METHODS: A cross-sectional survey using the EQ-5D-3L instrument was conducted between May to September 2018 across various public hospitals in Malaysia. Using a multi-stage sampling, patients diagnosed with TDT and receiving iron chelating therapy were sampled. The findings on the EQ-5D-3L survey were converted into utility values using local tariff values. A two-part model was used to examine and derive the HSUVs associated with the treatment and complications of iron overload in TDT.
RESULTS: A total of 585 patients were surveyed. The unadjusted mean (SD) EQ-5D-3L utility value for TDT patients were 0.893 (0.167) while mean (SD) EQ VAS score was 81.22 (16.92). Patients who had more than two iron overload complications had a significant decline in HRQoL. Patients who were on oral monotherapy had a higher utility value of 0.9180 compared to other regimen combinations.
CONCLUSION: Lower EQ-5D-3L utility values were associated with patients who developed iron overload complications and were on multiple iron chelating agents. Emphasizing compliance to iron chelating therapy to prevent the development of complications is crucial in the effort to preserve the HRQoL of TDT patients.
METHODS: The standard forward-backwards translation technique was used to convert English version of the WHOQOL HIV Bref into Urdu. After cognitive debriefing, final Urdu version of instrument was developed. Based on the principle of at least 5 subjects for each item, a sample of 182 patients was used using a universal random sampling technique from the Pakistan Institute of Medical Sciences, Islamabad. The Cronbach's alpha and intra-class correlation coefficients (ICC) were estimated to assess internal validity and reliability of the translated version. Exploratory factor analysis was carried out to determine the factor structure and independent associations between the instrument domains and CD-4T-cell count were assessed using multivariable linear regression RESULTS: High Cronbach alpha 0.93 was found for all WHOQOL HIV Bref facets. The test-retest reliability demonstrated a statistically significant ICC ranged from 0.88 to 0.98 (p
METHODS: Three hundred patients treated for uncomplicated malaria in selected primary healthcare facilities of Plateau state, Nigeria, completed the EQ-5D-5L scale. Classical test theory was used to establish validity and Cronbach's alpha reliability of the scale. Rasch analysis was used to confirm the unidimensionality, item fitness, item and person separations and reliabilities, and targeting of item difficulty to patient ability levels and presentation on Wright map (item-person map).
RESULTS: The outcome of classical test theory revealed unidimensional scale with average variance extracted values > 0.5, and the square root of the average variance extracted for construct was greater than the correlation coefficients, indicating convergent and discriminant validities of the scale whose Cronbach's alpha coefficient (α) was 0.87. Rasch analysis indicated variance explained values of 88.3% and the eigenvalues of the first contrast was 1.3, further confirming the unidimensionality of the scale, whose fit index values were within accepted ranges. The high item and person separation and reliability values indicated the instrument's strength in detecting and evenly spreading items and persons on the Wright map based on item difficulty and the respondents' ability levels, respectively.
CONCLUSION: The EQ-5D-5L scale performed well in uncomplicated malaria, hence, it is recommended for use in the assessment of health-related quality of life in this patient population.
METHODS: A cross-sectional study was conducted over 6 months in the two main tertiary centres for CAH patients in Malaysia. Participants including 59 female-raised CAH patients (mean age ± SD = 16.3 ± 4.2 years, range 10-28 years) compared to 57 age-matched female diabetic patients (mean age ± SD = 16.5 ± 3.4 years, range 10-26 years). Socio-demographic and medical profiles was obtained through semi-structured interviews. HRQOL of participants were evaluated utilising validated, Malay translated questionnaires which were age appropriate: Pediatric Quality of Life Inventory (PedsQL v4.0) scales for Child (8-12) and Adolescent (13-18) and Medical Outcome Survey 36-item Short Form version. These were then compared to the diabetic controls.
RESULTS: The CAH participants consisted of children (ages 10-12 years, n = 12), adolescents (ages 13-17 years, n = 29) and adults (≥ 18 years, n = 18). The majority were Malays (64.4%) and had salt-wasting CAH (67.8%). There were no significant differences between the total mean score of the HRQOL of the combined children and adolescents CAH group (total mean score ± SD = 81.6 ± 17.9, 95% CI = 75.6-87.6) when compared to age-matched diabetic patients (total mean score ± SD = 80.8 ± 11.0, 95% CI = 77.0-84.5, P = 0.81, effect size = 0.05); no significant difference between the adult CAH and diabetic controls in the physical [median score (IQR) CAH vs diabetics; 49.3 (11.4) vs. 50.2 (6.1), P = 0.60, effect size = 0.09] and the mental composite scores [median score (IQR) CAH vs. diabetics; 47.8 (14.1) vs. 50.0 (10.8), P = 0.93, effect size = 0.01].
CONCLUSIONS: The HRQOL of the Malaysian CAH cohort were comparable to the diabetic controls.
METHODS: All patients, who underwent magnetic anal sphincter augmentation procedure at a single center between December 2008 and January 2016, were consecutively included. Symptom severity [Cleveland Clinic Incontinence Score (CCIS)], quality of life [Fecal-Incontinence Quality of Life Questionnaire (FIQL)], bowel diary data, and patients' satisfaction were assessed before and after implantation.
RESULTS: Forty-five patients (43 female), mean (s.d.) age 66.82 (±10.07), were followed for a median of 36 months (range 6-84). Two patients were explanted and 1 lost to follow-up. On a 3-week diary, major leakage rate significantly improved as did CCIS and FIQL. No significant difference was seen for flatus and minor leaks. Postoperative decrease of CCIS by ≥5.5 points correlated best with satisfaction, expressed by 22 patients (48% in intention-to-treat analysis). An independent predictive factor for success after implantation was no previous fecal incontinence surgical treatment.
CONCLUSIONS: Satisfaction, functional, and quality of life outcomes improve significantly following magnetic anal sphincter augmentation.
DESIGN: Retrospective cohort study.
SETTING: Singapore's nationwide claims database.
PARTICIPANTS: Singaporeans and permanent residents.
OUTCOMES: Patients were identified by International Classification of Disease, Ninth Revision, Australian Modification (ICD-9-AM) and ICD-10-AM codes from all admissions between 2000 and 2017, and categorised according to aetiology: venous, arterial, diabetic and pressure. Comorbidities were extracted from a national database of Charlson Comorbidity Index scores.
RESULTS: Between 2000 and 2017, 124 023 wound-related claims among 86 631 patients were identified. Age-specific rate (ASR) and age-adjusted incidence rates of all wounds increased over 18 years, with greatest increases among those aged ≥80. In 2017, the median age of patients was 74 (IQR 63-84). Half were male (51%). 70% were ethnic Chinese, 15% Malay and 9% Indian. In 2017, the crude incidence rate (CIR) was 15 per 100 000 persons (95% CI 14 to 16) for venous wounds, 56 (95% CI 53 to 58) for arterial, 168 (95% CI 164 to 173) for diabetic and 183 (95% CI 179 to 188) for pressure wounds. The CIR of any chronic wound was 296 (95% CI 291 to 301). ASRs were greatest in patients aged ≥80: 92 (95% CI 74 to 112) for venous, 478 (95% CI 436 to 522) for arterial, 1791 (95% CI 1710 to 1876) for diabetic, 3647 (95% CI 3530 to 3766) for pressure and 4277 (95% CI 4151 to 4407) for any wound. Compared with the Chinese, Indians had thrice the ASRs of venous and arterial wounds and double the ASR of diabetic wounds. Malays had double the ASRs of arterial and diabetic wounds.
CONCLUSIONS: Chronic wounds are common in the elderly with significant ethnic disparities in this Asian cohort. With the incidence expected to rise with ageing populations, it is crucial to address health disparities and evaluate utilisation and cost to inform clinical practice and health policy.
METHODOLOGY: A cross-sectional study was conducted among 269 older persons with diabetes in all government health clinics in Kuantan using Diabetes Quality of Life questionnaire. SPSS version 23 was used for the statistical analysis.
RESULTS: Majority of the respondents were females (61%), Malays (84.8%), pensioners (54.3%) with education up to primary school (52%) and are staying with family members (93.7%). Most of the patients were on two antidiabetic agents (48%) followed by a single antidiabetic agent (32%). Despite the risk of hypoglycaemia, 0.4% of them are on glibenclamide. The use of insulin is still common among 21% of them that are on intermediate-acting insulin, 15.6% on premixed insulin and 7.8% on short-acting insulin. Those taking a higher number of antidiabetic agents were found to be associated with poorer quality of life (p=0.001) compared to those taking one or two antidiabetic medications. Those on insulin also have significantly poorer quality of life score (p=0.012).
CONCLUSION: Despite aiming for controlled diabetes, older persons suffer poor quality of life with further intensification of their antidiabetic medications according to the guidelines. This includes the complexity of insulin usage and polypharmacy, which contribute to the low quality of life score.
METHODS: A prospective study was conducted on children with infantile esotropia aged 8-17 years old and their parents/guardians who attended two tertiary hospitals with a paediatric ophthalmology service from 2017 to 2018. The patients and parents answered the Intermittent Exotropia Questionnaire (IXTQ), translated into Malay, at the time of enrolment and three months after the surgery.
RESULTS: Thirty-four children and one (each) of their parents/guardians were enrolled. Thirteen (38.2%) children had esotropia with angles of deviation of more than 50 prism dioptres. A total of 33 (97.1%) children achieved successful alignment correction three months after surgery. Surgery significantly improved the total mean scores of the children, which were 62.87 (17.05) preoperatively and 87.13 (13.26) postoperatively (p<0.001). There was statistically improvement in the total mean scores in the parent/guardian group, which was 37.07 (22.01) preoperatively and 75.39 (22.09) postoperatively (p<0.001). The parents/guardians functional, psychosocial and surgery subscales also had a significant increment in the score postoperatively (p<0.001). Older children and children with poorer visual acuity on presentation had a lower score preoperatively, while girls scored better postoperatively (p<0.05). Mothers scored significantly lower preoperatively and postoperatively (p<0.05).
CONCLUSION: Surgery significantly improved the HRQoL score in Malaysian children with infantile esotropia and their parents/guardians. The score was significantly higher in female children after the surgery. Mothers exhibited poor scores before and after surgery.
METHODS: In this cross-sectional study, 504 Iranian older adult participants from Qazvin province were recruited between December 2015 and April 2016. They completed a questionnaire that included the Revised Adult Attachment Scale, the Life Satisfaction Index-Z, and the Herth Hope Index.
RESULTS: Participants in the study had a mean age of 66.20 years (SD: 5.76) and most of them were women (57.5%). A mediation model testing the direct relationships between attachment, hope, religiosity, and life satisfaction showed a positive relationship between close attachment and religiosity (β = .226, p life satisfaction (β = .448, p life satisfaction. More specifically, while religiosity and hope fully mediated the relationship between close attachment and life satisfaction, they partially mediated the attachment anxiety-life satisfaction link.
CONCLUSIONS: Findings of the study provide insight into only a narrow perspective of life satisfaction and attachment given the many and varied variables that influence these constructs. Future research is needed whereby other related variables are introduced into the model to be examined further.
METHODS: Seventeen POAG patients with suboptimal IOP control despite pre-existing topical medications were subjected to adjunct SLT (50 applications 180 degrees) or second line medical therapy. Current medications were continued, and patients were followed up for 6 months for degree of intraocular pressure (IOP) lowering. HRQoL was assessed using Glaucoma Quality of Life 36-item (GlauQoL-36), Assessment of Quality of Life-7D (AQoL-7D) and Vision related Quality of Life (VisQoL). Costs involved were calculated and compared to the effect (IOP reduction) achieved in each arm.
RESULTS: Ten patients were in the SLT group and 7 in the topical medication (MED) group. Mean baseline intraocular pressure (IOP) was 18.90±3.48mmHg in SLT group and 15.57±2.23mmHg in MED group. Mean reduction of IOP was 4.30±1.64mmHg in SLT group and 2.71±2.56 mmHg in MED group at 6 months which was not statistically significant (p=0.14) between two groups. All the HRQoL questionnaires did not show significant changes in the groups or between groups when compared baseline with 6-month post treatment (p-values ranging from 0.247 to 0.987). For every 1mmHg reduction in IOP, cost involved in MED group (RM53.61) was 165% of the cost involved in SLT group (RM32.56).
DISCUSSION AND CONCLUSION: This study has shown that SLT was as effective clinically and tolerable as topical anti glaucoma medications and was possibly more cost effective in the step-up treatment of patients with POAG at 6 months follow- up.
METHODS: This was a cross-sectional study of stroke survivors attending post-stroke care clinics in three public hospitals in the states of Pahang and Terengganu, Malaysia. The HRQoL was assessed by EuroQol-5 dimension-5 levels. Data on socio-demographic, clinical profiles, malnutrition risk, and physical activity level were collected through an interviewer-administered survey. Descriptive analyses for HRQoL profiles and multiple logistic regression analyses for its associated factors were performed. Crude and adjusted odds ratios were reported.
RESULTS: A total of 366 stroke survivors were recruited with a mean age of 59 ± 11 years. The most -commonly reported health problems were mobility (85%), followed by usual activities (82%), pain/discomfort (63%), anxiety/depression (51%) and self-care (41%). The mean of the EQ visual analogue scale and the median of the EQ5D summary index was reported at 60.3 ± 14.2 and 0.67 ± 0.37, respectively. Malnutrition risk (mobility, usual activities, and self-care), wheelchair users (self-care and usual activities), speech impairment (usual activities and pain/discomfort), number of stroke episodes (self-care and pain/discomfort), body mass index, physical activity level and types of strokes (usual activities), age and use of a proxy (anxiety/depression), working and smoking status (mobility), were factors associated with either single or multiple dimensions of HRQoL.
CONCLUSION: Routine malnutrition screening, tailored program for speech therapy, prevention of recurrent stroke, and physical activity promotion should be addressed and further reinforced in current rehabilitation interventions to improve the HRQoL among stroke survivors in Malaysia.
METHODOLOGY: This study was approved by the institutional Joint Research and Ethics Committee, International Medical University, Malaysia (number 373/2016); consisted of 180 eligible pre-school children from a private school. Study tools included demographic, clinical oral health data form, the Early Childhood Oral Health Impact Scale (ECOHIS) and family functioning-12-item general functioning subscale. Written consent was sought prior to data collection. Data were analysed by SPSS v.22.0; descriptive statistics for socio-demographic details, clinical information, HRQoL and FAD scores. The parametric tests included independent sample t test and ANOVA to evaluate the associations between the dependent variable. Binary logistic regression models were applied to assess the impacts on OHRQoL (P value life. However, family functioning does not mediate poor HRQoL in association to dental caries.
Materials and Methods: This study was aimed to identify the relationship between NS and HRQOL among young motorcycle riders (undergraduate university students) aged between 19 and 25 years (n = 301) through a cross-sectional questionnaire-based study, that is, Weinstein noise sensitivity scale and the World Health Organization Quality of Life. The effects of NS on HRQOL were assessed based on gender, the years of motorcycle driving experience, and noise sensitive among groups using one-way analysis of variances with an alpha value of 0.05.
Results: The results showed no significant difference in NS between males and females. On the other hand, motorcycle driving experience for <4 years displayed a higher tendency toward NS. Moreover, a significantly (P = 0.004) decreasing trend among low, moderate, and high NS with their respective HRQOL was observed, while a high NS showed significantly (P = 0.015) lower scores on the social domain of the quality of life.
Conclusion: The overall premise of the study has statistical significance and shows that individuals with high NS tend to have degraded HRQOL compared to individuals with low NS. Furthermore, in-depth studies are required from the other demographical background of participants to investigate the motorcyclist's NS and HRQOL as an integral requirement for the rider's safety and health.
METHODS: This was a cross-sectional study in a semi-urban primary care clinic in Selangor, Malaysia, among pregnant women aged 18 years old and above. The validated study instruments consisted of questions on socio-demography, the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI SF) to determine UI and the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSQoL) to assess their QoL. A generalised linear model was used to determine the association between the continent and incontinent pregnant women with QoL.
RESULTS: Of the approached 610 respondents, 440 consented to participate in the study, resulting in a response rate of 72.1%. The mean age was 29.8 years old (SD 4.69) with 82.2% (n = 148) having stress UI. Significant independent factors related to the decreased QoL were mid to late trimester (OR 3.06, 95% CI 1.48-6.32), stress UI, (OR 6.94, 95%CI 4.00-12.04) and urge UI (OR3.87, 95%CI 0.48-31.28). Non-Malay improved QoL (OR 0.29, 95% CI 0.16-0.52).
CONCLUSIONS: All types of UI significantly affecting pregnant women's QoL. This information is useful in enhancing antenatal management at the primary care level, whereby they should be screened for UI and provided with effective early intervention to improve their QoL.
METHODS: A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12).
RESULTS: The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008).
CONCLUSIONS: Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.
METHODS: A descriptive and correlational survey was conducted in a private hospital in Kuala Lumpur, Malaysia. A convenience sample of 118 Malaysian breast cancer patients voluntarily participated in the study and responded to a set of questionnaires including: socio-demographic questionnaire, the short form of Locus of Control Scale, the Functional Assessment of Cancer Therapy-Breast (FACT-B), the Hospital Anxiety and Depression Scale (HADS), and the Short-Form Mishel Uncertainty in Illness Scale (SF-MUIS).
RESULTS: The results revealed that breast cancer patients with higher internal locus of control and lower external locus of control experience a higher quality of life, lower anxiety, and lower depression. Also, uncertainty mediated the relationship between locus of control with quality of life and depression (quasi-significant).
CONCLUSIONS: The findings indicated the need for early, targeted psychological interventions seeking to gradually shift cancer patients' locus of control from external to internal in order to improve their quality of life and reduce their depression and anxiety. Moreover, health care providers by providing relevant information to cancer patients, especially for externally oriented patients, can reduce their uncertainty which in turn would improve their quality of life.