ABSTRACT
BACKGROUND: No study has examined the impact of vitiligo support group membership on vitiligo patient quality of life (QoL).
OBJECTIVE: We sought to examine the QoL impact of vitiligo support groups by comparing QoL and associated patient characteristics between vitiligo patients who are and are not members of a vitiligo support group.
METHODS: Members of a Henry Ford Hospital-sponsored, Southeast Michigan Vitiligo Support Group were compared to non-member vitiligo patients recruited from a previous study cohort.17 Eligible patients were asked to complete the Dermatology Life Quality Index (DLQI) and a study-specific questionnaire designed to collect relevant patient characteristics.
RESULTS: The mean DLQI scores for the support group members and non-members were similar (7.1 ± 5.4 and 6.0 ± 6.5, respectively; P-value 0.2), despite the support group members reporting more severe overall disease and increased disease severity in exposed portions of the body. The African-American: Caucasian ratio and the prevalence of unemployment were both significantly higher among the support group participants. LIMITATIONS: Small sample size may have limited the study's ability to demonstrate the differences between the support group participants and the controls.
CONCLUSIONS: The similar QoL despite an increased prevalence of poorer QoL indicators among the support group participants suggests a protective effect of support group membership.
J Drugs Dermatol. 2017;16(4):344-350.
.Subject(s)
Quality of Life , Self-Help Groups , Vitiligo/psychology , Adult , Aged , Case-Control Studies , Female , Humans , Male , Middle Aged , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
PURPOSE: To design and validate a survey instrument that measures vision-related functional status, which is appropriate for self-administration in a clinical practice and mail survey setting. DESIGN: Observational, validation study in sequential patients. METHODS: A prototype visual function instrument (the Cataract TyPE Spec) was developed based on focus group input and then validated in an outcomes study conducted among 1,823 patients who underwent cataract extraction performed by 22 surgeons at six centers in the United States. Reliability was determined by calculating Cronbach alpha for different types of administration (self-administration at the site of care and mailed survey) and across race and gender. Criterion validity was determined by correlating scores on the TyPE Spec with baseline measures and changes in visual acuity, overall rating of vision, and general quality of life. RESULTS: The instrument was internally valid (Chronbach alpha = 0.94), both on self-administration in the patient care setting and upon mailed survey administration and across patient race and gender. The TyPE Spec score was highly correlated with overall rating of vision (r =.54, P <.0001) and moderately correlated with Snellen acuity (r =.32, P <.0001), rating of vision in the better eye (r =.42, P <.0001), and quality of life, as measured by the physical component summary score of the SF-36 (r =.27, P <.001). Change in TyPE Spec similarly correlated with change in rating of vision overall, change in best-corrected Snellen acuity, and change in rating of vision in the operated eye. CONCLUSIONS: The cataract TyPE Spec instrument was found to be equally valid and internally consistent when administered in the patient care setting and by mail survey.
Subject(s)
Cataract Extraction/standards , Health Surveys , Ophthalmology/instrumentation , Outcome Assessment, Health Care , Quality of Health Care/standards , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Quality of Life , Reproducibility of ResultsABSTRACT
BACKGROUND: Congestive heart failure is the leading cause of hospital admissions for adults in the United States. To our knowledge, there are limited data comparing the clinical presentation, hospital length of stay, and readmission in patients with preserved and decreased left ventricular (LV) systolic function. HYPOTHESIS: The goal of the study was to determine whether there are differences in clinical presentation, hospital length of stay, and readmission in patients with preserved (> or = 50%) and reduced (< 50%) systolic function. METHODS: We prospectively evaluated 187 patients admitted with congestive heart failure confirmed by the presence of pulmonary vascular congestion on chest x-ray, and with recent (< 6 months) documentation of LV systolic function by two-dimensional echocardiography. History and physical examination findings, patient demographics, comorbidities, discharge medications, and length of hospital stay data were documented. Readmission rate over a 6-month follow-up period was also documented. RESULTS: Of the 187 patients, 130 (70%) patients had an ejection fraction (EF) <50%, and 57 (30%) patients had an EF > or = 50%. Patients with EF < 50% were more likely to be men (54 vs. 37%, p = 0.03). African Americans (79 vs. 60%, p = 0.007), had a higher prevalence of previous stroke (17 vs. 5%, p = 0.03), and were more likely to carry no medical insurance at the time of admission (14 vs. 2%, p = 0.01) and to be discharged on digoxin (60 vs.30%, p<0.001). There were no significant differences in symptoms (exertional dyspnea, rest dyspnea, orthopnea, or paroxysmal nocturnal dyspnea), or in physical examination findings (S3, S4, elevated jugular venous pressure, rales, or peripheral edema). According to chest x-ray, patients with EF <50% had more frequent cardiomegaly (88 vs. 72% p = 0.008), but there were no differences in the presence of pleural effusion or pulmonary vascular congestion (p = NS). The mean length of stay was 5.9 and 5.2 days, respectively (p = 0.34). During the 6-month follow-up period, the readmission rates were 33% (43 patients) and 26% (15 patients), respectively (p = 0.36). CONCLUSION: The clinical presentation, hospital length of stay, and readmission rate for congestive heart failure are similar in patients with preserved and decreased LV systolic function.
