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Health-related quality of life profiles of adults with arthritis and/or fibromyalgia: a cross-sectional study. 患有关节炎和/或纤维肌痛的成年人的健康相关生活质量概况:一项横断面研究。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-20 DOI: 10.1007/s11136-024-03831-9
Erin M Knight, Kathleen L Carluzzo, Bryce B Reeve, Kristen L Mueller, Jasvinder A Singh, Li Lin, Karen E Schifferdecker

Purpose: Adults with arthritis experience poor health-related quality of life (HRQOL), though research often focuses on single HRQOL outcomes or summary scores. We aimed to identify HRQOL profiles in adults with different arthritis types and determine risk and protective factors.

Methods: Data including PROMIS-29 Profile v2.1 and PROMIS Short Form v2.0 - Emotional Support 4a were collected through a national foundation's online survey of adults with arthritis in the U.S. We used latent profile analysis (LPA) to characterize the heterogeneity in arthritis patients by clustering them into HRQOL profiles, based on statistical model fit and clinical interpretability. We fit a multinomial logistic regression model with HRQOL profile assignment as the outcome to determine associations with protective and risk factors.

Results: We included 25,305 adults with arthritis. The LPA results favored a five-HRQOL profile solution (entropy = 0.83). While some profiles displayed better HRQOL in some domains, 93% of the sample displayed impacted pain and physical functioning. One profile (20%) displayed mean T-scores nearly 2 standard deviations below the population mean. Despite poor physical HRQOL outcomes, one profile (10%) displayed average mental health. All demographic and clinical factors contributed significantly to the model, including risk factors (arthritis types, work status) and protective factors (more emotional support, starting exercise).

Conclusion: We identified profiles with consistently impacted HRQOL in arthritis, though one displayed average mental health functioning despite poor physical functioning. These results highlight the value of considering the patient's HRQOL experience alongside treatment options, and the potentially positive impact of non-pharmacological interventions.

目的:成人关节炎患者的健康相关生活质量(HRQOL)较差,但研究通常只关注单一的 HRQOL 结果或总分。我们旨在确定不同类型关节炎成人的 HRQOL 状况,并确定风险和保护因素:我们使用潜特征分析法(LPA),根据统计模型拟合度和临床可解释性,将关节炎患者聚类为 HRQOL 特征,从而描述关节炎患者的异质性。我们拟合了一个以 HRQOL 特征分配为结果的多项式逻辑回归模型,以确定与保护性因素和风险因素之间的关联:结果:我们纳入了 25305 名成人关节炎患者。LPA结果倾向于五HRQOL档案解决方案(熵=0.83)。虽然某些特征在某些领域显示出更好的 HRQOL,但 93% 的样本显示出疼痛和身体功能受到影响。有一个样本(20%)的平均 T 值低于人群平均值近 2 个标准差。尽管身体 HRQOL 结果不佳,但有一个样本(10%)的心理健康状况一般。所有人口统计学和临床因素都对模型有重要影响,包括风险因素(关节炎类型、工作状况)和保护因素(更多的情感支持、开始锻炼):我们发现了关节炎患者的 HRQOL 一直受到影响的特征,尽管其中一人的身体机能较差,但其心理健康功能却处于平均水平。这些结果凸显了在选择治疗方案的同时考虑患者的 HRQOL 体验的价值,以及非药物干预可能产生的积极影响。
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引用次数: 0
EQ-5D-5L value set for Norway: a hybrid model using cTTO and DCE data. 挪威的 EQ-5D-5L 值集:使用 cTTO 和 DCE 数据的混合模型。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-20 DOI: 10.1007/s11136-024-03837-3
Andrew M Garratt, Knut Stavem, James W Shaw, Kim Rand

Purpose: To develop the Norwegian value set for the EQ-5D-5L based on interviews with a representative sample of the Norwegian adult population.

Methods: Random and quota sampling were used to recruit the sample of adults (age> 18 years) representative of the Norwegian general population. Data collection followed EQ-VT 2.1 undertaken before and after the COVID-19 pandemic from November 2019 to December 2022, using PC-assisted and video conferencing interviews, respectively. Each respondent valued 10 health states using composite time trade-off (cTTO) and 7 health states using a discrete choice experiment (DCE). Different statistical models were assessed for logical consistency and predictive accuracy using cTTO and DCE data alone or in combination as hybrid models.

Results: Of the 1,321 respondents, 1,237 met inclusion criteria. All statistical models demonstrated logical consistency. The weighted hybrid model combining both cTTOand DCE data was preferred and had the highest predictive accuracy. Predicted values ranged from -0.453 to 1, and the dimension of anxiety/depression was the most highly valued by respondents, followed by pain/discomfort, self-care, mobility, and usual activities. These findings are not dissimilar to those for most Western European countries, and regression coefficients are closest to those for other Scandinavian countries.

Conclusion: This study provides the Norwegian value set for the EQ-5D-5L based on health state values obtained from members of the adult general population in Norway. This is an important contribution to economic evaluation and the broader application ofthe EQ-5D-5L in Norway including clinical and health services research, and quality measurement.

目的:根据对挪威成年人口中具有代表性的样本进行的访谈,制定挪威的EQ-5D-5L数值集:方法:采用随机抽样和配额抽样的方法,招募代表挪威一般人口的成年人(年龄大于18岁)样本。2019年11月至2022年12月,在COVID-19大流行之前和之后,分别使用PC辅助访谈和视频会议访谈,按照EQ-VT 2.1进行数据收集。每位受访者采用综合时间权衡法(cTTO)对 10 种健康状况进行估值,采用离散选择实验法(DCE)对 7 种健康状况进行估值。使用 cTTO 和 DCE 数据单独或组合作为混合模型,对不同统计模型的逻辑一致性和预测准确性进行了评估:在 1,321 名受访者中,1,237 人符合纳入标准。所有统计模型均显示出逻辑一致性。结合 cTTO 和 DCE 数据的加权混合模型更受青睐,预测准确率最高。预测值从-0.453到1不等,受访者最看重的是焦虑/抑郁维度,其次是疼痛/不适、自我护理、活动能力和日常活动。这些结果与大多数西欧国家的结果并无不同,而回归系数与其他斯堪的纳维亚国家的结果最为接近:本研究根据从挪威成年人口中获得的健康状况值,提供了挪威的EQ-5D-5L值集。这对挪威的经济评估和EQ-5D-5L的更广泛应用(包括临床和医疗服务研究以及质量测量)是一个重要贡献。
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引用次数: 0
Health-related quality of life and its association with socioeconomic status and mental health in 5- to 7-year-old children: a cross-sectional study. 5 至 7 岁儿童的健康相关生活质量及其与社会经济地位和心理健康的关系:一项横断面研究。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-20 DOI: 10.1007/s11136-024-03834-6
Eva-Grethe Befus, Eirin Mølland, Sølvi Helseth, Thomas Westergren, Eirik Abildsnes, Milada Hagen, Sandra Nolte, Kristin Haraldstad

Purpose: Assessing socioeconomic status (SES), mental health, and health-related quality of life (HRQoL) in young children is crucial for making informed health care decisions and identifying areas of intervention. The present study aimed to investigate potential associations between SES, mental health, and HRQoL in 5-7-year-old children.

Method: The present study included mother-reported health assessments for 621 children aged 5-7 years in Grade 1 collected between 2019 and 2023 as part of the Starting Right™ project. Online questionnaires were used to support public health nurses in assessing children's health status. HRQoL (KIDSCREEN-27, 5 subscales) and mental health [Strength and Difficulties Questionnaire (SDQ), 4 subscales] were assessed. Sociodemographic characteristics, sex, maternal education, and income were obtained from Statistics Norway. The data were analyzed using multiple robust regression.

Results: Mother-reported mean scores for the KIDSCREEN-27 were within the normal range compared with European norms (8-11 years). However, for each KIDSCREEN-27 dimension, there were individuals whose mothers reported scores that were substantially lower than average. Having mental health problems, defined as being in the 80th and 90th percentiles of the SDQ Total problem score, was associated with 2.1-10.7-point lower KIDSCREEN-27 scores (p < 0.001-0.021), which was most noticeable in the KIDSCREEN-27 school environment subscale. Weak but significant positive associations were found between SES and HRQoL.

Conclusion: Our results provide important insights into the associations between SES, mental health, and HRQoL in young children. Given the strong association between mental health problems and HRQoL in Grade 1 children, the assessment of both is essential, so that early interventions, an improved caring environment, and nurturing support can be initiated.

目的:评估幼儿的社会经济地位(SES)、心理健康和与健康相关的生活质量(HRQoL)对于做出明智的医疗保健决策和确定干预领域至关重要。本研究旨在调查 5-7 岁儿童的社会经济地位、心理健康和 HRQoL 之间的潜在关联:本研究收集了2019年至2023年期间621名5-7岁一年级儿童的母亲报告健康评估,作为 "正确起步™"项目的一部分。在线问卷用于支持公共卫生护士评估儿童的健康状况。评估内容包括 HRQoL(KIDSCREEN-27,5 个分量表)和心理健康(力量与困难问卷 (SDQ),4 个分量表)。社会人口特征、性别、母亲教育程度和收入均来自挪威统计局。数据采用多元稳健回归法进行分析:与欧洲标准(8-11 岁)相比,母亲报告的 KIDSCREEN-27 平均得分在正常范围内。然而,在 KIDSCREEN-27 的每个维度上,母亲报告的得分都远远低于平均水平。有心理健康问题,即在 SDQ 问题总分中处于第 80 和 90 百分位数,与 KIDSCREEN-27 分数低 2.1-10.7 分有关(p 结论:我们的研究结果提供了重要的见解:我们的研究结果为了解幼儿的社会经济地位、心理健康和 HRQoL 之间的关系提供了重要启示。鉴于一年级儿童的心理健康问题与 HRQoL 之间存在密切联系,因此对两者进行评估至关重要,以便及早采取干预措施、改善关爱环境和提供培养支持。
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引用次数: 0
Quality of life and testosterone recovery after androgen deprivation therapy in high-risk prostate cancer patients: long-term data from a phase III trial. 高危前列腺癌患者接受雄激素剥夺疗法后的生活质量和睾酮恢复情况:III 期试验的长期数据。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-20 DOI: 10.1007/s11136-024-03843-5
Abdenour Nabid, Nathalie Carrier, André-Guy Martin, Jean-Paul Bahary, Peter Vavassis, Sylvie Vass, Boris Bahoric, Robert Archambault, François Vincent, Redouane Bettahar, Luis Souhami

Purpose: The aim was to compare quality of life (QoL) of patients with testosterone recovery (TR) to patients without TR after the completion of either 18- or 36-month androgen deprivation therapy (ADT) for prostate cancer.

Methods: From a Phase III trial, we selected all 630 randomised patients with testosterone measured at baseline (during screening, before randomisation) and follow-up and who completed baseline, 6-month and, at least, one further QoL questionnaire in follow-up (EORTC 30 - PR25). We estimated means and standard deviation of items and scales for each group at each time point. We analyzed items and scales scores with general linear model with repeated measures to evaluate changes between patients with or without TR to a normal level. p-values were adjusted for multiple comparisons with Benjamini-Hochberg's false discovery rate procedure (padj). A padj < 0.05 was considered significant and mean differences of 10 points or more considered clinically relevant.

Results: 494 patients retained for analysis (median follow-up 16.2 years). A significantly higher number of patients (177/314 vs 79/180, p = 0.008) recovered a normal testosterone level in a significantly shorter time [median (IQR): 3.06 (2.55-3.65) vs 5.00 years (4.5-5.96), p < 0.001] in the 18- vs the 36-month cohort. Patients with TR had a significantly better QoL: 37/55 items and 14/21 scales (padj<0.05) in the 18-month and 25/55 items and 13/21 scales in the 36-month cohort. Moreover, 9 items and one scale reached clinical relevance in the 18-month cohort and 7 items and one scale in the 36-month cohort.

Conclusions: TR is associated with significant regaining in QoL. A faster and significantly higher TR is seen in the shorter ADT schedule.

目的:旨在比较睾酮恢复期(TR)患者和非睾酮恢复期(TR)患者在完成18个月或36个月的前列腺癌雄激素剥夺疗法(ADT)后的生活质量(QoL):从一项 III 期试验中,我们选取了所有 630 名随机患者,这些患者在基线(筛查期间、随机化之前)和随访期间均进行了睾酮测定,并完成了基线、6 个月和至少一次随访的 QoL 问卷调查(EORTC 30 - PR25)。我们估算了各组在每个时间点的项目和量表的平均值和标准偏差。我们采用重复测量的一般线性模型对项目和量表得分进行分析,以评估有无TR的患者之间的变化是否达到正常水平。padj<0.05被认为具有显著性,10点或以上的平均差异被认为具有临床相关性:保留 494 例患者进行分析(中位随访 16.2 年)。更多患者(177/314 vs 79/180,p = 0.008)在更短的时间内恢复了正常的睾酮水平[中位数(IQR):3.06(2.55-3.65) vs 5.00年(4.5-5.96),p adj结论:TR与QoL的显著恢复有关。在较短的 ADT 计划中,TR 速度更快,且明显更高。
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引用次数: 0
Multiple social factors are associated with wellbeing when accounting for shared genetic and environmental confounding. 在考虑到共同的遗传和环境干扰因素的情况下,多种社会因素与福祉相关。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-20 DOI: 10.1007/s11136-024-03832-8
Ludvig Daae Bjørndal, Ragnhild Bang Nes, Ziada Ayorech, Olav Vassend, Espen Røysamb

Purpose: Social factors are associated with mental health and wellbeing. However, few studies have examined genetic and environmental influences on social factors themselves, limiting current understanding of influences on aspects of the social environment. Most studies which have identified links between social factors and mental health are also limited by the possible influence of unmeasured genetic and environmental confounding. In this study, we investigated the genetic and environmental underpinnings of multiple social factors (relationship satisfaction, loneliness, attachment, trust, relationship disruptions), and their associations with life satisfaction measured concurrently and six years later, after accounting for shared genetic and environmental confounding.

Methods: Data from a population-based sample of adult twins (N = 1987) and two measurement timepoints were used for the primary analyses. We used multivariate Cholesky models to estimate genetic and environmental influences across five social factors. Subsequently, we conducted co-twin control analyses to examine associations between social factors and wellbeing after controlling for shared genetic and environmental confounding.

Results: Heritability estimates for the social factors ranged from 24 to 42%. Genetic correlations across social factors were substantial, indicative of considerable genetic overlap. Associations between wellbeing and relationship satisfaction, loneliness, anxious and avoidant attachment, trust, and disruptions in relationships in the past year were attenuated in co-twin control analyses but remained statistically significant. Relationship satisfaction, loneliness, and attachment avoidance were also associated with wellbeing measured six years later in estimates which controlled for shared genetic and environmental confounding.

Conclusion: Our findings provide evidence that multiple social factors are associated with wellbeing after accounting for potential confounding by shared genetic and/or environmental factors. These findings highlight the importance of multiple aspects of the social environment for wellbeing in older adulthood. Future studies should examine the directionality in associations between social factors and mental health and assess these relationships beyond older adulthood.

目的:社会因素与心理健康和幸福感有关。然而,很少有研究对遗传和环境对社会因素本身的影响进行研究,这限制了目前对社会环境各方面影响的了解。大多数确定了社会因素与心理健康之间联系的研究也受到了未测量的遗传和环境混杂因素可能造成的影响的限制。在这项研究中,我们调查了多种社会因素(关系满意度、孤独感、依恋、信任、关系中断)的遗传和环境基础,以及它们与同时和六年后测量的生活满意度之间的关系,并考虑了共同的遗传和环境混杂因素:主要分析采用了基于人口的成年双胞胎样本数据(N = 1987)和两个测量时间点的数据。我们使用多变量 Cholesky 模型来估计五个社会因素的遗传和环境影响。随后,我们进行了同卵双生子对照分析,在控制了共同的遗传和环境混杂因素后,研究了社会因素与幸福之间的关联:社会因素的遗传率估计值从 24% 到 42% 不等。各社会因素之间的遗传相关性很大,表明存在相当大的遗传重叠。在同卵双生子对照分析中,幸福感与人际关系满意度、孤独感、焦虑型和回避型依恋、信任以及过去一年人际关系中断之间的相关性有所减弱,但在统计学上仍然显著。在控制共同遗传和环境干扰的估计中,关系满意度、孤独感和依恋回避也与六年后测量的幸福感相关:我们的研究结果证明,在考虑了共同遗传和/或环境因素的潜在干扰后,多种社会因素与幸福感相关。这些发现强调了社会环境的多个方面对老年期幸福感的重要性。未来的研究应考察社会因素与心理健康之间的关联的方向性,并对这些关系进行超越老年期的评估。
{"title":"Multiple social factors are associated with wellbeing when accounting for shared genetic and environmental confounding.","authors":"Ludvig Daae Bjørndal, Ragnhild Bang Nes, Ziada Ayorech, Olav Vassend, Espen Røysamb","doi":"10.1007/s11136-024-03832-8","DOIUrl":"10.1007/s11136-024-03832-8","url":null,"abstract":"<p><strong>Purpose: </strong>Social factors are associated with mental health and wellbeing. However, few studies have examined genetic and environmental influences on social factors themselves, limiting current understanding of influences on aspects of the social environment. Most studies which have identified links between social factors and mental health are also limited by the possible influence of unmeasured genetic and environmental confounding. In this study, we investigated the genetic and environmental underpinnings of multiple social factors (relationship satisfaction, loneliness, attachment, trust, relationship disruptions), and their associations with life satisfaction measured concurrently and six years later, after accounting for shared genetic and environmental confounding.</p><p><strong>Methods: </strong>Data from a population-based sample of adult twins (N = 1987) and two measurement timepoints were used for the primary analyses. We used multivariate Cholesky models to estimate genetic and environmental influences across five social factors. Subsequently, we conducted co-twin control analyses to examine associations between social factors and wellbeing after controlling for shared genetic and environmental confounding.</p><p><strong>Results: </strong>Heritability estimates for the social factors ranged from 24 to 42%. Genetic correlations across social factors were substantial, indicative of considerable genetic overlap. Associations between wellbeing and relationship satisfaction, loneliness, anxious and avoidant attachment, trust, and disruptions in relationships in the past year were attenuated in co-twin control analyses but remained statistically significant. Relationship satisfaction, loneliness, and attachment avoidance were also associated with wellbeing measured six years later in estimates which controlled for shared genetic and environmental confounding.</p><p><strong>Conclusion: </strong>Our findings provide evidence that multiple social factors are associated with wellbeing after accounting for potential confounding by shared genetic and/or environmental factors. These findings highlight the importance of multiple aspects of the social environment for wellbeing in older adulthood. Future studies should examine the directionality in associations between social factors and mental health and assess these relationships beyond older adulthood.</p>","PeriodicalId":20748,"journal":{"name":"Quality of Life Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality of life among obstructive sleep apnoea patients: a systematic review and meta-analysis of EQ-5D studies. 阻塞性睡眠呼吸暂停患者的生活质量:EQ-5D 研究的系统回顾和荟萃分析。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-19 DOI: 10.1007/s11136-024-03828-4
P Shirisha, Bhavani Shankara Bagepally, S Sajith Kumar, Bhanupriya Raghu

Background: Obstructive Sleep Apnoea (OSA) is a chronic condition which is associated with extreme daytime sleepiness, cognitive impairment, and other comorbidities and, hence, decreased quality of life (QoL). EQ-5D is one of the most widely used preference-based measures of QoL in patients with different diseases worldwide. This study aims to review the EQ-5D utility value of OSA across primary studies and perform a meta-analysis to derive pooled utility scores for OSA.

Methods: A systematic review and meta-analysis of the EQ-5D scores of OSA patients adhering to PRISMA guidelines was conducted. Studies reporting EQ-5D utility scores among adult OSA patients were systematically searched across PubMed-Medline, Scopus, and Embase. Selected studies were systematically reviewed and we have assessed the studies for their quality. Meta-analysis was performed using a random-effect model with subgroup analysis to explore heterogeneity.

Results: The search yielded 9,121 articles, of which twenty-eight studies were included in the synthesis. The pooled mean EQ-5D utility score was 0.73 (0.69 to 0.78) with high heterogeneity (I2 = 99.6%). The pooled EQ-5D VAS score was 67.14 (63.97 to 70.32) with high heterogeneity (I2 = 87.04%). Subgroup analyses indicated significant variability in utility scores across different countries, age groups, and disease severities. The variation of utility values for OSA was influenced by the characteristics of patients, the living environment, and the EQ-5D value set.

Conclusion: The synthesis revealed that the QoL is significantly lower in OSA, and the aggregated quantitative estimates of EQ-5D utility scores are essential inputs for economic evaluations.

背景:阻塞性睡眠呼吸暂停(OSA)是一种慢性疾病,与白天极度嗜睡、认知障碍和其他合并症有关,因此会降低生活质量(QoL)。EQ-5D 是全球最广泛使用的基于偏好的 QoL 测量方法之一,适用于不同疾病的患者。本研究旨在回顾主要研究中有关 OSA 的 EQ-5D 实用价值,并进行荟萃分析以得出 OSA 的集合实用价值得分:方法:根据PRISMA指南,对OSA患者的EQ-5D评分进行了系统回顾和荟萃分析。我们在PubMed-Medline、Scopus和Embase中系统检索了报告成年OSA患者EQ-5D效用评分的研究。我们对所选研究进行了系统审查,并对研究质量进行了评估。采用随机效应模型进行了元分析,并进行了亚组分析以探讨异质性:结果:搜索结果显示有 9,121 篇文章,其中 28 项研究被纳入综合分析。汇总的 EQ-5D 实用性平均得分为 0.73(0.69 至 0.78),异质性较高(I2 = 99.6%)。汇总的 EQ-5D VAS 得分为 67.14(63.97 至 70.32),异质性较高(I2 = 87.04%)。亚组分析表明,不同国家、年龄组和疾病严重程度的效用值存在显著差异。OSA效用值的变化受患者特征、生活环境和EQ-5D值集的影响:综述显示,OSA 患者的 QoL 明显较低,EQ-5D 实用性评分的综合定量估计值是经济评估的重要输入。
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引用次数: 0
Quality of life dimensions in people living with mental disorders: moving beyond global scores. 精神障碍患者的生活质量维度:超越总体评分。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-16 DOI: 10.1007/s11136-024-03844-4
Eleni Petkari, Brittany Lapin, Jan R Boehnke
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引用次数: 0
Impact of sleep quality on health-related quality of life domains and the mediating effects of symptoms in people with multiple sclerosis. 睡眠质量对多发性硬化症患者健康相关生活质量领域的影响以及症状的中介效应。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-13 DOI: 10.1007/s11136-024-03836-4
Baye Dagnew, Cynthia A Honan, Laura L Laslett, Bruce V Taylor, Julie Campbell, Leigh Blizzard, Ingrid van der Mei

Purpose: Many people living with multiple sclerosis (PwMS) experience poor sleep, which is associated with diminished overall health-related quality of life (HRQoL). We quantified associations between sleep quality and HRQoL domains and examined the extent to which other MS symptoms could account for these associations.

Methods: In this cross-sectional survey of 1,717 Australians with MS, we used Assessment of Quality of Life (AQoL) 8D and Pittsburgh Sleep Quality Index (PSQI) to assess HRQoL and sleep quality, respectively. Total, direct, and indirect effects of sleep quality on HRQoL domains were determined using mediation regression analysis.

Results: Poor sleep quality was significantly associated with all domains of HRQoL, with strongest associations seen for mental health (β=-0.08) and pain (β=-0.11), and weaker associations for independent living (β=-0.05) and senses (β=-0.03). Poor sleep quality had the largest direct effect on mental health (60.8%), happiness (48.7%), and pain (49.7%). MS symptom clusters mostly contributing to indirect effects were "feelings of anxiety and depression" for psychosocial, and "pain and sensory symptoms" for physical HRQoL super dimensions.

Conclusion: Improving sleep could lead to substantial improvements in all HRQoL domains and the improvement in HRQoL could be partially achieved through indirect improvements in sleep on MS symptoms.

目的:许多多发性硬化症患者(PwMS)睡眠质量差,这与整体健康相关生活质量(HRQoL)下降有关。我们对睡眠质量与 HRQoL 领域之间的关联进行了量化,并研究了其他多发性硬化症症状在多大程度上可以解释这些关联:在这项对 1717 名澳大利亚多发性硬化症患者进行的横断面调查中,我们使用生活质量评估 (AQoL) 8D 和匹兹堡睡眠质量指数 (PSQI) 分别评估 HRQoL 和睡眠质量。通过中介回归分析确定了睡眠质量对 HRQoL 领域的总影响、直接影响和间接影响:睡眠质量差与所有 HRQoL 领域都有明显相关性,其中与心理健康(β=-0.08)和疼痛(β=-0.11)的相关性最强,与独立生活(β=-0.05)和感官(β=-0.03)的相关性较弱。睡眠质量差对心理健康(60.8%)、幸福感(48.7%)和疼痛(49.7%)的直接影响最大。对间接影响贡献最大的多发性硬化症症状集群是社会心理方面的 "焦虑和抑郁感",以及身体方面的 HRQoL 超级维度 "疼痛和感觉症状":结论:改善睡眠可显著改善所有 HRQoL 领域,而 HRQoL 的改善可部分通过间接改善睡眠对多发性硬化症症状的影响来实现。
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引用次数: 0
Psychometric evaluation of the Functional Assessment of chronic illness therapy-fatigue (FACIT-Fatigue) in adults with moderately to severely active Crohn's disease. 对中度至重度活动性克罗恩病成人慢性病治疗疲劳功能评估(FACIT-疲劳)进行心理计量学评估。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-13 DOI: 10.1007/s11136-024-03829-3
Miguel Regueiro, Sylvia Su, Aisha Vadhariya, Xian Zhou, Frederick Durand, Larissa Stassek, Ariane K Kawata, Claudine Clucas, Vipul Jairath

Purpose: To provide further evidence on the psychometric properties of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) in moderately to severely active Crohn's disease (CD), and to determine thresholds for meaningful improvement in fatigue.

Methods: The FACIT-Fatigue is a 13-item patient-reported outcome measure (range, 0-52) assessing fatigue over the previous week. Using pooled data from the Phase 3 VIVID-1 study of moderately to severely active CD, psychometric properties of FACIT-Fatigue were evaluated up to Week 52. The Patient Global Rating of Severity (PGRS) and Patient Global Impression of Change (PGIC) were used as primary anchors to estimate the FACIT-Fatigue score change representing meaningful improvement.

Results: Psychometric analyses included 1065 adults. The FACIT-Fatigue demonstrated good internal consistency, and correlations between individual items and the total score were moderate to strong. The FACIT-Fatigue score showed moderate to strong correlations with other patient-reported assessments and weak correlations with endoscopic/laboratory assessments. The FACIT-Fatigue differentiated between distinct groups of participants varying in disease severity, quality of life, and fatigue based on PGRS and other assessments. FACIT-Fatigue improvements during the study differed significantly between most PGRS change and PGIC categories. Anchor-based estimates suggested a 6-9-point increase in the FACIT-Fatigue total score as meaningful improvement.

Conclusions: The FACIT-Fatigue demonstrated strong psychometric properties in the VIVID-1 population of adults with moderately to severely active CD and determined a FACIT-Fatigue score change threshold representing meaningful improvement.

Trial registration: NCT03926130. Registered 23 April 2019, https://clinicaltrials.gov/study/NCT03926130 .

目的:为慢性疾病治疗功能评估-疲劳(FACIT-疲劳)在中度至重度活动性克罗恩病(CD)患者中的心理测量特性提供进一步证据,并确定疲劳得到有意义改善的阈值:FACIT-疲劳是一项由13个项目组成的患者报告结果测量(范围为0-52),用于评估前一周的疲劳情况。利用针对中度至重度活动性 CD 的 VIVID-1 3 期研究的汇总数据,评估了 FACIT-Fatigue 在第 52 周前的心理测量特性。患者全球严重程度评分(PGRS)和患者全球变化印象(PGIC)被用作主要锚点,以估算代表有意义改善的 FACIT-Fatigue 评分变化:心理测量分析包括 1065 名成人。FACIT-疲劳表现出良好的内部一致性,单个项目与总分之间的相关性为中等至较强。FACIT-疲劳评分与其他患者报告的评估结果显示出中等至较强的相关性,而与内窥镜/实验室评估结果的相关性较弱。根据 PGRS 和其他评估结果,FACIT-疲劳可将疾病严重程度、生活质量和疲劳程度不同的参与者区分为不同的组别。在研究期间,FACIT-疲劳的改善情况在大多数 PGRS 变化和 PGIC 类别之间存在显著差异。基于锚点的估计表明,FACIT-疲劳总分增加 6-9 分即为有意义的改善:FACIT-疲劳在VIVID-1中度至重度活动性CD成人人群中表现出很强的心理测量特性,并确定了代表有意义改善的FACIT-疲劳得分变化阈值:试验注册:NCT03926130。注册时间:2019年4月23日,https://clinicaltrials.gov/study/NCT03926130 。
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引用次数: 0
Comparison of the early childhood oral health impact scale (ECOHIS-4D) and EuroQol-5D-Y for measuring oral health-related quality of life utility in children. 比较幼儿口腔健康影响量表(ECOHIS-4D)和 EuroQol-5D-Y 在测量儿童口腔健康相关生活质量效用方面的作用。
IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-10 DOI: 10.1007/s11136-024-03816-8
Gayani Shashikala Amarasinghe, Sanjeewa Kularatna, Sucharitha R Weerasuriya, Peter Arrow, Lisa Jamieson, Utsana Tonmukayakul, Sameera Senanayake

Purpose: The psychometric properties of the Early Childhood Oral Health Impact Scale (ECOHIS-4D), an oral health-related quality-of-life tool for children, and EuroQol 5D-Young (EQ-5D-Y), a commonly used generic quality-of-life tool for children, were compared across a clinical severity index to determine which tool is better for measuring oral health-related quality of life in children.

Methods: Delayed and filled surfaces score (dfs) was calculated for under six-year-old children at the recruitment and one year later. ECOHIS-4D and EQ-5D were filled out on both occasions. The following properties were examined: (i) Content validity by comparing mean utility values using the Wilcoxson Signed Rank Test and Bland Altman Test, (ii) Construct validity (ability to discriminate between groups of different clinical severity) by examining effect size between severity groups (iii) Responsiveness (for changes in health status) using floor and ceiling effect, standard response mean and linear regression (iv) Correlation between the utilities and dfs.

Results: Respectively, 287 and 189 children were examined at the baseline and follow-up. Mean utility estimates from the tools were significantly different. All items of EQ-5D-Y showed high ceiling effects compared to items of ECOHIS-4D. Only the utility scores of ECOHIS-4D showed a significant association with the dfs score (β=-0.003, 95%CI=-0.004 to -0.002) in the linear regression models. Utility values form ECOHIS-4D, but not EQ-5D-Y correlated with the dfs (spearman's r=-0.33, 95%CI -0.43 to -0.23).

Conclusion: ECOHIS-4D performs better than EQ-5D-Y in assessing young children's oral health-related quality of life.

目的:将儿童口腔健康影响量表(ECOHIS-4D)(一种与口腔健康相关的儿童生活质量工具)和EuroQol 5D-Young (EQ-5D-Y)(一种常用的通用儿童生活质量工具)的心理测量特性与临床严重程度指数进行比较,以确定哪种工具更适合测量与口腔健康相关的儿童生活质量:方法:在招募时和一年后计算六岁以下儿童的延迟和充填牙面得分(dfs)。两次均填写 ECOHIS-4D 和 EQ-5D。对以下特性进行了检验:(i) 通过使用 Wilcoxson Signed Rank Test 和 Bland Altman Test 比较平均效用值,检验内容效度;(ii) 通过检验严重程度组之间的效应大小,检验结构效度(区分不同临床严重程度组的能力);(iii) 通过使用最低效应和最高效应、标准响应平均值和线性回归,检验响应度(健康状况的变化);(iv) 效用值和 dfs 之间的相关性:分别有 287 名和 189 名儿童接受了基线和随访检查。两种工具得出的效用估计值平均值存在显著差异。与 ECOHIS-4D 的项目相比,EQ-5D-Y 的所有项目都显示出较高的上限效应。在线性回归模型中,只有 ECOHIS-4D 的效用评分与 dfs 评分有显著关联(β=-0.003,95%CI=-0.004 至-0.002)。ECOHIS-4D的效用值与dfs相关,但EQ-5D-Y与dfs无关(spearman's r=-0.33, 95%CI -0.43 to -0.23):结论:在评估幼儿口腔健康相关生活质量方面,ECOHIS-4D 比 EQ-5D-Y 效果更好。
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Quality of Life Research
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