropriateness for a Phase III randomised controlled trial (RCT). METHODS The SEIQoL-DW was administered according to its instructions within a Phase II RCT 3-5 times per patient, across 13 patients and the process audio-recorded. Quantitative and qualitative criteria were used to assess feasibility, acceptability and appropriateness. Qualitative analysis of the transcripts and fieldwork notes was conducted using Framework Analysis. RESULTS The SEIQoL-DW steps (of identifying five quality of life cues, rating their functioning and importance) were completed at 48/51 interviews. However, some respondents were overwhelmed by the scripted introduction, experienced difficulty with cue identification, and focused only on certain types of cues (Step 1); some had difficulty interpreting and rating the concept of Step 2; and some had difficulty interpreting 'importance' and manipulating the SEIQoL-DW disc (Step 3). CONCLUSIONS Patients with advanced COPD were able to complete the SEIQoL-DW but analysis of its administration identified practical and conceptual concerns which question the validity of the results obtained. Suggestions for the development of the SEIQoL-DW and future feasibility studies are given.
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Affiliation(s)
- Morag Farquhar
- General Practice and Primary Care Research Unit, Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, and Addenbrooke's Hospital, Cambridge University Hospitals' NHS Foundation Trust, Robinson Way, Cambridge, CB2 0SR, UK.
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The impact of Type D personality on health-related quality of life in tinnitus patients is mainly mediated by anxiety and depression. Otol Neurotol 2010; 31:11-8. [PMID: 19816233 DOI: 10.1097/mao.0b013e3181bc3dd1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the impact of Type D personality on health-related quality of life (HRQoL) and self-reported tinnitus-related distress in chronic tinnitus patients and whether this relationship is mediated by indicators of psychological distress (i.e., vital exhaustion, anxiety, and depression). MATERIALS AND METHODS Using a cross-sectional study design, 265 consecutive tinnitus patients were asked to complete the Hospital Anxiety and Depression Scale, the Maastricht Questionnaire, the Type D Scale (DS14), the Short-Form Health Survey 36, and the Tinnitus Reaction Questionnaire. RESULTS The prevalence of Type D was 35.5%. Type D patients were significantly more anxious, depressed, and vitally exhausted, and experienced more impaired HRQoL and increased tinnitus-related distress compared with non-Type D patients. Structural equation modeling showed that Type D personality directly increased symptoms of depression and anxiety, but not vital exhaustion. Type D was also a direct predictor of poor mental and physical HRQoL and increased tinnitus-related distress, although this influence was mainly mediated by symptoms of depression and anxiety. Anxiety, depression, and vital exhaustion had a direct influence on HRQoL and self-reported tinnitus-related distress, with a higher impact on mental HRQoL (R2 = 0.74) compared with physical HRQoL (R2 = 0.33). Vital exhaustion was a predictor of HRQoL and self-reported tinnitus-related distress; however, its influence was moderated by enhanced levels of anxiety and depression. CONCLUSION Tinnitus patients with a Type D personality were more likely to be anxious and depressed and to experience poor HRQoL and increased self-reported tinnitus-related distress, with the impact of Type D mainly being mediated by symptoms of anxiety and depression, although Type D also exerted a direct influence on these outcomes. These findings underline that to reduce the impact of tinnitus on HRQoL and self-reported tinnitus-related distress, treatment should be directed toward reducing anxiety and depression, especially in patients with a Type D personality.
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Schenkeveld L, Pedersen SS, van Nierop JW, Lenzen MJ, de Jaegere PP, Serruys PW, van Domburg RT. Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention. Am Heart J 2010; 159:471-6. [PMID: 20211311 DOI: 10.1016/j.ahj.2009.12.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 12/19/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND Health status has become increasingly important as an outcome measure in patients with cardiovascular disease. Poor patient-rated health status has been shown to predict mortality in patients with coronary artery disease and heart failure. In patients treated with percutaneous coronary intervention (PCI), we examined whether poor health status predicts 6-year mortality and whether a decline in health status is associated with adverse clinical outcome. METHODS Consecutive patients (N = 872) treated with PCI as part of the RESEARCH registry, completed the 36-item Short-Form Health Survey (SF-36) at 1 and 12 months post-PCI. RESULTS The SF-36 domains physical functioning (hazard ratio [HR] 2.59, 95% CI 1.61-4.16), social functioning (HR 2.76, 95% CI 1.74-4.37), role limitations due to physical functioning (HR 2.45, CI 1.52-3.92), mental health (HR 2.12, 95% CI 1.35-3.31), vitality (HR 1.73, 95% CI 1.09-2.74), bodily pain (HR 2.25, 95% CI 1.43-3.54), and general health (HR 2.46, 95% CI 1.57-3.87) were associated with 6-year mortality. A decline in health status was not related with higher 6-year mortality. CONCLUSIONS Health status domains as measured with the SF-36 predicted death at 6-year follow-up in PCI patients treated with drug-eluting stenting, independent of demographic and clinical characteristics. In contrast, a decline in health status between 1 and 12 months post index procedure, as measured with the SF-36, was not associated with 6-year mortality in PCI patients treated with drug-eluting stenting.
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Resnick B, Sabol V, Galik E, Gruber-Baldini AL. The Impact of Anemia on Nursing Home Residents. Clin Nurs Res 2010; 19:113-30. [DOI: 10.1177/1054773810362089] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this secondary data analysis was to describe the prevalence and treatment of anemia and test the impact of anemia on physical and psychosocial outcomes at baseline and following restorative care interventions. A total of 451 residents from 12 nursing homes participated in this study. The average age of the participants was 83.74 ( SD = 8.24), the majority were female (79%), White (66%), and unmarried (90%). A total of 245 (54%) residents were anemic, and 66% were treated with at least one medication. Physical performance was worse in those with anemia, and those with anemia associated with chronic kidney disease had lower self-efficacy and outcome expectations for functional activities than those without anemia. There was no time by treatment interaction between those with and without anemia. The findings provide some additional support for the prevalence of anemia and suggest that those with anemia associated with chronic kidney disease are less motivated to engage in functional activities.
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Taminiau-Bloem EF, Visser MRM, Tishelman C, Koeneman MA, van Zuuren FJ, Sprangers MAG. Somatically ill persons' self-nominated quality of life domains: review of the literature and guidelines for future studies. Qual Life Res 2010; 19:253-91. [PMID: 20047087 PMCID: PMC2816248 DOI: 10.1007/s11136-009-9569-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2009] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To review which domains somatically ill persons nominate as constituting their QoL. Specific objective is to examine whether the method of enquiry affect these domains. METHODS We conducted two literature searches in the databases PubMed/Medline, CINAHL and Psychinfo for qualitative studies examining patients' self-defined QoL domains using (1) SEIQoL and (2) study-specific questions. For each database, two researchers independently assessed the eligibility of the retrieved abstracts and three researchers subsequently classified all QoL domains. RESULTS Thirty-six eligible papers were identified: 27 studies using the SEIQoL, and nine presenting data derived from study-specific questions. The influence of the method of enquiry on patients' self-nominated QoL domains appears limited: most domains were presented in both types of studies, albeit with different frequencies. CONCLUSIONS This review provides a comprehensive overview of somatically ill persons' self-nominated QoL domains. However, limitations inherent to reviewing qualitative studies (e.g., the varying level of abstraction of patients' self-defined QoL domains), limitations of the included studies and limitations inherent to the review process, hinder cross-study comparisons. Therefore, we provide guidelines to address shortcomings of qualitative reports amenable to improvement and to stimulate further improvement of conducting and reporting qualitative research aimed at exploring respondents' self-nominated QoL domains.
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Affiliation(s)
- Elsbeth F Taminiau-Bloem
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
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Abstract
The objective of the study was to explore, in a sample of spouses of mild-to-moderate Alzheimer disease patients, predictors of quality of life (QoL) by rating QoL and burden. The authors assessed 97 spouses in a cross-sectional study with the Schedule for the Evaluation of Individual Quality of Life (SEIQoL), Self-Rated Burden scale (SRB), self-perceived stress scale (EDIZ; Ervaren Druk door Informele Zorg/Self-Perceived Pressure from Informal Care), and Zarit Burden Interview (ZBI). Patient cognition was rated with the Mini-Mental State Examination (MMSE). Factors best predicting QoL were analyzed with multiple regression analysis. Eighty-seven (53% male, mean 72 y) fulfilled the SEIQoL internal reliability criteria, and had a mean SEIQoL score of 68.6+/-14.8. Most important QoL domains were condition of patient (31%) and marriage (26%). Caregiver burden scores on SRB, Ervaren Druk door Informele, Zorg, and ZBI were 44.1+/-23.5 (n=67), 4.9+/-2.2 (n=53), and 13.1+/-6.2 (n=53), respectively. Mean patient MMSE score (0 to 30) was 20.3+/-4.2. Spouses experienced lower QoL than Alzheimer disease patients and healthy elderly (historical controls), and perceived moderate levels of burden. Patient cognition is a significant predictor of caregiver QoL. Burden, measured by ZBI, is significantly negatively correlated with SEIQoL. The results underline the importance of implementing health services known to improve QoL and alleviate burden, and to explore new effective interventions.
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Prevalence and characteristics of multiple psychiatric disorders in cardiac rehabilitation patients. J Cardiopulm Rehabil Prev 2009; 29:161-8; quiz 169-70. [PMID: 19471134 DOI: 10.1097/hcr.0b013e3181a33365] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Anxiety and depressive disorders have been established as independent risk factors for the development of and recovery from coronary heart disease (CHD). However, few studies have reported on the prevalence and personal characteristics of comorbid psychiatric disorders (PD) among cardiac populations. This project examined the prevalence of comorbid depressive and anxiety disorders among men and women with CHD commencing cardiac rehabilitation (CR) and the demographic, medical, and psychosocial characteristics among those meeting multiple PD criteria. METHODS Participants were 143 CHD patients (M age, 61 years; SD, 11.2; 70% men, 91% Caucasian, 64% married) entering CR who were evaluated via a semistructured, psychiatric interview to assess both current and lifetime prevalence rates of PD. Demographic, medical, and psychosocial variables were also assessed. RESULTS Approximately 45% met criteria for at least 1 anxiety disorder, and 20% met criteria for either major depressive disorder or dysthymic disorder either at the time of evaluation or in their lifetime. Across all participants, 26% met criteria for >or=2 PD. Of those with a depressive disorder, 76% also met criteria for at least 1 anxiety disorder. Participants with comorbid PD were of younger age and female and reported less education (P < .01). Comorbidity was also associated with self-reported overall diminished physical, emotional, and social quality of life, depression, and anxiety. CONCLUSION Comorbid PD are highly prevalent in the CR setting and are associated with specific demographic characteristics and reduced quality of life. These data offer additional support that routine screening for PD is warranted in outpatient cardiac settings.
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El Baz N, Middel B, van Dijk JP, Boonstra PW, Reijneveld SA. Coronary artery bypass graft (CABG) surgery patients in a clinical pathway gained less in health-related quality of life as compared with patients who undergo CABG in a conventional-care plan. J Eval Clin Pract 2009; 15:498-505. [PMID: 19366385 DOI: 10.1111/j.1365-2753.2008.01051.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to determine the difference between clinical pathway (CP) and conventional care in terms of health-related quality of life (HRQoL) domains, depression and anxiety, as well as to determine the relative contribution of CP towards an improved HRQoL after coronary artery bypass graft (CABG). METHOD A longitudinal quasi-experimental pre-test/post-test design was used to study and compare clinical outcome, HRQoL depression and anxiety for CP versus conventional-care patients after CABG. HRQoL was measured by using Sf-36, while depression and anxiety were measured by using hospital anxiety and depression scale. Length of stay and patient complications were derived from the hospital database. RESULTS We found that implementing a CP decreased hospital delay from 2.50 (+/-7.19) to 1.80 (+/-1.60), which was statistically significant P = 0.002. We also found that patients in the conventional-care plan improved more than patients in the CP in HRQoL. Outcomes in favour of patients in the conventional-care trajectory were based on the difference between small effect sizes (ES) (> or =0.20 <0.50) for pathway patients and moderate ES (> or =0.50 <0.80) for conventional-care patients, except for the domain of physical functioning and physical component summary, where the ES for conventional care was large (>0.80). CONCLUSION The aim of designing and implementing pathways is to decrease length of stay and costs, while maintaining quality of care and improving patient outcomes. Our findings suggest that these aims were not fulfilled in this CABG pathway. We recommend that when designing a CP, all patient-related characteristics, risk indicators, along with physiological status, be taken into consideration.
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Affiliation(s)
- Noha El Baz
- University Medical Center Groningen, Department of Health Sciences, Subdivision Care Sciences, University of Groningen, Groningen, the Netherlands
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Nakajima KM, Rodrigues RCM, Gallani MCBJ, Alexandre NMC, Oldridge N. Psychometric properties of MacNew Heart Disease Health-related Quality of Life Questionnaire: Brazilian version. J Adv Nurs 2009; 65:1084-94. [DOI: 10.1111/j.1365-2648.2009.04962.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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