Search Results (1,370)

Background and Objectives: This study examined the association between active aging and health-related quality of life (HRQoL) in older Korean adults. Furthermore, it examined how socioeconomic factors were related to active aging and HRQoL. Methods: Data were analyzed using the 8th Korea National Health and Nutrition Examination Survey (KNHANES). This study used the Health-Related Quality of Life Instrument with Eight Items (HINT-8), a Korean-specific HRQoL instrument. Multivariable regression analyses were conducted to estimate the associations of overall active aging and its health, participation, and security domains with HRQoL. Results: The health domain showed the largest coefficient, and the security domain was also significantly associated with HRQoL. The participation domain showed a relatively limited and statistically non-significant association, which may partly reflect measurement constraints in the operationalization of participation. Older adults with lower educational levels and those residing in rural areas had lower levels of both active aging and HRQoL. Conclusions: Active aging was positively associated with HRQoL among older Korean adults. These findings highlight health as the domain most strongly associated with HRQoL and identify security as an additional relevant domain, while participation-related findings should be interpreted cautiously given the limited operationalization of participation and its statistically non-significant association. However, longitudinal or intervention studies are needed to examine temporal and causal relationships between active aging and HRQoL. Full article

Background: Quality of life (QoL) after spinal cord injury (SCI) is influenced by psychosocial factors, yet less is known about how these factors are examined across national contexts. Objective: This scoping review mapped studies examining depression, employment, and social participation in relation to QoL or health-related QoL (HRQoL) among individuals with SCI in the United States and South Korea. Methods: Following PRISMA-ScR guidelines, five databases were searched for peer-reviewed English- and Korean-language studies published between 2007 and 2025. Results: Sixteen studies were included: nine from South Korea and seven from the United States. Depression and psychological distress were associated with lower QoL/HRQoL in both countries, although South Korean studies more often examined depression with stress and functional concerns, whereas U.S. studies situated depression within participation, spirituality, and youth psychosocial functioning. Employment was linked to QoL/HRQoL in both contexts, with South Korean studies emphasizing economic activity, vocational rehabilitation, and financial strain, and U.S. studies emphasizing employment status and vocational outcomes. Social participation was important in both countries, but South Korean studies focused more on community transition, functional independence, and social attitudes, whereas U.S. studies emphasized participation contexts, accessibility, and social relationships. Conclusions: Across the three domains, depression, employment, and social participation emerged as recurring psychosocial domains associated with QoL/HRQoL after SCI in both countries. These differences suggest that psychosocial adaptation after SCI should be understood within cultural and rehabilitation contexts. Full article

Background: Deep infiltrating endometriosis (DIE), particularly when involving the bowel, significantly impairs health-related quality of life (HRQoL) and gastrointestinal function. This study aimed to evaluate the short- and mid-term impact of minimally invasive excision on these parameters in a large multicenter cohort. Methods: A retrospective observational study was conducted on 837 patients treated for endometriosis in two tertiary referral centers between 2018 and 2024. All patients underwent laparoscopic or robotic-assisted excision. Quality of life was assessed preoperatively and at 6 months (VAS: n = 69; SF-36: n = 100; GIQLI: n = 98) and 12 months (VAS: n = 30; SF-36: n = 46; GIQLI: n = 44) postoperatively, using validated patient-reported outcome measures (PROMs): the Visual Analog Scale (VAS) for pain, the Short Form-36 (SF-36) survey, and the Gastrointestinal Quality of Life Index (GIQLI). Results: The study population presented with predominantly advanced disease (Stage III–IV in 83.4% of cases), with 39.7% of patients undergoing segmental bowel resection. Postoperatively, a statistically significant reduction was observed in dysmenorrhea (VAS 7.6 vs. 5.0, p < 0.001) and chronic pelvic pain. The SF-36 scores improved significantly across all eight domains at 6 months, with the most dramatic recovery seen in Role Physical (p < 0.001) and Bodily Pain (p < 0.001). Regarding digestive function, the mean GIQLI score showed a progressive increase, reaching statistical significance at 12 months compared to baseline (112.6 vs. 106.6, p = 0.027), indicating superior long-term functional outcomes. Conclusions: Multidisciplinary minimally invasive surgery for deep infiltrating endometriosis was associated with significant and sustained improvements in quality of life among patients with available follow-up. Gastrointestinal quality of life, as measured by GIQLI, improved significantly at 12 months postoperatively, including in patients who underwent segmental bowel resection. Systematic use of PROMs is essential for accurate patient counseling and outcome monitoring. Full article

Introduction: Low back pain is one of the commonly overlooked late complications of an intestinal stoma. Its severity may be associated with impaired quality of life across multiple dimensions of patient functioning. Objective: This cross-sectional study evaluated the impact of low back pain on self-reported health-related quality of life in colostomy patients. Material and Methods: The study was conducted using a cross-sectional questionnaire-based design across 12 regional branches of the Pol-ILKO Association in Poland between December 2023 and September 2024. The study sample consisted of 95 patients. The standardized Oswestry Disability Index (ODI) questionnaire, which assesses the level of disability in patients with back pain, and the WHOQOL-BREF questionnaire, which assesses health-related quality of life, were used in the survey. In addition, detailed data on medical history, past surgical interventions, and stoma self-care skills were collected using an author-developed tool. Results: Greater disability due to back pain is associated with lower self-rated quality of life. The higher the degree of disability as assessed by the Oswestry questionnaire and the higher the number of postoperative complications, the worse the subjective rating of health-related quality of life (HRQoL) (p < 0.05). Factors associated with a significantly (p < 0.05) increased risk of lower back pain include postoperative complications, irrespective of the time since stoma creation, as well as avoidance or restriction of full trunk movements. Preoperative agreement on the stoma site was associated with greater independence in stoma hygiene. Conclusions: The results underscore the importance of early and targeted interventions to improve physical and psychosocial well-being in the subject population, especially at the preoperative stage. More attention should be paid to the needs of colostomy patients, both in hospitals and in outpatient specialty care centers, to improve their overall quality of life and self-assessment of their condition. Full article

Background: Early detection of joint damage in haemophilia is essential to prevent haemophilic arthropathy. This study longitudinally evaluated joint health in paediatric patients with haemophilia in Greece using the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) scoring system. Methods: Children aged 5–18 years with haemophilia of any severity, all receiving prophylaxis, were assessed at baseline and during longitudinal follow-up visits scheduled at 6, 12, 24, and 36 months. Evaluations included HEAD-US and Haemophilia Joint Health Score (HJHS), functional ability (PedHAL), health-related quality of life (HRQoL), and pain (BPI). Results: Forty-seven boys (mean age 11.5 ± 3.7 years) were included (severe 83%, moderate 11%, mild 6%). Baseline HEAD-US scores were low (mean ± SE: 0.22 ± 0.069). No significant overall change was observed over time, although left knee showed significant improvement (p < 0.05). Ankles consistently exhibited higher scores compared to other joints (p < 0.05). Synovitis was the most frequent abnormality, while cartilage damage was infrequent and subchondral bone changes were negligible. HEAD-US detected more abnormalities than HJHS. Conclusions: Joint health was well preserved under prophylaxis, with synovitis representing the earliest detectable change, although interpretation is limited by incomplete long-term follow-up. HEAD-US proved more sensitive than clinical assessment, supporting its role in routine longitudinal monitoring. Full article

Background/Objectives: Teachers in educational institutions are continuously exposed to high occupational demands, which may contribute to the development of increased adiposity and comparatively unfavorable health-related quality of life (HRQoL) scores. However, there is limited evidence regarding how years of professional experience is associated with these indicators in teachers. The objective of this study is to examine the association between years of professional experience, adiposity indicators, and HRQoL among teachers in educational institutions. Methods: An observational, relational, exploratory cross-sectional study was conducted in 175 teachers from educational institutions in the city of Temuco, Chile. Body mass index (BMI), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) were assessed as adiposity indicators, and health-related quality of life (HRQoL) was measured using the SF-12. Age, sex, and years of professional experience were recorded. Simple and multivariable linear regression models were used to analyze the association between years of experience and the study variables, adjusting for age and sex. Additionally, experience tertiles were compared using ANOVA and ANCOVA. Results: In the unadjusted analyses, greater years of professional experience were associated with higher adiposity indicators, including BMI (β = 0.071; 95% CI: 0.020 to 0.129). However, after adjustment for age and sex, these associations were attenuated and no longer statistically significant (adjusted BMI: β = −0.172; 95% CI: −0.434 to 0.053). Associations with PCS and MCS scores were also not statistically significant after adjustment. Conclusions: Teachers exhibited high levels of adiposity and HRQoL scores suggesting an unfavorable perceived health profile. The observed associations between years of professional experience and adiposity or HRQoL appear to be largely explained by age rather than by professional experience itself. Future longitudinal studies are needed to more precisely distinguish between the effects of aging and prolonged occupational exposure. However, the findings should be interpreted cautiously given the convenience sampling design and the inclusion of teachers from a single city. Full article

Background/Objectives: Breast cancer affects working-age women not only through treatment and survival but also through health-related quality of life (HRQoL), work capacity and informal caregiving needs. Evidence from Central and Eastern Europe remains limited. This study estimated the indirect societal burden of breast cancer among working-age women in Croatia and reported economic indirect costs separately from monetised HRQoL/welfare loss. Methods: A multicentre cross-sectional study conducted in 2024 included women aged 18–65 years receiving outpatient oncology care at two tertiary centres in Croatia. HRQoL was assessed with the EuroQol five-dimension five-level instrument (EQ-5D-5L) and compared with Croatian general-population norms. Utility decrements were annualised and monetised using a national willingness-to-pay threshold of €17,000 per quality-adjusted life year (QALY). Work productivity impairment was measured using the Work Productivity and Activity Impairment: General Health (WPAI:GH) questionnaire and valued, together with informal care, using the human-capital approach. Deterministic sensitivity analyses and approximate 95% confidence intervals were used to show how the estimates changed under key assumptions. Results: A total of 271 women participated (mean age 51.3 years among age-eligible records). Mean EQ-5D-5L utility was 0.76 versus 0.91 in the general population, corresponding to an annual QALY loss of 0.15 and a monetised HRQoL/welfare loss of €2550 per patient-year (95% CI €2083–€3017). Among employed participants, mean overall work productivity loss was 43.9% (842.9 h/year), equivalent to €7333 annually (95% CI €6311–€8355). Informal caregiving was reported by 54.7% of participants, with mean annual costs of €1566 (95% CI €1269–€1863). Economic indirect costs were €8899 per patient-year (95% CI €7835–€9963). In an extended welfare-inclusive scenario, the estimated burden was €11,449 per patient-year (95% CI €10,287–€12,611), corresponding to an illustrative national estimate of €86 million (95% CI €77–€95 million; 0.11% of gross domestic product). Conclusions: Breast cancer in working-age women imposes a substantial societal burden in Croatia, driven by reduced HRQoL, productivity losses and informal caregiving needs. These findings support taking societal burden into account in public health planning, survivorship care and health policy decision-making. Full article

Objective: This study aimed to examine the associations of morphological variables, maximal isometric handgrip strength (MIHS), and static postural balance with self-esteem, motivational climate, school climate, and health-related quality of life (HRQoL) in early adolescents. Methods: A cross-sectional study was conducted in 235 Chilean adolescents, in whom morphological variables, MIHS, and static postural balance were assessed using center-of-pressure (CoP) parameters under eyes-open (EO) and eyes-closed (EC) conditions. Psychosocial variables, including self-esteem, motivational climate, school climate, and HRQoL, were evaluated via validated questionnaires. Multiple linear regression analyses were performed to determine associations between physical and psychosocial variables. Results: Reduced CoP sway area and lower CoP velocity under eyes-closed conditions were significantly associated with higher self-esteem (R² = 0.168; p < 0.001). Greater non-dominant MIHS and younger age were associated with more favorable perceptions of a task-involving motivational climate (R² = 0.438; p < 0.001). Higher HRQoL scores were associated with male sex and better postural balance performance. Conclusions: Better static postural balance and greater muscle strength were associated with more favorable psychosocial outcomes, particularly self-esteem and HRQoL. However, these findings should be interpreted as associative rather than causal relationships due to the cross-sectional design. Full article

Objective: This study aimed to assess health-related quality of life (HRQoL) and fatigue in patients with osteogenesis imperfecta (OI) and to compare these outcomes with those of healthy controls. In addition, the associations between fatigue and the physical and mental components of HRQoL, as well as related clinical factors, were examined. Method: Between June 2024 and June 2025, 27 adults with OI were enrolled and compared with 27 healthy controls. Fatigue was assessed with the FSS and HRQoL with the SF-36, including PCS and MCS scores. We evaluated factors associated with the PCS and MCS and examined the associations between the PCS/MCS and fatigue. Results: PCS scores were significantly lower in patients with OI types III and IV compared with controls, whereas no difference was observed between type I and controls. No significant differences were found in MCS scores or mental health domains among the groups. Fatigue levels did not differ significantly among the groups. Height was positively correlated with the PCS, while the number of fractures showed a moderate negative correlation. Lower PCS scores were observed in patients with lower extremity deformities and a history of orthopedic surgery. Alendronate use and longer treatment duration showed associations with higher PCS scores. In addition, a significant negative correlation was found between the MCS and fatigue severity. Conclusions: Adults with OI showed impaired physical functioning compared with controls, with relatively preserved mental functioning and similar fatigue levels. Physical functioning was associated with height, fracture burden, orthopedic surgery, and alendronate use, while fatigue was associated with mental functioning, underscoring the need for patient-centered care addressing both skeletal and psychosocial outcomes. Full article

Background: Stress urinary incontinence (SUI) is defined as involuntary urine loss during activities that increase intra-abdominal pressure. It is highly prevalent among women and significantly affects physical, emotional, and social well-being. Pelvic floor muscle training (PFMT) is the gold-standard conservative therapy. Second-generation radiofrequency (RF) therapy has shown promise as an alternative. It stimulates collagen synthesis and promotes tissue remodeling. This study will compare the effects of PFMT, RF, and their combination on pelvic floor function, urethral stability, and health-related quality of life (HRQoL) in women with SUI due to urethral hypermobility. Methods/Design: This will be a single-blinded, three-arm, randomized controlled trial conducted at Clínica Traña (San José, Costa Rica). Women aged ≥18 years with clinically confirmed SUI and a retrovesical (β) angle ≥ 140° during the Valsalva maneuver on functional transperineal ultrasound will be randomized (1:1:1) to PFMT (16 weeks, twice-weekly supervised sessions), RF (5 weekly sessions using Capenergy^® C500 Urogyne), or combined RF + PFMT (39 per arm; total N = 117 accounting for 30% attrition). The primary outcome is the change from baseline in pelvic floor muscle strength at 12 months post-intervention, measured by the modified Oxford scale and vaginal manometry. Secondary outcomes will include urethral stability (retrovesical β angle and bladder neck descent on ultrasound), incontinence severity (Sandvik Severity Index), and HRQoL (ICIQ-UI SF and King’s Health Questionnaire). All outcomes will be assessed at baseline, immediately post-intervention, 15 days, 3 months, 6 months, and 12 months follow-up. Assessments will be performed by blinded evaluators. Analysis will follow intention-to-treat principles using repeated-measures ANOVA or non-parametric equivalents (SPSS v.29; p < 0.05). The trial was prospectively registered on ClinicalTrials.gov (NCT07095283, registered on 24 July 2025), prior to the recruitment of the first participant. Expected outcomes: This study will provide comparative effectiveness data on whether the addition of RF to PFMT offers additional benefits over PFMT alone in the management of SUI. Full article

Executive functions (EFs) are key cognitive processes for behaviour. However, there is little information about interaction with the dimensions of health-related quality of life (HRQoL), therefore the objective of this study was to analyse the association between lifestyle habits (physical activity and screen time), sleep, HRQoL and EFs in children and adolescents. Specifically, this study aimed to identify the extent to which perceived well-being dimensions are associated with EFs and to determine the potential mediating role of HRQoL in the relationships between lifestyle habits and these cognitive domains, examining whether these direct and indirect pathways remain robust after adjusting for gender and age. A total of 943 children and adolescents (51.3% female) aged 10–17 years participated. Lifestyle parameters (PA Krece Plus, sleep duration and KIDSCREEN-10 questionnaire) and EFs (CogniFit neurocognitive assessment battery) were evaluated. The analysis of the individual KIDSCREEN-10 items revealed that perception of school performance presented the most consistent association with EFs, being positively related to attention (b = 16.39, p = 0.018), cognitive flexibility (b = 30.65, p = 0.005), inhibition (b = 24.66, p = 0.022), and working Memory (b = 42.33, p < 0.001). Furthermore, parental fairness reported a significant association for three out of four domains: attention (b = 13.89, p = 0.006), flexibility (b = 22.93, p = 0.003), and working Memory (b = 25.42, p < 0.001). Having enough time for self was also significantly related to attention performance (b = 12.60, p = 0.026). Regarding lifestyle habits, the composite lifestyle index (PA + ST) showed the most consistent positive association across all cognitive domains, while sleep duration was inversely associated with attention, cognitive flexibility, and working Memory. The mediation analysis revealed that global HRQoL significantly mediated the relationship between lifestyle habits and executive functions, accounting for 9.55% of the total effect on attention, 5.45% on cognitive flexibility, and 4.14% on working memory, whereas no mediation was observed for inhibition. In conclusion personal time, parental fairness, and school adjustment were positively associated with EFs. HRQoL and physical activity levels also showed consistent links with all EFs, whereas sleep duration was inversely related. Furthermore, mediation analysis revealed that global HRQoL acts as a critical indirect pathway, explaining a significant proportion of the lifestyle habits’ total effect on attention, cognitive flexibility, and working memory. Overall, these findings highlight the multifactorial and interrelated mechanisms shaping executive functioning in children and adolescents. Full article

Objective: This study aimed to assess health-related quality of life (HRQoL) among postpartum women in Jordan and identify the factors that may influence it. Methodology: This study employed a cross-sectional design and was conducted among women who had given birth within the last year, selected through cluster randomization from four primary healthcare centers in Amman. Household resource quality of life was measured on the validated 36-Item Short Form Survey (SF-36), which covers eight domains of health. Descriptive statistics were calculated. Independent t-tests and one-way ANOVA were used to compare mean HRQoL scores across categories of socio-demographic variables (e.g., marital status, income, employment, feeding type). Pearson correlation was used to examine the relationship between age (the only continuous variable) and HRQoL domains. Statistical significance was set at p < 0.05. Results: The physical functioning had the highest HRQoL (62.48 ± 25.19), and the lowest HRQoL (34.59 ± 37.46) was found in role limitations due to physical health and emotional problems (36.37 ± 40.90). Key socio-demographic factors were highly related to HRQoL. Better general health perceptions (p = 0.003) and emotional well-being (p = 0.005) were found to be correlated with higher income. The married women scored much higher in physical functioning (p = 0.015) and emotional well-being (p = 0.013) than divorced women. Infant feeding methods and employment status were also significantly associated with certain domains of HRQoL. Conclusions: Postpartum women in Jordan experience low HRQoL, particularly in the domains related to role limitations. Socio-demographic factors were found to be crucial, wherein marital status and income are specific aspects. This study strongly recommends immediate integration of an appropriate multidimensional support program in postpartum care as an intervention toward improving maternal well-being. Full article

Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by bilateral and multifocal polyps and has been shown to decrease health-related quality of life (HRQOL). Standard treatment includes steroids and endoscopic sinus surgery. Office-based endoscopic polypectomy has become increasingly popular in recent years. This study aimed to evaluate the outcomes and tolerability of office-based endoscopic polypectomy using a microdebrider under local anesthesia. This prospective observational study enrolled 19 patients with CRSwNP, according to the EPOS2020 criteria. All patients underwent office-based endoscopic polypectomy. Efficacy of treatment was assessed using the SNOT-22 questionnaire three and six months postoperatively. The perioperative experiences of patients and surgeons were evaluated using questionnaires. The mean SNOT-22 score decreased from 59.7 (SD 21.8) to a mean of 37.1 (SD 26.6 p < 0.001) after three months, and was maintained at 6 months, with a mean of 35.2 (SD 17.6 p < 0.001). The majority reported good comfort levels and did not prefer performing the procedure in an operating room under general anesthesia. The results show that office-based endoscopic polypectomy under local anesthesia is an effective method for relieving symptoms (SNOT-22) and is well-tolerated. The effect was maintained after six months. Full article

Introduction: Advances in pediatric oncology have transformed cancer into a condition with chronic and long-term developmental consequences. While survival rates have improved significantly, the literature on psychosocial outcomes remains fragmented and inconsistent, with a notable lack of person-centered analyses that account for the heterogeneity of adaptive trajectories. Current evidence fails to explain why survivors with similar clinical profiles exhibit divergent psychological phenotypes, particularly regarding the late effects of multimodal treatments. The aim of this study was to identify heterogeneous psychosocial profiles among adolescent cancer survivors and to examine their associations with treatment complexity and quality of life. Materials and Methods: This cross-sectional study included 165 adolescents aged 12–18 years (mean age: 14.64 years) who were in clinical remission following oncological treatment. Standardized assessment tools were used: the Children’s Depression Inventory 2 (CDI-2™) to measure depressive symptoms, the KIDSCREEN-10 index to assess health-related quality of life (HRQoL), and a scale evaluating satisfaction across 14 life domains. Adaptive profiles were identified using a Two-Stage Cluster Procedure, and risk factors were examined using multinomial logistic regression. Results: Four clusters were identified in the study population: a depressive–dysphoric profile, an anhedonic-withdrawn profile, a highly adaptive profile, and a mixed (struggling) profile. Treatment complexity was identified as a significant independent predictor of membership in the high-distress (depressive) cluster. While each additional therapeutic modality beyond standard chemotherapy was associated with a markedly increased risk (OR = 8.91; p < 0.001), the relatively wide confidence interval (95% CI: 3.27–24.31) suggests that the exact magnitude of this effect should be interpreted with caution. The high lower bound of the interval (3.27), however, strongly supports the directional association of cumulative iatrogenic burden with psychological adaptation. Subjective quality of life functioned as a protective factor against depressive symptoms (OR = 0.57); however, paradoxically, higher self-reported quality of life increased the likelihood of classification into the anhedonic group (OR = 1.81). This divergence between high self-reported HRQoL and social withdrawal potentially suggests a ‘well-being paradox’. It is hypothesized that standard HRQoL instruments may primarily capture physical remission and relief from acute somatic symptoms, potentially masking underlying social–emotional deficits. This suggests that HRQoL scores in survivors should be interpreted with caution and complemented by specific affective screenings. Conclusions: The absence of a uniform pattern of psychological response to cancer among adolescent survivors supports the validity of a patient-centered approach. The burden associated with intensive multimodal treatment significantly increases the likelihood of full-syndrome depression during adolescence. Moreover, the identification of a cluster suggestive of anhedonic and socially withdrawn features highlights the limitations of standard screening tools focused solely on the detection of overt sadness. This heterogeneity underscores the need for personalized psycho-oncological care and the implementation of intensified monitoring for patients at high medical risk. Full article

Background and Objectives: Young women treated for breast cancer often face persistent sexual and reproductive challenges post-treatment, which frequently remain unaddressed during routine follow-up. This study evaluated health-related quality of life (HRQoL), sexual health, and fertility-related counselling in breast cancer survivors younger than 40 years. Materials and Methods: We performed a single-centre cross-sectional study including 65 women with non-metastatic breast cancer (at least 12 months post-primary treatment). Patients completed the EORTC QLQ-C30 and SHQ-22 questionnaires, along with a pilot-tested 7-item fertility preservation survey. Data were analyzed using descriptive statistics and non-parametric tests to compare treatment subgroups (e.g., endocrine therapy vs. others). Results: Overall quality-of-life scores were relatively preserved (median 66.67), with high functional scores. However, patients reported symptomatic distress, particularly fatigue and insomnia (both median 33.33). Sexual health was significantly impacted: communication with healthcare professionals was the most impaired domain (median score 100), followed by low libido (66.7) and vaginal dryness (66.7). Women receiving endocrine therapy reported significantly lower functional scores and a higher symptom burden compared to those not on endocrine treatment (p < 0.05). While 60% of patients received fertility information, only 16.9% underwent preservation procedures. Notably, a significant association was observed between reproductive health actions and sexual behaviour; women who had undergone fertility preservation procedures reported higher levels of sexual activity (p = 0.015). Conclusions: Despite relatively preserved functional status, young breast cancer survivors face significant symptomatic and sexual challenges. The profound lack of communication regarding sexual health and the gaps in fertility counselling highlight the need for a more integrative, multidisciplinary approach in survivorship care. Full article