Quality of Life Research最新文献

Purpose: Older adults are increasingly taking up caregiving roles due to the mismatch between available formal care services and growing demands. We aimed to identify profiles of older caregivers according to their quality of life (QoL), and to explore the associations of such profiles with loneliness and social isolation.

Methods: A cross-sectional analysis was conducted using cohort data from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). The study included a total of 994 unique caregivers aged 60 and above, assessed between 2001 and 2016. Multiple correspondence analysis and cluster analysis were used to obtain caregiver profiles according to the items of SF-12 QoL instrument. Multinomial logistic regressions with robust standard errors were performed to study the associations between QoL, loneliness and social isolation.

Results: Three distinct QoL profiles were identified: good (57.9%), moderate (34.8%), and moderate physical, poor mental (7.3%) QoL. The latter profile was characterized by the predominance of female spousal caregivers, who provided the most hours of care. Loneliness and social isolation were independently associated with higher odds of being in the moderate physical, poor mental QoL profile, compared to the good QoL profile. Men with higher social isolation levels were more likely to be in the worse QoL profile compared to women with similarly high levels of isolation.

Conclusion: Our findings emphasize that a substantial proportion of older caregivers have suboptimal QoL, and that those with poor mental QoL also experience higher levels of loneliness and social isolation. Targeted policies to reduce caregiver burden and enhance their QoL are essential.

Background: Tenosynovial giant cell tumor (TGCT) is a locally aggressive neoplasm associated with limited range of motion (ROM), stiffness, joint damage, pain, and reduced physical functioning (PF). The MOTION Phase 3 trial (NCT05059262) was a randomized, placebo-controlled, double-blind study of vimseltinib among patients with TGCT. The objective of the current study was to define meaningful changes in clinical outcome assessments (COAs) measuring active ROM, PF, and stiffness using qualitative and quantitative data from patients in the MOTION trial.

Methods: Embedded exit interviews with patients in MOTION were conducted to explore meaningful changes in Patient Global Impression of Change (PGIC) anchors, active ROM, Patient-Reported Outcomes Measurement Information System (PROMIS)-PF, and Worst Stiffness numeric rating scale (NRS). Anchor- and distribution-based analyses of the MOTION data, informed by the exit interviews, were used to define responder thresholds.

Results: In the MOTION trial, 96/123 patients (78%) completed an exit interview. Most considered "minimally improved" responses for each question (PGIC-PF: 67%; PGIC-ROM 73%) as meaningful. Responder estimates ranged from 1.45 to 4.9 (PROMIS-PF), from 6.0 to 14.8 (active ROM), and from - 2.3 to - 0.5 (Stiffness). The cumulative distribution function curves show a clear separation between treatment groups at a wide range of values around the proposed thresholds.

Conclusions: The responder definitions were at least a 3-point improvement for PROMIS-PF, a 10% improvement for active ROM, and a 2-point improvement for the Worst Stiffness NRS. Qualitative interviews facilitate integrating the patient perspective in the selection of anchors and defining meaningful change.

Purpose: To evaluate changes in health-related quality of life (HRQoL) of different patient groups, as measured using the EuroQoL (EQ5D) during outpatient multidisciplinary rehabilitation.

Methods: Patients with acquired brain injury, chronic pain, neurodegenerative diseases or oncological diagnoses, who received outpatient multidisciplinary rehabilitation, were included in a multi-center prospective observational cohort study. They completed the EQ5D, consisting of an index and a Visual Analogue Scale (VAS), at the start of outpatient rehabilitation (T0) and 6 months thereafter (T1), and two perceived change questions (about quality of life and about general health) at T1.

Results: Both EQ5D index and VAS improved for the total sample (n = 419, 68.8% females, mean age 54.5 years) and for each patient group, with the exception of the EQ5D VAS in patients with neurodegenerative diseases. The latter group showed less improvement, as measured on the EQ5D index, than patients with chronic pain (p = 0.004), and less on VAS compared to the other patient groups (all p < 0.05). At an individual level, 76.8% (304/396) of all patients reported improvement on the perceived change question about quality of life and 279/419 (66.6%) on the perceived change question about general health. Again, patients with neurodegenerative diseases had the lowest percentages (49/83 (59.0%) and 39/85 (47.0%), respectively).

Conclusion: All patient groups improved on HRQoL during outpatient multidisciplinary rehabilitation, both at group and individual level. However, patients with neurodegenerative diseases showed slightly less improvement than other patient groups, which may reflect the progressive nature of their disease rather than lower rehabilitation effectiveness.

Introduction: Cancer survivors may experience loneliness, which can impair the capacity to self-regulate lifestyle behaviors, induce systemic inflammation, and deteriorate mental and physical health. Previous studies have found an association between loneliness and health outcomes in the general population, but few studies have examined health effects of loneliness among cancer survivors and its differential effects by sociodemographic characteristics.

Methods: In a cross-sectional analysis of All of Us Research program data, we examined the association between loneliness (defined using the UCLA-3 items loneliness scale) and overall quality of life and four other health outcomes among cancer survivors aged ≥ 18 years in the United States (N = 17,367).

Results: Lonely cancer survivors were more likely to have fair/poor overall quality of life, severe pain, severe fatigue, and fair/poor physical and mental health compared to non-lonely cancer survivors, controlling for multiple health behaviors and sociodemographic factors. Models stratified by sociodemographic characteristics generally showed similar results, but differences existed between some age, sex, and living arrangement subgroups. For example, the association between loneliness and fair/poor mental health was stronger among older survivors (≥ 65 years, AOR = 5.30; 95% CI = 4.30-6.54) than younger survivors (18-39 years, AOR = 3.07; 95% CI = 1.95-4.85); p for difference < 0.05. The association between loneliness and severe fatigue was stronger among survivors living alone (AOR = 3.15; 95% CI = 2.33-4.25) than survivors living with others (AOR = 2.16; 95% CI = 1.81-2.59); p < 0.05.

Conclusions: Loneliness generally showed adverse association with all evaluated health outcomes, but the magnitude of associations varied between certain subpopulations. Results of this study suggest the need for screening and monitoring of loneliness among cancer survivors.

Purpose: To examine sex differences in health-related quality of life (HRQoL) among patients surgically treated for renal cell carcinoma (RCC) in Sweden, utilizing data from the National Swedish Kidney Cancer Register (NSKCR).

Methods: In this study of 4658 surgically treated RCC patients, data on HRQoL, clinical, demographic, and socioeconomic characteristics were retrieved from the NSKCR for patients undergoing surgical treatment between January 2016, and April 2024. HRQoL was measured using the 14- and 19-item versions of the Functional Assessment of Cancer Therapy - Kidney Symptom Index (FKSI-14/19) instrument six months after surgery. The association between sex and HRQoL was estimated using linear regression. Separate analyses were performed for the FKSI-14 and FKSI-19 total scores and underlying domains.

Results: In total, 3086 (66.3%) men and 1572 (33.7%) women were included. After adjusting for clinical, demographic, and socioeconomic characteristics, male sex was significantly associated with higher HRQoL. Specifically, men had higher scores, indicating fewer symptoms, for physical and mental symptoms according to FKSI-14 (P < 0.001), and for physical (P < 0.001) and emotional (P < 0.001) disease-related symptoms, as well as treatment side effects (P < 0.022), according to FKSI-19. Total HRQoL was significantly higher in men, according to both the FKSI-14 (P < 0.001) and the FKSI-19 (P < 0.001).

Conclusions: HRQoL differed significantly between men and women six months after surgery, with men reporting higher HRQoL, even after accounting for clinical, demographic, and socioeconomic factors. Healthcare professionals should be aware of the risk of lower HRQoL among female patients.