The impact of multifactorial factors on the Quality of Life of Behçet's patients over 10 years.

Objective: This study analyses the 2020 survey and reviews the 2009, 2014 surveys to ascertain which Behçet's symptoms, personal and family status, patients' lifestyle, and work-related outcomes impacted on Health-Related Quality of Life (HRQoL). Methods: Four hundred and fifty-nine Behçet's patients submitted an online survey/questionnaire. Patients provided information on socio-demographic characteristics, disease duration, historical and current symptoms, systemic and topical medication, health related lifestyle, work-related outcomes regarding employment status and claiming benefits and Quality of Life (QoL) measured by EQ-5D index. Results: Four hundred and nineteen patients met the inclusion criteria, and 371 who had full data (Males: Females: Others = 84:285:2, mean-age = 41.1 ± 23.3:38 ± 13.2:40 ± 5). The main symptoms associated with patients seeking medical care were mouth ulcers 30% and genital ulcers 23%, joint 14%, and eye problems 9%. The EQ-5D index for 2009, 2014, 2020 was (mean ± SD); 0.47 ± 0.38, 0.42 ± 0.37, 0.34 ± 0.40, respectively, p < 0.05. 2020 patients had the worst values of the five domains compared to 2014 and 2009. Interestingly, mobility value was the same over the 10 years of monitoring patients. Behçet's syndrome (BS) symptoms that had significant negative impact on QoL were; 2009 (arthropathy, neurological problems, pathergy reaction, and stomach/bowel symptoms), 2014 (arthropathy, headache, neurological problems, pathergy reaction, and skin lesions), 2020 (arthropathy, neurological problems, and stomach/bowel symptoms). The 2014 and 2020 surveys reported the QoL is significantly better in patients on immunosuppressant, who did sport, continued in employment and not receiving benefits. Conclusion: Joints and neurological symptoms are the main symptoms which had negative impact on BS patients over the 10 years, sociodemographic (gender, age, marital, and education status), lifestyle (medication, cannabis, drinking wine, and regular exercise), employment status (employee and no career change), and accessing benefits (never claim benefit) had significant influence on patients' HRQoL.

Behçet's syndrome and health-related quality of life: influence of symptoms, lifestyle and employment status.

OBJECTIVES: Behçet's syndrome (BS) is a chronic multisystemic disorder. The complex pattern of BS symptoms can effect negatively on patients' quality of life. The aim of this study is to evaluate the influence of BS symptoms, oral health related lifestyles and employment status on Health Related Quality of Life (HRQoL). METHODS: A questionnaire was mailed to a cohort of 641 adult members of the Behçet's Syndrome Society (BSS) and patients attending a Behçet's syndrome centre in the UK. Respondents gave information on socio-demographic characteristics, disease duration, current symptoms, symptom control, health related lifestyle, diet, smoking and alcohol, employment status and quality of life (the EQ-5D index). RESULTS: 315 out of 426 BS participants (Males: Females=136:179) were recruited. BS symptoms and EQ-5D score model (R=0.67 and R2=0.45) and standardised coefficients for symptoms were; arthropathy (-0.336), headache (-0.227), neurological problems (-0.135), pathergy reaction (-0.119) and skin lesions (-0.107) in decreasing order. This finding was similar to a 2009 study of the same cohort. Regression analysis of tobacco consumption revealed that tobacco use was a risk factor for decreasing the EQ-5D score (beta value = - 0.72, p=0.001). Using an effective mouthwash has a positive impact on HRQoL (beta value= 0.149 and p=0.012). The mean EQ-5D in patients who continued in employment and who were not receiving benefits was better compared to other sub groups. CONCLUSIONS: BS symptoms, employment status, a healthy lifestyle combined with a good oral health have a significant impact on the HRQoL of BS patients.

The impact of oral health on the quality of life of nursing home residents.

BACKGROUND: Good oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents' quality of life. OBJECTIVE: To assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London. METHOD: Overall, 325 residents from nine nursing homes were clinically examined and 180 residents were interviewed to assess their oral symptoms and their OHRQoL using the OIDP measure. Managers and carers working in the homes were also interviewed. RESULTS: Almost two thirds of the sample were dentate (64.5%). 61.3% of dentate and 50.9% of edentate residents reported problems such as dry mouth, sore cracked lips, broken teeth and toothache and ill-fitting dentures. Oral health impacted considerably upon resident's OHRQoL; 20.2% of dentate and 30.9% of edentate reported at least one oral impact in the past 6 months. Sensitive teeth, toothache, bleeding gums, dry mouth and loose natural teeth among the dentate and loose or ill-fitting dentures among the edentate were strongly associated with higher prevalence of oral impacts even after adjusting for demographic and socio-economic factors, and for the number of teeth (dentate only). CONCLUSION: The burden of oral conditions was considerable. Oral symptoms were very common and were strongly associated with residents' worse OHRQoL. Health promotion programmes are important to help residents maintain an acceptable level of oral health and function.

Family structure, socioeconomic position and utilization of oral health services among Nigerian senior secondary school pupils.

OBJECTIVE: To test the relationship between socioeconomic position (SEP), family composition, number of siblings, and birth position in the family, and the utilization of oral health services by senior secondary school pupils in Ile-Ife, Nigeria. METHODS: A cross-sectional study design included senior secondary school pupils in the Central Local Government Area of Ile-Ife during 2007/2008. Sample size calculation was performed and 1,200 pupils were invited to participate. A multistage, stratified sampling technique was used. Data collection included a self-administered questionnaire. Data were analyzed using logistic regression. RESULTS: The response rate was 76 percent (n=1043). The mean age was 15.8 (standard deviation=1.9) and 49 percent were males. Only 22.5 percent of pupils had ever visited a dentist in their lives. Results from multivariate analyses showed that pupils attending free schools, those paying 1 to 10,000 naira (equivalent to US$ 63.31) and 10,000 to 19,000 naira (equivalent to US$ 120.29) were respectively 1.93, 1.87, and 2.74 times less likely to have attended a dentist in the past than pupils in more expensive schools. Pupils living with single mothers or without a parent were unlikely to have visited the dentist. Number of siblings and birth position in the family were not associated with utilization of oral health services. CONCLUSIONS: Adolescents from families with a low SEP growing up without their parents may need extra incentives to visit dentist.