Quality of life and health status after Girdlestone resection arthroplasty in patients with an infected total hip prosthesis

Introduction: The Girdlestone resection arthroplasty (GRA) is a salvage procedure for a recurrent or persistent prosthetic joint infection of the hip. This procedure negatively impacts the functional outcome and presumably also diminishes health status (HS) and quality of life (QOL). However, studies investigating the QOL after GRA are lacking. This cross-sectional study compares patients with a Girdlestone situation after an infected total hip prosthesis with a normative population with regard to HS and QOL. Methods: Patients with a permanent GRA were suitable to be enrolled in the study. Subjects completed the World Health Organization Quality of life (WHOQOL-BREF) and the EuroQol 5 dimension 3 level version (EQ-5D-3L). Scores were compared with data from the normal populat

The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study

Purpose: The aim of this prospective study was to describe the course of health status (HS), health-related quality of life, and quality of life (QOL) in patients with lower extremity fractures (LEF) up to 6 months post-fracture. Methods: Patients (n = 171; age range 18–100 years) completed the World Health Organization Quality of Life assessment instrument-Bref (WHOQOL-Bref) and the Short Musculoskeletal Function Assessment questionnaire (SMFA) at time of diagnosis (i.e., pre-injury status), 1 week, and 6 months post-fracture. Linear mixed modeling was performed. Results: Interaction effects of time with treatment were detected for the WHOQOL-Bref facet Overall QOL and General health (p = .002) and Physical health (p = .003). Patients did not return to their pre-injury Physical health, Psychological health, and Environment 6 months post-fracture (p < .05). No effects were found for Social relationships. The SMFA subscale Lower extremity dysfunction showed main effects for time and treatment (p < .0001) with full recovery at 6 months (p = .998). An interaction effect of time with treatment was found for Daily life consequences (p < .0001) with nonoperatively treated patients showing full recovery (p = 1.00), whereas surgically treated patients did not (p = .002). Conclusions: Six months after LEF, patients still experienced impaired physical and psychological health on the WHOQOL-Bref compared to their pre-injury status. However, patients showed full recovery on SMFA Lower extremity dysfunction, indicating that the choice of the questionnaire influences the derived conclusions. LEF did not affect satisfaction with social relationships

Trajectories in quality of life of patients with a fracture of the distal radius or ankle using latent class analysis

Purpose: This prospective study aimed to identify the different trajectories of quality of life (QOL) in patients with distal radius fractures (DRF) and ankle fractures (AF). Secondly, it was examined if subgroups could be characterized by sociodemographic, clinical, and psychological variables. Methods: Patients (n = 543) completed the World Health Organization Quality of Life assessment instrument-Bref (WHOQOL-Bref), the pain, coping, and cognitions questionnaire, NEO-five factor inventory (neuroticism and extraversion), and the state-trait anxiety inventory (short version) a few days after fracture (i.e., pre-injury QOL reported). The WHOQOL-Bref was also completed at three, six, and 12 months post-fracture. Latent class trajectory analysis (i.e., regression model) including the Step 3 method was performed in Late

The association of depressive symptoms, personality traits, and sociodemographic factors with health-related quality of life and quality of life in patients with advanced-stage lung cancer: An observational multi-center cohort study

Background: Identification of patient-related factors associated with Health-Related Quality of Life (HRQoL) and Quality of Life (QoL) at the start of treatment may identify patients who are prone to a decrease in HRQoL and/or QoL resulting from chemotherapy. Identification of these factors may offer opportunities to enhance patient care during treatment by adapting communication strategies and directing medical and psychological interventions. The aim was to examine the association of sociodemographic factors, personality traits, and depressive symptoms with HRQoL and QoL in patients with advanced-stage lung cancer at the start of chemotherapy. Methods: Patients (n = 151) completed the State-Trait Anxiety Inventory (trait anxiety subscale), the Neuroticism-Extraversion-Openness-Five Factor Inventory (NEO-FFI), the Center for Epidemiologic Studies Depression (CES-D), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Simple linear regression analyses were performed to select HRQoL and QoL associated factors (a P ≤ 0.10 was used to prevent non-identification of important factors) followed by multiple linear regression analyses (P ≤ 0.05). Results: In the multiple regression analyses, CES-D score (β = - 0.63 to - 0.53; P-values < 0.001) was most often associated with the WHOQOL-BREF domains and general facet, whereas CES-D score (β = - 0.67 to - 0.40; P-values < 0.001) and Eastern Cooperative Oncology Group (ECOG) performance status (β = - 0.30 to - 0.30; P-values < 0.001) were most often associated with the scales of the EORTC QLQ-C30. Personality traits were not related with HRQoL or QoL except for trait anxiety (Role functioning: β = 0.30; P = 0.02, Environment: β = - 0.39; P = 0.007) and conscientiousness (Physical health: β = 0.20; P-value < 0.04). Conclusions: Higher scores on depressive symptoms and ECOG performance status were related to lower HRQoL and QoL in patients with advanced-stage non-small cell lung cancer. Supportive care interventions aimed at improvement of depressive symptoms and performance score may facilitate an increase of HRQoL and/or QoL during treatment

Frequency of low-grade adverse events and quality of life during chemotherapy determine patients' judgement about treatment in advanced-stage thoracic cancer

Purpose In lung cancer, the preservation of well-being is warranted given the limited prognosis. Chemotherapy may negatively influence health-related quality of life (HRQoL) due to adverse events. However, patients’ judgement about this negative impact is not well understood. We examined the relationship between expectations, feelings about side effects, and satisfaction with therapy and (HR)QoL in advanced-stage thoracic cancer and investigated which of these factors has the highest impact on (HR)QoL. Methods Sixty-nine patients completed the Cancer Therapy Satisfaction Questionnaire (CTSQ), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Multiple regression analyses were performed to investigate the relation of the CTSQ domains (i.e., expectations of therapy, feelings about side effects, satisfaction with therapy) with (HR)QoL and simple regression analyses to identify the factors of the CTSQ domain that was most often associated with (HR)QoL. Results Feelings about side effects were associated with the (HR)QoL domain/scale scores (i.e., WHOQOL-BREF domains: β = 0.36 to 0.58; EORTC QLQ-C30 scales: β = 0.33 to 0.61) except social relationships of the WHOQOL-BREF. Low-grade adverse events were related to feelings about side effects (β = − 0.326; P = 0.007). Conclusions Patients experiencing negative feelings about side effects have worse (HR)QoL. Additional care should be provided to prevent low-grade adverse events

Seksuele disfunctie en relatieproblemen na prostaatkankerbehandeling: De gewenste zorg vanuit het oogpunt van patiënt en partner

Erectile dysfunction (ED) is one of the most common side effects of prostate cancer (PC) treatment and may lead to changes in a relationship. The aim of this study was to identify sexual and/or relational problems and to investigate what kind of supportive care is preferred by patients and their partners. A cross-sectional survey was performed among men diagnosed with PC enrolled in active surveillance or treated with laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy or hormonal therapy. If possible, partners were included as well. Out of 250 patients, 80,5% suffered from moderate to severe erectile complaints. Half of them (53,7%) was treated for ED and a great part was partially (30,7%) up to not satisfied (25,7%). Out of 168 partners, 50,6% found it difficult to cope with changes around sexuality. The majority of men (74,7%) preferred a standard consultation with a urologist-sexologist three months after treatment to discuss sexuality

Psychometric properties of the Dutch Short Musculoskeletal Function Assessment (SMFA) questionnaire in patients with a fracture of the upper or lower extremity

Purpose: This prospective study examined the psychometric properties of the adapted Dutch translation of the Short Musculoskeletal Function Assessment (SMFA) questionnaire in patients with isolated unilateral lower fracture (LEF) or upper extremity fracture (UEF). Methods: Patients (N = 458) completed the SMFA, WHOQOL-BREF, and the RAND-36 at time of diagnosis (i.e. pre-injury status), 1, and 2 weeks post-fracture. Principal axis factoring was performed, and Cronbach's alpha coefficients (α) and intra-class correlation coefficients (ICC) were calculated. Furthermore, Pearson's product-moment correlations (r), paired t tests, and standardized response means (SRM) were calculated. Results: A three-factor structure was found: Lower extremity dysfunction, Upper extremity dysfunction, and Daily life consequences. This struct

Discussing sexuality with patients with Parkinson's disease: a survey among Dutch neurologists

Sexual functioning is often impaired in patientswith Parkinson&rsquo;s disease (PD) and may affect quality oflife of patients and their spouse. However, little is knownabout the practice patterns of neurologists with regard todiscussing sexuality in this field. The aim of this cross-sectional study was to evaluate to what extent neurologistsdiscuss sexuality with PD patients. A 22-item questionnairewas sent to 139 neurologists specializing in PD. The surveycontained questions about their attitudes, knowledge, andpractice patterns with respect to sexual dysfunction (SD) inpatients with PD. The response rate of the survey was66.9%. Most participants (56.8%) stated that they addresssexuality in less than half of their PD patients. High age ofpatients (42.0%), insufficient consultation time (37.5%),and a lack of patients&rsquo; initiative to raise the topic them-selves (36.4%) were frequently reported barriers towardsdiscussing sexuality. The majority of participants consid-ered that discussing sexuality is a responsibility that laywith neurologists (85.2%), nurses (73.9%), and patients(72.7%). One quarter of the neurologists reported to haveinsufficient or no knowledge on SD. The majority of par-ticipants regarded screening for SD important or slightlyimportant (85.2%). A large proportion of Dutch neurolo-gists specializing in PD do not routinely discuss sexualitywith their PD patients. Sexual healthcare in PD patientsmay benefit from time-efficient tools and agreements onwho is responsible for discussing SD. Furthermore, rec-ommendations in PD guidelines on screening and manag-ing SD should be adapted to fit everyday practicehttps://creativecommons.org/licenses/by/4.0/&nbsp;CC BY 4.0https://creativecommons.org/licenses/by/4.0

What is the role of nephrologists and nurses of the dialysis department in providing fertility care to CKD patients?: A questionnaire study among care providers.mong Dutch neurologists

Purpose This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrolo- gists and nurses in the dialysis department. Methods Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N=312) and dialysis nurses (N=1211). &nbsp; Results Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9.0% of the nephrologists and 15.6% of the nurses. 61.7% of the nephrologists and 23.6% of the nurses informed &ge;50% of their patients on potential changes in fertility due to a decline in renal function. Fertility subjects discussed by nephrologists included &ldquo;wish to have children&rdquo; (91.2%), &ldquo;risk of pregnancy for patients&rsquo; health&rdquo; (85.8%), and &ldquo;inheritance of the disease&rdquo; (81.4%). Barriers withholding nurses from discussing FD were based on &ldquo;the age of the patient&rdquo; (62.6%), &ldquo;insufficient training&rdquo; (55.2%), and &ldquo;language and ethnicity&rdquo; (51.6%). 29.2% of the nurses felt competent in discussing fertility, 8.3% had sufficient knowledge about fertility, and 75.7% needed to expand their knowledge. More knowledge and competence were associated with providing fertility health care (p&lt; 0.01). &nbsp; Conclusions In most nephrology departments, the guide- lines to appoint which care provider should provide fertil- ity care to CKD patients are absent. Fertility counseling is routinely provided by most nephrologists, nurses often skip this part of care mainly due to insufficiencies in self- imposed competence and knowledge and barriers based on cultural diversity. The outcomes identified a need for fer- tility guidelines in the nephrology department and training and education for nurses on providing fertility care. &nbsp; CC BY 4.0 https://creativecommons.org/licenses/by/4.0

Unravelling current sexual care in chronic kidney disease: perspective of social workers

Background: Fifty to eighty percent of patients suffering from chronic kidney disease (CKD) experience a form of sexual dysfunction (SD), even after renal transplantation. Despite this, inquiring about SD is often not included in the daily practice of renal care providers. Objectives: This paper explores the perspectives of renal social workers regarding sexual care for patients and evaluates their practice,attitude towards responsibility and knowledge of SD. Design: A cross-sectional study was conducted using a 41-item online survey. Participants: Seventy-nine members of the Dutch Federation of Social Workers Nephrology. Results: It was revealed that 60% of respondents discussed SD with a fifth of their patients. Frequency of discussion was associated with experience (p&frac14;0.049), knowledge (p&frac14;0.001), supplementary education (p&frac14;0.006), and the availability of protocols on sexual care (p&frac14;0.007).Main barriers towards discussing SD consisted of &lsquo;culture and religion&rsquo; (51.9%), &lsquo;language and ethnicity&rsquo; (49.4%), and &lsquo;presence of a third person&rsquo; (45.6%). Sufficient knowledge of SD was present in 28% of respondents. The responsibility for discussion was 96% nephrologists and 81% social workers. Conclusion: This study provides evidence that a part of Dutch nephrology social workers do not provide sexual care regularly, due to insufficient experience and sexual knowledge, absence of privacy and protocols and barriers based on cultural diversity. According to the respondents the responsibility for this aspect of care should be multidisciplinary. Recommendations include a need for further education on the topic, private opportunities to discuss SD and multidisciplinary guidelines on sexual car