Localized Prostate Cancer and Quality of Life: Screening, treatment and methodological issues

In Western countries prostate cancer is the most prevalent malignancy in males. In its early stage prostate cancer usually does not cause any pain or other symptoms. It can be detected early by testing for prostate-specific antigen (PSA). Since the 1980s the PSA-test has been applied at a large scale, resulting in an increased prevalence of prostate cancer. Overdiagnosis, defined as the detection and subsequent treatment of prostate cancer through PSA-testing that otherwise would not have been diagnosed within the patients’ lifetime, is considered a major potential drawback of PSA-testing. The increase in the number of men being diagnosed with prostate cancer – especially in its early stage – and subsequently receiving primary treatment is associated with a proportional rise in the prevalence of side effects. Side-effects mainly concern erectile and urinary dysfunction after radical prostatectomy, and erectile and bowel dysfunction after external radiotherapy. This thesis focuses on the effects of prostate cancer diagnosis and primary treatment on quality of life of patients. ‘Quality of life’ (QoL) will be restricted to ‘health-related quality of life’ or ‘health status’, defined as quality of life relating to disease and/or treatment.In westerse landen is prostaatkanker de meest prevalente maligniteit (vorm van kanker) onder mannen. In een vroeg stadium veroorzaakt prostaatkanker normaal gesproken geen pijn of enig ander symptoom. Het kan vroeg ontdekt worden door te testen op prostaat-specifiek antigeen (PSA). Sinds de jaren tachtig van de vorige eeuw wordt de PSA-test op grote schaal toegepast, hetgeen resulteerde in een toegenomen prevalentie van prostaatkanker. Overdiagnose, gedefinieerd als de ontdekking en daaropvolgende behandeling van prostaatkanker middels de PSA-test die anders niet gediagnosticeerd zou zijn tijdens het leven van de patiënt, wordt als een belangrijk potentieel nadeel van de PSA-test beschouwd. De toename in het aantal mannen dat in een vroeg stadium van prostaatkanker wordt gediagnosticeerd en vervolgens primarie behandeling ondergaat, gaat gepaard aan een toename in de prevalentie van bijeffecten van die behandeling. Bijeffecten betreffen met name erectiestoornissen en plasklachten na radicale prostatectomie (operatie), en erectiestoornissen en darmproblemen na externe radiotherapie. Dit proefschrift richt zich op de effecten van prostaatkankerdiagnose en primaire behandeling op de kwaliteit van leven van patiënten. In dit proefschrift beperkt ‘kwaliteit van leven’ (KvL) zich tot ‘gezondheidsgerelateerde kwaliteit van leven’ oftewel ‘gezondheidstoestand’, gedefinieerd als kwaliteit van leven in relatie tot ziekte en/of behandeling

The urinary-specific quality of life of multiple sclerosis patients: Dutch translation and validation of the SF-Qualiveen

Aims: The SF-Qualiveen is a short questionnaire that measures the impact of urinary symptoms on the quality of life of patients with urological dysfunction due to neurological disorders. The aim of this study is to translate, culturally adapt and validate a Dutch version of the SF-Qualiveen for use in Multiple Sclerosis (MS) patients. Methods: Cross-cultural adaptation of the original English SF-Qualiveen into Dutch was performed according to standardized guidelines. Adult MS patients with symptomatic urinary disorders who visited the Urology or Rehabilitation outpatient clinic of the Erasmus Medical Center completed the SF-Qualiveen and the Urinary Distress Inventory-6 (UDI-6), that evaluates bother caused by lower urinary tract symptoms and was used as a gold standard, at baseline and 1-2 weeks later. A control group recruited from the Otolaryngology outpatient clinic completed the questionnaires once. Reliability and validity were determined. Results: Fifty MS patients and 50 controls were included. SF-Qualiveen scores in patients were higher than in controls (on a scale of 0-4: 1.73 vs. 0.34; P 0.8) and reproducibility (Intraclass correlation coefficients >0.8) were good for the total SF-Qualiveen. Content validity was adequate and a significant relationship between SF-Qualiveen and UDI-6 (r = 0.510-0.479, P < 0.

Measuring leprosy case detection delay and associated factors in Indonesia:a community-based study

Background: Leprosy is a public health burden in Indonesia with a high number of new cases every year and a high proportion of disability among new cases. Case detection delay (CDD) can contribute to ongoing transmission and increased disability chances among leprosy patients. This study aimed to establish the CDD of leprosy and the factors associated with detection delay in Indonesia. Method: Community-based study with a cross-sectional design. Data were collected through interviews about sociodemographic and behavioral factors, anticipated stigma, and duration of CDD. Leprosy classification and case detection methods were obtained from health service records. A random sample was taken of 126 leprosy patients registered between 1st October 2020 and 31st March 2022 in the Tegal regency in the Central Java Province. Data were analysed by descriptive and analytical statistics using multiple linear regression. Results: The mean CDD, patient delay, and health system delay were 13.0 months, 9.7 months, and 3.2 months, respectively. Factors associated with longer CDD are younger age (below 35 years), male, found through passive case detection, and not having a family member with leprosy. Factors associated with longer patient delay were being younger (below 35 years), being male, not having a family member with leprosy, and anticipated stigma of leprosy. It was not possible to reliably identify factors associated with health system delay. Conclusion: CDD in leprosy should be reduced in Indonesia. The Indonesian National Leprosy Control Program (NLCP) is advised to adopt an integrated intervention programme combining active case detection with targeted health education to reduce CDD and thereby preventing disabilities in people affected by leprosy.</p

The role of acculturation in the process of advance care planning among Chinese immigrants:A narrative systematic review

Background: Acculturation is the process of two different cultures coming into contact. It is unclear how acculturation influences Chinese immigrants’ engagement in advance care planning due to the complexity and multifaceted nature of both acculturation and advance care planning. Aims: To synthesize evidence regarding the role of Chinese immigrants’ acculturation in their engagement in advance care planning. Design: Systematic mixed-method review, registered in PROSPERO (CRD42021231822). Data sources: EMBASE, MEDLINE, Web of Science, and Google Scholar were searched for publications until January 21, 2021. Results: Twenty-one out of 1112 identified articles were included in the analysis. Of those 21 articles, 17 had a qualitative design and 13 originated from the United States. Three of four quantitative studies reported that higher acculturation levels were associated with better knowledge or higher rate of engagement in advance care planning. Analysis of qualitative studies showed that Chinese immigrants’ engagement in advance care planning was associated with their: (1) self-perceived cultural identity (native or non-native); (2) interpretation of filial piety (traditional or modern); and (3) interpretation of autonomy (individual or familial). To facilitate their engagement, Chinese immigrants prefer an implicit approach, non-family-related initiators, contextualization advance care planning in Chinese culture and using Chinese language. Conclusion: Chinese immigrants’ willingness to engage in advance care planning varied with their acculturation level. To engage them in advance care planning, we recommend adapting the introduction of advance care planning to address people’s perceptions of their cultural identity, filial piety, and autonomy, as well as their preference for certain approach, initiator, context, and language.</p

Trajectories and predictors of women's health-related quality of life during pregnancy

The objective of this study was to identify distinct trajectories and their predictors of healthrelated quali