Search Results (5,307)

Background: Sexual health is a fundamental pillar of well-being during the perinatal period. However, many studies suffer from scoring bias associated with zero values by failing to distinguish between women who are sexually inactive and those with physiological dysfunction. This study aimed to identify the distinct sociodemographic and psychological determinants of sexual inactivity versus sexual dysfunction quality in a Romanian perinatal cohort. Methods: An observational, cross-sectional study was conducted with 100 women (52% sexually active, 48% inactive). Participants were evaluated using the Female Sexual Function Index (FSFI), Patient Health Questionnaire-9 (PHQ-9), RSES (Rosenberg Self-Esteem Scale), and Generalized Anxiety Disorder-7 (GAD-7). Data were analyzed using binary logistic regression for activity status and multiple linear regression for functional quality. Results: Among sexually active women, 84.6% met the clinical criteria for sexual dysfunction (median FSFI = 21.6). Binary logistic regression revealed that self-esteem (RSES) was the sole independent predictor of sexual activity status (aOR = 1.144; 95% CI: 1.028–1.217, p = 0.016). Conversely, multiple linear regression showed that depression (PHQ-9) was the only significant independent predictor of functional quality (B = −0.73, p = 0.006). Maternal age, residence, and obstetric history did not significantly predict either outcome. Conclusions: Based on the findings of our preliminary, exploratory study, we propose a conceptual interpretation, framing perinatal sexuality as a potential two-stage process, where self-esteem appears to serve as a primary behavioral barrier for the resumption of intimacy, while depression serves as the primary disruptor of functional quality. Clinical interventions may benefit from moving beyond physical recovery to include psychological screening for body image and mood disorders to restore sexual quality of life. Full article

Introduction: The work-related quality of life affects employee satisfaction and organizational effectiveness, with a direct impact on the quality of healthcare. This study aims to investigate the work-related quality of life (WRQoL) among nurses in tertiary healthcare, as perceived by the nurses themselves, in relation to their demographic and professional characteristics. At the same time, it seeks to highlight the way in which the individual dimensions of WRQoL influence their sexual and mental health. Materials and Methods: A descriptive cross-sectional study was conducted in 2023 in a General Hospital in Greece. Data were collected using structured questionnaires assessing sociodemo-graphic and occupational characteristics, WRQoL, mental health (Depression, Anxiety and Stress Scale—DASS-21), and female sexual function (Female Sexual Function Index—FSFI-19). Pearson correlation analysis and multiple linear regression analysis were performed. The regression model was adjusted for age, marital status, number of children, and work experience. Results: The results demonstrated a significant negative association between depression and sexual function (β = −0.388, p = 0.029), while stress was positively associated with sexual function (β = 0.371, p = 0.038). The overall regression model was statistically significant (p = 0.001), explaining 18.6% of the variance in sexual function. Conclusions: The findings highlight the close interrelationship between work-related quality of life, mental health, and sexual function among nurses. Poorer psychological well-being was associated with reduced sexual function, emphasizing the impact of occupational and emotional burden on nurses’ overall health. These results underline the importance of supportive workplace environments and targeted interventions to promote mental and sexual well-being among healthcare professionals. Full article

Improving the comprehensiveness of old community renewal is a key approach to enhancing residents’ quality of life and the community environment. Currently, research on improving comprehensiveness from both supply and demand perspectives remains limited. This study constructs an evaluation system comprising 27 indicators that cover three dimensions: physical infrastructure, community services, and community governance. Adopting the approach of “single indicator, two-way assessment, and comprehensive evaluation,” this study conducts evaluations from both supply and demand perspectives. On the supply side, facility coverage is calculated through field surveys, POI data, and ArcGIS spatial analysis; on the demand side, resident satisfaction is measured via questionnaires, and an evaluation framework for supply–demand matching is constructed using the IPA model. An empirical analysis using Community X in Beijing as a case study reveals that the completeness of community renewal exhibits significant hierarchical differentiation: supply–demand matching and conditions are favorable for basic services, elderly care and services for special groups, and cultural services; supply and demand for buildings, infrastructure, and public safety are balanced and moderately complete; environmental facilities exhibit oversupply and excessive completeness; and long-term management and resident participation suffer from insufficient supply and lack of completeness, emerging as core constraints. Based on these findings, targeted optimization strategies are proposed, which can provide scientific guidance for the development of comprehensive communities and the renewal of existing urban stock. Full article

COVID-19 has had profound global impacts, and Long COVID may continue to affect quality of life and well-being in some individuals. Young adults may be particularly vulnerable to these impacts due to ongoing physiological, behavioral, and psychological development. This study aimed to examine the associations between Long COVID, mental health-related outcomes, and quality of life among university students. A total of 365 Thai undergraduate students participated in this cross-sectional study screening for Long COVID. Long COVID symptoms, mental health, sleep quality, and quality of life were assessed using validated Thai versions of the Long COVID Screening Questionnaire, DASS-21, PSQI, and EQ-5D-5L. Regression and group comparison analyses were conducted between participants with Long COVID and those without Long COVID. Fatigue and cough were the most reported symptoms, while sleep disturbances were also prevalent. Long COVID was associated with significantly lower quality of life scores (p = 0.035). However, no significant differences were observed in DASS-21 or PSQI scores between groups. Vaccination doses and prior COVID-19 infections differed significantly between groups (p < 0.001 and p = 0.017). These findings highlight the multisystem impacts of Long COVID and emphasize the importance of identification and supportive interventions to enhance student health and well-being. Full article

Background/Objectives: Understanding nutrient intake and diet quality in older adults is essential for promoting healthy ageing and quality of life. The aim of the study was to assess dietary intake and nutritional status in two age groups of older adults in Croatia (65–74 years and ≥75 years). Methods: A total of 786 participants aged 65 and older were included in this cross-sectional study. Data from the National food consumption survey (OC/EFSA/DATA/2017/01), based on the EU Menu methodology, were used. Data collection included a general questionnaire, the International Physical Activity Questionnaire, two 24-h recalls or food diaries, and anthropometric measurements. The effects of body mass index and physical activity level on dietary intake were analysed using a general linear model. Results: 21.5% of older adults in Croatia had a normal weight, while 78.5% of were classified as overweight or obese. Significant differences were recorded in energy and macronutrient intake between the two age groups. Body mass index was significantly associated with energy (kcal/day), fat intake (g/day), and intake of the meat, poultry, fish and eggs food group in the 65–74 year age group. In the ≥75 year age group, physical activity level showed an effect on energy, carbohydrates, and milk and dairy product intake. Intake of nutrient-dense foods and fluids was below recommendations in both observed groups. Conclusions: The study results, based on a representative sample, provide the first overview of the nutritional status of older adults in Croatia. These findings offer a foundation for public health initiatives and further research on the nutritional status of the older population in Croatia. Full article

Background/Objectives: Duchenne muscular dystrophy (DMD) is a rare progressive neuromuscular disorder associated with increasing care demands. Despite the critical role of caregivers, their physical activity (PA) levels and health-related quality of life (HRQoL) have not been sufficiently investigated. This study aimed to compare PA levels and HRQoL between caregivers of children with DMD and caregivers of typically developing children. Methods: This cross-sectional observational study included 44 individuals: caregivers of children with DMD (n = 22) and caregivers of typically developing children (n = 22). The 36-Item Short-Form Health Survey (SF-36) was used for assessing HRQoL and the International Physical Activity Questionnaire—Short Form (IPAQ-SF) for determining PA levels. Results: IPAQ-SF-derived metabolic equivalent of task (MET) values and PA levels were similar between the groups (DMD caregivers: 1744.63 ± 1163.22, controls: 1945.09 ± 1042.12; p > 0.05). Caregivers of children with DMD demonstrated significantly poorer scores in several SF-36 domains, including vitality, social functioning, role limitations due to physical problems, bodily pain, and mental health (p < 0.05), with the largest difference observed in role limitations due to emotional problems (DMD caregivers: 45.27 ± 28.33, controls: 84.83 ± 24.63; p < 0.05). Physical functioning and general health perception scores were comparable (p > 0.05). Conclusions: Caregivers of children with DMD experience substantial impairments in multiple HRQoL domains, particularly those related to psychosocial well-being and pain, despite comparable PA levels and physical functioning. These findings suggest that reduced HRQoL is not directly explained by PA alone and highlight the need for multidisciplinary interventions targeting psychological health, pain management, and social well-being. Full article

Background/Objective: Kinesiophobia is a major fear-avoidance concept in chronic low back pain (CLBP); however, its independent contribution to pain, disability, and health-related quality of life (HRQoL) beyond sociodemographic and clinical variables remains unclear. This study aimed to evaluate the associations between kinesiophobia and patient-reported outcomes in adults with chronic low back pain regarding (i) pain intensity, (ii) functional disability, and (iii) HRQoL. Methods: This cross-sectional study included 298 participants with CLBP (average age 38.7 ± 13.2 years; 58.0% female). Kinesiophobia was evaluated using the Tampa Scale of Kinesiophobia (range, 17–68). Outcomes were pain intensity (Numerical Pain Rating Scale; 0–10), functional disability (Roland–Morris Disability Questionnaire; 0–24), and HRQoL (RAND-36; 0–100). Two multivariable linear regression models were used per outcome. Model 1 was adjusted for sex and age, and Model 2 was additionally adjusted for BMI, marital status, education, employment, smoking status, and chronic disease. Hierarchical regression analysis evaluated the incremental variance explained by kinesiophobia (ΔR²) when entered after all covariates. Effects were reported per 10-point increase in Tampa score, with 95% confidence intervals (CI). Results: In the fully adjusted models, higher kinesiophobia was associated with greater pain intensity (B = +1.17 points per 10 Tampa; 95% CI 0.55–1.79, p < 0.001), greater disability (B = +3.24 points; 95% CI 2.05–4.43; p < 0.001), and lower HRQoL (B = −7.98 points; 95% CI −11.1–−4.81; p < 0.001). Hierarchical regression analyses showed that kinesiophobia explained additional variance in pain (ΔR² = 0.11), disability (0.12), and HRQoL (0.11), all p < 0.001. Conclusions: In adults with CLBP, kinesiophobia was associated with greater pain intensity, functional disability, and lower HRQoL, accounting for 11–12% of variance in each outcome beyond demographic and clinical covariates. These findings support routine assessment of kinesiophobia and justify longitudinal and interventional studies to determine temporal relationships and treatment effects. Full article

Immune checkpoint inhibitors (ICIs) have substantially improved outcomes in advanced melanoma but are frequently linked to immune-related adverse events (irAEs). Vitiligo is a common cutaneous irAE and has been consistently associated with improved patient outcome, including prolonged progression-free and overall survival. It also represents significant visual stigma, particularly when the face is involved. Traditional treatment comprises topical steroids, calcineurin inhibitors, laser, and phototherapy which often have insufficient effects. Since 2023, the first approved drug for non-segmental vitiligo (NSV) with facial involvement, the topical Janus kinase inhibitor ruxolitinib, has been available. However, experience with its use in ICI-induced vitiligo remains limited. In this exploratory analysis, three patients who developed facial vitiligo following ICI therapy applied 1.5% ruxolitinib cream to affected facial areas twice daily. After six (two patients), and twelve months (one patient), extensive repigmentation was observed, quantified at 95.7%, 78.9%, and 99.1% using a novel semi-automatic tool. Quality-of-life questionnaires showed mean reductions of 57.6% (Vitiligo DLQI) and 68.2% (Vitiligo-specific Quality of Life) in disease burden. Treatment was associated with substantial repigmentation without observed side effects. Further evaluation in larger, prospective cohorts is warranted to better define treatment effects, clinical applicability, and long-term safety. Full article

Background/Objectives: Advanced age in Parkinson’s disease (PD) is linked to worse motor function, more severe symptoms, and impaired activities of daily living (ADLs). Lee Silverman Voice Treatment (LSVT)^® BIG may be suitable for older patients, as it can be adapted to individual abilities. This study evaluated whether age affects the effectiveness of LSVT^® BIG on gait speed, motor symptoms, ADLs, and quality of life (QoL) in PD. Methods: In this retrospective, single-center cohort study, 22 patients with PD were divided into an older group (≥65 years; n = 16) and a younger group (<65 years; n = 6). All participants completed 16 one-hour, face-to-face LSVT^® BIG sessions. Gait speed was assessed with the 10-m walk test; motor symptoms with Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III; ADLs with MDS-UPDRS Part II; and QoL with the Parkinson’s Disease Questionnaire-39 Summary Index. Two-way mixed-design analysis of variance with aligned rank transformation was used for statistical analysis. Results: Significant improvements were observed for all outcomes (gait speed, motor symptoms, ADLs, and QoL) after the intervention. A significant effect of age group was found for gait speed, with younger patients walking faster overall. No significant interaction between timepoint and group was observed for any measure. Conclusions: LSVT^® BIG appears to improve gait speed, motor symptoms, ADLs, and QoL in patients with PD, regardless of age, suggesting it is an effective intervention for both older and younger patients. Full article

Background/Objectives: Urinary incontinence (UI) is common among women and is often underreported and undertreated, partly due to limited health literacy and persistent misconceptions regarding its causes and management. Instruments that reliably assess knowledge about UI are important for identifying educational needs and evaluating the impact of educational interventions. Although the Incontinence Quiz (IQ) has been validated in other languages, no psychometrically tested French version was previously available. This study aimed to translate, culturally adapt, and evaluate the measurement properties of the French version of the Incontinence Quiz (IQ-Fr) in adult women, following internationally recommended procedures for cross-cultural adaptation. Methods: A methodological validation study with a two-sample design was conducted. An extended sample (n = 289) was used to examine internal consistency and convergent validity, while a validation subsample (n = 40) was used to assess divergent validity and reproducibility. The translation process included forward translation, synthesis, back-translation, expert committee review, and pretesting. The internal consistency of the IQ-Fr was assessed using Cronbach’s Alpha. The convergent validity of the IQ-Fr was assessed by both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The divergent validity of the IQ-Fr was evaluated by Pearson’s correlation IQ-Fr and Ditrovie quality-of-life scores. Finally, the reproducibility of the IQ-Fr was evaluated by Intraclass Correlation (ICC) between the IQ-Fr scores obtained at two different time points (T0 and T1) over a one-week interval. Results: The IQ-Fr showed acceptable internal consistency (Cronbach’s Alpha = 0.654) comparable to other translations/cultural adaptations made for the same instrument. The EFA and CFA suggest the same four-dimension structure (IQ-Fr) found in the original instrument (IQ), although the factorial model fit would benefit from the additional removal of item 6 from the questionnaire, as already suggested by the increase in the instrument’s Cronbach’s Alpha (from 0.646 to 0.659). The IQ-Fr also showed good divergent validity, as assessed by the absence of a statistically significant Pearson correlation between the scores of the IQ-Fr and the scores of a non-related construct—the Ditrovie scale (r_p = 0.097, p-value = 0.552). Lastly, the IQ-Fr showed good reproducibility, as demonstrated by the high ICC coefficient (ICC = 0.752) between the instrument’s overall scores at T0 and T1. Conclusions: The French version of the Incontinence Quiz (IQ-Fr) presents good indicators of internal consistency, convergent validity, divergent validity, and reproducibility for it to be used in research and educational contexts in French-speaking populations. Full article

Background: Cancer is a chronic disease with significant health impacts and is a leading cause of mortality worldwide. Cancer patients often require frequent hospital visits to manage their condition effectively. Therefore, understanding the factors that influence their ability to access healthcare services—such as age, gender, citizenship, region of residence, educational level, and income—is crucial, as these factors can impact continuity of care and overall quality of life. Purpose: This study aims to identify the factors determining cancer patients’ healthcare access and to propose alternative solutions that will enhance their ability to access services. Methods: This cross-sectional quantitative study utilized the health belief model for data analysis. Data were collected randomly through an online questionnaire targeting cancer patients across Saudi Arabia. Results: The findings indicated that payment method, distance to healthcare facilities, tumor type, and willingness to use virtual appointments were significantly associated with access to healthcare services. A total of 391 participants were included, the majority of whom were female (n = 291), aged 39 to 48 (n = 111), Saudi citizens (n = 376), residing in the Eastern region (n = 210), holding a bachelor’s degree (n = 193), and reporting no monthly income (n = 110). Conclusions: Access to healthcare services for cancer patients in Saudi Arabia is challenged by several factors, including payment methods, travel distance, cancer type, and the acceptance of health applications. Promoting digital health tools and virtual appointments can significantly improve access to care and facilitate ongoing management for cancer patients. Full article

Background: Autism spectrum disorder (ASD) is consistently associated with a high prevalence of sleep disturbances across the lifespan, with reported rates ranging from 60% to 86% depending on age and clinical characteristics. Although this issue has been widely described in the international literature, Spain currently lacks large-scale data to estimate the prevalence of sleep disturbances or to examine their relationship with factors such as age, intellectual disability, and co-occurring conditions. This study aims to estimate the prevalence and severity of sleep disturbances in individuals with autism spectrum disorder in Spain and to examine their associations with developmental stage, intellectual disability, affective symptoms, and contextual factors. Methods: This is a cross-sectional observational survey with nationwide dissemination approved by the Ethics Committee of the Universidad Católica San Antonio de Murcia. Data will be collected through an online survey (SurveyMonkey) including validated instruments: the Children’s Sleep Habits Questionnaire–Autism (CSHQ-Autism) and the Sleep Disturbance Scale for Children (SDSC) for pediatric participants; the Pittsburgh Sleep Quality Index (PSQI) for adolescents and adults without intellectual disability; and the Diagnostic Assessment for the Severely Handicapped–II (DASH-II) for adults with intellectual disability. Anxiety and depressive symptoms will be assessed using the Child Behavior Checklist (CBCL) in children and adolescents and the Hospital Anxiety and Depression Scale (HADS) and DASH-II. Statistical analyses will be conducted using SPSS v22 by applying parametric or non-parametric tests according to data distribution. Conclusions: This study represents one of the first survey protocols with nationwide dissemination designed to assess sleep disturbances in individuals with ASD in Spain. The resulting findings are expected to help identify vulnerability profiles, inform public health strategies, and support the development of multidisciplinary interventions aimed at improving sleep and, consequently, the quality of life of individuals with autism and their families. Full article

Background/Objectives: Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by intestinal and extraintestinal symptoms triggered by gluten ingestion. Although anti-gliadin IgG antibody (AGA IgG) has been proposed as a potential biomarker for NCGS, its sensitivity and specificity in real-world clinical settings remain unclear. This study aimed to evaluate the clinical utility of AGA IgG in NCGS and to characterize its clinical features, including psychological distress and physical quality of life (QOL), in patients with clinically suspected NCGS attending a specialized outpatient unit in Japan, where patients reported symptoms related to the ingestion of gluten-containing grains (primarily wheat). Methods: We evaluated plasma AGA IgG levels in 45 patients with suspected NCGS based on clinical presentation and in 83 age- and sex-matched healthy controls. Plasma AGA IgG was measured using ELISA. Clinical symptoms and QOL were assessed using validated scales, including the 36-Item Short Form Health Survey (SF-36), Patient Health Questionnaire (PHQ-9 and PHQ-15), Generalized Anxiety Disorder-7 (GAD-7), and the Japanese version of the Irritable Bowel Syndrome Quality of Life measure (IBS-QOL-J). Results: The AGA IgG positivity rate was significantly higher in the suspected NCGS group (33.3%) than in the control group (13.3%; p < 0.01). Using clinical suspicion as the reference, the sensitivity and specificity of AGA IgG were 33.3% and 86.7%, respectively. Patients with suspected NCGS exhibited significantly lower physical and mental QOL and higher scores for depressive, anxiety, and somatic symptoms compared to controls. No significant clinical differences were found between AGA IgG-positive and IgG-negative individuals within the suspected NCGS group. Conclusions: AGA IgG demonstrated a specificity of 86.7% and a sensitivity of 33.3% for suspected NCGS, indicating its limited utility as a standalone biomarker. These findings suggest that suspected NCGS involves significant somatic and psychological burdens regardless of serological status. Future studies should explore whether a multi-marker panel could improve the identification of “True NCGS” in diverse clinical populations. Full article

Background: Chronic obstructive pulmonary disease (COPD) is associated with systemic alterations in body composition, including muscle mass loss and fat redistribution, which may influence patient-reported outcomes. However, the independent contribution of bioimpedance-derived parameters, particularly phase angle, to quality of life (QoL) remains unclear. Methods: This exploratory pilot study included 75 clinically stable patients with moderate-to-severe COPD (GOLD stages II–III). Body composition was assessed using segmental multi-frequency bioelectrical impedance analysis with the InBody 770 system. Evaluated parameters included fat-free mass (FFM), skeletal muscle mass (SMM), percent body fat (PBF), visceral fat area (VFA), extracellular water-to-total body water ratio (ECW/TBW), bone mineral content (BMC), and phase angle (PhA). Quality of life was assessed using the WHOQOL-BREF questionnaire. Associations between body composition parameters and QoL domains were analyzed using Spearman correlation analysis and multivariable linear regression models. Results: Despite a median body mass index (BMI) within the normal range (23.4 kg/m²), body fat mass exceeded reference values in both men and women. Fat-free mass and skeletal muscle mass were located near the lower range of expected values. Correlation analysis demonstrated predominantly weak associations between body composition parameters and QoL domains. Significant positive correlations were identified between the psychological QoL domain and fat-free mass (ρ = 0.238, p = 0.041), skeletal muscle mass (ρ = 0.240, p = 0.040), basal metabolic rate (ρ = 0.236, p = 0.043), and bone mineral content (ρ = 0.249, p = 0.033). In multivariable regression models, fat-free mass and skeletal muscle mass demonstrated consistent positive associations with both physical and psychological QoL domains. Whole-body and segmental phase angle parameters did not demonstrate significant associations with QoL outcomes. Conclusions: In patients with COPD, BMI alone may inadequately reflect underlying alterations in body composition. Muscle-related parameters, particularly fat-free mass and skeletal muscle mass, demonstrated more consistent associations with physical and psychological aspects of quality of life than obesity-related indicators. These findings suggest that bioelectrical impedance analysis may provide additional clinically relevant information beyond BMI when assessing body composition and quality of life in patients with COPD. Full article

Background: technology can significantly improve quality of life for individuals with motor and cognitive disabilities, especially during the transition from rehabilitation to home. However, the success of assistive solutions depends on understanding patients’ functional status, needs, and attitudes toward technology. Methods: we investigated these factors using a multimodal assessment protocol, including the USASS questionnaire and ADL/IADL scales, among 69 participants admitted to intensive neuromotor rehabilitation, most of whom had caregivers (83.6%). Participants were grouped into three sample-derived ordinal categories (Low, Medium, High) based on ADL/IADL scores and age. Results: functional autonomy strongly predicts technology adoption and perceived benefits, surpassing age as a determinant. Individuals in the group with higher sample-derived functional levels reported greater independence in technology use and higher Quality Tech Impact scores. Correlation analysis confirmed moderate-to-strong positive associations between ADL/IADL scores and Quality of Life Index, with the strongest association observed for IADL (ρ = 0.703, 95% CI: 0.559–0.806, p < 0.001). These findings suggest that interventions should prioritise improving functional skills rather than focusing solely on age-related factors to enhance technology adoption and its positive impact. A proactive attitude toward technology is essential to avoid ineffective investments in assistive solutions. Ultimately, functional autonomy emerges as an important contributor of both technological engagement and overall well-being. Full article