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Resumen: Introducción: la artropatía de Charcot es una condición incapacitante, no infecciosa, progresiva, que se caracteriza por destrucción ósea y articular en pacientes con neuropatía sensorial. En casos avanzados, en los que se tiene deformidad severa e inestabilidad de tobillo, se requieren procedimientos más invasivos como la artrodesis de tobillo con clavo centromedular retrógrado bloqueado. Se desconoce si en estos pacientes las puntuaciones de la valoración funcional postquirúrgica con la escala de AOFAS (American Orthopaedic Foot and Ankle Society) correlaciona con las puntuaciones de la escala de calidad de vida medida con el test EuroQol-5D y las posibles complicaciones postquirúrgicas. Material y métodos: se trata de un ensayo autocontrolado de práctica clínica habitual, cuasiexperimental, longitudinal y prospectivo con recolección ambispectiva (retrospectiva y prospectiva) de datos para evaluar los resultados funcionales y de calidad de vida a un año de seguimiento de los pacientes con artropatía de Charcot tratados mediante artrodesis de tobillo con clavo centromedular retrógrado bloqueado del 1 de Enero de 2010 al 1 de Noviembre de 2018. Resultados: la consolidación se logró en nueve casos de un total de 11 pacientes para una tasa de éxitos de 81.8% y únicamente dos casos (18.2%) en los cuales no se observó consolidación. Las escalas de AOFAS y EuroQol-5D se correlacionaron positivamente de acuerdo con la correlación de Pearson. Conclusiones: las escalas de AOFAS y EuroQol-5D se correlacionan positivamente, obteniéndose 45 y 63% con resultados aceptables y satisfactorios respectivamente en ambas escalas.
Abstract: Introduction: Charcot's arthropathy is a disabling non-infectious, progressive condition characterized by bony and articular destruction in patients with sensory neuropathy. In advanced cases with deformities and ankle instability, it requires a more invasive treatment as an ankle fusion with a retrograde locked intramedullary nail. It is unknown if, in these patients, the functional results of AOFAS (American Orthopaedic Foot and Ankle Society) correlate with the quality of life ones from the EuroQol-5D test and the possible postoperative complications. Material and methods: the design is experimental, longitudinal prospective with ambispective data analysis (retrospective and prospective) to evaluate the functional results and life quality with a year of following patients with Charcot's arthropathy diagnosis treated with a retrograde locked nail from January 1, 2010, to November 1, 2018. Results: this study resulted in complete consolidation from nine out of 11 cases, with a success rate of 81.2%, and only two cases (18.2%) developed nonunion. AOFAS and EuroQol-5D tests correlate positively in agreement with the Pearson correlation. Conclusions: AOFAS and EuroQol-5D correlate positively, having a 45 and 63% of acceptable and satisfactory results, respectively, for both tests.
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Objetivo. Evaluar la calidad de vida relacionada con la salud (CVRS) en pacientes con amputación, independientemente de la causa; así mismo, evaluar las relaciones familiares a partir de sus percepciones. Metodología. Se realizó un estudio descriptivo, transversal, en pacientes amputados que acudieron para tratamiento rehabilitador al área de salud del Policlínico Docente Universitario del Cerro (La Habana, Cuba). El grupo de estudio estuvo conformado por 26 pacientes, observados entre marzo de 2017 y enero de 2020, quienes cumplieron los criterios de inclusión. Resultados. La mayoría de los amputados fueron hombres entre 55 y 65 años, con una edad media de 57 años. Predominaron los pacientes que tenían condiciones materiales de vida deficientes, con el 80,7 % entre regular y mala, según las cinco dimensiones del test EuroQol5D distribuidas por frecuencia. Predominaron los pacientes que estaban en el nivel 2 con problemas ocasionales o moderados. El mayor porcentaje de los pacientes con problemas en la esfera psicológica pertenecían a familias disfuncionales; así mismo, aquellos pacientes con un nivel medio de movilidad y desarrollo de algunas actividades cotidianas pertenecían a familias funcionales o moderadamente funcionales. Conclusiones. Se hallaron de pocos a moderados problemas en las cinco dimensiones de la calidad de vida evaluadas. El funcionamiento familiar ciertamente contribuyó a la percepción del estado de salud, el cual exhibió puntajes de 50 y más en la mayoría de los casos, con un mejoramiento de la calidad de vida de estos pacientes
Objective. To evaluate the health-related quality of life (HRQOL) in patients with amputation, regardless of the cause; likewise, to evaluate family relationships based on their perceptions. Methodology. A descriptive, cross-sectional study was carried out in amputee patients who came for rehabilitation treatment to the health area of the Policlínico Docente Universitario del Cerro (Havana, Cuba). The study group consisted of 26 patients, observed between March 2017 and January 2020, who met the inclusion criteria. Results. Most of the amputees were men between 55 and 65 years of age, with a mean age of 57 years. Patients with poor material living conditions predominated, with 80.7 % between fair and poor, according to the five dimensions of the EuroQol-5D test distributed by frequency. Patients in level 2 with occasional or moderate problems predominated. The highest percentage of patients with problems in the psychological sphere belonged to dysfunctional families; likewise, those patients with an average level of mobility and development of some daily activities belonged to functional or moderately functional families. Conclusions. Few to moderate problems were found in the five dimensions of quality of life assessed. Family functioning certainly contributed to the perception of health status, which exhibited scores of 50 and above in most cases, with an improvement in the quality of life of these patients.
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Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: This study aimed to analyze effects of postpartum care services to women after birth, identify the factors affecting their use, and examine the extent of income-related inequality in the postpartum care services utilization and expenditures using Korean Health Panel data between 2010 and 2013. METHODS: The panel data of the year 2010–2013 of the 247 women after birth were used. First, EuroQoL-5D was used to evaluate the effects of postpartum care service to women's quality of life. Second, multinominal logistic regression analysis was used to identify determinants of the use of the postpartum care services. Finally, concentration index and HIwv (horizontal equity) index were used to find that the concentration index for the inequality in the use of postpartum care services showed negative sign, which implied pro-rich. RESULTS: The estimation results showed that utilization of the postpartum services has a positive effect on women after birth. Also age, area of residence, and number of household members turn out to be the factors of using postpartum services. And there are inequality in the use of postpartum care services whose HIwv index showed positive sign, which implied pro-rich. CONCLUSION: Therefore, the government's policy of the postpartum care service is necessary to be expanded and diversified considering the personal characteristics and equity of the women after birth.
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Feminino , Humanos , Características da Família , Gastos em Saúde , Modelos Logísticos , Parto , Cuidado Pós-Natal , Período Pós-Parto , Qualidade de Vida , Fatores SocioeconômicosRESUMO
PURPOSE: To analyze the association of visual efficiency and quality of life using data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V). METHODS: The present study included 5,244 glaucoma or glaucoma suspect subjects who completed a visual acuity test, visual field test and health-related questionnaire from the KNHANES V. Visual efficiency was calculated using best corrected visual acuity and visual field test. Quality of life was assessed with EuroQoL 5D (EQ-5D). Visual efficiency was compared with best corrected vision of the better eye to evaluate the relationship with quality of life. One-way analysis of variance (ANOVA) and partial correlations analysis were used to analyze the associations between factors. RESULTS: Both visual efficiency and best corrected visual acuity of the better eye were significantly different with all EQ-5D parameters (p < 0.005). After controlling for age, gender, income, education, spouse and house ownership, visual efficiency showed a positive correlation coefficient of +0.040 (p = 0.006) with the quality of life and the best corrected visual acuity of the better eye showed negative correlation coefficient of -0.044 (p = 0.002) with the quality of life. CONCLUSIONS: Visual efficiency was associated with the quality of life. Not only visual acuity but also visual efficiency would be a valuable parameter when considering the quality of life. Further studies are needed to evaluate non-glaucomatous populations.
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Humanos , Educação , Glaucoma , Coreia (Geográfico) , Inquéritos Nutricionais , Propriedade , Qualidade de Vida , Cônjuges , Acuidade Visual , Testes de Campo VisualRESUMO
Objective To assess the quality of life (QoL) of rural elderly persons using the health-related dimensions of the EuroQol-5 (EQ-5D) scale to analyze the scale's reliability and validity.Methods A total of 2575 elderly residents of Tongchun rural community in Kaihua county,Zhejiang Province,were surveyed using the instrument EQ-5D,and the visual analogue scale of EQ.They included 1027 with and 1548 without chronic disease.Results The mean total EQ-5D score was 6.49 ± 1.94 for the chronic disease group and 5.15 ± 0.44 for the healthy group.The corresponding average visual analogue scale (VAS) scores were 78.15 ± 17.26 and 91.47 ± 4.37,showing significant differences.About 75％ of the elderly respondents reported no difficulties in their living.There was strong correlation between the EQ-VAS scores and the scores on all the EQ-5D scale dimensions.Conclusion The health-related quality of life reported by the rural elderly using this scale seems quite good.The EQ-5D scale,with the EQ-VAS scale as a part of it,is one useful and effective tool for evaluating the health-related quality of life of the elderly in rural areas.
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PURPOSE: To evaluate the health-related quality of life (QOL) in Koreans according to visual acuity. METHODS: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. The present study included 11,022 Koreans who completed the KNHANES IV. The relation of visual acuity and QOL was verified, and EuroQoL 5D (EQ-5D) was identified using the adjusted mean based on linear regression analysis. RESULTS: As visual acuity decreased, QOL decreased. QOL in mobility, usual activities, and pain/discomfort were affected by the vision gradient, while self-care and anxiety/depression were less influenced by the vision gradient. In particular, QOL in usual activities was significantly affected by the visual gradient. Subjects with a visual acuity of 1.6-3.0 were less likely to have a low QOL in usual activities compared to subjects with a visual acuity of 0.0-0.5 as a reference group (adjusted Odds Ratio = 23.6, 95% CI, 4.8-115.5). QOL in usual activities was statistically low in subjects older than 65 years of age, with low household monthly income, low education, and living without a spouse. CONCLUSIONS: As visual acuity decreased, QOL in the aspect of mobility, usual activities, and pain/discomfort decreased severely, which resulted from activity limitation. Considering that the risk group with increasing age, low income, low education, and living without a spouse had lower QOL, the most important is to increase activity, which can induce the improvement of QOL in Koreans who have low visual acuity and related risk factors is.
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Humanos , Educação , Características da Família , Coreia (Geográfico) , Modelos Lineares , Inquéritos Nutricionais , Razão de Chances , Qualidade de Vida , Fatores de Risco , Autocuidado , Cônjuges , Acuidade VisualRESUMO
La enfermedad de Parkinson (EP) es un trastorno neurológico, discapacitante y progresivo caracterizado por múltiples síntomas motores y no motores que contribuyen al deterioro en la calidad de vida del paciente. La diversidad de síntomas asociados a la enfermedad y su manejo afectan a la funcionalidad y las expectativas del individuo sobre su bienestar físico, social y mental, que son los componentes fundamentales de la calidad de vida relacionada con la salud (CVRS). El objetivo del presente trabajo fue identificar las principales dimensiones de la CVRS afectadas en una población con EP con un grado de afectación leve-moderado. Treinta y seis pacientes con EP completaron este estudio transversal. Se emplearon el estadio de Hoehn y Yarh, el Unified Parkinson's Disease Rate Scale, la escala de actividades de la vida diaria de Schwab y England y el Test Get Up & Go. La calidad de vida fue valorada con el EuroQoL-5D y con el cuestionario Parkinson's Disease Questionnaire-39 items. Las dimensiones del PDQ-39, excepto el dominio PDQ-39 Dolor, así como el cuestionario EuroQoL-5D se correlacionaron de manera significativa con la gravedad de la enfermedad. La CVRS se correlacionó con el estado funcional de los pacientes. Únicamente el dominio PDQ-39 Dolor se correlacionó con el riesgo de caídas. Nuestros resultados sugieren que la CVRS de los pacientes con EP, en un estado leve-moderado de afectación, está muy influenciada por la gravedad de la enfermedad y el estado funcional.
Parkinson's disease is a disabling and progressive neurological condition characterized by multiple motor and non motor symptoms that contribute to deterioration in quality of life. The diversity of symptoms associated with the disease and its management affect the patients on their physical, social and mental quality of life. The aim of this study was to identify key dimensions of health related quality of life (HRQOL) in a population affected with Parkinson's disease with a degree of mild-moderate impairment. Thirty six patients with Parkinson were recruited. The Hoehn and Yarh scale, the Unified Parkinson's Disease Rate Scale, the scale of activities of daily life and Schwab & England Get Up & Go Test were applied. HRQOL was assessed with the EuroQol-5D and the specific questionnaire Parkinson's Disease Questionnaire-39 items. The dimensions of the PDQ-39, except the PDQ-39 Pain domain and the EuroQol-5D correlated significantly with the severity of the disease. HRQOL was correlated with the functional status of patients. Only the PDQ-39 pain domain correlated with the risk of falls. Our results suggest that the HRQOL of patients with PD, in a state of mild-moderate impairment, is strongly influenced by disease severity and functional status.