Quality of Life Research最新文献

Purpose: While some studies report improved outcomes following exercise-based interventions, the overall findings regarding their impact on individuals with lower limb amputation (LLA) remain inconsistent. Therefore, there is a need to synthesize the available evidence. In this regard, this systematic review and meta-analysis aimed to clarify the effects of organized physical activity on quality of life (QoL) and phantom limb pain (PLP) in adults with LLA.

Methods: This review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42024582703). Eight databases were searched in November 2024, including PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, SPORTDiscus, ICI World of Papers, and ClinicalTrials.gov. Search terms combined concepts related to amputation, physical activity, quality of life, and phantom limb pain. Studies were included if they examined adults aged 18-60 with lower limb amputation and reported outcomes on quality of life or phantom limb pain following structured physical activity interventions. Only studies using validated outcome measures were considered.

Results: Six studies met the inclusion criteria for the systematic review. Three studies (reporting four independent effect sizes) were included in the meta-analysis of QoL outcomes. The pooled effect size was small and not statistically significant (SMD = -0.06, 95% CI: -0.29 to 0.16; p = 0.58), with no observed heterogeneity (I² = 0%). Narrative synthesis indicated that most studies found either non-significant or short-term improvements in QoL. Only one study reported a reduction in phantom limb pain (PLP; NPRS: 9 to 2), precluding a meta-analysis for this outcome due to insufficient data.

Conclusions: Current evidence does not provide statistically significant support for improvements in QoL following organized physical activity among adults with lower-limb amputation, while effects on PLP remain unclear due to limited and heterogeneous data. Further high-quality research using standardized, context-sensitive outcome measures and well-defined intervention protocols is needed. A more person-centered and contextually grounded understanding of QoL may help capture meaningful recovery outcomes in this population.

Objective: Urolithiasis has emerged as a substantial public health burden, characterized by recurrent pain and profound disruptions to health-related quality of life (HRQoL). While multiple patient-reported outcome measurements (PROMs) have been developed to assess HRQoL in this population, yet the methodological quality and psychometric properties of these condition-specific instruments remain unclear. This study aimed to systematically identify urolithiasis-specific PROMs for assessing HRQoL, evaluate and integrate the quality of the measurement properties.

Materials and methods: PubMed, Web of Science and relevant reference lists were systematically searched until January 2025. Studies developing or validating urolithiasis-specific HRQoL PROMs were included. The methodological qualities were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. The measurement properties were assessed against the criteria COSMIN recommended. The final overall rating was established through a synthesis based on modified GRADE approach.

Result: Thirty-three publications were deemed eligible. Six urolithiasis-specific PROMs for assessing HRQoL were identified, each of which has specific value in clinical practice and research. The most common finding was the limited evidence of comprehensiveness of content validity. Half of all measures lacked the necessary psychometric evidence on structural validity. The Urinary Stones and Intervention Quality of Life (USIQOL) received a Class A recommendation, the remaining five PROMs were assigned Class B recommendations.

Conclusion: This systematic review provides the basis for identifying urolithiasis-specific PROMs with potential utility. The USIQOL is currently the most rigorously validated PROM for comprehensive HRQoL assessment in urolithiasis. Other instruments are useful for targeted applications but require further validation. Further research is required to validate and complement the missing information on the psychometric properties of these instruments.

Purpose: Many studies have demonstrated that chronic pain negatively impacts quality of life (QoL). However, it remains uncertain whether an individual's QoL prior to an episode of acute pain is associated with an increased risk of chronic pain-related disability. Our objective was to determine if an individual's QoL prior to an acute painful event is associated with significant chronic pain-related disability following an emergency visit for acute pain.

Methods: This was a planned sub-study on a prospective cohort with a 3 month follow-up. The primary outcome was defined as at least a moderate disability on the Pain Disability Index. QoL was assessed using the Short Form-12 Health Survey, which consists of 12 questions grouped into eight subscales, each ranging from 0 to 100. These subscales are divided into four physical factors and four mental factors, with lower scores representing worse quality of health. We used a multivariable logistic regression to assess the association between pre-event QoL and at least moderate chronic pain-related disability.

Results: A total of 1493 patients were included (mean age: 52 years [SD ± 16]; female: 53%). After multivariable analysis, poorer physical factors (AOR = 1.53; 95% CI 1.22-1.93) and poorer mental factors (AOR = 1.22; 95% CI 1.02-1.46) were independently associated with at least moderate chronic pain-related disability.

Conclusions: Patients with poorer QoL prior to experiencing acute pain are more likely to develop significant chronic pain-related disability. This could help identify patients at higher risk, enabling the implementation of preventive strategies aimed at improving overall prognosis.