Quality of life in children newly diagnosed with cancer and their mothers

Background With current treatments, approximately 75% of children diagnosed with cancer can expect to achieve disease-free survival. However, treatments are complex and aggressive, potentially compromising QOL for children and their parents. Although previous work has shown increased anxiety and depression among parents after diagnosis, the recent development of standardised measures of QOL enables us to look more directly at the impact of diagnosis on mothers' and children's QOL. The aims of this study are to i) describe QOL for children and their mothers after diagnosis by comparing their scores with population norms, ii) explore the relationship between mothers' worries about the illness and their QOL, and iii) determine the relationship between mothers ratings of their own QOL and their child. Method A total of 87 families took part, constituting 60% of those eligible. The children included 58 males and 29 females aged between 2 years 6 months to 16 years 3 months (mean = 7 years, median = 5 years 8 months). Diagnoses were acute lymphoblastic leukaemia (ALL, n = 57), brain tumours (n = 11), bone tumours (n = 17) and 2 rare cancers. Mothers completed questionnaires about their own and the child's QOL. Results Mothers' reported their own and the child's QOL to be significantly lower than population norms. There were significant correlations between mothers' worries and their own and their ratings of the child's QOL and mothers' ratings of their own QOL correlated with their ratings of the child's QOL. Conclusion Both children and their mothers experience significantly compromised QOL in the months following diagnosis. Mothers who rated their own QOL to be poor also rate their child's QOL to be low. These results suggest caution is required where mothers rate their child's QOL. Efforts must continue to be made to improve QOL of children especially in the period immediately following diagnosis

Quality of Life (QoL) in Patients with Traumatic Brain Injury (TBI): a Literature Review

Purpose: To describe the definition of quality of life (QoL) and identify the most appropriate tool for QoL assessment used in patients with TBI.Method: Searching was conducted from PubMed, CINAHL, EBSCO, and ProQuest during 2000-2011. A total of 33 studies were analyzed for this review consisting of 9 review studies, 2 intervention studies, and 22 descriptive studies.Result: Two important definitions of QoL were used in studies related to TBI namely achievement and subjective well-being. Although varieties of generic measurements have been used to measure QoL in TBI patients, there was a lack of TBI-specific Health-related Quality of Life (HRQoL) instrument. Despite the different approach and time measured either short or long outcomes, appropriate domains of QoL tool seem essential particularly among those with moderate and severe TBI.Conclusion: QoL is a wide concept which can be defined in several dimensions. The QOLIBRI as a new disease-specific QoL measurement in TBI seems a feasible and valid approach for the assessment of QoL in TBI. However, the application across cultural remains a challenge and needs a validation

Validation of the Wound-QoL-17 and the Wound-QoL-14 in a European sample of 305 patients with chronic wounds

The Wound-QoL assesses the impact of chronic wounds on patients' health-related quality of life (HRQoL). A 17-item and a shortened 14-item version are available. The Wound-QoL-17 has been validated for multiple languages. For the Wound-QoL-14, psychometric properties beyond internal consistency were lacking. We aimed to validate both Wound-QoL versions for international samples representing a broad range of European countries, including countries for which validation data had yet been pending. Patients with chronic wounds of any aetiology or location were recruited in Austria, Lithuania, the Netherlands, Poland, Slovakia, Spain, Switzerland and Ukraine. Psychometric properties were determined for both Wound-QoL versions for the overall sample and, if feasible, country-wise. We included 305 patients (age 68.5 years; 52.8% males). Internal consistency was high in both Wound-QoL-17 (Cronbach's α: 0.820–0.933) and Wound-QoL-14 (0.779–0.925). Test–retest reliability was moderate to good (intraclass correlation coefficient: 0.618–0.808). For Wound-QoL-17 and Wound-QoL-14, convergent validity analyses showed highest correlations with global HRQoL rating (r = 0.765; r = 0.751) and DLQI total score (r = 0.684; r = 0.681). Regarding clinical data, correlations were largest with odour (r = −0.371; r = −0.388) and wound size (r = 0.381; r = 0.383). Country-wise results were similar. Both Wound-QoL versions are valid to assess HRQoL of patients with chronic wounds. Due to its psychometric properties and brevity, the Wound-QoL-14 might be preferrable in clinical practice where time is rare. The availability of various language versions allows for the use of this questionnaire in international studies and in clinical practice when foreign language patients are being treated.</p

The effect of visual impairment on quality of life of children aged 3-16 years

Background: It is well known that visual impairment (VI) has a detrimental effect on Quality of Life (QoL) in adults. Little is known about the effects of VI in childhood. Aims: To evaluate the effects of VI on QoL of children. To the authors’ knowledge, this is the first study containing a comparison arm for children with VI. Methods: QoL in children with VI (n¼24, age 10.1362.89, 18 male, 6 female) was compared with an age-matched comparison group (n¼24, age 9.8362.81, 18 male, 6 female) using the Low Vision Quality of Life Questionnaire. Factors (distance and near visual acuity and age) that could be used as predictors of QoL were assessed. These were measured with standard clinical tests. Results: Children with VI had significantly lower QoL scores than the comparison group (p<0.001), resulting in a 35.6% reduction in total QoL score. QoL scores in children with VI were correlated with distance and near visual acuity (p<0.05). 38% of the variance could be predicted by these factors and age. Conclusions: Consideration of the effects of this reduced QoL must be made. Further studies are needed to establish the benefit to QoL of different habilitation strategies

Quality-of-life aspects in idiopathic epilepsy in dogs

Quality of life (QoL) plays a significant role in the treatment of dogs with idiopathic epilepsy (IE), yet is so far understudied. This study describes the outcome evaluation of an online questionnaire based on the carer's perception focusing on 62 QoL questions in 159 dogs with IE. Results showed that seizure frequency, but not seizure severity or presence of cluster seizures, was significantly associated with carer-perceived dog's QoL. Dogs receiving third-line antiepileptic drugs had a significantly lower perceived QoL than those that did not. Generalised linear mixed model analysis demonstrated that severity of the side effects sleeping more and ataxia were significantly associated with carer-perceived dog's QoL, with higher severities predicting lower QoL scores. The degree of carer acceptability of seizure frequency and severity was significantly associated with the dog's reported seizure frequency and severity. Moreover, there was a significant association between IE-related QoL changes of the dog and the carer, with reductions in perceived canine QoL scores associated with reductions in carer QoL, and vice versa. In conclusion, aspects of canine IE can affect both the carer and their dog's QoL. This has implications for the management and requires consideration when treatment options and outcomes are discussed

Quality of life and visual function in Nigeria: findings from the National Survey of Blindness and Visual Impairment

Aims To assess associations of visual function (VF) and quality of life (QOL) by visual acuity (VA), causes of blindness and types of cataract procedures in Nigeria. Methods Multi-stage stratified cluster random sampling was used to identify a nationally representative sample of persons aged >= 40 years. VF/QOL questionnaires were administered to participants with VA = 6/12. Results VF/QOL questionnaires were administered to 2076 participants. Spearman's rank correlation showed a strong correlation between decreasing VA and VF/QOL scores (p< 0.0001) with greatest impact on social (p< 0.0001) and mobility-related activities (p< 0.0001). People who were blind due to glaucoma had lower VF and QOL scores than those who were blind due to cataract. Mean VF and QOL scores were lower after couching compared with conventional cataract surgery (mean VF score=51.0 vs 63.0 and mean QOL score=71.3 vs 79.3). Finally, VF and QOL scores were lower among populations with specific characteristics. Conclusions Populations with the following characteristics should be targeted to improve VF and QOL: people who are blind, older people, women, manual labourers, people living in rural areas, those living in the northern geopolitical zones, those practising Islamic and Traditionalism faith, those not currently married and those who have undergone couching

Gender-specific changes in quality of life following cardiovascular disease: a prospective study

Gender-specific changes in Quality of Life (QoL) following cardiovascular disease (CVD) were studied in 208 patients to determine whether gender-related differences in postmorbid QoL result from differences in disease severity, premorbid QoL, or different CVD-related recovery. Premorbid data were available from a community-based survey. Follow-ups were done at 6 weeks, 6 months, and 12 months after diagnosis. Results showed that females had worse QoL at all three postmorbid assessments compared to males. However, multivariate analyses adjusting for premorbid gender differences and disease severity showed no significant gender-related differences for physical and psychologic, functioning. Therefore, gender differences in QoL following CVD mainly result from premorbid differences in QoL, age, comorbidity, and disease severity at the time of diagnosis, and do not appear to be the consequence of gender-specific recovery. However, in clinical practice it is important to acknowledge the poorer QoL of females following CVD. (C) 2002 Elsevier Science. All rights reserve

Cervical Deformity Patients Have Baseline Swallowing Dysfunction but Surgery Does Not Increase Dysphagia at 3 Months: Results From a Prospective Cohort Study.

Study designProspective cohort study.ObjectivesMost studies of dysphagia in the cervical spine have focused on a degenerative patient population; the rate of dysphagia following surgery for cervical deformity (CD) is unknown. This study aims to investigate if surgery for cervical deformity results in postoperative dysphagia.MethodsPatients with CD undergoing surgery from 2013 to 2015 were prospectively enrolled to evaluate dysphagia. Demographic, operative, and radiographic variables were analyzed. The Quality of Life in Swallowing Disorders (SWAL-QoL) was used to measure dysphagia. Paired t test, independent t tests, and bivariate Pearson correlations were performed.ResultsA total of 88 CD patients, aged 61.52 ± 10.52 years, were enrolled. All patients (100%) had 3-month SWAL-QoL for analysis. The baseline preoperative SWAL-QoL was 78.35. This is roughly the same level of dysphagia as an anterior cervical discectomy patient that is 3 weeks removed from surgery. Increasing body mass index (BMI) was correlated with decreased SWAL-QoL score (r = -0.30, P = .001). Age, gender, smoking, and Charlson Comorbidity Index (CCI) showed no significant correlations with preoperative SWAL-QoL. Patients with prior cervical surgery had a lower preoperative SWAL-QoL (P = .04). While 11 patients had acute postoperative dysphagia, CD surgery did not result in lower SWAL-QoL at 3 months (77.26 vs 78.35, P = .53). Surgical variables, including estimated blood loss (EBL), anterior or posterior fusion levels, steroid use, preoperative traction, staged surgery, surgical approach, anterior corpectomy, posterior osteotomy, and UIV (upper instrumented vertebrae) location, showed no impact on postoperative SWAL-QoL. Correction of cervical kyphosis was not correlated to 3-month SWAL-QoL scores or the change in SWAL-QoL scores.ConclusionsWhile patients undergoing surgery for cervical deformity had swallowing dysfunction at baseline, we did not observe a significant decline in SWAL-QoL scores at 3 months. Patients with prior cervical surgery and higher BMI had a lower baseline SWAL-QoL. There were no surgical or radiographic variables correlated to a change in SWAL-QOL score

The measurement of health-related quality of life (QOL) in paediatric clinical trials: a systematic review

Background The goal of much care in chronic childhood illness is to improve quality of life (QOL). However, surveys suggest QOL measures are not routinely included. In addition, there is little consensus about the quality of many QOL measures. Objectives To determine the extent to which quality of life (QOL) measures are used in paediatric clinical trials and evaluate the quality of measures used. Design Systematic literature review. Review Methods Included paediatric trials published in English between 1994 and 2003 involving children and adolescents up to the age of 20 years, and use of a standardised QOL measure. Data Sources included MEDLINE, CINAHL, EMB Reviews, AMED, BNI, PSYCHINFO, the Cochrane library, Internet, and reference lists from review articles. Results We identified 18 trials including assessment of QOL (4 Asthma, 4 Rhinitis, 2 Dermatitis, and single studies of Eczema, Cystic fibrosis, Otis media, Amblyopia, Diabetes, Obesity associated with a brain tumour, Idiopathic short stature, and Congenital agranulocytosis). In three trials, parents rated their own QOL but not their child's. Fourteen different QOL measures were used but only two fulfilled our minimal defined criteria for quality. Conclusions This review confirms previous reports of limited use of QOL measures in paediatric clinical trials. Our review provides information about availability and quality of measures which will be of especial value to trial developers