Lege Artis Medicinae

[QUALITY OF LIFE MEASUREMENTS IN BRONCHIAL ASTHMA]

MÉSZÁROS Ágnes

APRIL 21, 2006

Lege Artis Medicinae - 2006;16(04)

[Bronchial asthma is a chronic disease with symptoms that significantly influence the daily life of patients causing difficulties in almost every area of life. The author reviews his own results and those published by others on the impact of asthma on the quality of life. The patients' quality of life was assessed using the general quality of life questionnaire EuroQol as well as the disease-specific St. George's Respiratory Questionnaire. Asthma was classified by severity according to GINA, an international classification system. The results of the study provide numerical proof of the concept that due to their disease, patients with asthma have lower quality of life indices than the non-asthmatic population. On examining the effect of age, sex and respiratory functions as factors that influence quality of life, the results indicate that the quality of life of women with asthma is lower compared to men, which is a warning that more attention should be paid on the care of women with bronchial asthma. Since there is only a moderate correlation between respiratory functions and quality of life (r=0.37), the extent of respiratory tract obstruction assessed by objective measurements is not indicative of how the patient is doing. Despite of having normal values, some patients are commonly anxious, are subjects to many real or pseudo-attacks, which in turn leads to greater drug consumption, and judge their state more severe in the symptom diary than actually it is. The findings indicate that beside considering clinical state, symptoms and laboratory results, asthma care should place greater emphasis on the patients’ self-judged quality of life and their own view on their disease.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[To Reward Performance... An Interview with Gyula Szegedi, Member of the Academy, by Elemér Nemesánszky, LAM’s Editor-in-Chief]

NEMESÁNSZKY Elemér, GYIMESI Andrea

Lege Artis Medicinae

[Snapshot – For a Lifetime...]

FEKETE György

Lege Artis Medicinae

[It is No Blasphemy!]

GRÉTSY Zsombor

Lege Artis Medicinae

[The Patent System: is it For or Against Us? ]

VARGA Orsolya, MOLNÁR Péter

Lege Artis Medicinae

[Our Idol, the Pill]

BÁNFALVI Attila

All articles in the issue

Related contents

Clinical Neuroscience

[Disease burden of Duchenne muscular dystrophy patients and their caregivers]

PÉNTEK Márta, HERCZEGFALVI Ágnes, MOLNÁR Mária Judit, SZŐNYI László Pál, KOSZTOLÁNYI György, PFLIEGLER György, MELEGH Béla, BONCZ Imre, BRODSZKY Valentin, BAJI Petra, SZEGEDI Márta, POGÁNY Gábor, GULÁCSI László

[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.]

Clinical Neuroscience

[The quality of life of the cluster headache patients during the active phase of the headache]

DIÓSSY Mária, BALOGH Eszter, MAGYAR Máté, GYÜRE Tamás, CSÉPÁNY Éva, BOZSIK György, ERTSEY Csaba

[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. ]

Journal of Nursing Theory and Practice

Use of Imogene King’s Nursing Model in the Care for a Patient with Heart Arrhythmias

CLOUBOVÁ Ivana, BULAVA Alan

Objectives: To discover the benefits of implementation of Imogene King’s nursing model into nursing care in a patient with arrhythmias. To find out how these patients are limited in saturation of their own needs and what are the most severe limitations for patients with arrhythmias. Material and methods: Qualitative research using semi-structured interviews. The interview with patients with arrhythmia was conducted in accordance with the structure of King’s nursing model. Results: The research group consisted of 20 respondents; 13 men and seven women. All respondents expressed satisfaction with their cooperation with staff. The respondents described a change in the subjectively perceived state, the psychic state, and emotions. Conclusions: Assessment of the subjectively perceived quality of life of patients with arrhythmias using the King’s interaction model allows nurses to see the patient from the holistic point of view and plan and provide individualized care.

LAM KID

[Quality of life of patients with osteoporosis in Hungary]

VOKÓ Zoltán, INOTAI András, HORVÁTH CSABA, BORS Katalin, SPEER Gábor, KALÓ Zoltán

[AIM - The aim of our study was to estimate the loss of quality of life due to osteoporotic fractures. We performed a cross-sectional study including 840 patients in 21 centers that specialise in the care of patients with osteoporosis and in acute care of fractures. METHODS - Patients were selected randomly and stratified for the location of and time elapsed since the fracture. Quality of life (QoL) was assessed by the Qualeffo-41 and the EuroQol-5D questionnaires. RESULTS - Patients with morphometric fractures of more than one vertebra had the lowest median EQ-5D index value (0.59). Symptomatic vertebral, hip and arm fractures also considerably decreased QoL. Patients with morphometric fractures of more than one vertebra had the lowest total Qualeffo-41 score. When controlled for age and gender, patients with hip fracture or morphometric vertebral fracture had at least 0.2 less mean utility values than had osteoporotic patients without history of fracture. Patients with more than a oneyear history of hip fracture had QoL scores as low as had patients with an acute fracture. In case of wrist and arm fractures, the acute loss of QoL somewhat decreased with time. CONCLUSION - In conclusion, osteoporotic fractures, especially hip and vertebral fractures result in a significant loss of patients’ quality of life. Our results show that physicians need to pay a close attention to morphometric vertebral fractures, which contribute to a great loss of human capital.]

Clinical Neuroscience

[Effects of neural therapy on quality of live in patients with inoperable lower extremity artery disease ]

MOLNÁR István, DEÁK Botond Zsolt, HEGYI Gabriella, KOVÁCS Zoltán, KAPÓCS Gábor, SZŐKE Henrik

[Objectives - Our aim was to evaluate the effects of percutaneous neurolysis of lumbal sympathetic ganglions on pain and the resulting changes in quality of life with validated objective and subjective methods. To follow the adverse effects and complications of the procedure. Materials and methods - A prospective, non-randomized, interventional, clinical cohort study under real life conditons was conducted. The time of the observation was 6 months. Palliative neural therapy was performed to reduce the ischemic pain of the affected leg of the patients involved in the study. Prior to treatment and after 35 days, Visual Analogue Scale (VAS) was used to measure the intensity of lower limb pain. The related changes in the quality of life were followed by a general 36-Item Short-Form Health Survey (SF-36) questionnaire. We measured the changes of the patients’ skin temperature and ankle/arm index. The post-treatment results were compared to the pre-treatment results. We compared the results of objective and subjective measures. We followed the side effects and complications of the pain therapy. Each of the examined subjects had obliterative (Fontaine II/b stage) arterial disease of the lower limbs, in which no revascularization intervention was feasible and their ischemic pain was of VAS≥7. Results - Data of 124 patients (69 male, 55 female) could be evaluated. The decrease in intensity of limb pain in the post-treatment period was significant (p=0.001). Quality of life also indicated a significant improvement (p=0.004). Changes in skin temperature and ankle/arm index demonstrated significant improvement (p≤0.005): skin temperature increased from 27.6°C to 31.2°C, the ankle/arm index inceased from 0.67 to 0.83 on average. Changes in objective and subjective measures correlated with each other. No worthening of symptoms, serious adverse events or complications were observed. Conclusion - The chemical denervation of the lumbar sympathetic ganglions with percutaneous application is a minimally invasive intervention, useful in outpatient care, which can be well tolerated by the patient without any significant side effect or complication. Its hyperaemic effect and the pain reduction of the leg can improve the quality of life of the patients.]