Feature of “qi, Blood, Fluid” Factors in Patients with Sjögrenʼs Syndrome : In Comparison with Patients of Rheumatoid Arthritis in Remission / 日本東洋医学雑誌

To determine the body constituents patterns comprised of “qi, blood, fluid” factors associated with oral health-­related QOL (OHRQOL) of patients with Sjögren's syndrome (SS), 41 SS patients and 32 RA patients in remission were enrolled. The body constituents patterns were measured by using Terasawa's “qi, blood, fluid” score, and the simple version of yin deficiency questionnaire (yin-­deficiency score). OHRQOL were evaluated using the oral health impact profile (OHIP-­14). In the first study, the body constituents pattern scores were compared between SS group and RA (in remission) group, using the univariate and multivariate analysis. In the second study, the association between OHIP­14 and the body constituents pattern scores was analyzed. In the first study, all the scores were significantly higher in SS group, and the multivariable logistic regression identified yin deficiency (p = 0.02) and blood stasis (p = 0.01) as the significantly associated factors with SS group. In the second study, all the scores, except for the blood stasis pattern, showed positive correlation with OHIP-­14. The multiple regression analysis identified qi stagnation (p = 0.003) as the significantly associated factors with OHIP­-14. This study revealed that yin deficiency and blood stasis are the significant body constituent patterns in SS patients. In the low OHRQOL cases, qi stagnation should be taken into consideration.

Reference Data, Characteristics and Related Factors of Quality of Life Assessed by a Questionnaire of Patient’s Behavior Survey in the General Population in Japan

To decide the policy to promote palliative care properly, a new questionnaire has been added to Patient’s behavior survey to assess Quality of Life (QOL) of inpatients and outpatients in Japan. The aim of this study was to survey QOL score of general population in Japan by using a questionnaire of patient’s behavior survey. A large nationwide postal survey was conducted from January through February 2013 in Japan. A total of 2400 subjects were selected randomly from among members of the general population who were 20 to 79 years of age and lived in Japan. A total of 978 (41.1%) questionnaires were analyzed, and reference data of QOL score weighted by the national standard value of sex-age group population were calculated. Correlation coefficients were calculated between QOL score and SF-8TM, Patient Health Questionnaire-9 (PHQ-9), Eastern Cooperative Oncology Group Performance Status (ECOG), Memorial Symptom Assessment Scale (MSAS) score. In addition, sociodemographic factors related to QOL score were evaluated. From the perspectives of public health and administrative policy, the results of this survey will provide important basic data to evaluate patient’s behavior survey broadly and continuously with the goal of establishing a palliative care system in Japan.

Difference in Spinal Sagittal Alignment and Health-Related Quality of Life between Males and Females with Cervical Deformity

STUDY DESIGN: Large cohort study. PURPOSE: To clarify spinal sagittal alignment and health-related quality of life (HRQOL) according to sex in volunteers aged >50 years with cervical deformity (CD). OVERVIEW OF LITERATURE: Adult spinal deformities, especially those associated with lumbosacral lesions, are more frequent in females; however, CD is observed to a greater extent in males. METHODS: We divided 656 volunteers (263 males, 393 females; age, 50–89 years [mean, 73 years]) as follows: males with CD (CDM; 82 patients); males without CD (NCDM, 181); females with CD (CDF, 36); and females without CD (NCDF, 357). CD was defined as C2–7 sagittal vertical axis (SVA) ≥40 mm. We measured pelvic tilt (PT), pelvic incidence minus lumbar lordosis (PI−LL), thoracic kyphosis, T1 slope, cervical lordosis, C7 SVA, and C2–7 SVA. HRQOL was evaluated using EuroQOL five dimensions questionnaire (EQ-5D). RESULTS: In CDM, NCDM, CDF, and NCDF groups, the respective parameters were as follows: PT: 15°, 14°, 26°, and 21°; PI−LL: 7°, 5°, 16°, and 10°; C2–7 SVA: 49, 24, 46, and 20 mm; C7 SVA: 61, 40, 75, and 47 mm; and EQ-5D: 0.82, 0.88, 0.78, and 0.81. PT and PI−LL were significantly greater in the CDF group than in the NCDF group (p < 0.05) but were not significantly different between CDM and NCDM groups. The CDF group already showed deterioration of spinopelvic alignment, although it was maintained in the CDM group. EQ-5D in showed significantly greater deterioration the CDM group than in the NCDM group; deterioration of lumbopelvic parameters had less influence in males (p < 0.05). CONCLUSIONS: Sagittal spinal deformity may have different mechanisms in males and females. The deterioration of spinal sagittal alignment in males may originate from the cervical spine, and CD may be associated with HRQOL.

Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis

The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

Factors Related to the Improvement of Quality of Life at 6 Months after Discharge for Myocardial Infarction Patients Treated with Percutaneous Coronary Intervention / Journal of Rural Medicine

<b>Objective:</b> The purpose of this study was to evaluate the relationship between improvement of health-related quality of life (QOL) and participation in self-care activities and coronary risk factor management at 6 months after discharge for acute myocardial infarction (AMI) patients treated with percutaneous coronary intervention (PCI).<br><b>Methods:</b> A total of 118 patients were asked to complete the MOS 36-Item Short-Form Health Survey (SF-36) questionnaire at discharge and 6 months after discharge. The SF-36 consists of eight subscales: Physical Functioning (PF), Role Physical (RP), Bodily Pain (BP), General Health Perception (GH), Vitality (VT), Social Functioning (SF), Role Emotional (RE) and Mental Health (MH). We examined self-care activities and coronary risk factor management and related factors from SF-36 scores to measure quality of life (QOL) at discharge and 6 months after discharge.<br><b>Results:</b> The PF and BP scores at 6 months after discharge were significantly higher than those at discharge. Increasing PF and BP scores indicated improvement in ability to perform physical activities and absence of intense bodily pain that would interfere with activities of daily living or work. Improvement of PF in AMI patients treated with PCI was related to performing exercise after discharge and absence of diabetes mellitus. However, there were no related factors for BP.<br><b>Conclusion:</b> Our results indicated that exercise, as a self-care activity after discharge, for AMI patients treated with PCI may be related to the improvement of QOL.

Generic health-related quality of life in patients with bronchial asthma / 천식및알레르기

BACKGROUND AND OBJECTIVE: It is recommend that health-related quality of life (HRQL) should be measured as well as conventional clinical indices in order to obtain a complete picture of a patient's health status. In patients with bronchial asthma, frequent symptoms and management related burdens may result in reduced HRQL. In Korea, asthma-specific quality of life (QOL) questionnaire has been developed and broadly applied in clinical practice. But little is known about the impact of asthma on generic HRQL. In this study, we evaluated the generic HRQL in adult asthmatic patients by using the Nottingham Health Profile (NHP). METHODS: Two-hundred three subjects with age over 40 years were enrolled in this study; 77 hospital out-patients with asthma, 63 with stable ischemic heart disease (IHD), 26 hospitalized patients with unstable IHD such as unstable angina or acute myocardial infarct (MI), and 37 healthy controls. All subjects were asked to answer the NHP by self-administration method. The NHP was composed of two parts. Part I consisted of 38 items in six domains and part II 7 items. Six domains of part I were physical mobility (8 items), pain (8 items), social isolation (5 items), emotional reaction (9 items), energy level (3 items) and sleep (5 items). RESULTS: Although patients with unstable IHD had most significant problems in all area of the NHP part I and II, bronchial asthmatics had similar or more restriction to patients with stable IHD. Patients with asthma also had significantly more problems of generic HRQL than healthy controls. Patients with more severe asthma suffered from more pain and loss of energy than mild asthmatics. In similar severity of asthma, patients with lower economic state had more restriction, especially in pain and emotional reaction. Patients with asthma experienced difficulties with daily activities in the NHP part II in order of holidays, work, home relationships, homework, hobbies, social life, sex life, and had more problems with their home work and home relationships than patients with stable IHD. CONCLUSION: Patients with bronchial asthma had similar or more restriction to patients with stable IHD in generic HRQL. To improve outcome measurement of asthma treatment, generic HRQL should be measured as well as asthma-specific QOL and clinical indices.

A Study of the Reliability of Health State Valuations in the Japanese EuroQol Instrument

Objective: Although the Japanese EuroQol instrument was developed in 1998 by a Japanese translation team, the reliability of health state valuations of the fuller questionnaire has not yet been investigated in Japan. We carried out a pilot study to investigate the reliability of health state valuations of the Japanese EuroQol instrument. Methods: The survey was conducted twice with the fuller questionnaire of the Japanese EuroQol instrument in a class of preventive medicine. We analyzed test-retest reliability based on the health state valuations and calculated Cronbach’s coefficient alpha of both tests. Results and Conclusions: The mean valuations of 14 hypothetical health states and ‘death’ between test and retest were not significantly different by paired t-test. The reliability by calculated correlation between test and retest was 0.996 (p<0.0001). In addition, Cronbach’s coefficient alpha of the first test was 0.827, and that of the second test was 0.865. Although good reliability was shown in the present study, our conclusion was limited to applications of population-based surveys because of the small number and limited subjects of the present study. Further investigations are required in the form of a population-based survey.