related quality of life

Health-related quality of life in cancer patients has been interested to researchers in the domain of health in recent decades. Mental adjustment to cancer is a concept known as an important indicator of life quality, well-being and health of cancer patients. The aim of this paper is to examine the relation between mental adjustment to cancer and health-related quality of life (HRQoL) among some women with breast cancer.
100 patients were non-randomly selected from hospitals and oncology clinics in Kermanshah and Shiraz cities, Iran. These patients completed the functional assessment of cancer treatment-breast (FACT-B) in order to measure HRQoL and mini-mental adjustment to cancer questionnaire (Mini-MAC). Data were analyzed by using correlation and regression.
The results show that helplessness/hopelessness (58%), fighting spirit (40%), fatalism (33%) and preoccupation anxiety (18%) explain the variance of HRQoL.
According to the findings, there is no relation between cognitive avoidance styles and HRQoL, and it can be concluded that coping styles helplessness/hopelessness and fighting spirit are the best predictors of HRQoL in patients with breast cancer. Consequently, the evaluation of the coping styles and emergency interventions in order to enhance coping with illness in cancer patients, decrease the sense of helplessness/hopelessness and anxiety are recommended, which in turn are accompanied by increasing HRQoL.

Visual impairment is one of the independent risk factors for falling among the elderly. Functional disabilities caused by vision disorders are the most common problems affecting the quality of life in this population. Therefore, vision self-management program (VSM) may be helpful for patients in reducing impairment and improving the quality of life.
Aim: The present study aimed to investigate the effect of self-management educational program on the vision-related quality of life among the elderly with visual impairment.
This randomized clinical trial was conducted on 57 elderly people in Mashhad, Iran, in 2017. The participants were assigned into two groups of intervention (n=28) and control (n=29). The intervention group received a 6-week VSM as a 60-minute session per week, while the control group underwent the routine education in the clinic. Visual-related quality of life was measured using the 39-item National Eye Institute Visual Function Questionnaire immediately and two months after the intervention to implement home-based intervention. The data were analyzed in SPSS software, version 23.
The mean age of the participants in the intervention and control groups were 66.4±0.7 and 66.1±7.0 years, respectively. The repeated measures ANOVA test showed that the mean score of vision-related quality of life in the intervention group was significantly higher than that in the control group (PImplications for Practice: The self-management education can increase vision-related quality of life and its various dimensions in the elderly with visual impairment. Given that the intervention duration in this study was two months, further studies with longer duration are recommended.

Socioeconomic status (SES) is an important determinant of health-related quality of life (HRQoL). We aimed to quantify socioeconomic-related inequality in poor-HRQoL among adults in Kermanshah, western Iran.
Study design: A cross-sectional study.
Overall, 1730 adults (18-65 yr) were selected using convenience sampling from Kermanshah, Iran. A self-administrated questionnaire was used to collect data on socio-demographic characteristics, SES, lifestyle factors and HRQoL of participants over the period between May and Aug 2017. The concentration curve and concentration index (C) were used to illustrate and measure wealth-related inequality in poor-HRQoL. Additionally, we decomposed the C index to identify factors explaining wealth-related inequality in poor-HRQoL.
The overall prevalence of poor-HRQoL was 35.3% (95% confidence interval[CI]: 33.1%, 37.6%). The poor-HRQoL was mainly concentrated among the poor adults (C=-0.256, 95% CI: -0.325, -0.187). Poor-HRQoL was concentrated among men (C=-0.256, 95% CI: -0.345, -0.177) and women (C=-0.261, 95% CI: -0.310, -0.204). Wealth, physical inactivity, the presence of chronic health condition(s), lack of health insurance coverage were the main factors contributing to the concentration of poor-HRQoL among socioeconomically disadvantaged adults.
Socioeconomic-related inequalities in poor-HRQoL among adult should warrant more attention. Policies should be designed to not only improve HRQoL among adults but also reduce the pro-rich distribution of HRQoL among adults in Kermanshah.

Cancer constitutes a huge burden on societies in countries with any level of economic development. Prostate cancer is the first most diagnosed cancer of men in developed countries and the forth one in developing countries in terms of incidence rate. It is also the third incident cancer of men in Iran along with a prevalence of about 10,000 cases. Castration-resistant prostate cancer (CRPC) is a severe stage of the disease with a number of newly discovered treatment options. These therapeutic alternatives including abiraterone acetate, enzalutamide, cabazitaxel, immunotherapy with sipuleucel-T, radiopharmaceuticals and bone-targeted therapies (zoledronic acid, denosumab) along with docetaxel have made the decision making process complex and challenging for clinicians. In addition to the challenges of selecting the best-fit treatment, high costs of new pharmaceuticals and technologies necessitates the health policy-makers to develop practice guidelines in adaptation with local resources and limitations. The aim of this paper is to review the clinical guidelines for the management of CRPC. For better comprehension of guideline recommendations, the main clinical trials on new treatments were also identified. The efficacy and safety outcomes including but not limited to overall survival, progression free survival, quality of life and adverse effects were summarized. The guidelines of American Urological Association (AUA), National Comprehensive Cancer Network (NCCN), European Association of Urology (EUA), Spanish Oncology Genitourinary Group (SOGG), Asian Oncology Summit, Saudi Oncology Society-Saudi Urology Association combined guideline, National Institute for Health and Care Excellence (NICE) and Canadian Urological Association-Canadian Urologic Oncology Group (CUA-CUOG) were covered in this paper.

Chronic diseases affect patients’ Quality of Life (QoL) and even their caregivers. By evaluating the QoL of patients with multiple sclerosis, the undiagnosed problems of the patients can be detected and the appropriate treatment objectives can be determined. This study was conducted to evaluate the QoL in patients with different types of MS. A total of 314 patients with Multiple Sclerosis (MS) referred to “Society for the support of MS patients”, “Raad Charity and Education complex”, and an outpatient clinic in Tehran during fall and winter 2014-2015 were recruited. All patients completed the 36-Item Short Form questionnaire (SF-36) and Dartmouth Coop Functional Health Assessment/World Organization of National Colleges, Academies and Academic Association of General Practitioners (COOP/WONCA) functional health assessment charts as self-report. To investigate the research hypothesis and analyzing the results of the two questionnaires, 1-way analysis of variance (ANOVA) was used. The results of the analysis showed a significant difference between the three types of MS (relapsing-remitting, secondary progressive and primary progressive) in the scores of all SF-36 questionnaire subscales. A significant difference was also found between the three types of MS regarding the scores of all charts of COOP/WONCA, except for social support. Then with the use of LSD post hoc test, scores of both questionnaires subscales in these three types of MS were pair-wisely compared. The results showed that the type of MS disease can affect the patients’ QoL. Patients with relapsing-remitting MS had the best level of QoL among all others. The COOP/WONCA charts were more sensitive in measuring the differences between the secondary-progressive MS and primary-progressive MS.

Health-related quality of life (HRQOL) is a multi-dimensional concept that is affected by different variables. A large body of evidence shows that socio-demographic factors have a significant influence on HRQOL. When considering differences in cultural contexts and social values of various countries and the lack of evidence regarding socio-demographic determinants of HRQOL among the Iranian general population, it is important to verify the main socio-demographic determinants of HRQOL in an urban Iranian population.
This study aimed to explore socio-demographic factors associated with HRQOL and to ascertain the determinants of poor HRQOL in participants of the Tehran lipid and glucose study (TLGS).
The participants included 3491 adults, aged ≥ 20 years, who had participated in the TLGS. To obtain socio-demographic and HRQOL information, participants were interviewed by trained interviewers. Mean HRQOL scores were compared using the student’s t test and analysis of variance (ANOVA). To determine significant determinants of poor HRQOL, multivariate logistic regression analysis was performed.
Mean ages of males and females were 47.7 ± 15.6 and 47.8 ± 14.2 years, respectively and 58.6% of participants were male. Males had significantly higher scores compared to females in both the physical and mental domains of HRQOL (P Current findings highlight the importance of socio-demographic determinants of HRQOL in both genders, specifically in the physical domain, and demonstrate their roles to be more prominent in males. These findings highlight gender-specific associations between socio-demographic factors and various aspects of HRQOL among the TLGS population, which could be applied in future research focusing on non-communicable diseases and planning health promotion programs.

Advances in treatment of thalassemia major have improved the life expectancy of the patients and therefore their quality of life as other chronic diseases. This study was conducted to assess health- related quality of life in these patients in Guilan province.
In a cross-sectional study, thirty-one children, aged 8-12 years, with β-thalassemia major were interviewed in Guilan, northern Iran, from January to March 2016. Source of data were health centers of the province and its satellite centers, blood transfusion organizations, general hospitals and private clinics. Health-related quality of life was assessed by using PedsQL questionnaire. The Questionnaire was completed at baseline by all patients and their parents. T and Chi-square tests were used as appropriated.
Of the 31 children, 58.1% were girls. Total summary score in children was 75.9±20.1. Physical, Emotional, social, school and psychosocial functioning scores were 70.6±24, 73.3±22.9, 85.9±21, 74.1±21.5, 77.7±19.7, respectively. None of the children underwent splenectomy. Sex, Serum ferritin and hemoglobin levels did not show any association with quality of life in this study.
Although quality of life in these patients was acceptable, HRQOL showed lower scores in comparison to the healthy population. It seems more social and familial support for increasing the quality of life of these children is surely needed.

Self-rated health (SRH) and life satisfaction (LS) are of increasing interest to medical researchers, because of their close relationship with different aspects of health..
This paper describes the patterns of LS and SRH among Iranian children and adolescents, analyzed by sex and residence area, at the national and provincial levels..
In this nationwide study 14880 students, aged 6-18 years, were selected by multistage random cluster sampling from urban and rural areas of 30 provinces in Iran, as part of the fourth survey of a national surveillance program conducted in 2011-2012. LS and SRH were assessed through a questionnaire following the World Health Organization-Global School-based Student Health Survey (WHO-GSHS) protocols..
13486 out of 14880 invited students completed the study (participation rate: 90.6%). Their average age was 12.47 ± 3.36 years. The prevalence of good SRH at national level was 80.13 (95% CI: 79.25, 80.99); the prevalence of LS among Iranian students at the national level was 80.17 (95% CI: 79.18, 81.13). At the provincial level, the highest and the lowest LS scores were 85.42 (80.01, 89.55) and 74.78 (68.74, 79.99), respectively. Likewise, the highest and the lowest prevalence of good SRH was 88.36 (83.99, 91.66) and 74.22 (69.06, 78.78), respectively..
Our findings show that, at provincial levels, a complex set of known/unknown influencing factors affect individuals’ assessments of their own health quality. Understanding these patterns of SRH and LS could be useful for better health policy and more targeted studies in this field..

The clinical COPD questionnaire (CCQ) has been developed to measure health status of COPD patients. The aim of this study, was to translate CCQ into the Persian language and assess the validity and reliability of the translated version.
We used a forward-backward procedure to translate the questionnaire. In a cross sectional study 100 COPD patients and 50 healthy subjects over 40 years old were selected to assess the reliability and construct validity of the instrument. The face and content validity were used for the questionnaire validity. Validity was examined on a population of patients with COPD, using the Persian validated version of the St George's Respiratory Questionnaire (PSGRQ). In order to assess the questionnaire’s reliability, the Intraclass correlation coefiiicient(ICC) and Cronbach’s alpha were calculated. Test-retest reliability was tested by re-administring the Persian version of the CCQ (PCCQ) after 1 week.
Test- retest carry out of data demonstrates that the PCCQ has excellent reliability ( ICC for all 3 domains were higher than 0.9). Internal consistency was found by Cronbach’s alpha to be 0.96, 0.94, 0.97, and 0.98 for symptom, mental state, functional state and total scores respectively. In addition, the correlation between the components of PCCQ and PSGRQ showed satisfactory construct validity. Analysing the data from healthy subjects and patients divulged that the PCCQ has acceptable discriminant validity.
In general, the PCCQ had satisfactory reliability and validity for assessing health related quality of life status of Iranian COPD patients.

Health-related quality of life (HRQoL) is an important determinant in a person’s life.
In this study aimed at physical education students, alcohol consumption and smoking as risk factors and sports as a healthy factor could affect HRQoL.
Patients and This study was an analytical cross-sectional study. For our purpose, the subjects (n = 519) were asked to answer the SF-36 questionnaire (short form health survey for HRQOL). To analyze the data, two-way multivariate analysis of variance (MANOVA), one-way analysis of variance (ANOVA), the independent-samples t-test, and Pearson correlation coefficient were conducted. In this study, the P The results suggest that statistically significant differences for alcohol consumption were only obtained from the role-emotional (RE) scale, in which drinkers had lower mean scores than nondrinkers. For smoking, significant differences were obtained from the scales of RE, vitality (VT), emotional well-being (EW), social functioning (SF), and general health (GH), in which nonsmokers outdid smokers. The combination of alcohol drinking and smoking led to statistically significant lower scores on the RE scale and strongly destroyed the role-emotional part of HRQOL.
It can be concluded that smoking and alcohol consumption may be related to poor HRQOL in physical education and sports students despite the fact that they regularly engage in sports programs that could positively affect their HRQOL.

Context: Health-related quality of life (HRQoL) is increasingly important in the assessment of chronic conditions, especially for irritable bowel syndrome (IBS), which has no associated mortality, but is prevalent and significantly impacts patient’s lives. Disease-specific instruments such as the irritable bowel syndrome quality of life instrument (IBS-QOL), in addition to generic instruments such as the short form (SF)-36, are useful in measuring health-related quality of life, and have been shown to be reliable in assessing disease severity and as an endpoint to monitor treatment response. We reviewed the impact of IBS on patients’ HRQoL, the factors causing HRQoL impairments, and the utility of HRQoL instruments in the assessment of IBS..
Evidence Acquisition: We performed electronic literature searches in Medline, the Cochrane library, and digestive disease week (DDW) meeting abstracts. Across all databases searched, common keywords included “Irritable bowel syndrome”, “Quality of life” and “Health related quality of life”. For databases that accommodated Boolean searches, terms specifically related to QOL and military were added..
We summarized the data available in the literature to show that HRQoL is poorer in patients with IBS compared to healthy controls, and compared to most serious chronic conditions. There are several factors that contribute to HRQoL impairments in IBS, of which gastrointestinal symptoms, physical co-morbidities, psychosocial factors and demographics all play significant roles..
It is crucial for clinicians to be aware of the importance of measuring HRQoL. Understanding the factors causing impairment of HRQoL is also important for clinicians seeing these patients as it helps to individualise treatment and treat the patient more holistically, to achieve greater patient satisfaction..

The premenstrual syndrome (PMS) is characterized by intense physical and psychological changes. The most common symptoms include anxiety, depression, fatigue, anger, irritability, sense of being out of control, confusion, change in appetite and sleep, bloating and breast tenderness. The symptoms affect the quality of life of women, and cause impairment in many aspects of life.
The purpose of this study was to examine the effects of cognitive-behavioral therapy (CBT) on improvement of health-related quality of life in female students with premenstrual syndrome (PMS).
In this study, 40 students with PMS were selected from Shahid Chamran university in Tehran, Iran, and were randomly assigned to the intervention and control groups. Participants in the intervention group received 10 sessions of CBT. Women in the control group did not receive any treatment.
The results of ANCOVA were statistically significant (P Cognitive-behavioral therapy can be effective in improvement of health-related quality of life of female students with PMS.

Heart valve disease gradually increases the pressure in the heart chambers and impairs heart pumping. It influences on quality of life due to low output، disability، fear، amnesia، anxiety، and depression. Although most of signs and symptoms in patients with heart valve diseases may significantly decrease after valve replacement surgery، there is limited information about the impact of surgery on patients’ quality of life. Therefore، we aimed to compare the scores of health-related quality of life (HRQoL) before and after the surgery in patients undergoing valve replacement surgery in Shahid Rajaei Heart Center، Tehran، Iran. In this descriptive cross-sectional study، 102 patients who underwent for valve replacement surgery including mitral valve، tricuspid valve، aortic valve، pulmonary valve or combinations of two or more of these valves were selected through convenience sampling method. The MacNew HRQoL questionnaire was used to collect data in this study. Subjects completed the questionnaire in two stages، before and 2 months after surgery. Collected data were analyzed using SPSS version 18. The majority of subjects were female (60. 8%) and married (89. 2%). Mitral valve disease (52%) and tricuspid valves abnormality (1%) were the most and the least common valve diseases among subjects، respectively. The results indicated an increase in the HRQoL score after valve replacement (p<0. 001). The results also showed that there is no significant relation between the HRQoL scores with gender، education level، type of valve dysfunction and income. Overall HRQoL scores in patients with value diseases improve significantly after surgery. Therefore، surgery not only is recommended to relief the symptoms of patients، but also can be considered as an effective strategy to improve the quality of life in patients with valve diseases.

Quality of life, when referring to an individual’s health, is called health-related quality of life. The purpose of this study is to assess self-perceived hearing loss related quality of life of adolescents with hearing loss and its relationship with sex, age sub-groups or school settings with domains of quality of life. A school based survey was conducted in Tehran city. Using stratified sampling, 255 7th to 12th grade students with hearing loss, aged 11-19 years, studying in main streaming and special school sitting, were participated in the study by completing the health-related quality of life adolescent’s questionnaire. Physical, Emotional and Social health-related quality of life domain scores as well as Total health-related quality of life scores was calculated in a 0-100 scoring system. As a whole, health-related quality of life of adolescents calculated to be 64.7 ± 16.5. Students with milder hearing loss reported their quality of life (physical, emotional and social domains, as well as total quality of life) better than those with more severe hearing loss. Girls reported their physical and total health-related quality of life better than boys, and adolescents who were studied in mainstreaming reported better physical, social and total health-related quality of life. No significant differences were seen between reported health-related quality of life in early, mid or late adolescent age sub-groups. Nevertheless the power of tests was not enough to exclude differences between groups. Findings of this study could be readily used to focus interventions on domains with more weakness in each group of adolescents. Beyond that the results could be helpful as a base line for detecting effectiveness of interventions in future.

Psoriasis has a significant negative impact on patients’ health-related quality of life (HRQOL). This study aims to evaluate HRQOL of adult patients with psoriasis in Iran, and explore the relationship between general and disease-specific outcome measures in psoriasis. Between May and August 2013, a cross-sectional questionnaire survey of consecutive outpatients was conducted at a single clinic in Shiraz, Iran. HRQOL was assessed by the general measure EuroQol 5 dimensions (EQ-5D), visual analogue scale (EQ VAS), and the disease-specific Dermatology Life Quality Index (DLQI). Disease severity was measured by the Psoriasis Area and Severity Index (PASI). Sixty-two patients (76% males) completed the questionnaire with a mean age (SD) of 40.4 (17.5) years. Overall, 39% of the patients used only topical and 48% received systemic non-biological therapy in the past 12 months. Median EQ-5D, EQ VAS, DLQI and PASI scores were 0.73, 60, 8 and 11.75, respectively. Out of the 62 patients, 18%, 26%, 28%, 63%, and 63% reported some or severe problem in mobility, self-care, usual activities, pain/discomfort and anxiety/depression, respectively. EQ-5D and EQ VAS correlated moderately with DLQI (rs = -0.44 for both, p < 0.001), but only EQ VAS correlated significantly with PASI (rs = -0.31, p < 0.01). This is the first study from Iran that assesses HRQOL in adult patients with psoriasis by EQ-5D and EQ VAS. Reduction in general HRQOL measured with EQ-5D and EQ-VAS is considerable, mostly in anxiety/depression and pain/discomfort dimensions. EQ-5D scores evaluated in this study provide country-specific data for economic evaluations.

The aim of this study was to determine the impact of malocclusions on oral healthrelated quality of life (OHRQOL) among female adolescents. This is an observational cross-sectional descriptive study. A total of 129 female students with age ranges between 14 and 17 years old were randomly selected from Mashhad (Iran) high schools and were asked to fi ll out an OHRQOL questionnaire included in four parts: Oral symptoms, functional limitations, emotional well-being and social well-being. Each participant was clinically examined to assess her malocclusion according to the index of complexity, outcome and need (ICON) and fi nally the data were entered to SPSS 11.5 and the relation between these two variables was assessed with Pearson correlation test. P < 0.05 was considered as statistically signifi cant. There was statistically signifi cant correlation between ICON scores and quality of life (P = 0.0176). Being separately assessed, among four parts of the questionnaire, only emotionalwell-being was signifi cantly correlated with the ICON score (P < 0.05). Malocclusions play a vital role in OHRQOL. However, in female adolescents among four parts of OHRQOL, emotional well-being had signifi cant relationship with malocclusions.