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Witts WK, Amu H, Dowou RK, Kwafo FO, Bain LE. Health-related quality of life among adults living with chronic non-communicable diseases in the Ho Municipality of Ghana: a health facility-based cross-sectional study. BMC Public Health 2024; 24:725. [PMID: 38448856 PMCID: PMC10918919 DOI: 10.1186/s12889-024-18143-3] [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: 04/03/2023] [Accepted: 02/17/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Morbidity and mortality rates from chronic non-communicable diseases (CNCDs) are increasing globally. In Ghana, CNCDs account for 43% of all deaths. We examined the Health-Related Quality of Life (HRQoL) and associated factors among adults living with CNCDs in the Ho Municipality. METHODS This was a health facility-based descriptive cross-sectional study among 432 adults living with cancer, diabetes, chronic kidney disease (CKD), stroke, and hypertension in the Ho Municipality of Ghana. The study adopted the EQ-5D-5L instrument and the Ugandan value set to compute respondents' HRQoL index. Quantile regression models were used in analysing the data with STATA v17.0 at 95% Confidence Intervals, and statistical significance set at p < 0.05. RESULTS 63.7% of our respondents reported having a problem across the five dimensions of the EQ-5D-5L. The most problems were reported in the dimensions "Anxiety/Depression" (94.4%) and "Pain/Discomfort" (91.4%). Divorced/separated respondents (aOR=-0.52, 95% CI=-0.71, -0.33) and those living with comorbidities (aOR=-0.95, 95% CI=-0.15, -0.04,) were less likely to report high index for HRQoL. However, respondents diagnosed with CKD (aOR = 0.26, 95% CI = 0.10, 0.42), diabetes (aOR = 0.28, 95% CI = 0.11, 0.45), hypertension (aOR = 0.35, 95% CI = 0.19, 0.50) and stroke (aOR = 0.26, 95% CI = 0.11, 0.40) were more likely to report higher index than those diagnosed with cancer. CONCLUSION Our study revealed elevated proportions of reported problems in the "Anxiety/Depression" and "Pain/Discomfort" dimensions, indicating noteworthy concerns in these areas of HRQoL. The prevalent issues reported across HRQoL dimensions are cause for concern, posing potential exacerbation of health conditions. We advocate for collaborative efforts from the Ministry of Health, Ghana Health Service, and relevant stakeholders to scrutinize and implement interventions targeting social and psychological factors. These efforts should specifically address contributors to diminished health-related quality of life, particularly among less educated, divorced, and comorbid individuals.
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Affiliation(s)
- William Kwame Witts
- Department of Epidemiology and Biostatistics, F.N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Hubert Amu
- Department of Population and Behavioural Sciences, F.N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, F.N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Frank Oppong Kwafo
- Department of Epidemiology and Biostatistics, F.N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Luchuo Engelbert Bain
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, Auckland Park, South Africa
- International Development Research Centre, IDRC, Ottawa, Canada
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Chung CCY, Chu ATW, Chung BHY. Rare disease emerging as a global public health priority. Front Public Health 2022; 10:1028545. [PMID: 36339196 PMCID: PMC9632971 DOI: 10.3389/fpubh.2022.1028545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/30/2022] [Indexed: 01/29/2023] Open
Abstract
The genomics revolution over the past three decades has led to great strides in rare disease (RD) research, which presents a major shift in global policy landscape. While RDs are individually rare, there are common challenges and unmet medical and social needs experienced by the RD population globally. The various disabilities arising from RDs as well as diagnostic and treatment uncertainty were demonstrated to have detrimental influence on the health, psychosocial, and economic aspects of RD families. Despite the collective large number of patients and families affected by RDs internationally, the general lack of public awareness and expertise constraints have neglected and marginalized the RD population in health systems and in health- and social-care policies. The current Coronavirus Disease of 2019 (COVID-19) pandemic has exposed the long-standing and fundamental challenges of the RD population, and has reminded us of the critical need of addressing the systemic inequalities and widespread disparities across populations and jurisdictions. Owing to the commonality in goals between RD movements and universal health coverage targets, the United Nations (UN) has highlighted the importance of recognizing RDs in policies, and has recently adopted the UN Resolution to promote greater integration of RDs in the UN agenda, advancing UN's commitment in achieving the 2030 Sustainable Development Goals of "leav[ing] no one behind." Governments have also started to launch Genome Projects in their respective jurisdictions, aiming to integrate genomic medicine into mainstream healthcare. In this paper, we review the challenges experienced by the RD population, the establishment and adoption of RD policies, and the state of evidence in addressing these challenges from a global perspective. The Hong Kong Genome Project was illustrated as a case study to highlight the role of Genome Projects in enhancing clinical application of genomic medicine for personalized medicine and in improving equity of access and return in global genomics. Through reviewing what has been achieved to date, this paper will provide future directions as RD emerges as a global public health priority, in hopes of moving a step toward a more equitable and inclusive community for the RD population in times of pandemics and beyond.
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Affiliation(s)
| | | | | | - Brian Hon Yin Chung
- Hong Kong Genome Institute, Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Ng YNC, Ng NYT, Fung JLF, Lui ACY, Cheung NYC, Wong WHS, Lee SL, Knapp M, Chung CCY, Chung BHY. Evaluating the Health-Related Quality of Life of the Rare Disease Population in Hong Kong Using EQ-5D 3-Level. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1624-1633. [PMID: 35568675 DOI: 10.1016/j.jval.2022.04.1725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to establish a normative profile of health-related quality of life (HRQOL) of the rare disease (RD) population in Hong Kong (HK) and identify potential predictors. METHODS Between March 2020 and October 2020, patients with RD and caregivers were recruited through Rare Disease Hong Kong, the largest RD patient group alliance in HK. HRQOL was derived using the EQ-5D 3-Level with reference to the established HK value set. Utility scores were stratified according to demographics and disease-related information. Multiple linear regression was performed to explore the associations between patient characteristics and HRQOL. RESULTS A total of 286 patients, covering 107 unique RDs, reported a mean utility score of 0.53 (SD 0.36). Thirty patients (10.5%) reported negative utility scores, indicating worse-than-death health states. More problems were recorded in the "usual activities" and "self-care" dimensions. Univariate analyses revealed that neurologic diseases, high out-of-pocket expenditure, home modification, and living in public housing or subdivided flats/units were significantly associated with lower HRQOL. A total of 99 caregivers reported a mean utility score of 0.78 (SD 0.17), which was significantly associated with the utility score of patients they took care of (r = 0.32; P = .001). CONCLUSIONS The normative profile of the RD population was established, which revealed lower HRQOL in the RD population than other chronic disease groups and general population in HK. Findings were corroborated by evidence from other cohorts using EQ-5D, combined as part of a meta-analysis. Identifying predictors highlight areas that should be prioritized to improve HRQOL of RD population through clinical and psychosocial dimensions.
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Affiliation(s)
- Yvette N C Ng
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Nicole Y T Ng
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jasmine L F Fung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Adrian C Y Lui
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Nicholas Y C Cheung
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - So Lun Lee
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Martin Knapp
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, England, UK
| | - Claudia C Y Chung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Brian H Y Chung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Xu RH, Keetharuth AD, Wang LL, Cheung AWL, Wong ELY. Measuring health-related quality of life and well-being: a head-to-head psychometric comparison of the EQ-5D-5L, ReQoL-UI and ICECAP-A. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:165-176. [PMID: 34338898 PMCID: PMC8327050 DOI: 10.1007/s10198-021-01359-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/20/2021] [Indexed: 05/16/2023]
Abstract
OBJECTIVE This study aimed to assess the psychometric properties of three generic preference-based measures and compare their performance in a sample of Hong Kong general population. METHODS Data used for this analysis were obtained from a cross-sectional telephone-based survey in July 2020. Participants were asked to complete several measures, including The EuroQol five-dimensional five levels (EQ-5D-5L), Recovering Quality of Life-Utility Index (ReQoL-UI) and ICEpop CAPability measure for adults (ICECAP-A). Acceptability, reliability, convergent and discriminant validity of three measures were assessed as well as the agreement between these instruments. RESULTS Based on data from 500 participants to the survey, a lower mean score of the ICECAP-A (mean = 0.85) was observed compared to the other two measures (meanReQoL-UI = 0.92; meanEQ-5D-5L = 0.92). All three measures showed an acceptable internal consistency reliability (Cronbach's alpha = 0.74, 0.82 and 0.77, respectively) as well as good test-retest reliability (intra-class correlation coefficient = 0.74, 0.82 and 0.77, respectively). Correlation analyses confirmed satisfactory convergent validity and the ability of the measures to differentiate between participants with different health or from socioeconomic status groups. The Bland-Altman plot revealed poor agreement between the three measures. CONCLUSIONS This study confirmed that EQ-5D-5L, ReQoL-UI and ICECAP-A were psychometrically robust to measure HRQoL in the general HK population. The EQ-5D-5L was more suitable for assessing physical HRQoL, whereas the ICECAP-A and ReQoL-UI were more appropriate for measuring interventions aimed at improving people's well-being and mental health.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China.
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | - Ling-Ling Wang
- Department of Blood Transfusion, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Niu J, Ning L, Zhang Q, Liu Z, Ma Y, Xu X, Wu Q, Hao Y, Cui Y, Liu C. Health-related quality of life of patients with haemophilia: a cross-sectional survey in the Northeast of China. BMJ Open 2022; 12:e056668. [PMID: 35105597 PMCID: PMC8808448 DOI: 10.1136/bmjopen-2021-056668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Haemophilia is a hereditary, chronic and haemorrhagic disorder caused by a deficiency in coagulation factors. Long-term spontaneous bleeding of joints and soft tissues can seriously affect the quality of life of patients. OBJECTIVE The study aimed to assess the health-related quality of life (HRQoL) of patients with haemophilia and associated factors. METHODS A snowball sampling strategy was adopted to select study participants. Eligible participants were those who were 18 years or older and had mild, moderate or severe haemophilia. They were asked to self-complete a questionnaire, collecting data regarding their sociodemographic characteristics, target joint status and HRQoL measured by the EQ-5D-5L(a tool developed by the European quality of life (EuroQol) Group). RESULTS The respondents reported a mean EQ-5Dutility(country-specific valuesets for the EQ-5D-5L) score of 0.51 (SD=0.34). Those with severe haemophilia had a lower utility score than those with mild/moderate haemophilia (0.46±0.37 vs 0.56±0.30, p=0.737). The linear regression analyses showed that older age (>25 years), two or more target joints, not working, low levels of knowledge of the disease and borrowing money to pay for medical treatments were associated with lower EQ-5Dutility scores. CONCLUSION Low HRQoL of patients with haemophilia is evident in China. Social support needs to be strengthened to address this issue.
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Affiliation(s)
- Jinyu Niu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Liangwen Ning
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qiao Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ze Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yi Ma
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xiaoxue Xu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yu Cui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Chaojie Liu
- School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
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Xu RH, Dong D, Luo N, Wong ELY, Yang R, Liu J, Yuan H, Zhang S. Mapping the Haem-A-QoL to the EQ-5D-5L in patients with hemophilia. Qual Life Res 2021; 31:1533-1544. [PMID: 34846671 DOI: 10.1007/s11136-021-03051-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study's objective was to develop an algorithm that mapping the Haem-A-QoL scores to EQ-5D-5L utility scores in patients with hemophilia in China. METHODS A national sample of 862 patients with hemophilia completed both the EQ-5D-5L and Haem-A-QoL instruments. Eight regression models were selected to develop the mapping algorithm, they were: the ordinary least squares, general linear regression, Tobit regression, censored least absolute deviation, mixture beta regression, adjusted limited dependent variable mixture, the two-part, and robust MM-estimator model. Root mean squared error (RMSE), mean absolute error (MAE), and R-square (R2) calculated using the tenfold cross-validation and random sample validation methods were used to assess the predictive ability of the models. RESULTS Based on RMSE, MAE, and R2, the mixture beta regression model with selected Haem-A-QoL subscale scores as the predicted variables showed the best performance. CONCLUSIONS Our mapping algorithm bolsters the calculation of QALYs while conducting an economic evaluation of hemophilia-related interventions when only Haem-A-QoL data are available. The external validity of the algorithm should be further assessed in the other populations.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
- 4/F School of Public Health, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, China.
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Renchi Yang
- Thrombosis and Hemostasis Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Junshuai Liu
- Beijing Society of Rare Disease Clinical Care and Accessibility, Beijing, China
| | - Huiqin Yuan
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, 100730, China.
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Spronk I, Haagsma JA, Lubetkin EI, Polinder S, Janssen MF, Bonsel GJ. Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome. Front Public Health 2021; 9:744405. [PMID: 34805069 PMCID: PMC8599146 DOI: 10.3389/fpubh.2021.744405] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS). Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D-5L and the EQ VAS. The level of education was selected as a proxy for socio-economic status (SES). EQ-5D-5L level sum scores (LSS) were compared against EQ VAS scores. Stratified and multivariable analyses were used to study the associations between SES and the LSS/EQ VAS relative to the presence of chronic health conditions. Results: A total of 10,172 people participated in this study. In the UK and Netherlands, the LSS was worst for respondents with a low educational level and better for respondents with middle and high educational levels. For Italy, the LSS was best for respondents with a middle educational level compared to respondents with low and high educational levels. The same patterns were observed for the EQ VAS, but differences were slightly smaller. Multivariable analyses showed generally stronger predictive relations in the UK, and with the LSS. The presence of chronic health conditions and being unable to work were independent strong predictors, canceling out the effects of education. Conclusions: In three different European countries, the EQ-5D measures show the presence of education-dependent health inequalities, which are universally explained in regression analysis by independently the presence of chronic health conditions and the inability to work. In stratified analysis, the EQ-5D-5L LSS discriminates slightly better between participants with different levels of SES compared to the EQ VAS.
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Affiliation(s)
- Inge Spronk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Association of Dutch Burn Centers, Maasstad Hospital, Rotterdam, Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, The City University of New York School of Medicine, New York, NY, United States
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - M F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, Netherlands
| | - G J Bonsel
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,EuroQol Research Foundation, Rotterdam, Netherlands
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Van Wilder L, Devleesschauwer B, Clays E, De Buyser S, Van der Heyden J, Charafeddine R, Boeckxstaens P, De Bacquer D, Vandepitte S, De Smedt D. The impact of multimorbidity patterns on health-related quality of life in the general population: results of the Belgian Health Interview Survey. Qual Life Res 2021; 31:551-565. [PMID: 34424487 PMCID: PMC8847309 DOI: 10.1007/s11136-021-02951-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic diseases and multimorbidity are a major cause of disease burden-for patients, caregivers, and society. Little is known however about potential interaction effects between specific disease combinations. Besides an additive effect, the presence of multiple conditions could also act synergistically or antagonistically regarding the impact on patients' health-related quality of life (HRQoL). The aim was to estimate the impact of coexisting chronic diseases on HRQoL of the adult general Belgian population. METHODS The Belgian Health Interview Survey 2018 provided data on self-reported chronic conditions and HRQoL (EQ-5D-5L) for a nationally representative sample. Linear mixed models were used to analyze two-way and three-way interactions of disease combinations on HRQoL. RESULTS Multimorbidity had a prevalence of 46.7% (≥ 2 conditions) and 29.7% (≥ 3 conditions). HRQoL decreased considerably with the presence of multiple chronic diseases. 14 out of 41 dyad combinations and 5 out of 13 triad combinations showed significant interactions, with a dominant presence of negative/synergistic effects. Positive/antagonistic effects were found in more subjective chronic diseases such as depression and chronic fatigue. Conditions appearing the most frequently in significant disease pair interactions were dorsopathies, respiratory diseases, and arthropathies. CONCLUSIONS Diverse multimorbidity patterns, both dyads and triads, were synergistically or antagonistically associated with lower HRQoL. Tackling the burden of multimorbidity is needed, especially because most disease combinations affect each other synergistically, resulting in a greater reduction in HRQoL. Further knowledge about those multimorbidity patterns with a greater impact on HRQoL is needed to better understand disease burden beyond mortality and morbidity data.
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Affiliation(s)
- Lisa Van Wilder
- Department of Public Health and Primary Care, Ghent University, University Hospital, Corneel Heymanslaan 10 4K3, 9000, Ghent, Belgium.
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, University Hospital, Corneel Heymanslaan 10 4K3, 9000, Ghent, Belgium
| | - Stefanie De Buyser
- Biostatistics Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Rana Charafeddine
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Pauline Boeckxstaens
- Department of Public Health and Primary Care, Ghent University, University Hospital, Corneel Heymanslaan 10 4K3, 9000, Ghent, Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, University Hospital, Corneel Heymanslaan 10 4K3, 9000, Ghent, Belgium
| | - Sophie Vandepitte
- Department of Public Health and Primary Care, Ghent University, University Hospital, Corneel Heymanslaan 10 4K3, 9000, Ghent, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, University Hospital, Corneel Heymanslaan 10 4K3, 9000, Ghent, Belgium
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Dimassi H, Nasser SC, Issa A, Adrian SS, Hazimeh B. Health-Related Quality of Life in Patients with Health Conditions in Lebanese Community Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168817. [PMID: 34444566 PMCID: PMC8391961 DOI: 10.3390/ijerph18168817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 11/18/2022]
Abstract
Background: The measurement of health-related quality of life (HRQoL) provides utility scores that could be used for health economics assessment. The aim of this study was to measure HRQoL in Lebanese patients with certain medical conditions, and to determine demographic and medical factors affecting such health utility scores. Method: This was a prospective cross-sectional pilot study conducted to gather information on the socioeconomic status, health condition and quality of life of participants with common diseases during their community pharmacy visit. The EuroQol-5-Dimension instrument was used to measure utility scores and SPSS v26 was used to perform the statistical analysis. Results: Participants (n = 102) gave an average of 6.8 and 7.4 out of 10 for their current health and for their satisfaction with their treatment, respectively. The mean utility score was 0.762 (SD 0.202). The number of prescribed medications per respondent indicated a significant impact on HRQoL (p = 0.002). On average, the utility scores were low for participants who were 75 years or older (0.15, p < 0.001), and those who were hospitalized in the past 12 months (0.111, p < 0.001). For every unit increase in treatment satisfaction, the quality-of-life score increased by 0.036 unit (p = 0.001). Conclusion: This pilot study measured health utility scores and factors influencing HRQoL in the Lebanese population. Further studies are needed to confirm our findings and to develop and validate tools helping to measure health related quality of life in the population in Lebanon.
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Affiliation(s)
- Hani Dimassi
- School of Pharmacy, Lebanese American University, Byblos 1401, Lebanon; (H.D.); (S.S.A.)
| | - Soumana C. Nasser
- School of Pharmacy, Lebanese American University, Byblos 1401, Lebanon; (H.D.); (S.S.A.)
- Correspondence: ; Tel.: +96-1348-9860
| | - Aline Issa
- School of Pharmacy, Saint Joseph University, Beirut 1100, Lebanon;
| | - Sarine S. Adrian
- School of Pharmacy, Lebanese American University, Byblos 1401, Lebanon; (H.D.); (S.S.A.)
| | - Bassima Hazimeh
- Institute of Public Health, Saint Joseph University, Beirut 1100, Lebanon;
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10
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Ageing, Health-Related Quality of Life and Physical Activity – Evidence Based on the EQ-5D-5L. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09445-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Xu RH, Keetharuth AD, Wang LL, Cheung AWL, Wong ELY. Psychometric Evaluation of the Chinese Recovering Quality of Life (ReQoL) Outcome Measure and Assessment of Health-Related Quality of Life During the COVID-19 Pandemic. Front Psychol 2021; 12:663035. [PMID: 34393899 PMCID: PMC8356898 DOI: 10.3389/fpsyg.2021.663035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The primary objective was to translate the Recovering Quality of Life (ReQoL) measures from English to traditional Chinese and assess their psychometric properties in Hong Kong (HK) Chinese population. The secondary objective was to investigate the mental health-related quality of life (HRQoL) of this sample during the coronavirus disease 2019 (COVID-19) pandemic. Method Recovering Quality of Life was translated to Traditional Chinese adhering to standard guideline recommended by the official distributors. Five hundred members of the general population were successfully recruited to participate in a telephone-based survey. The following psychometric properties of the ReQoL were evaluated: construct, convergent, and known-group validity and internal consistency and test-retest reliability. The item measurement invariance was assessed on the basis of differential item functioning (DIF). Multiple regression analysis was used to assess the relationship between respondents' characteristics and mental HRQoL. Results Results of confirmatory factor analysis (CFA) supported a two-factor structure of the ReQoL. The ReQoL showed significant correlations with the other mental health, quality of life, and well-being measures, which indicated a satisfactory convergent validity. Known-group validity confirmed that ReQoL is able to differentiate between people with different mental health status. The (Cronbach's alpha = 0.91 and 0.76 for positive [PF] and negative [NF] factor), and McDonald's omega of 0.89 (PF = 0.94, NF = 0.82) indicated the ReQoL has good reliability as well as test-retest reliability with an intraclass correlation coefficient of 0.75. Four items showed negligible DIF with respect to age. Respondents who were highly educated and without psychological problems reported a high ReQoL score. Conclusion Traditional Chinese ReQoL was shown to be a valid and reliable instrument to assess the recovery-focused quality of life in HK general population. Future studies are needed to appraise its psychometric properties in local people experiencing mental disorders.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.,Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | - Ling-Ling Wang
- Blood Transfusion Department, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Comparing the measurement properties of the EQ-5D-5L and the EQ-5D-3L in hypertensive patients living in rural China. Qual Life Res 2021; 30:2045-2060. [PMID: 33821418 DOI: 10.1007/s11136-021-02786-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to compare the measurement properties of two versions of EQ-5D (i.e.EQ-5D-3L and EQ-5D-5L) in hypertensive patients in rural China. METHODS A cross-sectional survey was carried out in hypertensive patients in rural China. We compared the ceiling effects, redistribution properties, informativity, known-groups validity, and relative efficiency of the 3L and 5L and examined their agreement. RESULTS A total of 11,412 patients were enrolled in our study. The mean EQ-5D index score was 0.84 (SD 0.21) according to the 5L and 0.86 (SD 0.17) according to the 3L. A good agreement was observed between the 3L and 5L. The overall ceiling effect decreased from 46.4% (3L) to 29.4% (5L). The Shannon index, H' improved in all dimensions when used 5L. When used 3L, the median responses of all groups were consistent with 5L across the three dimensions of 'mobility', 'self-care', 'usual activities', while the median responses were inconsistent for the 'pain/discomfort' and 'anxiety/depression' dimensions. The 3L performed better in eight comorbidities in terms of F-statistics and six comorbidities in terms of the area under the receiver operating characteristic curves (AUROCs). The 5L performed better both in terms of the F-statistics and AUROCs in age, education level, anti-hypertensive medication use. CONCLUSION Taking all comparisons into account, we recommend the EQ-5D-5L for use in patients with hypertension in rural China.
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Xu RH, Wong ELY, Cheung AWL. Estimation of minimally important difference of the EQ-5D-5L utility scores among patients with either hypertension or diabetes or both: a cross-sectional study in Hong Kong. BMJ Open 2020; 10:e039397. [PMID: 33243797 PMCID: PMC7692985 DOI: 10.1136/bmjopen-2020-039397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To estimate and report the minimally important difference (MID) of the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) using the Hong Kong (HK) utility score among patients with either hypertension or diabetes or both. DESIGN Data were analysed using secondary data analysis based on a cross-sectional study assessing patients' experiences in HK. SETTING A representative sample was recruited from 26 specialist outpatient clinics in HK. PARTICIPANTS We analysed data from 2231 and 662 patients who reported having hypertension or diabetes alone, respectively, and 874 patients had these two diseases. INTERVENTION An instrument-defined approach was applied to estimate MID stratified according to sex and age for the three subpopulations. RESULTS The overall MID (oMID) estimates were 0.089, 0.086 and 0.089 for patients with hypertension or diabetes alone and with these two diseases, respectively. The adjusted MID (aMID) estimate was smaller than the oMID, and the improved MID was larger than the deteriorated MID. Women had larger oMID but smaller aMID than men. Younger respondents had larger aMID than older respondents. Effect sizes ranged from 0.30 to 0.503, which fit our preset criteria. CONCLUSION Four types of MID of the EQ-5D utility score for patients with hypertension or diabetes alone and with these two diseases were reported. Variations in the MID estimates should be further explored in other populations or using different statistical methods.
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Affiliation(s)
- Richard Huan Xu
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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14
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Yang Q, Yu X, Zhang W. Health variations among breast-cancer patients from different disease states: evidence from China. BMC Health Serv Res 2020; 20:1033. [PMID: 33176759 PMCID: PMC7661201 DOI: 10.1186/s12913-020-05872-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 10/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study aimed to obtain health utility parameters among Chinese breast cancer patients in different disease states for subsequent health economics model. In addition, we aimed to explore the feasibility of establishing a breast cancer health utility mapping model in China. METHODS Multiple patient-reported health attributes were assessed, including quality of life, which was measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B) instrument; health utility and self-rated health, which were measured by the EuroQol-5 Dimension-5 Level (EQ-5D-5L) questionnaire. Multivariate regression models, including a linear regression model, an ordinal logistic regression model and a Tobit model, were employed to analyze health differences among 446 breast cancer patients. Subgroup analyses were performed to examine differences in multiple dimensions of health derived from the FACT-B and EQ-5D-5L instruments. A mapping function was used to estimate health utility from quality of life. Rank correlation analyses were employed to examine the correlation between estimated and observed health utility values. RESULTS A total of 446 breast cancer patients with different disease states were analyzed. The health utility values of breast cancer patients in the P state (without cancer recurrence and metastasis), R state (with cancer recurrence within a year), S state (with primary and recurrent breast cancer for the second year and above), and M state (metastatic cancer) were 0.81 (SD ± 0.23), 0.90 (SD ± 0.12), 0.78 (SD ± 0.31), and 0.74 (SD ± 0.27), respectively. There were positive correlations between all scores, including every domain of the FACT-B instrument (p < 0.001). Results from multivariate analysis suggested that patients in the R and M states had lower scores for overall quality of life (R, β = - 9.45, p < 0.01; M, β = - 6.72, p < 0.05). Patients in the M state had lower health utility values than patients in the P state (β = - 0.11, p < 0.05). Estimated health utility values, which were derived from quality of life by using a mapping function, were significantly correlated with directly measured health utility values (p < 0.001). CONCLUSIONS We obtained the health utility and health-related quality of life (HRQoL) scores of Chinese breast cancer patients in different disease states. Mapping health utility values from quality of life using four disease states could be feasible in health economic modelling, but the mapping function may need further revision.
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Affiliation(s)
- Qing Yang
- Institute of Hospital Management, West China Hospital, Sichuan University, 37 Guo Xue Alley, Chengdu, 610040 Sichuan China
| | - Xuexin Yu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Alley, Chengdu, 610040 Sichuan China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Alley, Chengdu, 610040 Sichuan China
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15
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A systematic review of the psychosocial impact of fibroids before and after treatment. Am J Obstet Gynecol 2020; 223:674-708.e8. [PMID: 32474012 DOI: 10.1016/j.ajog.2020.05.044] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/15/2020] [Accepted: 05/20/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Despite the high prevalence of uterine fibroids, the psychosocial impact of fibroids has not been evaluated across different quality of life indicators and compared with other chronic conditions. Here, we rigorously analyzed available evidence pertaining to the psychosocial burden of uterine fibroids in premenopausal women and compared validated quality of life and symptom scores before and after treatment. DATA SOURCES We searched PubMed, PsycINFO, ClinicalTrials.gov, Embase, and Cochrane Library for publications from January 1990 to January 2020. STUDY ELIGIBILITY CRITERIA We considered English-language publications that evaluated the association between uterine fibroids diagnosed by imaging studies in premenopausal women and quality of life by standardized and validated questionnaires at baseline and after treatment. We used a detailed list of terms related to quality of life, questionnaires, and uterine fibroids to conduct the search. METHODS Three reviewers screened titles and abstracts and then obtained full-text articles for further analysis. The reviewers assessed risk of bias using established Cochrane and Newcastle-Ottawa Scale guidelines. The quality of life scores of premenopausal women with fibroids were reviewed at baseline and compared with those of published quality of life scores in other disease populations in addition to after fibroid treatment. RESULTS A total of 57 studies were included in the review: 18 randomized controlled trials and 39 observational studies. Of note, the 36-Item Short Form Survey and European Quality of Life Five-Dimension Scale questionnaires both indicated a diagnosis of uterine fibroids to have a disability score that was similar to or exceeded (was a greater psychosocial stressor) a diagnosis of heart disease, diabetes mellitus, or breast cancer. Quality of life scores were lower at baseline than after treatment in all instruments measuring these variables in women with uterine fibroids, indicating significantly impaired psychosocial functioning. Uterine fibroids were associated with significant patient-reported health disabilities related to bodily pain, mental health, social functioning, and satisfaction with sex life. CONCLUSION A diagnosis of uterine fibroids was a significant psychosocial stressor among women at baseline and relative to other diseases. Validated quality of life instruments indicated therapeutic success and the improvement of both physical and emotional symptoms after treatment.
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Van Wilder L, Clays E, Devleesschauwer B, Pype P, Boeckxstaens P, Schrans D, De Smedt D. Health-related quality of life in patients with non-communicable disease: study protocol of a cross-sectional survey. BMJ Open 2020; 10:e037131. [PMID: 32912984 PMCID: PMC7485234 DOI: 10.1136/bmjopen-2020-037131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Non-communicable diseases (NCDs) are associated with lower health-related quality of life (HRQoL). However, knowledge about those diseases and predictors with a greater impact on patients' HRQoL as well as knowledge on the complex relationship between HRQoL and comorbidities is lacking. The aim of this study is to assess the impact of NCDs on patients' HRQoL, with a focus on multimorbidity and socioeconomic status. METHODS AND ANALYSIS A primary care-based cross-sectional study is conducted in Flanders (Belgium). Study participants (≥18 years) are medically diagnosed with at least one of the following diseases: cardiometabolic disorders, mental disorders and musculoskeletal disorders. A minimum of 50 general practitioners will participate to recruit participants (convenient sample) and a total of 531 patients will be enrolled (voluntary response sample). Each participant will complete a paper-based questionnaire to gather research outcomes. Statistical analyses will be performed using multiple linear regression models with HRQoL as main outcome parameter, adjusted for possible confounders. This study will generate new evidence on the key predictors of HRQoL in patients with NCDs, and particularly provide new insights in multimorbidity to improve the quality of care in primary care, to support patients' self-management and to allocate resources more effectively. ETHICS AND DISSEMINATION The study has been approved by the Ethical Committee of Ghent University Hospital, Ghent, Belgium (reference number: B670201939629) prior to the beginning of the recruitment. Study results will be disseminated through peer-reviewed publications and conference presentations.
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Affiliation(s)
- Lisa Van Wilder
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Diego Schrans
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Pauly M, Mateti UV, Shenoy P, Saj N, Philip ML. Dimensions of quality of life in the different stages of chronic kidney disease patients – A cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Yusransyah, Halimah E, Suwantika AA. Measurement of the Quality of Life of Prolanis Hypertension Patients in Sixteen Primary Healthcare Centers in Pandeglang District, Banten Province, Indonesia, Using EQ-5D-5L Instrument. Patient Prefer Adherence 2020; 14:1103-1109. [PMID: 32753850 PMCID: PMC7352006 DOI: 10.2147/ppa.s249085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/12/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction The prevalence of hypertension in Indonesia is increasing, not least in some peripheral areas, including in Pandeglang District, Banten Province. The government of Indonesia, through the Social Health Insurance Administration Body (BPJS Kesehatan) has launched a chronic disease management program (Prolanis) to achieve more optimal results in treating patients with chronic diseases, including hypertension. Objective This study aimed to measure the quality of life of Prolanis hypertension patients at the primary healthcare centers (PHCs) using EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) instrument and taking pharmacists' counseling intervention into account. This study was conducted in 96 Prolanis patients, consisting of 48 patients from 8 PHCs who did not receive pharmacists' counseling intervention (control group) and 48 other patients from 8 different PHCs who received 4 times intervention (intervention group). This study was conducted in a period of 3 months (June–August 2019) in 16 sub-districts of Pandeglang District. Methods An experimental study design was applied by considering a purposive sampling method. Patients' quality of life were measured by using EQ-5D-5L instrument and its Indonesian value set. For data analysis, we applied the Kruskal–Wallis, Mann–Whitney, Wilcoxon, and Binomial tests to investigate the differences of patients' quality of life in both groups of control and intervention. Results and Conclusions The results showed that the average utility value of the intervention group experienced an improvement at each meeting (m1 = 51.25%; m2 = 66.25%; m3 = 84.17%; and m4 = 91.67%), while the control group experienced a lower and more fluctuative improvement than the intervention group (m1 = 65.42%; m2 = 70.42%; m3 = 80.42%; and m4 = 76.67%). The same results also occurred in the average value of visual analogue scale (VAS). There was a better improvement in the intervention group than in the control group. Clinical Trial Registration Number 62/UN6.KEP/EC/2019. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/e0ehLVzB4Ig
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Affiliation(s)
- Yusransyah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia.,STIKes Salsabila Serang, Pharmacy Study Program, Banten, Indonesia
| | - Eli Halimah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Auliya A Suwantika
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, West Java, Indonesia
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Dong D, Jin J, Oerlemans S, Yu S, Yang S, Zhu J, Xu RH. Validation of the Chinese EORTC chronic lymphocytic leukaemia module - application of classical test theory and item response theory. Health Qual Life Outcomes 2020; 18:96. [PMID: 32264961 PMCID: PMC7137502 DOI: 10.1186/s12955-020-01341-z] [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: 10/01/2019] [Accepted: 03/23/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose The association of chronic lymphocytic leukemia (CLL) with health-related quality of life (HRQoL) is rarely studied globally. This study evaluated the psychometric properties of the EORTC-Chronic Lymphocytic Leukaemia (CLL17 [phase III]) module, a newly developed assessment on CLL patients’ HRQoL, among Chinese CLL patients. Methods The Chinese CLL17, comprised of three subscales (symptom burden [SB], physical condition [PC] and worries/fears [WF]), was provided by the developer team through EORTC. A cross-sectional online survey was conducted to collect data. The classical traditional theory (CTT) and the item response theory (IRT) were used to evaluate the psychometric properties of CLL17. Internal consistency reliability was determined by the Cronbach’s alpha and item-total correlation. Dimensionality was verified through confirmatory factor analysis (CFA). Convergent validity was also assessed. The generalized partial credit model was used for the IRT. The difficulty, discrimination, item fit, and differential item functioning (DIF) were calculated to assess the instrument’s psychometric properties. Results In all, 318 patients, aged between 26 and 82 years, completed the questionnaire. A good level of internal reliability was achieved (Cronbach’s alpha = 0.92). The item-total correlation coefficient ranged from 0.46 to 0.72. There was a mid-to-high correlation between CLL17 and domains of EQ-5D and QLQ-C30. The IRT model showed a satisfactory homogeneity, item fit and good discrimination of items, except for item 4, 6 and 16 (< 1.0). low information provided by item 16 and 17. SB and PC provided more information with theta > 0, whereas WF provided more information with theta < 0. Item 17 perform inconsistently for respondents from different age groups (DIF). Conclusion The EORTC-CLL17 Chinese version shows acceptable reliability and validity, making it a valuable instrument to evaluate the impact on the HRQoL of Chinese CLL patients.
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Affiliation(s)
- Dong Dong
- JC School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jun Jin
- Department of Sociology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Simone Oerlemans
- Netherlands Comprehensive Cancer Organization, Eindhoven, Netherlands
| | - Siyue Yu
- JC School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Shenmiao Yang
- Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - Jianfeng Zhu
- School of Social Development and Public Policy, Fudan University, Shanghai, China.
| | - Richard Huan Xu
- JC School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR, China.
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Alanazi MQ. Evaluation of Health-Related Quality of Life in Women with Community-Acquired Urinary Tract Infections Using the EQ-5D-3L in Saudi Arabia. Patient Prefer Adherence 2020; 14:2419-2426. [PMID: 33304096 PMCID: PMC7723225 DOI: 10.2147/ppa.s277367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Community-acquired urinary tract infection (CA-UTI) is a common and costly condition in females. Currently, there are no data on CA-UTI and quality of life (QoL) in Saudi Arabia. The aim of this study was to evaluate the impact of UTI and related socio-demographic characteristics on health-related quality of life (HRQoL) of Saudi females using the EuroQol 5-Dimension, 3-Level (EQ-5D-3L) instrument before and after treatment. PATIENTS AND METHODS This was a cross-sectional questionnaire study conducted in the emergency department (ED) of a tertiary hospital over a three-month period. RESULTS A total of 339 out of 524 females with a mean age of 36.2 years (SD: 9.57 years; range 19-59 years) completed both the baseline and follow-up questionnaires of the EQ-5D-3L for a response rate of 64.7%. The baseline utility index for the worst health state "33333" was -0.495 representing 1.18% of the patients, and the full health state "11111" was 1 corresponding to 30.68% of the patients. The utility index after treatment for the moderate health state "22222" was 0.524 corresponding to 0.88% of the total patients, and the full health state "11111" was 1 corresponding to 80.24% of the patients. The mean EuroQol Visual Analogue Scale (EQ-VAS) was 73 ± 26 before treatment and 87.46 ± 18.55 after treatment. The frequency of patients reporting problems in the EQ-5D dimensions of mobility, self-care, usual activities, pain/discomfort and anxiety/depression decreased following treatment (27.43% vs 0.88%, 4.42% vs 0.88%, 25.96% vs 6.78%, 61.95% vs 13.27%, 39.52% vs 15.63%, respectively; all P < 0.001). There were statistically significant associations between HRQoL and socio-demographic characteristics, chronic diseases, and herbal supplements. CONCLUSION Community-acquired tract infections (CA-UTIs) have a significant negative impact on the HRQoL of Saudi females with a varying effect depending on the socio-demographic characteristics and chronic diseases.
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Affiliation(s)
- Menyfah Q Alanazi
- Drug Policy and Economics Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Correspondence: Menyfah Q Alanazi Drug Policy and Economics Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, P.O. Box 22390, Riyadh11426, Saudi ArabiaTel +966-1-8011111 Email
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Wong ELY, Xu RH, Cheung AWL. Health-related quality of life among patients with hypertension: population-based survey using EQ-5D-5L in Hong Kong SAR, China. BMJ Open 2019; 9:e032544. [PMID: 31562165 PMCID: PMC6773333 DOI: 10.1136/bmjopen-2019-032544] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To evaluate the effect of hypertension and related comorbidities on the health-related quality of life (HRQoL) using EuroQol 5-dimensions instrument with five-level scale (EQ-5D-5L) Hong Kong (HK) version. DESIGN Data were analysed by a secondary data analysis based on a cross-sectional study assessing experience on public specialist outpatient service. SETTING A representative sample was recruited from 26 specialist outpatient clinics in HK. PARTICIPANTS A total of 4528 patients with hypertension aged 18 or above who responded to the survey. INTERVENTION EQ-5D-5L HK was applied to assess the HRQoL. The five-dimension descriptive system and the utility index of EQ-5D-5L were treated as the dependent variable in the current study. Regression modelling was applied to estimate the effect of hypertension and related comorbidities on health-related quality of life. RESULTS More respondents were women (53.9%), aged ≥65 years old (60.1%), and with primary educational attainment or below (52.3%). A total of 1466 respondents (32.4%) also reported suffering from diabetes, heart disease (20.8%), vision problem (1.7%) and cancer (1.5%). In the ordinal least squares model, utility decreased most when patients reported having physical disability associated with hypertension (beta=-0.395, SE=0.047), and 0.128, 0.064, 0.05 and 0.048 for mental problem, cancer, vision problem and heart problem. In the Tobit model, the utility reduced most for comorbidity of physical disability, and then mental problem, cancer, vision problem, heart problem and diabetes. For first part of two-part model, respondents coliving with mental problem were 10% less likely to report a full health. For the second part of two-part model, the respondents with physical disability had 0.294 lower in utility. CONCLUSIONS Respondents with hypertension reported a low EQ-5D utility score. Respondents were women, with a high education, fully employed and living with families reported better HRQoL. There is a significant effect of comorbidity influence on the decreased HRQoL, particularly those with physical disability and mental problem.
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Affiliation(s)
- Eliza Lai Yi Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Richard Huan Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai Ling Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Wong ELY, Cheung AWL, Wong AYK, Xu RH, Ramos-Goñi JM, Rivero-Arias O. Normative Profile of Health-Related Quality of Life for Hong Kong General Population Using Preference-Based Instrument EQ-5D-5L. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:916-924. [PMID: 31426933 DOI: 10.1016/j.jval.2019.02.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 02/12/2019] [Accepted: 02/20/2019] [Indexed: 05/18/2023]
Abstract
OBJECTIVES To establish a normative profile of health-related quality of life (HRQoL) for Hong Kong (HK) Chinese residents aged 18 years and above and to examine the relationship between socioeconomic characteristics and health conditions and the preference-based health index. METHODS We recruited 1014 representative Cantonese-speaking residents across 18 geographical districts. The normative profiles of HRQoL were derived using established HK value sets. Mean values were computed by sex, age group, and educational attainment to obtain the EQ-5D HK normative profile for the general HK population. To explore the relationships among potential covariates (socioeconomic characteristics and health conditions) and the HK health index, a multivariable homoscedastic Tobit regression model was employed for the analysis. RESULTS The mean index value was 0.919 using the EQ-5D-5L HK value set. Younger ages reported greater problems with anxiety or depression than did older ages, whereas older ages reported greater problems with pain or discomfort than did younger ages. Persons with higher educational attainment and those who reported higher life satisfaction reported significantly higher health index scores (P < .05). On the contrary, receiving government allowance and having experienced a serious illness were significantly associated (P < .05) with a lower health index. CONCLUSIONS The norm values fully represent the societal preferences of the HK population, and knowledge of societal preferences can enable policy makers to allocate resources and prioritize service planning. The study was conducted with the EuroQol International EQ-5D-5L Valuation Protocol and therefore enabled us to compare the EQ-5D-5L values with other countries to facilitate understanding of societal preferences in different jurisdictions.
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Affiliation(s)
- Eliza Lai-Yi Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Annie Wai-Ling Cheung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Amy Yuen-Kwan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Richard Huan Xu
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Dai H, Mei Z, An A, Wu J. Association between sleep problems and health-related quality of life in Canadian adults with chronic diseases. Sleep Med 2019; 61:26-30. [PMID: 31255481 DOI: 10.1016/j.sleep.2019.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study aimed to explore the association between sleep problems and health-related quality of life (HRQoL) in Canadian adults with chronic diseases, and whether mental illness can mediate the association. METHODS Data were drawn from the Canadian Community Health Survey, 2015. A total of 10,900 participants aged ≥18 years and diagnosed with chronic diseases were enrolled in this study. RESULTS Of these participants, 23.6% (95% CI 22.1, 25.2) suffered from severe impairment of HRQoL. Extreme sleep durations, including both short (<5, 5 to <6, and 6 to <7 h) and long (9 to <10, and ≥10 h) sleep durations, were significantly associated with severe impairment of HRQoL (compared to 7 to <8 h). Insomnia was also independently associated with severe impairment of HRQoL when compared to those without insomnia. In the mediation analyses, mental illness was shown to partly mediate the associations of extreme sleep durations and insomnia with severe impairment of HRQoL. CONCLUSIONS In conclusion, both extreme sleep durations and insomnia were independently associated with severe impairment of HRQoL in adults with chronic diseases, and mental illness partly mediated the association.
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Affiliation(s)
- Haijiang Dai
- Centre for Disease Modelling, Department of Mathematics and Statistics, York University, Toronto, M3J 1P3, Canada.
| | - Zhen Mei
- Manifold Data Mining, Toronto, M3B 3J5, Canada
| | - Aijun An
- Department of Electrical Engineering and Computer Science, York University, Toronto, M3J 1P3, Canada
| | - Jianhong Wu
- Centre for Disease Modelling, Department of Mathematics and Statistics, York University, Toronto, M3J 1P3, Canada.
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Health-related quality of life among rural men and women with hypertension: assessment by the EQ-5D-5L in Jiangsu, China. Qual Life Res 2019; 28:2069-2080. [PMID: 30830645 DOI: 10.1007/s11136-019-02139-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Hypertension is a major global public health problem, including rural China. However, studies examining health-related quality of life (HRQoL) for patients with hypertension have been mostly conducted in urban populations. This study aimed to use the EuroQol five-dimensional-five-level (EQ-5D-5L) and its recently developed Chinese value set to analyze HRQoL and its influencing factors among hypertensive population in rural China. METHODS This is a cross-sectional population-based survey. Standard interview of participants was conducted from July to September 2016 in Donghai County's 334 villages of Jiangsu Province, China. Data collection included the EQ-5D-5L, along with sociodemographic characteristics and disease-related factors such as duration of hypertension, antihypertensive treatment and comorbid conditions. The Tobit regression model was employed to analyze potential influencing factors on HRQoL. RESULTS A total of 16,596 adults (18 years and older) with hypertension participated in this study. 62.4% were women. The mean utility score was 0.85 (standard deviation [SD] = 0.23). The proportion of participants reporting pain/discomfort problems was highest, while least patients reported problems in self-care dimension. Females, elderly, illiterate patients, ex-smokers and patients with longer duration of hypertension or comorbidities scored lower on HRQoL than others. Stroke, heart failure and coronary heart disease were associated with a larger negative impact on HRQoL among all comorbidities. CONCLUSIONS The HRQoL was lower in this rural hypertensive population than previously reported urban counterparts. To improve the HRQoL of hypertensive patients in rural areas, it is important to control hypertension and prevent its associated co-morbidities. More attention needs to be directed to elderly female patients with less education who scored much lower HRQoL than their male counterparts.
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Liu HY, Tsai WC, Chiu MJ, Tang LY, Lee HJ, Shyu YIL. Mild cognitive impairment in combination with comorbid diabetes mellitus and hypertension is negatively associated with health-related quality of life among older persons in Taiwan. Qual Life Res 2019; 28:1281-1291. [PMID: 30635850 DOI: 10.1007/s11136-019-02101-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To fill the gap in knowledge about associations of health-related quality of life (HRQoL) with comorbid diabetes mellitus (DM), hypertension (HTN), and/or mild cognitive impairment (MCI) in the elderly, we explored associations of comorbid DM, HTN, and/or MCI with HRQoL. METHODS Data for this study were from a population-based cross-sectional survey of elderly Taiwanese (≥ 65 years old). Participants (N = 4,634; 47.9% male) were categorized into eight chronic-illness groups: DM only (n = 224); HTN only (n = 1226); DM and HTN (n = 365); MCI only (n = 497); DM and MCI (n = 58); HTN and MCI (n = 303); DM, HTN, and MCI (n = 101); and none (healthy; n = 1860). Associations were examined between the eight chronic-illness groups and HRQoL (measured by EQ-5D scores) using binary logistic regression analyses and generalized linear models adjusted for covariates. Index scores were calculated from EQ-5D scores using Taiwan's general population-preference weights. RESULTS Compared to the healthy group, after adjusting covariates, MCI alone or with other comorbidities was significantly, negatively associated with HRQoL. Among all chronic-illness groups, comorbid DM, HTN, and MCI exhibited the lowest HRQoL. After adjusting covariates, between-group odds ratios for index scores were significant when comparing comorbid DM and MCI to DM only, comparing comorbid HTN and MCI to HTN only and comorbid DM, comparing HTN and MCI to comorbid DM and HTN, suggesting that MCI additively affects HRQoL. CONCLUSIONS HRQoL of older Taiwanese adults was negatively associated with having MCI. Thus, clinicians managing older persons with chronic illnesses should assess their cognitive function to identify high-risk groups needing HRQoL assistance.
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Affiliation(s)
- Hsin-Yun Liu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Psychology, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Li-Yu Tang
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Huey-Jane Lee
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Yea-Ing L Shyu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
- School of Nursing, College of Medicine, Chang Gung University, 259 Wenhua 1st Road, Guishan District, Taoyuan, 33302, Taiwan.
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
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