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Sexuality and intimacy after head and neck cancer treatment: An explorative prospective pilot study.Dental and Medical Problems 2022While sexuality and intimacy are suggested to contribute to quality of life (QoL), it is striking that the sexual problems of head and neck cancer patients have not been...
BACKGROUND
While sexuality and intimacy are suggested to contribute to quality of life (QoL), it is striking that the sexual problems of head and neck cancer patients have not been adequately studied.
OBJECTIVES
Our aim was to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy.
MATERIAL AND METHODS
A questionnaire study with a 6-month follow-up period was conducted at the University Hospitals Leuven, Belgium, using the Maudsley marital questionnaire (MMQ), the sexual adjustment questionnaire (SAQ) and the short sexual functioning scale (SSFS) to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy.
RESULTS
Twelve patients (67%) reported a negative impact on their sexuality and/or intimacy. There were significant declines in marital, sexual and general life satisfaction (p < 0.000) at the 6-month follow-up as compared to baseline. There was a significant increase in frustration after sexual activity (p = 0.031). Sexual desire was also impacted, with a near doubling of patients reporting a decline. The perceived importance of discussing sexual issues with one's physician significantly increased from 7 to 16 patients (p = 0.004).
CONCLUSIONS
Sexual problems are common after head and neck cancer treatment. Using a screening instrument can help to identify patients that need intervention. Discussing sexuality and intimacy issues that patients may face before, during and after treatment can have a positive impact on QoL.
Topics: Head and Neck Neoplasms; Humans; Pilot Projects; Prospective Studies; Quality of Life; Sexual Behavior; Sexuality
PubMed: 36068944
DOI: 10.17219/dmp/148156 -
Clinical Practice and Epidemiology in... 2021Obsessive-Compulsive Disorder (OCD) is a chronic neuropsychiatric disorder associated with unpleasant thoughts or mental images, making the patient repeat physical or...
BACKGROUND
Obsessive-Compulsive Disorder (OCD) is a chronic neuropsychiatric disorder associated with unpleasant thoughts or mental images, making the patient repeat physical or mental behaviors to relieve discomfort. 40-60% of patients do not respond to Serotonin Reuptake Inhibitors, including fluvoxamine therapy.
INTRODUCTION
The aim of the study is to identify the predictors of fluvoxamine therapy in OCD patients by Bayesian Ordinal Quantile Regression Model.
METHODS
This study was performed on 109 patients with OCD. Three methods, including Bayesian ordinal quantile, probit, and logistic regression models, were applied to identify predictors of response to fluvoxamine. The accuracy and weighted kappa were used to evaluate these models.
RESULTS
Our result showed that rs3780413 (mean=-0.69, sd=0.39) and cleaning dimension (mean=-0.61, sd=0.20) had reverse effects on response to fluvoxamine therapy in Bayesian ordinal probit and logistic regression models. In the 75 quantile regression model, marital status (mean=1.62, sd=0.47) and family history (mean=1.33, sd=0.61) had a direct effect, and cleaning (mean=-1.10, sd=0.37) and somatic (mean=-0.58, sd=0.27) dimensions had reverse effects on response to fluvoxamine therapy.
CONCLUSION
Response to fluvoxamine is a multifactorial problem and can be different in the levels of socio-demographic, genetic, and clinical predictors. Marital status, familial history, cleaning, and somatic dimensions are associated with response to fluvoxamine therapy.
PubMed: 34880926
DOI: 10.2174/1745017902117010151 -
International Journal of Community... Jul 2021Quality of life (QOL) and marital contentment, especially marital satisfaction, are important aspects of life. These items are more important in couples involved in HIV...
BACKGROUND
Quality of life (QOL) and marital contentment, especially marital satisfaction, are important aspects of life. These items are more important in couples involved in HIV due to the present social stigma among this population considering women more vulnerable. The aim of this study was to determine the QOL and marital contentment status among seroconcordant and serodiscordant HIV couples compared to non-HIV ones.
METHODS
In this cross-sectional study, 66 serodiscordant, 74 seroconcordant, and 70 non-HIV couples who referred to Lavan High-risk Behavior Counseling Center, Shiraz during September 2017 and December 2019 were studied. QOL and marital contentment were assessed by World Health Organization Quality of Life-BRIEF (WHOQOL BREF) and ENRICH questionnaire, respectively. Chi-square test for qualitative variables, independent T-test and ANOVA followed by LSD post hoc test for quantitative variables were performed. All statistical analyses were performed using SPSS 19.0, and P<0.05 was set as the significant level.
RESULTS
The score of QOL questionnaire was significantly higher in non-HIV couples than serodiscordant and seroconcordant groups (P<0.001). There was no significant difference among seroconcordant and serodiscordant groups (P=0.99), and infected males vs. females (P=0.13). Non-HIV couples had significantly higher marital contentment in comparison to serodiscordant and seroconcordant groups (P<0.001). No difference was detected among seroconcordant and serodiscordant groups (P=0.81) although more contentment was observed among the males (P=0.01).
CONCLUSION
Our study revealed that QOL and marital contentment were different among non-HIV and HIV infected couples. Besides, marital contentment was higher among males than female's in infected patients.
PubMed: 34222545
DOI: 10.30476/ijcbnm.2021.87420.1430 -
PloS One 2022Marital status has been proposed as a promising prognostic factor in many malignancies, including non-small-cell lung cancer (NSCLC). However, its prognostic value is...
Marital status has been proposed as a promising prognostic factor in many malignancies, including non-small-cell lung cancer (NSCLC). However, its prognostic value is still unclear for individual non-surgical treatments for stage I NSCLC. This study investigated the prognostic value of marital status in patients with early-stage NSCLC treated with stereotactic body radiotherapy (SBRT). Patients with early-stage NSCLC treated with SBRT between January 2003 and March 2014 at our institute were enrolled, and marital status at the time of SBRT was investigated. Propensity score matching (PSM) was applied to reduce potential selection bias between the married and unmarried groups. Two hundred and forty patients (median age 77 years; 152 married, 87 unmarried) were analyzed. The unmarried included higher proportions of the elderly, women, never smokers, and those with decreased pulmonary function compared to the married. PSM identified 53 matched pairs of married and unmarried patients, with no significant difference in patient background parameters. The 5-year overall survival (OS) was 52.8% and 46.9% in the married and unmarried groups, respectively (P = 0.26). There was no significant difference in NSCLC death or non-NSCLC death between the two groups (P = 0.88 and 0.30, respectively). There was no significant difference in OS between married and unmarried male patients (n = 85, 5-year OS, 52.6% vs. 46.0%; P = 0.42) and between married and unmarried female patients (n = 21, 54.5% vs. 50.0%; P = 0.44). In conclusion, marital status was not associated with OS in patients receiving SBRT for early-stage NSCLC.
Topics: Aged; Carcinoma, Non-Small-Cell Lung; Female; Humans; Lung Neoplasms; Male; Marital Status; Neoplasm Staging; Radiosurgery; Retrospective Studies; Small Cell Lung Carcinoma
PubMed: 35657816
DOI: 10.1371/journal.pone.0269463 -
Seizure Dec 2020To evaluate psychosocial long-term outcome in patients diagnosed with psychogenic nonepileptic seizures (PNES) and to predict outcome of PNES, economic status, and...
PURPOSE
To evaluate psychosocial long-term outcome in patients diagnosed with psychogenic nonepileptic seizures (PNES) and to predict outcome of PNES, economic status, and quality of life (QoL) at follow-up.
METHODS
Patients diagnosed with PNES in the video-EEG-monitoring unit at our Epilepsy center between 2002-2016 were contacted by phone 1-16 years after communicating the diagnosis. Patients underwent a structured interview asking for current PNES status, psychosocial situation (economic status, marital status, setting of living, driving), depression, and QoL.
RESULTS
Of 70 PNES patients without comorbid epilepsy (age: 41.1 ± 13.5 years; 74 % female, follow-up: 5.2 ± 4.2 years), 23 patients (33 %) reported to be free of PNES during the last 12 months. Patients with cessation of PNES were younger at PNES onset (p < .01) and diagnosis (p < .01) and had a higher education (p < .05). At follow-up, the proportion of economically active patients only increased in individuals with cessation of PNES (p < .001) while an increased number of patients with persisting PNES relied on governmental support (p < .001). Cessation of PNES was associated with better mood (p < .01) and QoL (p < .001). In multiple regression models, cessation of PNES was only predicted by younger age at onset, while good economic outcome was determined by younger age and good economic status at diagnosis and cessation of PNES at follow-up. Good QoL at follow-up was predicted by low depressive symptoms, freedom of PNES, and economic activity at follow-up.
CONCLUSION
Long-term outcome in patients with PNES remains to be poor and the majority of patients continue to have PNES. Cessation of PNES was associated with good economic outcome, mood, and QoL.
Topics: Adult; Affect; Electroencephalography; Epilepsy; Female; Humans; Male; Middle Aged; Quality of Life; Seizures; Socioeconomic Factors; Somatoform Disorders
PubMed: 33181426
DOI: 10.1016/j.seizure.2020.09.014 -
Annals of Clinical and Translational... Dec 2022To investigate intercultural neurologists' perception of well-being in patients with amyotrophic lateral sclerosis (ALS) using gastrostomy (PEG), non-invasive, and/or...
OBJECTIVE
To investigate intercultural neurologists' perception of well-being in patients with amyotrophic lateral sclerosis (ALS) using gastrostomy (PEG), non-invasive, and/or invasive ventilation (NIV/IV) and to analyse the determinants and impact on the management of the above medical interventions (MIs).
METHODS
The study was based on anonymous questionnaires addressing the clinical approach and personal attitude towards the use of PEG, NIV and IV in ALS patients completed by 465 neurologists: 228 from Germany and 237 from Poland.
RESULTS
The German and Polish neurologists estimated the quality of life in ALS patients using PEG and NIV as neutral, whilst low in individuals using IV. A regression model revealed an independent influence of palliative care training (PCT) and age on that attitude in the German group. Higher values of estimated patients' depressiveness on PEG, NIV and IV were found amongst the Polish neurologists. Marital status, experience in ALS and being a parent independently influenced the perception of patients' depressiveness in the German, whilst marital status, age and PCT were factors in the Polish group. Amongst German neurologists, a higher perception of patients' depressiveness in individuals using PEG, NIV and IV was linked to the later timing of the MIs discussion. In the Polish group, it was a lower estimation of QoL in patients using PEG.
CONCLUSION
Neurologists' perception of ALS patients' well-being on MIs reflects their demographic status, professional experience and potentially their cultural background. This perception plays an important role in the timing of MIs discussion, possibly influencing the decision-making process.
Topics: Humans; Amyotrophic Lateral Sclerosis; Quality of Life; Surveys and Questionnaires; Neurologists; Gastrostomy
PubMed: 36448241
DOI: 10.1002/acn3.51663 -
Journal of Oncology 2021Recent years, there has been a rapid increase in the incidence of esophageal adenocarcinoma (EAC), while the prognosis for patients diagnosed remains poor and has...
OBJECTIVE
Recent years, there has been a rapid increase in the incidence of esophageal adenocarcinoma (EAC), while the prognosis for patients diagnosed remains poor and has slightly improved.
METHODS
We extracted 6,466 cases with detailed demographical characteristics including age at diagnosis, sex, ethnicity, marital status, and clinical features, involving tumor grade and stage at diagnosis and treatment modalities (radiation therapy, chemotherapy, and surgery) from the Surveillance, Epidemiology, and End Results (SEER) (1975-2017) dataset. They were further randomly divided into the training and validating cohorts. Univariate and multivariate Cox analyses were conducted to determine significant variables for construction of nomogram. The predictive power of the model was then assessed by Harrell concordance index (C-index) and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.
RESULTS
Multivariate analysis revealed that age, marital status, insurance, tumor grade, TNM stage, surgery, and chemotherapy all showed a significant association with overall survival (OS) and cancer-specific survival (CSS). These characteristics were employed to build a nomogram. Particularly, the discrimination of nomogram for OS and CSS prediction in the training set were excellent (C-index = 0.762, 95% CI: 0.754-0.770 and C-index = 0.774, 95% CI: 0.766-0.782). The AUC of the nomogram for predicting 2- and 5-year OS was 0.834 and 0.853 and CSS was 0.844 and 0.866. Similar results were observed in the internal validation set.
CONCLUSION
We have successfully established a novel nomogram for predicting OS and CSS in EAC patients with good accuracy, which can help clinicians predict the survival of individual patient survival and provide optimal treatment strategies.
PubMed: 34567114
DOI: 10.1155/2021/4138575 -
African Health Sciences Dec 2022The number of cancer survivors is growing continuously due to advances in treatment of cancer patients. In developed countries, numerous studies on quality of life (QoL)...
BACKGROUND
The number of cancer survivors is growing continuously due to advances in treatment of cancer patients. In developed countries, numerous studies on quality of life (QoL) of cancer survivors have been conducted. Little is known regarding the QoL of cancer survivors in Kenya. Therefore, the aim of this study was to explore the factors that contribute to QoL of cancer survivors in Kenya.
METHODS
A descriptive cross-sectional design was used for the study. Participants were 108 adult cancer survivors. Self and interviewer administered QoL Patient/Cancer Survivor Questionnaire was used.
RESULTS
Findings indicate a statistically significant relationship between QoL and age (rs =-.055 p<.05), marital status (rs=.490 p<.01), income (rs =.228 p<.05), stage of cancer diagnosis (rs =-.269. p<.01), year of cancer diagnosis (rs =-.295 p<.01), religious affiliation (rs =-.279, p<.01) and the religion one belonged to (rs =-.198 p<.05). Regression analysis showed that age, stage of cancer diagnosis, time off treatment, educational level, and religious affiliation are significant predictors of QoL in cancer survivors.
CONCLUSIONS
The findings highlight the importance of key factors associated to QoL in cancer survivors in Kenya. Interventions aimed at early cancer detection, treatment, and spiritual support among cancer survivors will improve QoL.
Topics: Adult; Humans; Cancer Survivors; Quality of Life; Survivors; Cross-Sectional Studies; Kenya; Surveys and Questionnaires; Neoplasms
PubMed: 37092050
DOI: 10.4314/ahs.v22i4.12 -
Journal of the American Heart... Dec 2022Background Acute myocardial infarction (AMI) is one of the leading causes of mortality worldwide, whereas social support is a known predictor of the prognosis after AMI....
Background Acute myocardial infarction (AMI) is one of the leading causes of mortality worldwide, whereas social support is a known predictor of the prognosis after AMI. As a common factor influencing social support, the impact of marital status on care quality, in-hospital mortality, and long-term prognosis of patients with AMI remains largely unknown. Methods and Results The present study analyzed data from the CAMI (China Acute Myocardial Infarction) registry involving 19 912 patients with AMI admitted at 108 hospitals in China between January 2013 and September 2014 and aimed to evaluate marital status-based differences in acute management, medical therapies, and short-term and long-term outcomes. The primary end point was 2-year all-cause death. The secondary end points included in-hospital death and 2-year major adverse cardiac and cerebrovascular events (a composite of all-cause death, myocardial infarction, or stroke). After multivariable adjustment, 1210 (6.1%) unmarried patients received less reperfusion treatment in patients with both ST-segment-elevation myocardial infarction and non-ST-segment-elevation myocardial infarction (adjusted odds ratio [OR], 0.520 [95% CI, 0.437-0.618]; <0.0001; adjusted OR, 0.489 [95% CI, 0.364-0.656]; <0.0001). Being unmarried was not associated with poorer in-hospital outcome but with long-term all-cause mortality and major adverse cardiac and cerebrovascular events in both ST-segment-elevation myocardial infarction (adjusted hazard ratio [HR], 1.225 [95% CI, 1.031-1.456]; =0.0209; adjusted HR, 1.277 [95% CI, 1.089-1.498]; =0.0027) and non-ST-segment-elevation myocardial infarction (adjusted HR, 1.302 [95% CI, 1.036-1.638]; =0.0239; adjusted HR, 1.368 [95% CI, 1.105-1.694]; =0.0040) populations. Conclusions The present study suggests that being unmarried is independently related to less reperfusion received, but could not explain the higher in-hospital mortality rate after covariate adjustment. Being unmarried is associated with a substantially increased risk of adverse events over at least the first 24 months after AMI. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01874691.
Topics: Humans; Hospital Mortality; Marital Status; Social Support; Myocardial Infarction; China
PubMed: 36444834
DOI: 10.1161/JAHA.122.025671 -
BMJ Open Jul 2015To identify variables that predict health service utilisation (HSU) by adults with mental disorders in the UK, and to determine the evidence level for these predictors. (Review)
Review
OBJECTIVES
To identify variables that predict health service utilisation (HSU) by adults with mental disorders in the UK, and to determine the evidence level for these predictors.
DESIGN
A narrative synthesis of peer-reviewed studies published after the year 2000. The search was conducted using four databases (ie, PsycINFO, CINAHL Plus with full text, MEDLINE and EMBASE) and completed on 25 March 2014.
SETTING
The majority of included studies were set in health services across primary, secondary, specialist and inpatient care. Some studies used data from household and postal surveys.
PARTICIPANTS
Included were UK-based studies that predicted HSU by adults with mental disorders. Participants had a range of mental disorders including psychotic disorders, personality disorders, depression, anxiety disorders, eating disorders and dementia.
PRIMARY OUTCOME
A wide range of HSU outcomes were examined, including general practitioner (GP) contacts, medication usage, psychiatrist contacts, psychotherapy attendances, inpatient days, accident and emergency admissions and 'total HSU'.
RESULTS
Taking into account study quality, 28 studies identified a range of variables with good preliminary evidence supporting their ability to predict HSU. Of these variables, comorbidity, personality disorder, age (heterogeneous age ranges), neurotic symptoms, female gender, a marital status of divorced, separated or widowed, non-white ethnicity, high previous HSU and activities of daily living, were associated with increased HSU. Moreover, good preliminary evidence was found for associations of accessing a primary care psychological treatment service and medication use with decreased HSU.
CONCLUSIONS
The findings can inform decisions about which variables might be used to derive mental health clusters in 'payment by results' systems in the UK. The findings also support the need to investigate whether combining broad diagnoses with care pathways is an effective method for mental health clustering, and the need for research to further examine the association between mental health clusters and HSU.
Topics: Activities of Daily Living; Age Factors; Anxiety Disorders; Comorbidity; Dementia; Depressive Disorder; Feeding and Eating Disorders; Female; Health Services; Hospitalization; Humans; Male; Marital Status; Mental Disorders; Mental Health Services; Personality Disorders; Primary Health Care; Psychotherapy; Psychotic Disorders; Risk Factors; Secondary Care; Sex Factors; Tertiary Healthcare; United Kingdom
PubMed: 26150142
DOI: 10.1136/bmjopen-2015-007575