Quality of Life Research最新文献

Purpose: Post-COVID-19 Syndrome (PCS) is associated with persistent fatigue and cognitive symptoms that may disrupt daily functioning and mental health. This study examined interrelationships among fatigue, cognitive function, activity and role functioning, and mental health in individuals with PCS.

Methods: We analyzed cross-sectional data from 535 adults in the Quebec Action for Post-COVID (QAPC) cohort who self-identified as experiencing PCS symptoms. Structural Equation Modelling was used to estimate associations among fatigue, self-reported cognitive concerns, cognitive performance, and two latent constructs: activity and role functioning and mental health. Models were adjusted for age, sex, education, race, alcohol use, prior mental health history, and vaccination status.

Results: Fatigue showed association with mental health (standardized regression coefficient, β_std = 0.44, p < 0.001), primarily through a direct path (β_std = 0.42) and a smaller indirect path via self-reported cognitive concerns (β_std = 0.10). Fatigue was also associated with reduced activity and role functioning (β_std = - 0.79), which did not mediate its link to mental health. Self-reported cognitive concerns were independently associated with poorer mental health (β_std = 0.19). Cognitive performance was positively associated with activity and role functioning (β_std = 0.11) but not with mental health. Covariates, including older age, Caucasian ethnicity, and vaccination, were linked to more favourable outcomes.

Conclusion: Fatigue and self-reported cognitive concerns were associated with mental health symptoms in PCS. These findings highlight the value of symptom cluster-based screening to inform referral pathways for cognitive, psychological, and functional support. Longitudinal research is needed to clarify temporal ordering.

Purpose: This study aimed to examine the association between the risk of obstructive sleep apnea (OSA) and health-related quality of life (HRQoL) using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES).

Methods: We analyzed data from the 2023 KNHANES, including 3968 adults aged 40 years and older. OSA risk was assessed using the STOP-BANG questionnaire, and HRQoL was measured with the HINT-8, a validated instrument developed in Korea. Complex sample linear regression analyses were performed to investigate the relationship between OSA risk categories and the HINT-8 utility index, adjusting for sociodemographic and health-related factors. Sensitivity analyses using multiple imputation and models with continuous variables were also conducted to assess robustness.

Results: Participants at moderate risk of OSA had significantly lower HINT-8 utility scores compared to those at low risk (β = -0.009; 95% CI = -0.017 to -0.001). The high-risk group showed a non-significant trend toward lower HRQoL. In a sensitivity analysis additionally adjusted for age and sex, the negative association remained consistent in both magnitude and direction. Overall, the results were robust across multiple analytical approaches.

Conclusion: Only the moderate-risk group showed a statistically significant reduction in HRQoL, whereas the high-risk group demonstrated a non-significant trend. The STOP-BANG questionnaire, owing to its simplicity and high sensitivity, may be useful for the early identification of individuals at moderate risk of impaired HRQoL. These findings support the value of integrating OSA risk screening into population-based health strategies to promote HRQoL. Obstructive sleep apnea (OSA) is a common sleep problem where breathing stops during sleep. Many people with OSA are not diagnosed, even though the condition can reduce energy, raise health risks, and lower quality of life. This study was done to find out how the risk of OSA affects how people feel and function in daily life.We used national data from South Korea to examine this. People were grouped by their risk for OSA using the STOP-BANG questionnaire, a simple screening tool. We measured their quality of life using the HINT-8, which looks at physical ability, pain, mental health, and daily functioning.The study found that people with a moderate risk of OSA had lower quality of life than those with low risk. These results remained even after adjusting for age, sex, income, and health conditions.Our findings suggest that people who are at risk for OSA already experience reduced well-being, even if they have not been diagnosed. Simple tools like STOP-BANG can help identify these individuals early so that they can receive care and improve their quality of life.

Purpose: Longitudinal patterns of patient-reported quality of life (QoL) remain poorly understood in patients with salivary gland cancer (SGC). This study aimed to identify distinct trajectories of QoL over 5 years following SGC treatment and to evaluate the baseline characteristics associated with adverse recovery patterns.

Methods: This prospective cohort study was conducted at a tertiary cancer center from 2016. Patients with histologically confirmed SGC were enrolled prior to treatment and followed longitudinally for up to 5 years. Repeated QoL assessments were conducted using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Head and Neck Cancer-Specific Module 35 questionnaires at standardized intervals. The primary outcome was the global QoL trajectory over 5 years, modeled using group-based trajectory analysis.

Results: Among 252 participants, three QoL trajectories were identified: Stable Good (n = 132, 52.4%), Declining (n = 41, 16.2%), and Delayed Recovery (n = 79, 31.3%). Female sex, older age, worse baseline pain score, and recurrence were significantly associated with an unstable trajectory of QoL. Interestingly, treatment intensity was not a significant factor for QoL. The Delayed Recovery group showed improvements in nutritional status and pain burden. The Declining group experienced deterioration in role, cognitive, and social functioning, along with increased fatigue, pain, and head-and-neck-specific symptoms.

Conclusion: Long-term QoL changes following SGC treatment are heterogeneous, with nearly half of the patients experiencing either persistent or delayed impairment. Trajectory-based classifications may support the early identification of vulnerable survivors and inform risk-stratified supportive care strategies targeting pain, nutrition, and emotional function.

Purpose: The validity of inferences from patient-reported outcome measure (PROM) scores can be confounded by differential item functioning (DIF). DIF occurs when there is heterogeneity in how patients respond to and interpret questions about their health, despite having the same underlying health status. Ignoring the effects of DIF could lead to inaccurate interpretations and misinformed clinical decisions resulting in compromised healthcare delivery. Tree-based item response theory (IRT) models are recommended as an alternative class of methods for analyzing PROMs because they offer a robust approach for identifying DIF when covariates associated with DIF are unknown a priori.

Methods: This paper introduces a web application developed using R Shiny, which enables users to implement tree-based IRT models for DIF assessment in potentially heterogeneous populations. The app provides flexible model specifications, visualization tools, and customizable settings to accommodate various data types and research needs. A practical tutorial is included, guiding users through the application interface, data preparation, model selection, and interpretation of results.

Results: The web application (https://ucalgary-pcma-lab.shinyapps.io/tree_based_dif_analysis/) offers interactive data upload in .CSV and .XLSX data formats. Recommendations are provided for selecting model parameters within the app based on the results of previous simulation studies. The web app tests for DIF on dichotomous- and polytomous-scored items. The coefficients, item parameters, and plots provide insights into potential sources of DIF.

Conclusion: This web application provides a user-friendly, interactive, innovative, easily accessible, and valuable tool for clinicians, applied health researchers, and analysts seeking to understand sample heterogeneity due to DIF in PROM data.

Objective: Examine the psychometric properties of the PROMIS Depression Short From 2.0 (PROMIS-D-SF), Caregiver and Youth Report in comparison with a legacy measure of depression, the Short Mood and Feelings Questionnaire, using a clinical sample.

Methods: Participants were 233 youth and caregivers referred to a behavioral health clinic by their pediatrician. Participants and their caregivers completed PROMIS-D-SF (youth and caregiver proxy), Short Mood and Feelings (SMFQ) (youth and caregiver proxy), and Semi-structured Interview. Descriptive, correlational, psychometric, receiver operating characteristic (ROC), and exploratory factor analysis were conducted for both measures.

Results: PROMISD-SF youth and caregiver correlations with the youth and caregiver SMFQ were 0.73 and 0.68 and had Area Under the Curve (AUCs) values ranging from 0.7 to 0.77 for the detection of a depression diagnosis. The PROMIS-D-SF youth measure had favorable test re-test reliability and the factor structure of the PROMIS measure correlated with each factor of the legacy SMFQ measure.

Implications: The PROMIS-D-SF demonstrated strong psychometric properties, correlated significantly with the SMFQ, and showed acceptable diagnostic accuracy for depression. This measure appears to be favorable for use in evidence-based assessment, including depression screening and progress monitoring.

Purpose: Little is known about the effectiveness of health behaviour intervention in improving health-related quality of life (HRQOL) despite HRQOL being an important outcome in Type 2 diabetes (T2DM) management. This study examined the effectiveness of a culturally appropriate health behavioural intervention in improving HRQOL of people with T2DM in Nepal.

Methods: A cluster randomized controlled trial was conducted among 481 people with T2DM from 30 randomly selected healthcare facilities in Kavrepalanchok and Nuwakot districts. The intervention group received 12 culturally tailored and group-based intervention sessions for six months whereas, the control group received usual care. The primary outcomes of this study were changes in the EuroQOL (EQ5D-3L) index score and EuroQOL visual analogue scale (EQVAS) score between baseline and six-month post-intervention. The intervention effect was assessed using generalized estimating equation models.

Results: At six-months post-intervention, there was a positive and statistically significant effect on EQVAS (β₁ = 3.61, 95%CI: 0.05, 7.17) in the intervention group compared to control group. No statistically significant effect was observed in EQ5D-3L index score. A statistically significant increase in EQVAS score of 0.5 was observed per session attended by the study participants (β₁ = 0.49, 95%CI: 0.01, 0.98).

Conclusion: The health behaviour intervention led to improved HRQOL. An increase in the number of intervention sessions attended was significantly associated with higher EQVAS scores, emphasizing the need for longer-term and engaging interventions that are well adhered to. Longer term assessment of change in HRQOL outcomes are needed when actual changes in HRQOL are more likely to be observed.

Trial registration: Australia and New Zealand Clinical Trial Registry (ACTRN12621000531819).

Background: Methods for collecting self-reported health status measures in population health surveys vary significantly across countries, presenting challenges to comparability. The EuroQol Data for Assessment of Population Health Needs and Instrument Evaluation (EQ-DAPHNIE) project aims to address this issue by developing infrastructure to generate representative datasets across multiple countries. This initiative aims to standardize data collection methodologies and to evaluate the performance of various health status measures, providing a foundation for reliable population health assessments. This paper describes the rationale, design and data collection methods for the EQ-DAPHNIE project.

Methods/design: EQ-DAPHNIE employs a cross-sectional online survey design targeting the general adult population across various countries. Participants were recruited through an online panel provider. Each country had a target sample of 4500 responses, with quota sampling to ensure representativeness based on age, sex, income, region, and language. The survey collected comprehensive data on social determinants of health at both individual and neighbourhood levels. Participation was voluntary, and measures were taken to maintain data anonymity and ensure data quality through pre-testing and various quality assurance approaches.

Discussion: The EQ-DAPHNIE project represents a significant advancement in generating large, representative, and comparable population health datasets across multiple countries. By employing precise sampling strategies, robust recruitment and data collection methods, and rigorous quality control measures, the project aims to provide a valuable resource for assessing and understanding population health and evaluating various health-related quality of life (HRQoL) and wellbeing instruments.