Lege Artis Medicinae

[Measuring the quality of life of breast cancer patients]

CSÉPE Péter1

JULY 29, 1992

Lege Artis Medicinae - 1992;2(07)

[After a review of quality of life studies the author describe a questionary worked out by Schipper in 1984. The quality of life of 118 breast cancer patients was measured during adjuvant chemotherapy. We have got information about physical concerns, future orientation, social functioning and emotional well being of our patients. We could detect the changes in their quality of life, so we could improve it with therapeutic interventions. The survey can influence the attitude of health care personnel favourably. ]

AFFILIATIONS

  1. Semmelweis Orvostudományi Egyetem Orvostörténeti és Társadalomorvostani Intézet Budapest

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[Psychologically intravascular coagulation of the blood is hampered by the endothelium, the inhibitors of the coagulation system and the circulation as well. Various pathological events may the diffuse activation of the blood coagulation factors causing disseminated intravascular coagulation. The two main consequences of the DIC are ischaemia in the organs concerned and the consumption of the blood coagulation factors. The activation of the fibrinolytic system improves the former though aggravates the latter pathological events. In the prevention and therapy the effective treatment of the basic disease is of primary importance. Thorough evaluation of the clinical symptoms and the laboratory data can help in the diagnostics. Heparin can be administered only in the hypercoagulative-consumptive forms of the DIC if bleeding does not exist actually. In recent years, the administration of the anti thrombin concentrate has come into prominence because it can promote the restitution of the coagulation system without increase of bleeding. Antifibrinolytic (Gordox) therapy is advised only in cases of extreme hyperfibrinolytic activity. ]

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[Background and purpose - Data on the disease burden of Duchenne Muscular Dystrophy are scarce in Hungary. The aim of this study was to assess patients’ and their caregivers’ health related quality of life and healthcare utilisations. Methods - A cross sectional survey was performed as part of the European BURQOL-RD project. The EQ-5D-5L and Barthel Index questionnaires were applied, health care utilisations and patients’ informal carers were surveyed. Results - One symptomatic female carer, 50 children (boys 94%) and six adult patients (five males) participated in the study, the latter two subgroups were included in the analysis. The average age was 9.7 (SD=4.6) and 24.3 (SD=9.8) years, respectively. Median age at time of diagnosis was three years. The average EQ-5D score among children and adults was 0.198 (SD=0.417) and 0.244 (SD=0.322), respectively, the Barthel Index was 57.6 (SD=29.9) and 53.0 (SD=36.5). Score of satisfaction with healthcare (10-point Likert-scale) was mean 5.3 (SD=2.1) and 5.3 (SD=2.9). 15 children were hospitalised in the past 12 months for mean 12.9 (SD=24.5) days. Two patients received help from professional carer. 25 children (mean age 11.1, SD=4.4 years) were helped/supervisied by principal informal carer (parent) for mean 90.1 (SD=44.4) hours/week and further family members helped in 21 cases. Correlation between EQ-5D and Barthel Index was strong and significant (0.731; p<0.01) as well as with informal care time (-0.770; p<0.01), but correlation with satisfaction with health care was not significant (EQ-5D: 0.241; Barthel Index: 0.219; informal care: -0.142). Conclusion - Duchenne muscular dystrophy leads to a significant deterioration in the quality of life of patients. Parents play outstanding role in the care of affected children. This study is the first in the Central and Eastern European region that provides quality of life data in this rare disease for further health economic studies.]

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[Introduction - Cluster headache (CH), which affects 0.1% of the population, is one of the most painful human conditions: despite adequate treatment, the frequent and severe headaches cause a significant burden to the patients. According to a small number of previous studies, CH has a serious negative effect on the sufferers’ quality of life (QOL). In the current study, we set out to examine the quality of life of the CH patients attending our outpatient service between 2013 and 2016, using generic and headache-specific QOL instruments. Methods - A total of 42 CH patients (16 females and 26 males; mean age: 39.1±13.5 years) completed the SF-36 generic QOL questionnaire and the headache- specific CHQQ questionnaire (Comprehensive Headache- related Quality of life Questionnaire), during the active phase of their headache. Their data were compared to those of patients suffering from chronic tension type headache (CTH) and to data obtained from controls not suffering from significant forms of headache, using Kruskal-Wallis tests. Results - During the active phase of the CH, the patients’ generic QOL was significantly worse than that of normal controls in four of the 8 domains of the SF-36 instrument. Apart from a significantly worse result in the ‘Bodily pain’ SF-36 domain, there were no significant differences between the CH patients’ and the CTH patients’ results. All the dimensions and the total score of the headache-specific CHQQ instrument showed significantly worse QOL in the CH group than in the CTH group or in the control group. Conclusion - Cluster headache has a significant negative effect on the quality of life. The decrease of QOL experienced by the patients was better reflected by the headache-specific CHQQ instrument than by the generic SF-36 instrument. ]

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