Impact of weight quality of life questionnaire and scale pdf

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impact of weight quality of life questionnaire and scale pdf

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The quality-adjusted life year or quality-adjusted life-year QALY is a generic measure of disease burden , including both the quality and the quantity of life lived. Critics argue that the QALY oversimplifies how actual patients would assess risks and outcomes, and that its use may restrict patients with disabilities from accessing treatment. Proponents of the measure acknowledge that the QALY has some shortcomings, but that its ability to quantify tradeoffs and opportunity costs from the patient and societal perspective make it a critical tool for equitably allocating resources.

Measuring the Quality of Life in Diabetic Patients: A Scoping Review

Arch Otolaryngol Head Neck Surg. The authors have no relevant financial interest in this article. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales.

Aspirators lost a mean of The presence of aspiration is associated with substantial weight loss, advanced initial tumor stage, diminished oropharyngeal swallowing efficiency, and lower scores on a variety of QOL scales.

The lingering effects of head and neck cancer treatment can have a lasting impact on the survivor's quality of life QOL. Head and neck cancer survivors ie, persons treated for cancers of the oral cavity, oropharynx, hypopharynx, larynx, and neck often undergo a combination of surgery, radiation therapy, and chemotherapy. As a result, some survivors experience persistent swallowing difficulties and aspiration long after completion of therapy. The combination of cancer and its treatment can have a significant impact on the survivor's ability to eat.

Persistent swallowing problems have been studied in the early posttreatment period. Pauloski et al 1 described 38 patients who were studied with videofluoroscopy at 0, 1, 3, 6, and 12 months after oral cavity and oropharyngeal resections. Despite an expectation that there would be a steady improvement in swallowing efficiency, there was no progressive recovery seen. The function documented at 3 months was equivalent to that seen at 12 months.

The investigators found that pharyngeal transit time increased at 1, 3, and 6 months and was back to baseline by 12 months. Oropharyngeal swallowing efficiency OPSE remained significantly diminished at 12 months.

In another important study evaluating pharyngeal function in early cancer survivors, Lazarus et al 2 demonstrated that pharyngeal motility was affected by chemotherapy and radiation therapy if the larynx and tongue base were included in the radiation port. Long-term survivors can have demonstrable QOL effects years after treatment. Zelefsky et al 3 received questionnaires from 29 survivors who had undergone surgery and radiation therapy for oral cavity and oropharyngeal cancers 7 years median prior to the survey.

Advanced-stage cancer and tongue base primary tumor were associated with a persistent impact on QOL compared with early-stage and non—tongue base cancers. In the present study, we determined the prevalence of aspiration among cancer-free 5-year survivors of head and neck cancer and then compared both objective and subjective measures of cancer treatment effects among the aspirators and nonaspirators. Each survivor had been originally treated at least 5 years prior to entry and had been free of all cancer for at least 3 years.

Each survivor had been evaluated at 1 of the 2 institutions prior to treatment and had been followed up subsequently. This project was part of a larger study of the long-term effects of head and neck cancer treatment. Survivors underwent a battery of functional tests and QOL questionnaires. A team including an otolaryngologist, a speech pathologist, a gastrointestinal radiologist, an oral surgeon, and a research nurse performed the testing. Survivors were reimbursed for travel expenses and participation.

For this portion of the study, survivors underwent a videofluoroscopic swallow study VFSS and videofluoroscopic evaluation with an oropharyngeal swallowing efficiency OPSE measurement. Four validated QOL scales were administered to the survivors following the format used in our prior study. The choices are then rescaled into a 0 to format, with representing the best possible function for that domain.

The Performance Status Scale for Head and Neck Cancer Patients PSS-HN 7 is a 3-domain questionnaire that gives the patient a series of statements to choose from describing eating in public, understandability of speech, and normalcy of diet.

A gastrointestinal radiologist and a speech and language pathologist, who were blinded to the results of the quality-of-life questionnaires, performed the VFSSs. Survivors were classified by the radiologist K. Survivors were classified as being "nonaspirators" if there was no evidence of barium penetration into the larynx or if a small amount of the barium transiently enters the laryngeal vestibule without reaching the level of the vocal folds.

The response to aspiration was classified as given in Table 1. Further analysis grouped all survivors into either "aspirators" or "nonaspirators. As an extension of the VFSS, an oropharyngeal swallowing efficiency was calculated from the videotapes. A single speech and language pathologist J.

Periodically, studies were reviewed and rerated to assure consistency. Oropharyngeal swallowing efficiency is the ratio of the percentage of bolus swallowed to the total oral and pharyngeal swallowing times and is calculated as follows:. Thus, the OPSE scores decrease as aspiration increases, as transit time increases, or as percentage of bolus swallowed decreases. Comparisons of demographic and cancer characteristics between the aspirators and nonaspirators were performed.

Analyses of variance were calculated to compare the mean values of age, weight change, OPSE score, and QOL measures between the aspirators and nonaspirators. A total of 62 nonlaryngectomy survivors were included in this analysis.

Weight information was available for each of the survivors. Table 1 gives the results of the VFSS examinations. However, 13 had a diminished response to the aspiration, including 8 who demonstrated neither detection nor response to the penetration.

Table 2 gives demographic information on the 62 patients. Table 3 shows the associations between aspiration status and several objective and subjective measures. Higher scores reflect better function for all of the scales. The presence of aspiration was associated with objective measures of weight change and decreased OPSE. Aspiration was not associated with objective measurement of age at the time of the study or length of time since completion of therapy.

The QOL for an individual head and neck cancer survivor can depend on simple pleasures such as the enjoyment of food, a decent night's sleep, and rewarding social interaction.

The QOL of the survivor reflects the gap between the survivor's perceived reality and his or her expectations or wishes. In the early months after completion of treatment, head and neck cancer survivors can expect a gradual return to baseline function of some of the parameters that are measured in standard QOL evaluations. Some of the scales more closely associated with specific functions do not show improvement; these include dry mouth, senses, teeth, and trismus. Further improvement beyond 3 years was not expected.

Cancer patients who have survived 5 years beyond treatment have not been systematically studied to any great extent. This project sought to identify lingering QOL concerns and to determine associations between subjective and objective measures. Several interesting findings emerged from the data that focused on swallowing.

Several subjective QOL questionnaire scales reflect difficulty with swallowing. The subjective questions that most directly reflect swallowing difficulties were associated with the objective discovery of aspiration on the VFSS. Conversely, scales that reflect nonswallowing domains were appropriately not associated with aspiration.

The scale includes a number of questions that cover swallowing issues as well as dryness, breathing, voice, disfigurement, tobacco, alcohol, and communication. The presence of this association might reflect the strength of the swallowing problems within the global scale and its relative importance to the individual. An unexpectedly high proportion of oral feeding—dependent nonlaryngectomy survivors demonstrated significant laryngeal penetration on the VFSS.

The long-term physiologic effect of this degree of aspiration is not known. The presence of aspiration was associated with a higher tumor stage at the primary site, although no association was seen between aspiration and other demographic characteristics including site of the initial tumor, age, sex, and type of treatment. Of note, as was customary in the era when these individuals were first treated, none of the survivors in this analysis received chemotherapy during their initial therapy.

The lack of associations between the various demographic groups and aspiration reflects either the small sample size available for study or the possibility of continued adaptation during the years after treatment. Aspiration of barium on the VFSS was associated with weight change ie, "usual" weight minus current weight. Survivors with any evidence of aspiration had a mean weight loss of This observation might allow clinicians to look more carefully at their patients in the future for evidence of aspiration.

Decreased OPSE scores were associated with aspiration as well. The OPSE reflects the ability of the individual to move a food bolus from the oral cavity to the cervical esophagus. This reflects a greater transit time, increased residue with each swallow, and a greater degree of aspiration. In summary, chronic aspiration was associated with diminished subjective QOL for a number of domains and scales. In addition, weight loss and diminished OPSE were associated with persistent aspiration in head and neck cancer survivors.

Finding such a high percentage of survivors who had evidence of persistent aspiration was unexpected. Persistent weight loss in long-term head and neck cancer survivors should alert the clinician to possible aspiration. The long-term physiologic effect of chronic aspiration in this group of patients is unknown. Interventions to reduce aspiration in head and neck cancer survivors might improve their QOL.

Correspondence: Bruce H. Submitted for publication July 28, ; final revision received January 22, ; accepted March 2, We gratefully acknowledge the contribution of the late Judith I. Our website uses cookies to enhance your experience. Table 1. View Large Download. Table 2. Table 3. Head Neck. PubMed Google Scholar. Am J Surg. Arch Phys Med Rehabil. J Clin Oncol. Clin Otolaryngol. Save Preferences. Privacy Policy Terms of Use. This Issue. Citations

Measuring the Quality of Life in Diabetic Patients: A Scoping Review

Nevertheless, this construct appears to be particularly complex, and its operationalization is variable across different measures. The purpose of this paper is to offer an updated review of the diabetes-specific QOL measures present in scientific literature with a specific focus on the broad domains assessed. A scoping review was carried out with the purpose of identifying the existing measures in literature and describing their implicit representation of QOL in diabetes care. Each measure was then qualified according to its structure, a qualitative assessment of the broad domains of QOL it comprises, and finally an overview of the psychometric properties of its first validation. Theme analysis shows that QOL is operationalized with multidimensional surveys comprising of both mental, physical, and social health components. Some scales also consider the impact of societal attitudes, public policies, and context on QOL. Several self-report measures of QOL specifically developed for diabetic patients exist in scientific literature.

Table S2. Table S3. Table S4. Table S5. Table S6.

Arch Otolaryngol Head Neck Surg. The authors have no relevant financial interest in this article. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales. Aspirators lost a mean of The presence of aspiration is associated with substantial weight loss, advanced initial tumor stage, diminished oropharyngeal swallowing efficiency, and lower scores on a variety of QOL scales.


Quality of Life (IWQOL) questionnaire, that assesses the effects of Scoring. Scores for each scale were computed by summing scores on.


Quality of Life Questionnaire: Framework and 20 Key Questions

Using BMI percentiles for age and sex, Compared with the normal weight group, children who are at risk for overweight scored significantly lower for physical functioning. Measures of HRQOL assess important aspects of health that are not detected by traditional physiological and clinical measurements. These aspects include the effect of a health condition on the child's daily activities, physical symptoms, social interactions, and emotional well-being. While there is strong evidence for the negative effect of obesity on HRQOL in adults, especially in the domains of general health perceptions, physical functioning, and emotional health, 7 - 9 these relationships have received less attention in children.

Quality of life questionnaire consists of a set of survey questions that can be used to collect data related to an individual in particular and society in general on various parameters that determine their general quality of life, their natural environment, their health, their living condition, their community and more. Quality of life is fast becoming a standard measure of outcomes in many clinical trials and clinical practices. There are many factors that are associated while measuring the quality of life, like physical health, physiological well-being, social relationships, functional roles and subjective sense of lifestyle satisfaction. To collect the data that actually talks about the detailed analysis of an individual, quality of life questionnaire is essential. The primary objective to develop this questionnaire is that it should be easy to use, should reflect consumer values and goals , and collect appropriate data.

Metrics details. Against a backdrop of population aging and improving survival rates for chronic noncommunicable diseases CNCD , researchers are placing growing emphasis on health-related quality of life HRQoL. The aim of this study was to identify the QoL assessment instruments used in population-based studies with adults conducted around the world. A systematic review of original research published in all languages between and was conducted.

Stroke Specific Quality of Life Scale (SS-QOL)

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