Search Results (705)

Background and Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder that primarily affects young adults and is frequently accompanied by psychiatric comorbidities such as depression and anxiety, both of which significantly diminish patients’ quality of life (QoL). This study investigated the effect of two oral disease-modifying therapies (DMTs), fingolimod and cladribine, on mental health and QoL in patients with relapsing-remitting MS (RRMS). The aim of the study was to compare levels of depression, anxiety, and health-related quality of life (HRQoL) in RRMS patients treated with fingolimod or cladribine, and to evaluate their associations with clinical and radiological parameters. Materials and Methods: Eighty RRMS patients aged 18 to 50 years with Expanded Disability Status Scale (EDSS) scores of 3.0 or less, no recent disease relapse, and no history of antidepressant use were enrolled. Forty patients were treated with fingolimod and forty with cladribine. Depression and anxiety were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). QoL was evaluated using the Multiple Sclerosis QoL-54 (MSQOL-54) instrument. Additional clinical data, including MRI-based lesion burden, EDSS scores, age, disease duration, and occupational status, were collected. Results: No statistically significant differences were observed between the two groups regarding HDRS and HARS scores (p > 0.05). However, patients treated with fingolimod had significantly higher scores in the Energy/Fatigue subdomain (7.55 ± 2.02 vs. 6.56 ± 2.57, p = 0.046) and Composite Mental Health (CMH) score (64.73 ± 15.01 vs. 56.00 ± 18.93, p = 0.029) compared to those treated with cladribine. No significant differences were found in the independent items of the MSQOL-54. A negative correlation was identified between total lesion load and QoL scores. Conclusions: Although fingolimod and cladribine exert comparable effects on depression and anxiety levels, fingolimod may be associated with better mental health outcomes and reduced fatigue in RRMS patients. Furthermore, lesion burden and clinical parameters such as age and EDSS score may independently influence QoL, regardless of the DMT used. Full article

Freezing of gait (FoG) impairs mobility and daily functioning and increases the risk of falls, leading to a reduced quality of life (QoL) in people with Parkinson’s disease (PD). The Cue2walk, a wearable smart cueing device, can detect FoG and hereupon provides rhythmic cues to help people with PD manage FoG in daily life. This study investigated the user experiences and device usage of the Cue2walk, and its impact on health-related QoL, FoG and daily activities. Twenty-five users of the Cue2walk were invited to fill out an online survey, which included a modified version of the EQ-5D-5L, tailored to the use of the Cue2walk, and its scale for health-related QoL, three FoG-related questions, and a question about customer satisfaction. Sixteen users of the Cue2walk completed the survey. Average device usage per day was 9 h (SD 4). Health-related QoL significantly increased from 5.2/10 (SD 1.3) to 6.2/10 (SD 1.3) (p = 0.005), with a large effect size (Cohen’s d = 0.83). A total of 13/16 respondents reported a positive effect on FoG duration, 12/16 on falls, and 10/16 on daily activities and self-confidence. Customer satisfaction was 7.8/10 (SD 1.7). This pilot study showed that Cue2walk usage per day is high and that 15/16 respondents experienced a variety of positive effects since using the device. To validate these findings, future studies should include a larger sample size and a more extensive set of questionnaires and physical measurements monitored over time. Full article

The quality of life (QoL) perception has been studied in neurological diseases; however, there is limited information linking brain morphological characteristics, QoL, and cognition. Human behavior and perception are associated with specific brain areas that interact through diffuse electrochemical networking. We used magnetic resonance imaging (MRI) to analyze the brain region volume (BRV) correlation with the scores of Rand’s 36-item Short Form Survey (SF-36) and cognitive domains (memory and dementia status). We analyzed data from 420 adult participants in the Maracaibo Aging Study (MAS). Principal component analysis with oblimin axis rotation was used to gather redundant information from brain parcels and SF-36 domains. Canonical correlation was used to analyze the relationships between SF-36 domains and BRV (adjusted for intracranial cavity), as well as sex, age, education, obesity, and hypertension. The average age (±SD) of subjects was 56 ± 11.5 years; 71% were female; 39% were obese; 12% had diabetes, 52% hypertension, and 7% dementia. No sex-related differences were found in memory and orientation scores, but women had lower QoL scores. The 1st and 2nd canonical correlation roots support the association of SF-36 domains (except social functioning and role emotional) and total brain volume, frontal lobe volume, frontal pole, lateral orbital lobe, cerebellar, and entorhinal areas. Other variables, including age, dementia, memory score, and systolic blood pressure, had a significant influence. The results of this study demonstrate significant correlations between BRV and SF-36 components, adjusted for covariates. The frontal lobe and insula were associated with the mental health component; the lateral-orbital frontal lobe and entorhinal area were correlated with the physical component. Full article

Background/Objectives: Quality of life (QoL) is a valuable tool for evaluating treatment outcomes and identifying patients who may benefit from early supportive interventions. This study aimed to determine whether specific QoL results in patients with advanced rectal cancer could identify groups with an unfavourable prognosis in long-term follow-up. Methods: A total of 570 patients with advanced rectal cancer were prospectively assessed, during and up to five years after neoadjuvant radiochemotherapy, using the QLQ-C30 and QLQ-CR38 questionnaires. We analysed 27 functional and symptom-related scores to identify associations with overall survival, once at baseline, three times during therapy, and annually from years one to five post-therapy. Results: Poor quality of life scores were consistently associated with shorter overall survival. The functional scores of physical functioning, role functioning, and global health, as well as the symptom scores of fatigue, dyspnoea, and chemotherapy side effects, were highly significant for overall survival at nearly all time points except for the immediate preoperative assessment. Patients over the age of 64 with lower QoL scores showed a significantly reduced probability of survival in the follow-up period, and patients who reported poor QoL in at least two of the first three questionnaires during the initial phase of treatment showed significantly reduced overall survival. Conclusions: Early and repeated QoL assessments, particularly within the first weeks of therapy, offer critical prognostic value in advanced rectal cancer. Identifying patients with an unfavourable prognosis might allow faster interventions that could improve survival outcomes. Integrating QoL monitoring into routine clinical practice could enhance individualised care and support risk stratification. Full article

Background/Objectives: Despite the psychological benefits of breast reconstruction (BR) after mastectomy, uptake remains limited among women with breast cancer. This study explores psychosocial and personality predictors of BR intentions in the pre-mastectomy phase, aiming to inform strategies for mental health promotion in oncology care. Methods: This cross-sectional analysis used preoperative data from a longitudinal study at a university hospital in Greece. Women with primary breast cancer scheduled for mastectomy completed a battery of validated self-report measures, including the International Personality Item Big-Five Factor Markers (IPIP-BFFM), the Hospital Anxiety and Depression Scale (HADS), and the Short Form-36 Health Survey (SF-36). Demographic, clinical, and psychosocial data were also collected. Binary logistic regression was used to examine predictors of (a) BR information-seeking and (b) BR intention. Results: Seventy-four women participated (mean age = 61.1 years). Older age predicted lower BR intention (Exp(b) = 0.897, 95% CI: 0.829–0.970) and information-seeking (Exp(b) = 0.925, 95% CI: 0.859–0.997). Single/divorced status was associated with reduced BR information-seeking (Exp(b) = 0.053, 95% CI: 0.005–0.549). Openness to experience significantly predicted both outcomes (BR information-seeking: Exp(b) = 1.115, 95% CI: 1.028–1.209); BR intention: Exp(b) = 1.095, 95% CI: 1.016–1.181). Higher physical health-related QoL scores were associated with increased BR intention (Exp(b) = 1.039, 95% CI: 1.007–1.072), whereas higher mental health-related QoL (Exp(b) = 0.952, 95% CI: 0.912–0.994) and higher depression scores (Exp(b) = 0.797, 95% CI: 0.638–0.996) were linked to decreased BR intent. No psychological factor significantly predicted information-seeking. Conclusions: These findings underscore the value of psychosocial screening and personality-informed counseling prior to surgery. By identifying individuals less likely to seek information or consider BR, pre-mastectomy assessments can contribute to tailored, mental health-promoting interventions and support informed, patient-centered surgical decision-making. Full article

This paper clarified the correlation among quality of life (QoL) indicators, exercise implementation level, and exercise habits in middle-aged and older adults under identical exercise intervention conditions. The survey items were anthropometric and physiologic measurements, physical strength measurements, and exercise habits. During the 3-month experimental period, a weekly “health exercise course” served as the primary intervention. For all participants, anthropometric and physiologic measurements, physical strength tests, questionnaire surveys, and other surveys were conducted before and after the experiment; then, the pre- and post-intervention effects were compared. After the exercise intervention, significant differences were observed among middle-aged and older adults in terms of various parameters, such as weight, fat rate, diastolic pressure, systolic pressure, sit-up, standing on one foot, lower limb extension force, activity of daily living (ADL), and subjective well-being (PGC). ADL and PGC changed significantly in the participants who engaged in exercise more than twice a week. However, the participants who engaged in exercise for less than twice a week showed no significant differences in any parameters except the life satisfaction (LSI) mean; the LSI increased in the “Less than twice a week” exercise group but decreased in the “More than twice a week” group. In terms of average walking time per session, the “More than 30 min” exercise group showed significant differences in ADL and PGC, whereas the “Less than 30 min” group showed significant differences only in the LSI. The influence of exercise on QoL indicators of middle-aged and older adults, under the same exercise intervention conditions, is related to their exercise habits. This study highlights the benefits of physical exercise in middle-aged and older adults, emphasizing the importance of regular and sustained exercise for this population. Furthermore, the study provides a scientific basis for improving QoL in middle-aged and older adults, thus, to some extent, addressing the concerns related to the growing population of older adults. Full article

Background: Chronic low back pain (CLBP) is the leading cause of disability both within the United States and globally. However, reliable diagnosis and treatment remains limited due to a lack of objective and image-based biomarkers. Modic changes (MCs) are visible vertebral endplate and bone marrow changes in signal intensity seen on MRI. MCs have emerged as promising correlates with degenerative disc disease and CLBP. Methods: This is a non-systematic literature review. Results: This review synthesizes current evidence on the classification, pathophysiology, and imaging of MCs, with a particular focus on their associations with patient-reported outcomes, including pain (Visual Analog Scale), functional status (Oswestry disability index and Roland-Morris Disability Questionnaire), and health-related quality of life (Short Form-36 and EuroQol 5-Dimension 5 Level). MC type 1 and 2 show significant correlations with symptom severity and predict positive response to basi-vertebral nerve (BVN) ablation, a minimally invasive intervention inhibiting the nerves’ ability to transmit pain signals. Conclusions: Across multiple trials, BVN ablation has shown significant sustained improvements in patient-reported outcomes among patients with MC, reinforcing their role as both a diagnostic and therapeutic biomarker. Full article

Background: Thyroid disorders are significant endocrine conditions in pediatric populations, sometimes requiring surgical intervention. While surgical outcomes are well-documented, the broader impact on quality of life (QoL) remains insufficiently synthesized. This systematic review aimed to evaluate the effects of thyroid surgery on QoL in pediatric patients, focusing on physical, emotional, and social dimensions. Methods: Following the PRISMA guidelines, we searched PubMed, EMBASE, and SCOPUS from inception to January 2025. Studies reporting health-related QoL outcomes in pediatric patients undergoing thyroid surgery were included. Quality assessment was conducted using the Newcastle–Ottawa Scale. Data synthesis focused on emotional and psychological outcomes, social functioning, physical health, and surgical-approach-specific effects. Results: Five studies (ranging from 37 to 92 participants) met the inclusion criteria. Unilateral thyroidectomy was associated with better QoL outcomes compared to bilateral procedures, particularly in emotional and physical domains. Post-surgical anxiety significantly improved. However, male survivors reported higher levels of depression and reduced motivation. Employment status emerged as a significant factor influencing physical functioning scores. Thyroid cancer patients demonstrated better social functioning than peers with other cancers, yet they lagged behind healthy controls. Long-term follow-up highlighted ongoing challenges in physical functioning and fatigue. Conclusions: Thyroid surgery impacts multiple dimensions of QoL in pediatric patients, with variations depending on surgical approach and patient characteristics. These findings underscore the need for comprehensive post-operative care, including routine QoL assessments and tailored psychological support. Future research should aim to standardize assessment timing and develop targeted interventions for high-risk groups. Full article

Burnout and work-related stress are extensively studied among mental health professionals (MHPs) in countries around the world, but there is a paucity of research emanating from Greece’s hybrid healthcare system. In Greece, MHPs may encounter unique challenges with economic obstacles and in putting ongoing community-oriented mental healthcare policies into practice. This study aims, first, to assess the prevalence of burnout, compassion fatigue, and compassion satisfaction among Greek MHPs; and second, to examine the sociodemographic and work-related factors influencing these dimensions of professional quality of life. A total of 287 Greek MHPs (25.4% male, 74.6% female; M = 39.85 years, SD = 9.52) completed the Maslach Burnout Inventory (MBI) and the Professional Quality of Life Scale-5 (ProQOL-5). Sociodemographic and occupational data were also collected. Findings revealed that 11.8% of participants reported high emotional exhaustion, 19.9% high depersonalization, and 35.9% a high risk of reduced personal accomplishment. Almost half of the participants (48.8%) reported high levels of compassion satisfaction, suggesting that many MHPs continue to find fulfillment in their work. Notably, none of the participants reported high levels of compassion fatigue. Sociodemographic characteristics, such as gender, ethnicity, and marital status, as well as work-related factors, including employment sector, specialization, and years of experience, were related to MHPs’ professional quality of life. These results highlight the need for targeted strategies to address burnout and promote positive professional experiences among MHPs in Greece. Interventions should support well-being and enhance the rewarding aspects of mental health practice. Full article

Background: Endocrine therapies are accompanied by side effects that significantly impact the quality of life (QoL) of women with breast cancer. Adequate diet is important for fulfilling nutritional requirements, preserving health, and supporting therapy in this vulnerable population. Methods: This preliminary study evaluated the QoL of life and dietary intake in 185 women with breast cancer on two therapies, aromatase inhibitors (AIs) and tamoxifen, using the Functional Assessment of Cancer Therapy—Endocrine Symptoms (FACT-ES), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and Breast Cancer Specific Questionnaire (QLQ-BR23) and a 24 h dietary recall. A total of 185 women were included in the study and fulfilled the FACT-ES, of whom 73 fulfilled other two questionnaires and a 24 h recall. Results: No significant differences were found in the overall QoL between groups. Joint pain (95.3%) and reduced libido (84.7%) were most common with AIs, while tamoxifen users more frequently reported weight gain and irritability (93.0%, each), and vasomotor and gynecological symptoms. Macronutrient intake was similar, though AIs users consumed more energy-dense (p ≤ 0.001) and sugary foods (p = 0.034), while tamoxifen users had higher omega-6 PUFA intake. Both groups exhibited suboptimal intake of vitamin D, calcium, and selenium, and a higher phosphorus consumption relative to recommended daily values. Conclusions: Preliminary findings showed that QoL and dietary intake were comparable between patients with BC on AIs and tamoxifen treatment. Endocrine-related symptoms were more prevalent among tamoxifen users, whereas joint pain was most common in AIs users. Nutritional interventions may be warranted in both groups to ensure adequate intake of essential micronutrients in accordance with recommended dietary guidelines. Full article

Background/Objectives: Over the past decades there has been a remarkable improvement in the clinical outcomes and prognoses after orthotopic liver transplantation (OLTx). Health-related quality of life (HRQoL) has emerged as an important concept for assessing the success of this procedure. We aimed to assess critical aspects of HRQoL in patients transplanted at our centre. Methods: We recruited 420 OLTx recipients and divided them into three groups based on the time since surgery. Two hundred and seventy-five controls were matched for age and gender. The Medical Outcomes Study Short Form (SF-36), International Physical Activity Questionnaire, Patient Health Questionnaire-9 (PHQ-9), and the Modified Fatigue Impact Scale (MFIS) were used to assess HRQoL, physical activity levels, depression, and chronic fatigue, respectively. Results: Compared to controls, OLTx patients exhibited grossly comparable HRQoL except for the physical component score (PCS) and mental domains of the SF-36. There was a significant correlation between the impairment of the PCS and depression and between the PCS and chronic fatigue. Physically active patients scored significantly lower in the MFIS, and there was a strong correlation between depression and chronic fatigue. Females exhibited more pronounced symptoms of depression and chronic fatigue than males but comparable physical activity levels and general QoL. Unemployed patients had significantly higher scores in the PHQ-9/MFIS. Conclusions: The general HRQoL of OLTx patients was similar to controls. However, patients were less physically active and more frequently unemployed. As depression and chronic fatigue occurred more often in females, particular attention should be paid to their psychiatric assessment. Full article

Background: Transradial access may affect health-related quality of life (QoL) in cerebral diagnostic angiography. However, its assessment is methodologically challenging, as repeated measurements can be influenced by response shift. To mitigate this bias, a retrospective cross-sectional study was designed using a then-test approach, allowing patients to reflect on their post procedural status at a single time point. Methods: Quality of life was assessed using the 12-Item Short Form Health Survey (SF-12). A then-test approach was also employed, whereby patients were asked to retrospectively indicate whether they perceived their condition as worse following the procedure. The survey yielded Physical (PCS) and Mental Component Summary (MCS) scores, standardized to a mean of 50 (range of 0–100), with lower values indicating greater health-related limitations. Group differences were analyzed using the Mann–Whitney U test. Associations between PCS and MCS, respectively, and clinical variables were assessed using multiple linear regression models. Results: Forty patients underwent diagnostic cerebral angiography over a 15-month observation period. Applying a then-test design, Group A included the 12.5% (n = 5) of patients who reported feeling worse post-procedure while Group B comprised the remaining 87.5% (n = 35). QoL scores were significantly lower in Group A (Mdn = 28.6) compared to B (Mdn = 46.7) for both PCS scores (p = 0.007) and MCS scores (45.3 vs. 54.6, p = 0.018). In the multiple linear regression analysis, no statistically significant associations were found between the PCS or MCS scores and any clinical variable, including age, sex, body mass index (BMI), procedure duration, dose area product, access site, prior neurosurgical history, and fluoroscopy time (p > 0.05). Conclusions: Transradial access for diagnostic cerebral angiography may affect QoL, as assessed using the SF-12 questionnaire. Applying the then-test approach, the group of patients who reported feeling worse after the procedure (12.5%) showed significantly lower physical and mental health scores. These findings underscore the need for prospective studies to further investigate patient-reported outcomes. Full article

Background: Endometriosis is a chronic, estrogen-dependent inflammatory condition, that not only leads to significant physical symptoms but also exerts a profound psychological and social burden. This study aimed to asjsess the relationship between quality of life (QoL) in women with endometriosis and selected socio-demographic, diagnostic-therapeutic, and psychological factors, emphasizing self-efficacy and dispositional optimism as potential protective resources. Methods: A cross-sectional survey was conducted between 2020 and 2022 in healthcare facilities in eastern Poland. The study included 425 women diagnosed with endometriosis. The research tools were the Endometriosis Health Profile, the General Self-Efficacy Scale, and the Life Orientation Test-Revised, as well as an original socio-demographic and clinical questionnaire. Data were analyzed using descriptive statistics, linear regression, and hierarchical regression to assess the predictive role of psychological resources beyond sociodemographic and clinical variables. Results: A higher number of physicians from various specialties consulted before diagnosis was significantly associated with lower QoL in all EHP-30 domains except infertility (p < 0.05). The perceived economic burden of treatment was significantly related to lower QoL across all domains (p < 0.05). In contrast, higher levels of self-efficacy and dispositional optimism emerged as independent protective factors, positively associated with emotional well-being, social support, sexual functioning, and relationships with medical staff (p < 0.05). Psychological variables accounted for an additional 8.1% of the variance in QoL beyond socio-demographic and clinical predictors. Conclusions: The findings support the relevance of a biopsychosocial framework in managing endometriosis. Psychological resources play a critical role in coping with the disease and should be integrated into personalized care strategies. Full article

A previous cross-sectional study found impaired health-related quality of life (HRQoL) in hyperthyroid cats, but the longitudinal impact of treatment—especially differences between radioiodine (RAIT) and antithyroid drug (ATD) approaches—remains unclear. This study aimed to evaluate changes in HRQoL in recently diagnosed (<6 months) hyperthyroid cats that underwent RAIT or received ATD. HRQoL was assessed using the validated HyperthyroidismQoL-cat questionnaire at baseline and after 1, 3, and 6 months, alongside thyroid status (eu-/hypo-/hyperthyroid) evaluation. Mixed-effects model analysed the influence of treatment type, timepoint, and thyroid status on log(HRQoL). HRQoL differences between groups at baseline and comparison to a non-hyperthyroid control group (n = 322) from a previous study at month 6 were examined using Mann–Whitney U tests. Data are presented as median (range), with significance set at p < 0.05. Thirty-eight client-owned hyperthyroid cats (15 ATD, 23 RAIT) were included. HRQoL scores at baseline did not differ between groups (RAIT: 103.5 [27–211], ATD: 73 [22–260], p = 0.22). HRQoL significantly improved over time (p < 0.001) but was not affected by treatment type (p = 0.20) or thyroid status (p = 0.40). Despite improvement, HRQoL remained lower than in non-hyperthyroid controls (hyperthyroid: 42.5 [3–161.5], non-hyperthyroid: 27 [0–249], p = 0.007). This study highlights the overall positive impact of treatment on HRQoL, but due to the lack of randomisation and heterogeneity of subjects and treatment, conclusion have to be considered preliminary. Full article

Background: Health-related quality of life (HRQoL) has emerged as a meaningful outcome measure in clinical trials and healthcare interventions in children with cerebral palsy (CwCP). We assessed the construct validity and internal consistency of the Italian version of the Paediatric QoL inventory (PedsQL^TM) 4.0 Generic Core Scales (GCS) and PedsQL^TM 3.0 Cerebral Palsy Module (CPM). Methods: A total of 125 CwCP and their parents were enrolled. Participants completed both the GCS and the CPM modules, and the results were compared to those of a sample of 121 healthy peers and their parents. The dimensionality of the two modules was assessed through exploratory factor analysis. Construct validity was assessed by a known-groups method evaluating the differences between CwCP and healthy sample. Results: Only a few GCS subscales were unidimensional, while all CPM subscales proved to be unidimensional, except for the Speech and Communication subscales of child self-reports. GCS internal consistency was good for all subscales of the parent proxy-reports, as well as for the Physical Activities and Psychosocial Health subscales of child self-reports. CPM internal consistency was good for both parent proxy-reports and—with a few exceptions—child self-reports. As for the PedsQL^TM validity, the GCS proved effective in discriminating between CwCP and healthy participants; the CPM showed a significant association between lower neurofunctional abilities and lower HRQoL. Parent–child concordance shows that child self-report scores were always higher than the those of the proxy-reports for both the GCS and CPM modules. Conclusions: The present study confirms the internal consistency and construct validity of the Italian version of both PedsQL^TM modules. In CwCP, greater functional disability resulted in lower HRQoL scores, and there was significant discrepancy between the parent and child ratings. Full article