ObjectiveTo investigate the quality of life (QoL) of patients with differentiated thyroid cancer (DTC) after surgery and analyze its relevant influencing factors. MethodsThe patients with DTC who underwent surgical resection in the First Affiliated Hospital of Zhengzhou University from December 1, 2021 to October 1, 2023 were investigated through the postoperative follow-up platform and follow-up management group. The postoperative QoL of DTC patients were evaluate using the Chinese version of the Thyroid Cancer Specific Quality of Life Questionnaire (THYCA-QoL) specific scale and the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) developed a quality of life questionnaire consisting of 30 items (QLQ-C30). The higher overall average score of THYCA-QoL scale, the more clinical symptoms of patients, namely the negative QoL. The higher the EORTC QLQ-C30 overall health status score, the better QoL. In addition, multiple linear regression was used to explore the risk factors affecting the postoperative specific QoL score of DTC patients. ResultsA total of 1 076 patients’ questionnaires were collected. The EORTC QLQ-C30 overall health status score of 1 076 patients was 67±22 and the THYCA-QoL overall score was 22±13. The results of multivariate linear regression analysis showed that the early postoperative period (<6 months), male, age, without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had negative effects on the overall score of THYCA-QoL scale (P<0.05), meanwhile the early postoperative period (<6 months) or later (≥12 months), without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had positive effects on the overall health status score of EORTC QLQ-C30 (P<0.05). ConclusionsEORTC QLQ-C30 combined with THYCA-QoL can evaluate not only the common symptoms of cancer, but also the specific symptoms of thyroid cancer after surgery. And understanding the factors affecting the QoL of patients with thyroid cancer after surgery could provide targeted and supportive treatment and nursing for discharged patients to improve the QoL of patients with thyroid cancer after surgery.
ObjectiveTo evaluate the functional outcomes and quality of life in patients with surgery for slow transit constipation (STC).MethodsFrom March 2013 to July 2017, 29 patients undergoing total or subtotal colectomy for STC in our department were analyzed prospectively. Their preoperative and postoperative 1-year follow-up details were analyzed. Evacuation function of all patients was assessed by bowel movements, abdominal pain, bloating, straining, laxative, enema use and the Wexner constipation scales. Quality of life was evaluated by the Gastrointestinal Quality of Life Index (GIQLI) and the short-form (SF)-36 survey.ResultsA high number of patients (93.1%, 27/29) in STC stated that surgery received benefits to their health. Compared with that before operation, the number of bowel movements per week during a 1-year follow-up increased significantly (31.6±19.9 vs. 1.21±0.6, P<0.05). Significant trends toward improvement of bloating, straining, laxative and enema use were noted 1-year following surgery (P<0.05). The Wexner constipation scales scores during a 1-year follow-up decreased significantly (5.69±3.4 vs. 20.34±0.6, P<0.05). The GIQLI scores during a 1-year follow-up increased significantly (120.7±20.4 vs. 78.6±17.3, P<0.05). Moreover, results of SF-36 showed significant improvements in 7 spheres (role physical, role emotional, physical pain, vitality, mental health, social function and general health) during a 1-year follow-up compared with those before operation (P<0.05).ConclusionTotal or subtotal colectomy for STC did not only alleviate constipation symptoms dramatically, but also received significant improvements in the patients’ quality of life.
ObjectiveTo investigate the short-term quality of life in patients after single-direction video-assisted thoracic surgery (VATS) for lung cancer, and explore the related influencing factors. MethodsPatients who underwent single-direction VATS for lung cancer in the Department of Thoracic Surgery, West China Hospital, Sichuan University from July 2020 to August 2021 were continuously selected. The QLQ-C30 and QLQ-LC13 were used to evaluate the quality of life of the patients after the surgery, and the influencing factors were analyzed. ResultsA total of 193 patients were collected. There were 73 males aged 59.44±11.40 years, and 120 females aged 53.73±11.15 years. The QLQ-C30 score of the patients after single-direction VATS for lung cancer was 69.09±20.21 points. Univariate analysis and Pearson correlation analysis showed that age, occupation, anesthesia time, postoperative complications, postoperative antibiotic use time, postoperative hospital stay, insomnia, economic stress, hemoptysis, chest pain, dysphagia, arm or shoulder pain were associated with the quality of life (P≤0.05). The results of multiple regression analysis showed that anesthesia time, economic pressure, insomnia and chest pain had a significant impact on the overall quality of life 30 days after the surgery (P≤0.05). ConclusionThe anesthesia time, economic pressure, insomnia and chest pain are independent influencing factors for the quality of life after the VATS lung cancer surgery.
ObjectiveTo compare the effect of catheter-directed thrombolysis (CDT) combined with anticoagulation (AC) and AC in the treatment of acute proximal deep venous thrombosis (APDVT) of the lower extremities. MethodsThe clinical data of 184 APDVT patients treated in Guizhou Provincial People’s Hospital from January 2017 to December 2022 were retrospectively collected. According to the treatment methods, the patients were divided into CDT group (n=82, CDT combined with AC) and AC group (n=102, AC alone). The prognosis indicators such as the incidence of bleeding events, the incidence of post-thrombotic syndrome (PTS), Villalta score, venous clinical severity score (VCSS) and chronic lower limb venous insufficiency questionnaire (CIVIQ) score were compared between the two groups. ResultsCompared with the AC group, the CDT group had a higher incidence of bleeding events [11.0% (9/82) vs. 2.9% (3/102)], a shorter time to detumescent [(2.8±1.2) d vs. (7.2±1.9) d], and lower VS score [3 (2,4) vs. 3 (2, 7)], VCSS score [2.0 (1.7, 4.0) vs. 3.0 (2.0, 5.2)] and postoperative venous patency score [1 (1, 2) vs. 2 (1, 3)], and higher CIVIQ score [80.0 (77.0, 86.0) vs. 71.5 (68.0, 78.0)], P<0.05. However, there were no significant differences in the incidence of PTS [28.2% (22/78) vs. 36.5% (35/96)] and thrombosis recurrence rate [9.0% (7/78) vs. 11.5% (11/96)] between the two groups (P>0.05). ConclusionCDT can relieve the symptoms and improve the quality of life of APDVT faster than AC, but it is necessary to strictly grasp the indications of thrombolysis to reduce the risk of bleeding.
ObjectiveTo compare the patient-reported outcomes regarding function, joint amnesia, and the quality of life after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). Methods The clinical data of patients who received UKA or TKA between September 2017 and June 2018 were retrospectively analyzed. After propensity score matching, 40 patients (40 knees) each in TKA group and UKA group were finally included in the study. There was no significant difference between the two groups in gender, age, body mass index, surgical side, preoperative knee range of motion, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, clinical and function scores of knee society score (KSS) (P>0.05). At 2 years after operation, WOMAC score, KSS clinical and function scores were performed on the two groups of patients, and compared with preoperative ones; knee injury and osteoarthritis outcome score-physical function short form (KOOS-PS), short-form 36 health survey scale (SF-36 scale), and forgotten joint score (FJS) were also performed. Results At 2 years after operation, the total score of WOMAC, the clinical and function scores of KSS in the two groups significantly improved when compared with preoperative ones (P<0.05), but there was no significant difference in the total score of WOMAC, the individual score of WOMAC, the clinical and function scores of KSS between the two groups (P>0.05). The total KOOS-PS score in the UKA group was significantly lower than that in the TKA group (t=4.243, P=0.000), and the scores of writhing/knee rotation, kneeling, and squatting in the UKA group were significantly lower than those in the TKA group (P<0.05). The total FJS score in the UKA group was significantly higher than that in the TKA group (t=−6.334, P=0.000). In the UKA group, the scores of 7 items were significantly lower than those of the TKA group (P<0.05) including when walking over 15 minutes, when climbing stairs, when walking on uneven ground, when standing for long periods, when doing housework or gardening, when taking a walk or hiking, and when doing your favorite sport. The SF-36 scales of physiological function, energy, social function, emotional function, and mental health in the UKA group were significantly higher than those in the TKA group (P<0.05). Conclusion Compared with TKA, patients treated with UKA may have better knee function recovery, joint amnesia, and higher quality of life.
ObjectiveTo understand the possible influential factors and the effectiveness of interventions for quality of life in breast cancer survivors. MethodThe latest literatures about studies on quality of life in breast cancer survivors were reviewed. ResultsAlthough the cure rate and survival rate of patients with breast cancer had improved, breast cancer as a major stress event, the disease itself and treatment related adverse reactions might cause the fatigue, activity decline, anxiety, depression, and other negative emotions of patients, which seriously affected the quality of life of patients and survival prognosis. The patients’ age, socio-economic background, tumor characteristics, and treatment methods were the factors affecting their quality of life. To a certain extent, meditation, music therapy, and proper physical exercise could improve the quality of life of patients with breast cancer. ConclusionBreast cancer itself and related treatment methods may affect not only the affected organs, but also multiple dimensions of patients’ quality of life, so attention should be paid to improve quality of life in breast cancer survivors, providing with individualized interventions.
ObjectiveTo analyze the influencing factors of fear of cancer recurrence (FCR) and its correlation with social support and quality of life in patients with differentiated thyroid cancer (DTC) at 5 years after surgery. MethodsA total of 116 patients with DTC from West China Hospital, Sichuan University at 5 years after surgery were selected as the research objects. The patients were investigated using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS) and the European Organization for Reasearch and Treatment of Cancer Quality of Life Questionnare-Core 30 (EORTC QLQ-C30, hereinafter referred to as QLQ-C30). The χ2 test or Fisher exact probability method were used for univariate analysis, and multivariate logistic regression analysis was used for influencing factor analysis. The diagnostic value of variables with significant influence on FCR in multivariate logistic regression was further studied by receiver operating characteristic (ROC) curve, and Pearson correlation analysis was finally adopted to analyze the relationship between FCR and social support and quality of life in patients with DTC at 5 years after operation. ResultsThe questionnaire survey showed that the FoP-Q-SF score of 116 patients with DTC at 5 years after surgery was (35.92±2.52) scores, of which 75 patients had FoP-Q-SF score ≥34 scores, 41 patients had FoP-Q-SF score <34 scores, and the FCR rate was 64.66% (75/116). Multivariate logistic regression showed that gender, family annual income, SSRS score and total QLQ-C30 score were the main factors of FCR in patients with DTC at 5 years after surgery (P<0.05). Further ROC curve diagnosis showed that the accuracy rate of diagnosis of FCR with SSRS score ≤47.5 scores was 70.70%, the total score of QLQ-C30 ≤617.225 scores was 69.02%. The accuracy rate of diagnosis of FCR was 66.03% when the annual income of family was less than 150 000 yuan. The accuracy of women’s diagnosis of FCR was 62.28%. Pearson correlation analysis showed that FoP-Q-SF score was negatively correlated with SSRS score and total score of QLQ-C30 in DTC patients at 5 years after operation (r=–0.629 6, P=0.000 1; r=–0.568 5, P=0.000 1). ConclusionsThe proportion of patients who have FCR at 5 years after DTC operation is high, and gender, family annual income, SSRS score and total score of QLQ-C30 are the influencing factors. Therefore, we can develop targeted management strategies to reduce patients’ FCR and improve their quality of life.
ObjectiveTo explore the correlation between readiness for hospital discharge and short-term quality of life among colorectal cancer (CRC) patients following enhanced recovery after surgery (ERAS) mode.MethodsSurveys of 127 CRC patients following ERAS mode were conducted in the West China Hospital of Sichuan University. The Readiness for Hospital Discharge Scale and EORTC QLQ-C30 Scale were issued at the discharge and 1 month after the operation, respectively.ResultsThe total score of RHDS was 149.43±33.25. The score of global quality of life was 66.80±18.84. Correlation analysis showed that the total score of RHDS was positively correlated with the score of global quality of life (r=0.220, P=0.013), and negatively correlated with the scores of fatigue, nausea and vomiting, pain, loss of appetite (r=–0.304, P=0.001; r=–0.189, P=0.033; r=–0.257, P=0.004; r=–0.254, P=0.004). The score of personal status dimension were positively correlated with the score of global quality of life and emotional function (r=0.213, P=0.016; r=0.197, P=0.027), and negatively correlated with scores of fatigue, pain and insomnia (r=–0.311, P=0.000; r=–0.264, P=0.003; r=–0.257, P=0.004). The score of knowledge dimension was negatively correlated with nausea and vomiting, pain and loss of appetite (r=–0.212, P=0.017; r=–0.182, P=0.040; r=–0.239, P=0.007). The score of coping ability dimension was positively correlated with the score of global quality of life and physical function (r=0.204, P=0.021; r=0.204, P=0.021), while negatively correlated with scores of fatigue, pain, insomnia and loss of appetite (r=–0.349, P=0.000; r=–0.240, P=0.007; r=–0.202, P=0.022; r=–0.201, P=0.024). The score of expected support was positively correlated with the score of global quality of life (r=0.220, P=0.013), and negatively correlated with scores of fatigue and loss of appetite (r=–0.249, P=0.005; r=–0.227, P=0.010).ConclusionsThe short term quality of life among CRC patients following ERAS keeps at upper middle level, and positively correlated with the readiness for hospital discharge. It is suggested that discharge preparation service is of great significance to improve the quality of life of patients.
Objective To investigate the latent categories of symptom cluster characteristics in patients with knee osteoarthritis (KOA) after total knee arthroplasty (TKA), and compare the quality of life between these categories. Methods Patients undergoing TKA for KOA in the joint surgery departments of four tertiary-level A hospitals in Urumqi, Xinjiang between November 2023 and March 2024 were selected for the study using the convenience sampling method. Symptoms of postoperative pain, swelling, anxiety, depression, and sleep disorders were collected from patients for latent class analysis using Mplus 8.3 software, and their influencing factors and differences in quality of life between categories were analyzed using SPSS 26.0 software. Results A total of 380 copies of questionnaire were distributed and 362 valid ones were returned, with a validity rate of 95.3%. Of the 362 patients, 342 (94.5%) had symptom cluster. The 342 patients aged 47-85 years, with a mean age of (65.25±7.03) years; 83 (24.3%) were male and 259 (75.7%) were female. According to the postoperative symptom cluster, the patients could be categorized into 3 latent categories: high-symptomatic group (16.1%), low-symptomatic group (51.8%), and high swelling group (32.2%). Compared to the low-symptomatic group, the current being the first joint surgery was a risk factor for the high-symptomatic group [odds ratio (OR)=2.732, 95% confidence interval (CI) (1.216, 6.139), P=0.015], whereas body mass index between 24.0 and 27.9 kg/m2 was a protective factor for the high-symptomatic group [OR=0.362, 95%CI (0.156, 0.840), P=0.018]; body mass index <24.0 kg/m2 was an independent risk factor for the high swelling group [OR=2.769, 95%CI (1.321, 5.803), P=0.007]. Comparison of the quality of life of patients in the 3 latent categories revealed that the high-symptomatic group had the lowest quality of life scores (P<0.05). Conclusion Post-TKA symptom cluster in patients with KOA can be classified into 3 potential categories, and the quality of life performance is different among different categories, so precise symptom management strategies should be provided according to the symptom characteristics of the patients to improve their quality of life.
Objective To explore the relationship between depression and quality of life in schizophrenic patients, and the mediating role of sleep quality and weakness. Methods We selected inpatients with schizophrenia from 4 secondary and above psychiatric hospitals in Chengdu for questionnaire survey by convenient sampling method between March and July 2022. The questionnaires included general demographic data, disease-related questionnaire, Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Fried Frailty Phenotype (FFP) and Schizophrenia Quality of Life Scale (SQLS). Results A total of 594 patients were included, including 373 males (62.8%) and 221 females (37.2%). The univariate analysis of the factors affecting the quality of life of the patients showed that there was no significant difference in the age, sex, only child or not, education level, course of schizophrenia, and combined medication (P>0.05), except for the family history of mental disorders (P<0.05). SQLS score was positively correlated with SDS score (r=0.635, P<0.001), PSQI score (r=0.402, P<0.001) and FFP score (r=0.327, P<0.001). The mediation of sleep quality and weakness on depression and quality of life are significant, and chain-mediated effect of depression and quality of life was significant. Conclusion The depression level of schizophrenia patients can not only directly affect their quality of life, but also indirectly affect their quality of life through the mediation of sleep quality, weakness and chain mediation of sleep quality and weakness.