Browsing by Subject "Health-related quality of life"

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  • Haywood, Kirstie L.; Pearson, Nathan; Morrison, Laurie J.; Castren, Maaret; Lilja, Gisela; Perkins, Gavin D. (2018)
    Aim: High quality evidence of out-of-hospital cardiac arrest (OHCA) survivors' health-related quality of life (HRQoL) can measure the long-term impact of CA. The aim of this study was to critically appraise the evidence of psychometric quality and acceptability of measures used in the assessment of HRQoL in cardiac arrest survivors. Methods: Systematic literature searches (2004-2017) and named author searches to identify articles pertaining to the measurement of HRQoL. Data on study quality, measurement and practical properties were extracted and assessed against international standards. Results: From 356 reviewed abstracts, 69 articles were assessed in full. 25 provided evidence for 10 measures of HRQoL: one condition-specific; three generic profile measures; two generic index; and four utility measures. Although limited, evidence for measurement validity was strongest for the HUI3 and SF-36. However, evidence for reliability, content validity, responsiveness and interpretability and acceptability was generally limited or not available in the CA population for all measures. Conclusions: This review has demonstrated that a measure of quality of life specific to OHCA survivors is not available. Limited evidence of validity exists for one utility measure - the HUI3 - and a generic profile - the SF-36. Robust evidence of the quality and acceptability of HRQoL measures in OHCA was limited or not available. Future collaborative research must seek to urgently establish the relevance and acceptability of these measures to OHCA survivors, to establish robust evidence of essential measurement and practical properties over the short and long-term, and to inform future HRQoL assessment in the OHCA population. (C) 2017 Elsevier B.V. All rights reserved.
  • Jansson, Victoria; Bergfeldt, Lennart; Schwieler, Jonas; Kenneback, Goran; Rubulis, Aigars; Jensen, Steen M.; Raatikainen, Pekka; Sciaraffia, Elena; Blomström-Lundqvist, Carina (2021)
    Aims: To assess the relation between atrial fibrillation (AF) characteristics and health-related quality of life (QoL), and which AF characteristic had the greatest impact. Method: The AF characteristics burden (percentage of time in AF), duration and number of AF episodes/month were obtained from implantable cardiac monitors during the 2-month run-in period in 150 patients included in the randomized CAPTAF trial comparing early ablation and antiarrhythmic drug therapy. The QoL was measured by the General Health and Vitality dimensions of the 36-Item Short-Form Health Survey. AF characteristics were analysed continuously and in quartiles (Q1-Q4). Results: Greater AF burden (p = 0.003) and longer AF episodes (p = 0.013) were associated with impaired QoL (Vitality score only) in simple linear regression analyses. Greater AF burden was, however, the only AF characteristic associated with lower QoL, when adjusted for sex, type of AF, hypertension, heart rate above 110 beats per minute during AF, and beta-blocker use in multiple linear regression analyses. For every 10% increase in AF burden there was a 1.34-point decrease of Vitality score (95% confidence interval (CI) -2.67 to -0.02, p = 0.047). The Vitality score was 12 points lower (95% CI -22.73 to -1.27, p = 0.03) in patients with an AF burden > 33% (Q4) versus those with < 0.45% (Q1), but only in unadjusted analysis. Conclusion: AF burden had a greater impact on QoL (Vitality), than the duration and number of AF episodes, corroborating that AF burden may be the preferred outcome measure of rhythm control in trials including relatively healthy AF populations. (C) 2021 The Authors. Published by Elsevier B.V.
  • Mikkola, Tuija M.; Kautiainen, Hannu; von Bonsdorff, Mikaela B.; Salonen, Minna K.; Wasenius, Niko; Kajantie, Eero; Eriksson, Johan G. (2020)
    Purpose Most studies examining the associations between body composition and health-related quality of life (HRQoL) in older age have been cross-sectional and analyzed only fat or lean mass. Hence, it is poorly known whether fat and lean mass are independently associated with subsequent changes in HRQoL. We investigated whether baseline lean and fat mass are associated with changes in HRQoL over a 10-year period in older adults. Methods We studied 1044 men and women from the Helsinki Birth Cohort Study (age 57-70 years at baseline). Bioelectrical impedance analysis was used to derive baseline fat mass index (FMI, fat mass/height(2)) and lean mass index (lean mass/height(2)), dichotomized at sex-specific medians. HRQoL was assessed using RAND 36-item Health Survey at baseline and follow-up 10 years later. Results When controlled for lean mass and adjusted for potential confounders, high baseline FMI was associated with a greater decline in general health (standardized regression coefficient [beta] = - 0.13, p = 0.001), physical functioning (beta = - 0.11, p = 0.002), role physical (beta = - 0.13, p = 0.003), vitality (beta = - 0.08, p = 0.027), role emotional (beta = - 0.12, p = 0.007), and physical component score (beta = - 0.14, p <0.001). High baseline FMI was also associated with low HRQoL in all physical domains at baseline (beta: from - 0.38 to - 0.10). Lean mass was not strongly associated with HRQoL at baseline or change in HRQoL. Conclusion In older community-dwelling adults, higher fat mass is, independent of lean mass, associated with lower physical HRQoL and greater decline in HRQoL. Prevention of adiposity may contribute to preservation of a good quality of life in older age.
  • Kokkonen, Kristiina; Tasmuth, Tiina; Lehto, Juho T.; Kautiainen, Hannu; Elme, Anneli; Jaaskelainen, Anna-Stina; Saarto, Tiina (2019)
    Background/Aim: To observe changes in symptoms and health-related quality of life (HRQoL) over 7 years among cancer patients at different stages of the disease. Patients and Methods: This prospective cross-sectional study at the Helsinki University Hospital Cancer Center, was carried out in 2006 and repeated in 2013. All participants filled in the EORTC-QLQ-C30 questionnaire. Results: Altogether, 581 patients responded (49% in 2006 and 54% in 2013). The disease was local in 51% and advanced in 49% of patients. The HRQoL was significantly lower, except for emotional and cognitive functions, and the symptom burden more severe in advanced cancer. The most prevalent symptoms were fatigue (93% and 85%; moderate/severe 22% and 9%), pain (65% and 47%; moderate/severe 16% and 5%), and insomnia (64% and 60%; moderate/severe 20 and 21%), respectively. No changes in HRQoL or symptoms were found at 7 years. Conclusion: There is a need for early integrated palliative care to improve HRQoL during cancer treatments.
  • Rissanen, Anne; Lindberg, Nina; Marttunen, Mauri; Sintonen, Harri; Roine, Risto (2019)
    BackgroundLittle is known about adolescents' perceptions about their health-related quality of life (HRQoL) in the course of routine adolescent psychiatric treatment. The aim of this 1-year follow-up study was to investigate HRQoL and changes in it among youths receiving adolescent psychiatric outpatient treatment.MethodsThe study comprised 158 girls and 82 boys aged 12-14years from 10 psychiatric outpatient clinics in one Finnish hospital district. Same-aged population controls (210 girls and 162 boys) were randomly collected from comprehensive schools. HRQoL was measured using the 16D instrument. The questionnaire was self-administered when the adolescents entered the polyclinics (=baseline), after a treatment period of 6months, and after 12months.ResultsThe mean age of respondents was 13.8years (SD 0.63). At baseline, the mean HRQoL score of both female and male outpatients was significantly lower than that of population controls (p
  • Rissanen, Anne; Lindberg, Nina; Marttunen, Mauri; Sintonen, Harri; Roine, Risto (BioMed Central, 2019)
    Abstract Background Little is known about adolescents’ perceptions about their health-related quality of life (HRQoL) in the course of routine adolescent psychiatric treatment. The aim of this 1-year follow-up study was to investigate HRQoL and changes in it among youths receiving adolescent psychiatric outpatient treatment. Methods The study comprised 158 girls and 82 boys aged 12–14 years from 10 psychiatric outpatient clinics in one Finnish hospital district. Same-aged population controls (210 girls and 162 boys) were randomly collected from comprehensive schools. HRQoL was measured using the 16D instrument. The questionnaire was self-administered when the adolescents entered the polyclinics (= baseline), after a treatment period of 6 months, and after 12 months. Results The mean age of respondents was 13.8 years (SD 0.63). At baseline, the mean HRQoL score of both female and male outpatients was significantly lower than that of population controls (p < 0.001). HRQoL of female patients was significantly worse than that of male patients (p < 0.001). In girls, HRQoL improved continuously during the 12-month follow-up, yet it remained worse than that of female population controls. Among boys, HRQoL was substantially better at the 6-month follow-up than at baseline, but this positive development was no longer seen at the 12-month follow-up. Conclusions From the perspective of HRQoL, girls seem to benefit more than boys from adolescent psychiatric outpatient treatment. Possible explanations for this finding are discussed.
  • Kantola, Taru; Mäklin, Suvi; Koivusalo, Anna-Maria; Räsänen, Pirjo; Rissanen, Anne; Roine, Risto; Sintonen, Harri; Höckerstedt, Krister; Isoniemi, Helena (2010)
  • Jokela, Johanna; Saarinen, Riitta; Mäkitie, Antti; Sintonen, Harri; Roine, Risto (2019)
    PurposeTo analyse costs related to the diagnosis and treatment of patients with sialolithiasis and sialadenitis managed with sialendoscopy, and to prospectively evaluate the impact of sialendoscopy on health-related quality of life (HRQoL) in a longitudinal follow-up study.MethodsAll patients undergoing sialendoscopy or sialendoscopy-assisted surgery at a tertiary care university hospital between January 2014 and May 2016 were identified from a surgical database, and the direct hospital costs were retrospectively evaluated from 1year before to 1year after the sialendoscopy. The 15D HRQoL questionnaire and a questionnaire exploring the use of health care services during the preceding 3months were mailed to the patients before sialendoscopy as well as at 3 and 12months after the operation.ResultsA total of 260 patients were identified. Mean total hospital costs, costs related to the sialendoscopy, and complications were significantly higher in sialolithiasis patients than in patients with other diagnoses. 74 patients returned the baseline 15D questionnaire, and 51 patients all three 15D questionnaires. At baseline, the dimensions discomfort and symptoms and distress were lower in patients than in age- and gender-standardised general population, but the total 15D score did not differ significantly. The dimension discomfort and symptoms improved significantly at 3 and 12months postoperatively, and the mean total HRQoL score improved in patients with sialolithiasis at 3months postoperatively.ConclusionsThe costs related to sialendoscopy are substantial and the cost-effectiveness of sialendoscopy warrants further studies. However, sialendoscopy seems to reduce patients' discomfort and ailments and to improve HRQoL at least in patients with sialolithiasis.
  • Kallio, Eeva-Liisa; Ohman, H.; Carlson, S.; Kautiainen, H.; Hietanen, M.; Pitkala, K. H. (2017)
    Introduction: Evidence is unclear whether cognitive training (CT) has efficacy in patients with dementia. We present the recruitment and baseline findings of a carefully designed Finnish cognitive training (FINCOG) trial exploring the effectiveness of CT among community-dwelling older persons with mild-to-moderate dementia. Methods: Participants were recruited from adult day care centres in Helsinki, Finland, and randomised into two groups: (1) day care with systematic CT twice a week for 12 weeks (n = 76) and (2) day care as usual (n = 71). Demographics, diagnoses and drug use were retrieved from medical records, and baseline cognition, functioning, health-related quality of life (HRQoL) and psychological well-being were assessed. A subgroup of participants was planned to undergo functional magnetic resonance imaging (fMRI) to measure changes in brain activity. Feedback from those attending CT was collected. Primary trial outcomes will be participants' cognition and HRQoL. Results: The mean (SD) age of the randomised participants was 83.1 (5.4) years, 72% were female and 37% at a moderate stage of dementia. The intervention and control groups were comparable at baseline. Compliance with CT was good, with a mean attendance of 22/24 sessions. General subjective gain was achieved by three-fourths of the feedback respondents. However, the fMRI was not feasible in this patient group. Conclusions: We successfully randomised 147 persons with mild-to-moderate dementia in the FINCOG trial. The feedback from participants in cognitive intervention was favourable. The trial will provide important information on the effects of CT in patients with dementia. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
  • CENTER-TBI Participants Investigat; Voormolen, Daphne C.; Polinder, Suzanne; von Steinbuechel, Nicole; Haagsma, Juanita A.; Palotie, Aarno; Piippo-Karjalainen, Anna; Pirinen, Matti; Raj, Rahul; Ripatti, Samuli (2020)
    Purpose The Quality of Life after Brain Injury overall scale (QOLIBRI-OS) measures health-related quality of life (HRQoL) after traumatic brain injury (TBI). The aim of this study was to derive value sets for the QOLIBRI-OS in three European countries, which will allow calculation of utility scores for TBI health states. Methods A QOLIBRI-OS value set was derived by using discrete choice experiments (DCEs) and visual analogue scales (VAS) in general population samples from the Netherlands, United Kingdom and Italy. A three-stage procedure was used: (1) A selection of health states, covering the entire spectrum of severity, was defined; (2) General population samples performed the health state valuation task using a web-based survey with three VAS questions and an at random selection of sixteen DCEs; (3) DCEs were analysed using a conditional logistic regression and were then anchored on the VAS data. Utility scores for QOLIBRI-OS health states were generated resulting in estimates for all potential health states. Results The questionnaire was completed by 13,623 respondents. The biggest weight increase for all attributes is seen from "slightly" to "not at all satisfied", resulting in the largest impact on HRQoL. "Not at all satisfied with how brain is working" should receive the greatest weight in utility calculations in all three countries. Conclusion By transforming the QOLIBRI-OS into utility scores, we enabled the application in economic evaluations and in summary measures of population health, which may be used to inform decision-makers on the best interventions and strategies for TBI patients.
  • Vartiainen, Pekka; Heiskanen, Tarja; Sintonen, Harri; Kalso, Eija; Roine, Risto P. (Helsingfors universitet, 2016)
    Health-related quality of life (HRQoL) measurement aims to capture the complete, subjective health state of the patients and to comprehensively evaluate treatment outcomes. The aim of this study was to assess, using the 15D HRQoL instrument, HRQoL in a sample of 1528 chronic pain patients, referred to the multidisciplinary pain clinic of the Helsinki University Hospital during 2004 to 2012. The 15D results of the chronic pain patients were compared with those of a matched general population. To analyse the properties of the 15D, the results were compared with the preadmission questionnaire of the pain clinic, containing questions about background factors, aspects of the pain, and its impact on life. The mean 15D score of the chronic pain patients was one of the lowest reported using 15D; 0.710 vs 0.922 in the general population. It equalled the score of advanced cancer patients in palliative care. The 15D scores were normally distributed, and 15D showed both statistically and clinically significant discriminative power in pain-related background factors. Visual analogue scale on pain intensity, visual analogue scale on pain-related distress, and the impact of pain on daily life correlated well with the 15D score. Pain intensity did not have independent predictive value on the score. The results indicate heavy perceived burden of illness in chronic pain patients. In light of the questions analysed, 15D appears sensitive and discriminative in chronic pain patients in tertiary care. Instead of pain intensity, the impaired HRQoL in chronic pain was mainly because of the psychosocial aspects of pain.
  • Liira, Helena; Mavaddat, Nahal; Eineluoto, Maija; Kautiainen, Hannu; Strandberg, Timo; Suominen, Merja; Laakkonen, Marja-Liisa; Eloniemi-Sulkava, Ulla; Sintonen, Harri; Pitkälä, Kaisu (2018)
    Background Health-related quality of life (HRQoL) is associated with survival in older people with multimorbidities and disabilities. However, older people differ in their characteristics, and less is known about whether HRQoL predicts survival in heterogeneous older population samples differing in their functional, cognitive, psychological or social disabilities. The aim of this study was to explore HRQoL in heterogeneous samples of older men and women, and to explore its prognostic significance for mortality. Methods We analysed combined individual patient data from eight heterogeneous study samples all of which were assessed with the same methods. We used 15D, a generic, comprehensive instrument for measuring HRQoL, which provides a single index in addition to a profile. Two-year mortality was retrieved from central registers. Results Health-related quality of life measurements with 15D were available for 3153 older adults. The mean HRQoL was highest among older businessmen (0.878) and lowest among nursing home residents (0.601). 15D predicted independently and significantly the 2-year survival in the total sample [hazard ratio (HR)/SD 0.44, 95% CI 0.40-0.48)]. However, 15D did not predict mortality in samples of spousal caregivers, lonely older adults and cardiovascular patients. Conclusions 15D captures health and disability factors associated with prognosis whereas in older populations suffering from psychological and social impairments such as caregiver burden or loneliness HRQoL may not reflect their health risks.
  • Strandberg, T.; Levalahti, E.; Ngandu, T.; Solomon, A.; Kivipelto, M.; Lehtisalo, J.; Laatikainen, T.; Soininen, H.; Antikainen, R.; Jula, A.; Tuomilehto, J.; Peltonen, M.; Lindstrom, J.; Rauramaa, R.; Pajala, S.; Hanninen, T.; Solomon, A.; Paajanen, T.; Mangialasche, F.; FINGER Study Grp (2017)
    Introduction: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) successfully demonstrated that multidomain lifestyle intervention can improve or maintain cognitive functioning in at-risk individuals. Health-related quality of life (HRQoL) was a secondary endpoint. Methods: The intervention (n = 631) aimed at healthy diet, increased physical activity, cognitive training, and vascular risk management. The control group (n = 629) was given general health advice. HRQoL was assessed at baseline, 12, and 24 months using validated RAND-36 (SF-36) instrument with 8 scales. Results: During the 2-year intervention period, mean scores in all scales decreased in the control group, but increased in the intervention group for vitality (12 months), social function (12 months), and especially general health at both 12 and 24 months. There was a statistically significant beneficial effect of intervention on the change in general health and physical function at 12 and 24 months. Conclusion: Multidomain lifestyle intervention improved also important dimensions of HRQoL. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
  • Karppinen, Noora; Linden, Riikka; Sintonen, Harri; Tarkkanen, Maija; Roine, Risto; Heiskanen, Ilkka; Matikainen, Niina; Schalin-Jäntti, Camilla (2019)
    Background: The prevalence of small intestine neuroendocrine tumors (SI-NETs) is increasing. Disease progression is often slow and treatment options and long-term survival rates have improved, but little is known about health-related quality of life (HRQoL) in these patients. Objective: To assess HRQoL and its predictors in SI-NET patients receiving contemporary treatments. Methods: We measured HRQoL with 15D and SF-36 questionnaires in 134 SI-NET patients and compared the 15D results to those of an age- and gender-standardized sample of the general population (n = 1,153). In the patients, we studied the impact of treatments, Ki-67, liver metastases, circulating tumor markers, comorbidities, and/or socioeconomic factors on HRQoL with linear regression analysis. Results: The mean disease duration of the patients was 81 (4-468) months, 91% had metastatic disease, and 79% received somatostatin analog treatment. Hepatic tumor load was 0% in 44.8%, <10-25% in 44.0%, and > 25% in 11.2%, respectively. Mean fP-CgA and S-5HIAA concentrations were 15 (1.3-250) and 344 (24-7,470) nmol/L, respectively. Overall, HRQoL was significantly impaired in patients compared to controls (15D score 0.864 +/- 0.105 vs. 0.905 +/- 0.028, p <0.001). SI-NET patients scored worse on 9 of 15 dimensions: sleep, excretion (i. e., bladder and bowel function), depression, distress, vitality, sexual activity (p <0.001), breathing, usual activities, and discomfort and symptoms (p <0.01-0.05). SF-36 scores were impaired and highly correlated with 15D scores (p <0.001). HRQoL was impaired in patients with (n = 85) compared to patients without (n = 49) impaired excretion (0.828 vs. 0.933, p <0.001). In the patient group, number of medications predicted impaired HRQoL. Conclusions: Despite contemporary treatments, SI-NET patients have severely impaired HRQoL, including diarrhea, sleep, depression, vitality, and sexual activity. (c) 2018 S. Karger AG, Basel
  • Törmälehto, Soili; Mononen, Mika E.; Aarnio, Emma; Arokoski, Jari P. A.; Korhonen, Rami K.; Martikainen, Janne (2018)
    Background: The purpose was to quantify the decrement in health utility (referred as disutility) associated with knee osteoarthritis (OA) and different symptomatic and radiographic uni- and bilateral definitions of knee OA in a repeated measures design of persons with knee OA or at increased risk of developing knee OA. Methods: Data were obtained from the Osteoarthritis Initiative database. SF-12 health-related quality of life was converted into SF-6D utilities, and were then handled as the health utility loss by subtracting 1.000 from the utility score, yielding a negative value (disutility). Symptomatic OA was defined by radiographic findings (Kellgren-Lawrence, K-L, grade >= 2) and frequent knee pain in the same knee. Radiographic OA was defined by five different definitions (K-L >= 2 unilaterally / bilaterally, or the highest / mean / combination of K-L grades of both knees). Repeated measures generalized estimating equation (GEE) models were used to investigate disutility in relation to these different definitions. Results: Utility decreased with worsening of symptomatic or radiographic status of knee OA. The participants with bilateral and unilateral symptomatic knee OA had 0.03 (p <0.001) and 0.02 (p <0.001) points lower utility scores, respectively, compared with the reference group. The radiographic K-L grade 4 defined as the mean or the highest grade of both knees was related to a decrease of 0.04 (p <0.001) and 0.03 (p <0.001) points in utility scores, respectively, compared to the reference group. Conclusions: Knee OA is associated with diminished health-related quality of life. Health utility can be quantified in relation to both symptomatic and radiographic uni- and bilateral definitions of knee OA, and these definitions are associated with differing disutilities. The performance of symptomatic definition was better, indicating that pain experience is an important factor in knee OA related quality of life.
  • Törmälehto, Soili; Mononen, Mika E; Aarnio, Emma; Arokoski, Jari P A; Korhonen, Rami K; Martikainen, Janne (BioMed Central, 2018)
    Abstract Background The purpose was to quantify the decrement in health utility (referred as disutility) associated with knee osteoarthritis (OA) and different symptomatic and radiographic uni- and bilateral definitions of knee OA in a repeated measures design of persons with knee OA or at increased risk of developing knee OA. Methods Data were obtained from the Osteoarthritis Initiative database. SF-12 health-related quality of life was converted into SF-6D utilities, and were then handled as the health utility loss by subtracting 1.000 from the utility score, yielding a negative value (disutility). Symptomatic OA was defined by radiographic findings (Kellgren-Lawrence, K-L, grade ≥ 2) and frequent knee pain in the same knee. Radiographic OA was defined by five different definitions (K-L ≥ 2 unilaterally / bilaterally, or the highest / mean / combination of K-L grades of both knees). Repeated measures generalized estimating equation (GEE) models were used to investigate disutility in relation to these different definitions. Results Utility decreased with worsening of symptomatic or radiographic status of knee OA. The participants with bilateral and unilateral symptomatic knee OA had 0.03 (p < 0.001) and 0.02 (p < 0.001) points lower utility scores, respectively, compared with the reference group. The radiographic K-L grade 4 defined as the mean or the highest grade of both knees was related to a decrease of 0.04 (p < 0.001) and 0.03 (p < 0.001) points in utility scores, respectively, compared to the reference group. Conclusions Knee OA is associated with diminished health-related quality of life. Health utility can be quantified in relation to both symptomatic and radiographic uni- and bilateral definitions of knee OA, and these definitions are associated with differing disutilities. The performance of symptomatic definition was better, indicating that pain experience is an important factor in knee OA related quality of life.
  • Riihimaki, K.; Sintonen, H.; Vuorilehto, M.; Jylhä, P.; Saarni, S.; Isometsa, E. (2016)
    Background: Depressive disorders are known to impair health-related quality of life (HRQoL) both in the short and long term. However, the determinants of long-term HRQoL outcomes in primary care patients with depressive disorders remain unclear. Methods: In a primary care cohort study of patients with depressive disorders, 82% of 137 patients were prospectively followed up for five years. Psychiatric disorders were diagnosed with SCID-I/P and SCID-II interviews; clinical, psychosocial and socio-economic factors were investigated by rating scales and questionnaires plus medical and psychiatric records. HRQoL was measured with the generic 15D instrument at baseline and five years, and compared with an age-standardized general population sample (n = 3707) at five years. Results: Depression affected the 15D total score and almost all dimensions at both time points. At the end of follow-up, HRQoL of patients in major depressive episode (MDE) was particularly low, and the association between severity of depression (Beck Depression Inventory [BDI]) and HRQoL was very strong (r = -0.804). The most significant predictors for change in HRQoL were changes in BDI and Beck Anxiety Inventory (BAI) scores. The mean 15D score of depressive primary care patients at five years was much worse than in the age-standardized general population, reaching normal range only among patients who were in clinical remission and had virtually no symptoms. Conclusions: Among depressive primary care patients, presence of current depressive symptoms markedly reduces HRQoL, with symptoms of concurrent anxiety also having a marked impact. For HRQoL to normalize, current depressive and anxiety symptoms must be virtually absent. (C) 2016 Elsevier Masson SAS. All rights reserved.
  • Zhang, Yanlei; Ning, Feng; Sun, Jianping; Pang, Zengchang; Wang, Xiaoyong; Kapur, Anil; Sintonen, Harri; Qiao, Qing (2015)
  • Grabala, Pawel; Helenius, Ilkka; Shah, Suken A.; Larson, A. Noelle; Buchowski, Jacob M.; Latalski, Michal; Grabala, Michal; Guszczyn, Tomasz (2020)
    OBJECTIVE: A retrospective multicenter comparative study was carried out to evaluate whether pregnancy leads to the loss of deformity correction (LOC) in female patients surgically treated for idiopathic scoliosis. METHODS: A total of 128 female patients who underwent segmental spinal instrumentation and fusion for adolescent idiopathic scoliosis (AIS) between 1999 and 2014 were reviewed. Of these patients, 62 became pregnant (surgery-pregnancy group [SPG]), whereas 66 did not (surgery-nonpregnancy [SNP] group). Radiographic parameters were analyzed before surgery, after surgery, before pregnancy, up to 1 year after delivery, and at final follow-up (FFU). Health-related quality of life was analyzed using the Scoliosis Research Society outcome questionnaire (SRS-22r). RESULTS: The mean age at the time of surgery was 16 years in both groups. The mean preoperative major curves were 65 degrees (standard deviation [SD], 12 degrees) versus 67 degrees (SD, 11 degrees), 18 degrees (SD, 9 degrees) versus 17 degrees (SD, 9 degrees) immediately after surgery, and 20 degrees (SD, 8 degrees) versus 20 degrees (SD, 8 degrees) at FFU in the SPG and SNP groups, respectively (P > 0.10 for all comparisons). The mean loss of correction was 3.5 degrees (SD, 3 degrees) in the SPG and 4.5 (SD, 3 degrees) for SNP groups, respectively (P = 0.379). The mean preoperative thoracic kyphosis (T5-T12) was 26.5 degrees (SD, 11.9 degrees) for SPG and 24.7 degrees (SD, 14.5 degrees) for SNP, after surgery 19.2 degrees (SD, 9.5 degrees) for SPG, 18.8 (SD, 8.9 degrees) for SNP and at FFU, 20.3 degrees (SD, 9 degrees) for SPG and 21.3 degrees (SD, 8.5 degrees) for SNP. CONCLUSIONS: Women who have undergone pedicle screw instrumentation and fusion who have had >= 1 pregnancies do not have curve progression or deterioration in the longer-term outcomes compared with patients who have not become pregnant.
  • Kesanen, Jukka; Leino-Kilpi, Helena; Lund, Teija; Montin, Liisa; Puukka, Pauli; Valkeapaa, Kirsi (2017)
    Purpose To assess the impact of preoperative knowledge on anxiety, health-related quality of life (HRQoL), disability, and pain in surgically treated spinal stenosis patients. Methods One hundred patients were randomised into an intervention group (IG, n = 50) or control group (CG, n = 50). Both groups received routine preoperative patient education. IG additionally underwent a feedback session based on a knowledge test. Primary outcome measure was anxiety at the time of surgery. HRQoL, disability, and pain constituted the secondary outcome measures during a 6-month follow-up. Results In IG, a significant reduction in anxiety was noted after the intervention, whereas in CG, anxiety reduced only after the surgery. In both groups, a significant improvement in HRQoL, disability, and pain was noticed at the 6-month follow-up, but there were no between-group differences. Conclusions Higher knowledge level may reduce preoperative anxiety but does not seem to affect the self-reported clinical outcomes of surgery.