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Fang S, Xu L, Liu J, Zhang X, Li M, Zhang T, Lu M. Self-rated health and health-related quality of life among cancer patients: the serial multiple mediation of anxiety and depression. BMC Psychol 2024; 12:415. [PMID: 39080782 PMCID: PMC11290125 DOI: 10.1186/s40359-024-01919-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL) in cancer patients has attracted increasing attention, which may be associated with self-rated health (SRH), anxiety, and depression. However, limited studies have focused on the mediating role of anxiety and depression in the relationship between SRH and HRQOL among cancer patients. Therefore, this study aims to explore the serial multiple mediating effects of anxiety and depression between SRH and HRQOL in cancer patients. METHODS This cross-sectional study investigated a total of 565 hospitalized cancer patients in Anhui province in China from November 2020 to October 2021. SRH was assessed using a single-item measure, anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Socio-demographic and clinical characteristics were analyzed using descriptive statistics. The relationships between SRH, anxiety, depression, and HRQOL were evaluated by Pearson correlation analysis. The serial multiple mediation of anxiety and depression was assessed by SPSS PROCESS macro. RESULTS SRH, anxiety, depression and HRQOL were significantly correlated(P < 0.001). In comparison to the fair SRH, the good SRH exhibited a significantly positive direct effect (Effect = 0.2366, Bootstrap 95%CI: 0.0642 ~ 0.4090) and total effect on HRQOL (Effect = 0.4761, Bootstrap 95%CI: 0.2975 ~ 0.6546). Conversely, the poor SRH demonstrated a significantly negative total effect on HRQOL (Effect= -0.4321, Bootstrap 95%CI: -0.7544~ -0.1099). When considering the fair SRH as the reference group, the poor SRH displayed a negative indirect effect on HRQOL through the single mediation of anxiety (Effect= -0.1058, Bootstrap 95%CI: -0.2217~ -0.0107) and the serial mediation of anxiety and depression (Effect= -0.0528, Bootstrap 95%CI: -0.1233~ -0.0035). Conversely, the good SRH had a positive indirect impact on HRQOL through the single mediation of anxiety (Effect = 0.1153, Bootstrap 95%CI: 0.0583 ~ 0.1900) and depression (Effect = 0.0667, Bootstrap 95%CI: 0.0206 ~ 0.1234), as well as the serial mediation of anxiety and depression (Effect = 0.0575, Bootstrap 95%CI: 0.0192 ~ 0.1030). CONCLUSION SRH can improve HRQOL through the decrease of anxiety and depression in cancer patients. Focusing on SRH would be beneficial for their mental health and HRQOL in cancer patients.
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Affiliation(s)
- Shuowen Fang
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Lingfeng Xu
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Jingsong Liu
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Xinzhou Zhang
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Mimi Li
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Tao Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Manman Lu
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China.
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Ren XQ, Zhao GM, Fang SW, Xu LF, Wang LD, Zhao LH, Lu MM. Mediating roles of activities of daily living and depression on the relationship between sleep quality and health-related quality of life. Sci Rep 2024; 14:14057. [PMID: 38890451 PMCID: PMC11189409 DOI: 10.1038/s41598-024-65095-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 06/17/2024] [Indexed: 06/20/2024] Open
Abstract
This study aimed to explore the mediating effects of ADL and depression on the relationship between sleep quality and HRQOL among older people in rural China, while also exploring the moderating impact of loneliness. The study gathered data from a household survey conducted among 1587 Chinese rural older adults (mean age = 73.63 years). The collected data was analyzed using SPSS version 23.0 software (IBM, New York, USA) and the PROCESS macro version 4.0 program. The findings indicated a significant correlation between sleep quality, ADL, depression, loneliness and HRQOL. ADL and depression exhibited a chain mediation effect on the relationship between sleep quality and HRQOL. Notably, the association between sleep quality and HRQOL was entirely mediated by ADL and depression. Additionally, loneliness acted as a moderator in the relationship between ADL and HRQOL. The findings of this study suggest that interventions focusing on sleep quality should prioritize strategies for enhancing older adults' ADL and depression as integral components of promoting older adults' HRQOL.
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Affiliation(s)
- Xiao-Qing Ren
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Gong-Ming Zhao
- School of Public Health, Fudan University, Shanghai, 200032, China
| | - Shuo-Wen Fang
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Ling-Feng Xu
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Li-Dan Wang
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- Health Policy Research Center, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Lin-Hai Zhao
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- Health Policy Research Center, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Man-Man Lu
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
- Health Policy Research Center, Anhui Medical University, Hefei, 230032, Anhui, China.
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Sun X, Wang Y, Lu X, Zhang S, Zhang Y. Factors influencing family resilience in adult patients with acute leukemia undergoing chemotherapy: A qualitative study. Asia Pac J Oncol Nurs 2024; 11:100389. [PMID: 38495641 PMCID: PMC10944098 DOI: 10.1016/j.apjon.2024.100389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/27/2024] [Indexed: 03/19/2024] Open
Abstract
Objective To explore the factors influencing family resilience in adult patients with acute leukemia undergoing chemotherapy, with the aim of providing a theoretical basis for the development of strategies to strengthen their family resilience. Methods A descriptive phenomenological qualitative research method was used to select 11 adult acute leukemia chemotherapy patients for semi-structured interviews. Colaizzi 7-step analysis and NVivo 12.0 were used to summarize information and refine themes. Results The main outcomes consisted of two themes and 11 sub-themes: protective factors for family resilience (positive traits, cognitive restructuring, positive family beliefs, organizational flexibility, clear communication, and social support) and risk factors for family resilience (symptom burden, self-concealment, role overload, economic distress, and social alienation). Conclusions Health care professionals should pay attention to screening protective and risk factors for family resilience in adult acute leukemia chemotherapy patients, affirming the positive role of internal and external resources available in the family in stressful situations, alleviating patients' negative experiences, and promoting the recovery of family function.
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Affiliation(s)
- Xuhan Sun
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuqing Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinyu Lu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shuyu Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuxi Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
- Geriatric Hematology/Radiotherapy Ward, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing, China
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He S, Chen L, Wang P, Xi X. Psychometric Comparison of EQ-5D-Y, CHU-9D, and PedsQL 4.0 in Chinese Children and Adolescents With Functional Dyspepsia: A Multicenter Study. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1754-1762. [PMID: 37722594 DOI: 10.1016/j.jval.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 08/20/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVES This study aimed to assess and compare psychometric properties of the 3 health-related quality of life (HRQOL) instruments EQ-5D Youth version (EQ-5D-Y), Child Health Utility 9D (CHU-9D), and Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) in children and adolescents with functional dyspepsia (FD) in China. METHODS A consecutive sample of FD outpatients were recruited from 6 tertiary medical centers in Hangzhou. The patients self-completed the 3 instruments in random order. Their feasibility, acceptability, construct validity (convergent, divergent, and known-group validity), and sensitivity were assessed. Multiple linear regression was used for identifying HRQOL-associated factors. RESULTS A total of 1100 patients (mean age, 9.2 years; girl, 56.8%) completed the survey with no missing responses. Ceiling effect was quite higher in EQ-5D-Y (60.9%) than CHU-9D (33.8%) and PedsQL 4.0 (1.0%). The EQ-5D-Y and CHU-9D utility scores and PedsQL 4.0 total score were highly correlated (|r| = 0.593-0.661), except for the EuroQol visual analog scale score (EQ-VAS). The intraclass correlation coefficient between the 2 utility scores was fair (0.542). Most conceptually similar dimensions among the 3 instruments showed moderate to high correlations (|r| > 0.3) as hypothesized. The difference was statistically significant for the 2 utility scores and PedsQL 4.0 total score in varied severity groups (P < .001), and PedsQL 4.0 total score had higher relative efficiency and effect size values. The child's age, severity of FD symptoms, and their guardian's education had significant impact on HRQOL (P < .001). CONCLUSIONS EQ-5D-Y, CHU-9D, and PedsQL 4.0 demonstrated acceptable psychometric properties in Chinese children with FD. PedsQL 4.0 showed superior sensitivity and is recommended. EQ-5D-Y and CHU-9D utility scores were not interchangeable. The measurement properties of EQ-VAS need to be further explored.
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Affiliation(s)
- Siyu He
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Liangjiang Chen
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China.
| | - Xiaoyu Xi
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu, China.
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Sun Y, Zhou HJ, Shen A, Wu B, Wang W, Luo N, Wang P. A cross-sectional study evaluating health-related quality of life of Chinese pediatric patients with hematological malignancies using EQ-5D-Y. Front Public Health 2023; 10:1050835. [PMID: 36711389 PMCID: PMC9874309 DOI: 10.3389/fpubh.2022.1050835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Background The study aimed to assess health-related quality of life (HRQoL) and to estimate the health utility of pediatric patients with hematological malignancies (HMs) in China. Method A cross-sectional study recruited a series of pediatric inpatients diagnosed with HM from November 2018 to May 2019 in the Shanghai Children's Medical Center. Subjects were interviewed to collect sociodemographic information about themselves and their guardians. The EQ-5D-Y was completed by each patient to rate their own HRQoL, which later derived the health utility. The health status was also assessed by clinicians following the Eastern Cooperative Oncology Group (ECOG) system. Upon the descriptive analysis and univariate analysis, multivariate generalized linear models were built to explore the associations of risk factors with HRQoL measures of utility, Visual Analog Scale (VAS) score, and the five EQ-5D-Y domains. Results The 96 subjects had a mean age of 10.5 years and included 62 (64.4%) boys. There were 46 (47.9%) and 25 (26.0%) children diagnosed with acute lymphoblastic leukemia and non-Hodgkin's lymphoma, respectively. The means (SD) of utility and EQ-VAS scores were 0.88 (0.10) and 85.8 (15.1), respectively. Twenty-six (27.1%) patients were graded poor health by the ECOG standard (score 2/3). Both univariate and multivariate analyses found strong correlations between ECOG and HRQoL. After adjusting for covariates, poor ECOG score was significantly associated with an impaired utility and VAS of -0.103 and -8.65, respectively. With regard to individual HRQoL domains, worse ECOG was more likely to report health problems with an increased risk of 2.94 to 12.50; residence, income, guardians' education, and disease duration were also found to be significantly related to either the utility or certain health domains. Conclusion The HRQoL of Chinese pediatric patients with HM is considered relatively poor and of great concern to healthcare. With the strong correlations between EQ-5D-Y-related HRQoL measures and the traditional clinical index ECOG, the EQ-5D-Y is able to provide valuable evidence for clinical decision-making at the individual level. At the same time, its health utility can inform resource allocation at a macro level.
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Affiliation(s)
- Yue Sun
- Division of Medical Affairs, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Hui-Jun Zhou
- Business School, University of Shanghai for Science and Technology, Shanghai, China,*Correspondence: Hui-Jun Zhou ✉
| | - Anle Shen
- Department of Pharmacy, Shanghai Children's Medical Centre, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Bin Wu
- Medical Decision and Economic Group, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wei Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Pei Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China,School of Public Health, Fudan University, Shanghai, China,Pei Wang ✉
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Systemic Diseases with Oral Manifestations and Their Impact on Health-Related Quality of Life. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Abstract
Health-related quality of life is a multidimensional concept established to evaluate the physical, psychological, and social impacts of health conditions on individuals’ well-being. Various tools for measuring health-related quality of life can be categorized into two subsets: generic and disease–specific instruments. The oral cavity can be stricken by a broad range of local and systemic diseases and their systemic treatment modalities. The most common systemic illnesses associated with oral lesions are hematologic disorders, endocrinopathies, neurological disorders, gastrointestinal conditions, mucocutaneous and rheumatic diseases, and neoplastic processes. Their manifestations in the oral cavity are, in most cases, rather nonspecific but should not be overlooked. Oral health is one of the most important parts of overall health, thus it has been proposed that poor oral health may affect health–related quality of life. The presence of oral manifestations of systemic diseases has a negative impact on the daily functioning of patients, decreasing their overall well-being. This article will review the most common systemic diseases with oral manifestations and their impact on the health–related quality of life. Oral health researchers should put a stronger emphasis on the patient-reported quality of life as a primary outcome in future clinical trials. The significance of this area has still not been widely understood in the current dental literature even though it could help improve patients’ health-related quality of life.
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Osaki K, Morishita S, Takami S, Sakai Y, Kamimura A, Shindo A, Kawata E. Quality of life of patients with hematological malignancies and factors affecting health state utility values. Support Care Cancer 2022; 30:5319-5327. [PMID: 35278136 DOI: 10.1007/s00520-022-06958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE It is well studied that physical function and social background affect the quality of life (QoL) of cancer patients. However, differences in QoL by age and factors affecting health state utility values (HSUV) of patients with hematological malignancies have not yet been sufficiently investigated. Our aim is to investigate the factors that affect QoL and HSUV in such patients. METHODS A total of 32 patients with hematological malignancies on outpatient chemotherapy were included. QoL and HSUV were evaluated using the EuroQol-5 Dimension 5-level (EQ-5D-5L). Physical function was assessed using grip strength, knee extension strength, 6-min walking distance, and Short Physical Performance Battery (SPPB). Fatigue was assessed using Brief Fatigue Inventory (BFI), and nutritional status was assessed using Mini Nutritional Assessment-Short Form (MNA-SF). RESULTS In the EQ-5D-5L, a high percentage of the patients were aware of mobility problems and pain/discomfort, and mobility problems were more common in the older-aged group (≥ 65 years old, n = 16) than in the middle-aged group (< 65 years old, n = 16). In addition, the older-aged group showed lower HSUV and physical function. SPPB (β = 0.38, p < 0.01), BFI (β = - 0.58, p < 0.01), and MNA-SF (β = 0.29, p = 0.02) were independent factors affecting HSUV (adjusted R2 = 0.65, p < 0.01). BFI was correlated with HSUV in both older and middle-aged groups. CONCLUSION Comprehensive supports, to improve lower extremity function, fatigue, and nutritional status, are required to augment QoL and HSUV in patients with hematological malignancies.
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Affiliation(s)
- Keiichi Osaki
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima, Fukushima, 960-8516, Japan.
| | - Suzuho Takami
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Yuki Sakai
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Akiho Kamimura
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Atsushi Shindo
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Eri Kawata
- Department of Hematology, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
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