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At least 1,729 records · Page 96Linked to original sources
PubMed2003

Gabapentin in the prophylaxis of chronic daily headache: a randomized, placebo-controlled study.

OBJECTIVE: To compare efficacy and safety of gabapentin (GPT) versus placebo for prophylaxis of chronic daily headache (CDH) (headache at least 15 days/month of greater than 4 hours duration over preceding 6 months). METHODS: This is a multicenter randomized placebo-controlled crossover study. After 4-week baseline, subjects, aged 18 to 65, were randomized to GPT 2,400 mg/day or placebo. There was 2 weeks titration, 6-week stable dosage, and 1 week washout period between treatment arms. The primary efficacy measure was the difference between the percentage of headache-free days per treatment period. Secondary efficacy measures included headache duration and severity, degree of disability, associated symptoms, concomitant medications, Visual Analogue Scale (VAS) scores, and quality of life (QOL). RESULTS: A total of 133 patients were enrolled (41 men, 92 women, mean age 43 years). All were eligible for safety analysis. Ninety-five received sufficient treatment to allow evaluation of efficacy. There was a 9.1% difference in headache-free rates favoring GPT over placebo (p = 0.0005). Benefits for GPT were also demonstrated for headache-free days/month (p = 0.0005), severity (p = 0.03), VAS (p = 0.0006), headache-associated symptoms of nausea (p = 0.03) and photophobia/phonophobia (p = 0.04), disability affecting normal activities (p = 0.02), attacks requiring bed rest (p = 0.001), and QOL related to bodily function (p = 0.01), health/vitality (p = 0.0001), social function (p = 0.006), and health transition (p = 0.0002). Reduction in headache days/month was seen across the spectrum of prerandomization headache frequencies. CONCLUSION: Gabapentin represents a therapeutic option for chronic daily headache.

Acetates↗
PubMedDate not supplied

[Quality of life in coronary patients].

This study compared measures of quality of life (QOL) in two groups of coronary heart disease patients: one with myocardial infarction (MI) and one with angina (A). The population studied consisted of 49 patients from Group MI and 27 patients from Group A. A questionnaire was used to identify socio-demographic and clinical data, as well as data from the SF-36 instrument, to assess the patients' QOL. It was observed in both groups that the QOI declined in the following aspects: physical functioning, pain, general health condition, vitality, social functioning, and mental health. Socio-demographic and clinical variables influenced the QOL score. Studies aiming at a larger number of individuals and a better understanding of the effects of the variables above upon the QOL of coronary patients are needed.

Adult↗
PubMed1994

[Longitudinal change in independence in the elderly--Kahoku Longitudinal Aging Study (KLAS)].

A community based study named Kahoku Longitudinal Aging Study (KLAS) was conducted since 1990 for the purpose of evaluating the comprehensive geriatric functional assessment (CGA) and preventing a decline in CGA in the community-dwelling elderly population. It was carried out in a Japanese rural town, in which 32% of the population was over 65 years of age. This study included a questionnaire about activity of daily living (ADL), information-related physical function, mental (cognitive and affective) and social functional domains. In addition to subjective informative instruments, various types of objective assessment such as quantitative neuro-behavioral function tests and medical examinations were performed. Subjects were all the eligible elderly aged over 65 years in the community. Although the ratio of subjects who were independent in ADL decreased with advancing age in both 1991 and 1993, the ratio of the independent elderly in ADL became significant higher (74%) in 1993 than in 1991 (71%). Scores on 2 kinds of neurobehavioral function tests in the 159 subjects aged over 75 years who attended the examination every year showed a significant and slight decrease during two years. However, some test indices significantly improved during the 2 years. These results suggested that age-related dependency in ADL and some kind of neurobehavioral functions might be prevented, in part, by health promoting education and improvement of life style.

Activities of Daily Living↗
PubMedDate not supplied

[The impact of vertebral fractures on quality of life in postmenopausal women with osteoporosis. Validity of the Italian version of mini-Osteoporosis Quality of Life Questionnaire.].

BACKGROUND: Vertebral fracture is one of the most commonly occurring osteoporotic fractures. Vertebral fractures associated with osteoporosis are a major cause of pain in elderly people and may hardly affect patient's health-related quality of life (HRQOL), making this an important parameter for assessment in these patients. Studies comparing the performance of HRQOL instruments in osteoporosis are lacking. OBJECTIVES: The purposes of this study were to assess the effect of vertebral fractures on health HRQOL in post-menopausal women with osteoporosis and to investigate the validity of the Italian version of the mini-Osteoporosis Quality of Life Questionnaire (mini-OQOL) in a clinical setting. METHODS: Patients were divided into two study groups, according to fracture status: vertebral fractures (41 patients) and no vertebral fractures (27 patients). Baseline assessments of anthropometric data, medical history, and prevalent fracture status were obtained from all participants. All of the participants were evaluated using both disease-targeted mini-OQOL and QUALEFFO, generic instrument (EUROQoL), disability scale (Roland Morris Disability questionnaire- RMDQ) and chronic pain grade questionnaire. RESULTS: Vertebral fractures due to osteoporosis significantly decreases scores on physical function, socio-emotional status, clinical symptoms, and overall HRQOL. Both disease-targeted questionnaires showing an association between the number of prevalent vertebral fractures and decreased HRQOL. Significant correlations existed between scores of similar domains of mini-OQOL and the QUALEFFO, especially for symptoms, physical function, activities of daily living and social function. The receiver operating characteristic (ROC) curve analysis of mini-OQOL and the QUALEFFO indicated that both questionnaires were significantly predictive of vertebral fractures. Number of concomitant diseases presented a weak significant correlation with EUROQoL (p=0.041). CONCLUSIONS: Our study suggests that the patients with vertebral fractures due to osteoporosis have a relevant impairment in quality of life. Both disease-targeted questionnaires discriminated between patients with and without vertebral fractures though the mini-OQOL, originally developed to measure the effect of vertebral fractures on quality of life, showed slightly better discriminant power. The benefit of the mini-OQOL is that it is efficient, self administered, and requires 3-4 minutes to complete.

Absorptiometry, Photon↗
PubMed2003

Multifunctional landscapes--perspectives for the future.

New methods in landscape ecology to study the link between landscape heterogeneity and landscape functionality are needed. Heterogeneity is a basic characteristic of landscape, and landscape function is the capacity to change the structural heterogeneity of a landscape system. In most developed countries the industrialisation of agriculture has in general resulted in a change of agricultural landscapes from a small-grained heterogeneous pattern towards more monotonous and monofunctional landscapes. During the 1990's this trends seem to have changed due to a diversification of rural land use, and new trends in ubanisation. Whether these phases of landscape development should be expected in developing countries is a totally open question. Dealing with the study of multifunctionality of landscapes it is proposed to distinguish between ecological functionality of landscape ecosystems, functionality pertaining to land use and social functionality. Further, the relation between function, space and scale is important by the determination of spatial and time segregation as well as spatial and time integration of multifunctionality in landscapes.

Agriculture↗
PubMed2006

[Effect of lamivudine treatment on the quality of life of chronic hepatitis B].

OBJECTIVE: To assess the quality of life of 3 types of chronic hepatitis B before and after the treatment of lamivudine, and to find an ideal way of medical treatment for chronic hepatitis B. METHODS: One hundred and fifty patients with chronic hepatitis B were investigated in this study, among whom 5 1 were in mild state illness, 53 were middle-range and the other 46 were severe. The quality of life of the patients was assessed by the quality of life questionnaire (SF-36). The marks of questionnaire were compared before and after the use of lamivudine to assess its comprehensive curative effect on chronic hepatitis B. RESULTS: The total score of SF-36, score of physical function, role-physical, mental health, social function, bodily pain and vitality were significant different before and after the treatment. Statistically significant differences were found among the 3 types of chronic hepatitis B before and after the treatment. CONCLUSION: The quality of life of patients with chronic hepatitis B can be improved by using lamivudine. Assessment of quality of life may be taken as an important index in treating chronic hepatitis B.

Female↗
PubMed1995

[The status of duodenum-preserving resection of the head of the pancreas in therapy of chronic pancreatitis].

AIM OF THE STUDY: To evaluate the efficacy of duodenum-preserving resections of the head of the pancreas in the treatment of chronic pancreatitis this study was devised. So far studies on the natural course and the different therapeutic approaches have primarily focused on pain measurement in rough categories and hard data as mortality and morbidity. In this study the improvement of the quality of life was assessed to determine the therapeutic success of both procedures. PATIENTS AND METHODS: In a prospective randomized study 24 patients underwent either Beger's (n = 11) or Frey's procedure (n = 13) so far. 15 patients suffered from distal common bile duct stenosis, 2 from segmental duodenal stenosis, 4 from segmental portal hypertension, and one from pancreato-pleural fistula. The quality of life questionnaire of the European Organization for Research and Treatment of Cancer was assessed before surgery and during follow-up. The multidimensional questionnaire incorporates functional scales (physical, cognitive, emotional, and social), symptom scales (fatigue, pain, dyspnea, loss of appetite, sleep disturbance, obstipation, diarrhea, nausea, and vomiting), and a global quality of life scale. Follow-up was 12 months in all patients. RESULTS: There was no postoperative mortality in neither group. Postoperative morbidity was 17% (n = 2 in either group). This included one transitory common bile duct stenosis, one bronchopneumonia, and two postoperative bleedings which were treated conservatively. The pain index was reduced by 94% in the Beger- and 90% in the Frey group. The physical status, working ability, emotional and social functioning, and global quality of life score had significantly improved by 46%, 50%, 69%, 60%, and 67% in the Beger group and by 38%, 50%, 64%, 80%, and 67% in the Frey group. CONCLUSION: The duodenum-preserving resections of the head of the pancreas according to Beger and Frey are equivalently safe and effective. Both techniques result in a significant improvement of the patients' quality of life.

Adult↗
PubMedDate not supplied

Quality of life and nutritional support in patients with cancer.

Nutritional support is often initiated in patients with cancer who are unable to meet their nutritional needs by the oral route. Much has been written about the effect of nutritional support on physiological outcomes in patients with cancer. However, less is known about the relationship between improvement of nutritional status and quality of life. Trends in the treatment of cancer highlight the need for an examination of home nutrition support and quality of life. The purpose of this article is to describe the state of knowledge about the relationship of home enteral and parenteral nutrition support and quality of life. Research exploring the dimensions of quality of life (physical functioning, psychological status, interpersonal relationships and social functioning, financial concerns, and symptoms, and complications of nutritional support) is presented. Implications for clinical practice and research are identified. The trend for increased numbers of patients on home nutrition support emphasizes the need to understand the patient's and family's experience in managing this treatment in the home.

Enteral Nutrition↗
PubMed1996

The effects of caring for a spouse with Parkinson's disease on social, psychological and physical well-being.

BACKGROUND: Several previous studies have examined the health of carers, but they have usually focused on elderly subjects and have often not had representative control samples. AIM: To determine whether caring for a partner with Parkinson's disease is associated with a worsening social, psychological and physical well-being than people with partners who do not suffer with Parkinson's disease. METHOD: One hundred and fifty-four carer spouses of subjects with Parkinson's disease, and 124 non-carer spouses of randomly selected population controls recruited from a national case-control study of early-onset Parkinson's disease in the Republic of Ireland, between 1992-1994, were studied. Outcome was measured along three dimensions: social functioning, assessed by the frequency of social contacts, outings and holidays; psychological well-being, measured by the General Health Questionnaire; and physical health, measured by the career's use of medical services, medications and episodes of chronic illness. RESULTS: Carer spouses were less likely to get out of the house once a week at least (odds ratio 1.79, 95% confidence intervals 1.00-3.20) or to have had a holiday in the last year (odds ratio 1.71, 95% confidence intervals 1.01-2.90). Contact with friends and neighbours decreased with increasing care provision. For spouses providing a lot of care, there was an almost fivefold increase in psychiatric morbidity (odds ratio 4.86, 95% confidence intervals 1.5-15.9) after adjusting for other variables. Most of the medical outcomes were less favourable among carers, but only the use of tranquilizers (odds ratio 3.73, 95% confidence intervals 1.18-11.8) and episodes of chronic illness (odds ratio 2.96, 95% confidence intervals 1.27-6.94) were significant. CONCLUSIONS: Overall, career spouses have slightly worse social, psychological and physical profiles. For social outcomes, increasing care provision is associated with fewer contacts, outings and holidays. For psychological and physical measures, carers providing a lot of care experience worse health. These results have implications for targeting appropriate interventions.

Caregivers↗
PubMed1997

Impact of portable APD on patient perception of health-related quality of life.

We assessed the impact of the introduction of a portable automated peritoneal dialysis (APD) system (Homechoice, Baxter Healthcare) on health-related quality of life (HRQOL). We evaluated HRQOL in 26 patients using the RAND 36-item Health Survey 1.0, which measures physical functioning, role limitations (physical and emotional), social functioning, emotional well-being, pain, energy, and general health perceptions. Questionnaires were administered prior to changing to the new system and 3 months later. Kt/V and albumin levels were measured at both time points. Eight patients had been on continuous ambulatory peritoneal dialysis (CAPD), and 18 had been using other APD systems (PacXtra, Baxter and AMP80, Fresenius). Kt/V increased significantly (p = 0.026); albumin was unchanged (p = 0.09). There was an improvement in the pain score (p = 0.079), although this did not reach statistical significance in the overall sample. Subgroup analysis showed that most of the improvement was from the group that had used the AMP80. No other statistically significant differences were found overall in the domains of HRQOL. Questioning of a random sample of patients indicated that perceived advantages of the new system were ease of setup and portability within the home. Neither of these translated into improvement in role-functioning domains of HRQOL. The improvement in pain score may reflect the capacity of newer cyclers to switch from drain to fill after a set proportion of dialysate has drained, leaving the patient empty for less of the time. Portable APD systems did not bring about predicted improvements in HRQOL. The HRQOL instrument may be insensitive, but technologically convenient advances may have limited impact on HRQOL due to its multifactorial nature.

Attitude to Health↗
PubMed1997

Prospective study of clinical and social outcome of stay in small group homes for people with mental illness.

BACKGROUND: Small group homes operating according to the principles of supported housing have, during the past five years, become a cornerstone of the housing services for the long-term mentally ill in Copenhagen. METHOD: During a 2.5-year period, 47 long-term mentally ill persons were examined at the time of entry to a group home programme. Residents' psychopathology, social integration, mastery and quality of life were measured by structured interviews, including the Present State Examination (PSE-10); and their social functioning was recorded by interview with the staff. Forty-four of the residents were re-examined at follow-up after a mean of 1.1 years using the same instruments. Data on hospitalisation were obtained through the Danish Psychiatric Case Register. RESULTS: Eighty-three per cent of the residents remained in the programme during the first year. They showed a significant improvement in subjective quality of life, PSE total score, social integration, functioning and hospitalisation index. The number of reciprocal supportive contacts in the social network increased. Lower baseline PSE total score was associated with adherence to the programme, and the improvement in quality of life during their stay was predicted by reduction in symptoms and improvement in social integration. CONCLUSIONS: A rehabilitation strategy of supplementing standard psychiatric treatment with a programme of small supportive group homes improves the quality of life, psychosocial functioning and community tenure of the long-term mentally ill.

Adult↗
PubMed2004

A community study of the health-related quality of life of schizophrenia and general practice outpatients in Singapore.

BACKGROUND: Health-related quality of life (HRQOL) is an important outcome indicator of healthcare that has been little studied in East Asia, where, culturally, there is greater family interdependence than in the West. We aimed to study the HRQOL of schizophrenia outpatients compared to general practice outpatients, and to examine determinants of schizophrenia HRQOL in our community. METHODS: The HRQOL of 94 schizophrenia and 90 general practice outpatients was assessed using the COOP/WONCA chart. Clinical status, demographics, medication dosages, extrapyramidal side-effects, and frequency of personal, family and social functioning were assessed using standardized questionnaires. RESULTS: Some 90% of schizophrenia outpatients still lived with their immediate families, and the majority were single, unemployed, and rarely engaged in social activities. They had poorer satisfaction with overall HRQOL compared to general practice outpatients. Using stepwise linear regression analysis, poorer schizophrenia overall HRQOL was predicted by dissatisfaction with and poorer participation in family relationships, dissatisfaction with emotional well-being and male gender [R(2) = 0.40, p = 0.040; F(4, 5.1) = 14.3, p < 0.001]. CONCLUSIONS: Strained family relationships appeared to be an important contributor to poorer schizophrenia HRQOL in our East Asian community. This could possibly be related to the narrowing of social-occupational functioning and its burden on the family.

Adult↗
PubMed2004

Emotional intelligence skills for maintaining social networks in healthcare organizations.

For healthcare organizations to survive in these increasingly challenging times, leadership and management must face mounting interpersonal concerns. The authors present the boundaries of internal and external social networks with respect to leadership and managerial functions: Social networks within the organization are stretched by reductions in available resources and structural ambiguity, whereas external social networks are stressed by interorganizational competitive pressures. The authors present the development of emotional intelligence skills in employees as a strategic training objective that can strengthen the internal and external social networks of healthcare organizations. The authors delineate the unique functions of leadership and management with respect to the application of emotional intelligence skills and discuss training and future research implications for emotional intelligence skill sets and social networks.

Emotions↗
PubMed2004

Is the evaluation of the global quality of life determined by emotional status?

The present study investigated relationships between global QOL perceptions and well-being dimensions. Especially our goal was to evaluate the impact of generally recognised four broad dimensions of QOL (physical, functional, social and emotional well-being) on global QOL perceptions, additionally person's satisfaction with life achievements and economical situation were measured as well as social demographic variables. The subjects were a representative sample of Finns (n = 4613, from 25 to 65 years) of the FINRISK-97 study. Correlation coefficients and models of hierarchical regression indicated that physical, functional and social well-being as well as sociodemographic factors and satisfaction with life achievements are important factors of global QOL perceptions both among males and females. However percentages of variances explained with these measures were only moderately high, ranging from 1 to 10%. After measures of emotional well-being were entered into the models of hierarchical analyses of regression, variances explained grew dramatically over 20%. The results of the study indicated that global QOL judgements are likely to be based on current emotional state.

Adult↗
PubMedDate not supplied

[Importance of rehabilitation in the evaluation of personal injury].

The paper distinguishes between rehabilitation and the conferring of ability, limiting the application of rehabilitation methods to recovery of disablement due to trauma or disease. This can be achieved with the collaboration of specialists in the various branches of medicine; microsurgery, orthopaedics, physiotherapy, together with socio-psycho-biological aids. The Artificial Limb Center of the National Institute for Insurance against Occupational Diseases (INAIL) located at Vigorso di Budrio (Bologna) has been particularly successful in designing myoelectric and modular prostheses for patients who have undergone amputation of limbs, thus achieving functional, social and occupational rehabilitation. The concept of functional and anatomical disablement and personal injury on a forensic medicine basis is illustrated, as applicable in criminal and civil law, insurance and social security. Rehabilitation plays an important rôle since it reduces personal injury on a social and occupational level.

Amputees↗
PubMed2001

The EORTC core quality of life questionnaire (QLQ-C30, version 3.0) in terminally ill cancer patients under palliative care: validity and reliability in a Hellenic sample.

In 1986, the European Organization for Research and Treatment (EORTC) initiated a research program to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. The questionnaire was designed to measure cancer patients' physical, psychological and social functions. The questionnaire is composed of 5 multiitem scales (physical, role, social, emotional and cognitive functioning) and 9 single items (pain, fatigue, financial impact, appetite loss, nausea/vomiting, diarrhea, constipation, sleep disturbance and quality of life). It was administered to the patients before the initiation of palliative treatment and then once again during the treatment. The validation of the questionnaire took place at Areteion Hospital, while the translation was conducted by the EORTC bureau. The final validation sample consisted of 120 cancer patients. The clinical variable assessed was the performance status. The aim of our study was to assess the applicability of this quality of life measurement on a Hellenic sample of cancer patients receiving palliative care. The results showed that the questionnaire was well accepted in the present patient population. In addition, the questionnaire was found to be useful in detecting the effectiveness of palliative treatment over time. The scale reliability was very good (pretreatment from 0.57-0.79, ontreatment from 0.56-0.75), especially for the functioning scale. In addition, very good validity was found in all the approaches used. Moreover, the factor analysis results in a 6-factor solution that satisfies the criteria of reproducibility, interpretability and confirmatory setting. Performance status showed an improvement (p < 0.0025) during the studied period. These results support that the QLQ-C30 (version 3.0) has proven to be a reliable and valid measure of the quality of life in Greek cancer patients receiving palliative care treatment.

Adult↗
PubMed1997

Quality of life analysis in patients with lower limb ischaemia: suggestions for European standardisation.

INTRODUCTION AND OBJECTIVES: In this era of evidence-based medicine and limited resources we seem obliged, on clinical and economic grounds, to demonstrate that we improve not only patient survival but also the quality of patients' lives. This study aims to determine the impact of increasing lower limb ischaemia on quality of life (QOL) and which of three commonly used generic QOL instruments is the most valid, reliable, and responsive to change in patients with lower limb ischaemia. PATIENTS AND METHODS: Two hundred and thirty-five patients, 144 men and 91 women, median age 68 years (range 41-87 years) were graded according to ISCVS suggested reporting standards, i.e. 16 mild, 116 moderate and 25 severe claudicants; 33 patients had rest pain and 45 tissue loss. Patients completed Short Form 36 (SF36), EuroQol (EQ-5D) and Nottingham Health Profile (NHP) questionnaires at interview. Additional copies of questionnaires were posted to 80 patients prior to attendance. Correlation between the two sets of responses reflects test-retest reliability. Correlation between domains measured by the three instruments reflects convergent and divergent validity. Kruskal Wallis ANOVA detected QOL changes across the whole group. Spearman Rank was used to analyse validity and reliability. Responsiveness was analysed using the Mann-Whitney U-test. RESULTS: Increasing lower limb ischaemia confers significant (p < 0.05) deterioration in: SF36 measured: physical functioning, physical role, pain, general health, vitality, social functioning and mental health. EQ-5D measured: mobility, self-care, usual activities, pain and anxiety/depression. NHP measured: energy, pain, emotional reaction, sleep, social isolation and physical mobility. All three instruments are significantly reliable (rs > 0.7). The validity of SF36 and NHP (rs = 0.68-0.78) is superior to EQ-5D (rs = 0.37-0.7). SF36 & NHP are equally responsive to changes in physical activity and pain. SF36 and EQ-5D are most responsive to changes in social activity. SF36 is most responsive to changes in psychological status. CONCLUSIONS: QOL deteriorates markedly with increasing lower limb ischaemia. The SF36 would appear to be the most appropriate generic QOL analysis tool for these patients. We recommend its widespread adoption throughout Europe, thus providing a standardised tool for reporting generic QOL.

Activities of Daily Living↗
PubMed2004

[Geriatric information in the hospital discharge reports of patients over 65 years of age admitted to an Internal Medicine Department].

CONTEXT: The hospital discharge report (HDR) is a document that serves as a link between the hospital clinician and the primary care team. Our objective has been to evaluate the level of geriatric information in the HDR developed in the Internal Medicine Department of an tertiary care university hospital. Besides, the possible changes along the last 5 years were also evaluated. METHODS: HDRs of 1,000 patients over 65 years (500 in 1996 and 500 in 2001) and cared in the Bellvitge University Hospital were evaluated. Data relative to social, functional (qualitative and quantitative), and cognitive (qualitative and quantitative) assessment were collected. RESULTS: In 269 patients (27%) there was some kind of geriatric information in the HDRs. In the 2001 HDRs a significant increase in the percentage of social, qualitative functional and qualitative cognitive information was observed compared to 1996 HDRs. There were no significant differences upon comparing the subgroup of 269 patients with geriatric data in their HDRs with the subgroup of 731 remaining patients. CONCLUSIONS: The level of geriatric information in the HDRs is low. Care of elderly patients admitted to the Internal Medicine Department requires an additional evaluation on the part of all the professionals involved in their assistance, carrying out a global assessment that let a better knowledge of the patient. These evaluations should be part of the HDR.

Aged↗