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Item Art Therapy Impact on Aging Adults’ Quality of Life: Leisure and Learning(T&F, 2022) Misluk, Eileen; Rush, Haley; Herron School of Art and DesignQuality of life (QoL) is influenced by physical and psychological health, but includes subjective qualities that are inherent in social and cognitive processes necessary for healthy aging and overall well-being. A quantitative study analyzed the effects of art therapy for 14 aging adults utilizing the Brunnsviken Brief Quality of Life Scale (BBQ) at pre, mid, and post 32-week study. Regression analysis showed significant positive changes in two areas: Importance of Learning and Leisure. Participating in art therapy increased the importance of learning and leisure, that are influential factors in QoL for aging adults. This demonstrates that art therapy has the potential to support healthy aging.Item Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors(Wiley, 2009) Mosher, Catherine E.; Sloane, Richard; Morey, Miriam C.; Snyder, Denise Clutter; Cohen, Harvey J.; Miller, Paige E.; Demark-Wahnefried, WendyBACKGROUND: Older cancer survivors are at increased risk for secondary cancers, cardiovascular disease, obesity, and functional decline and, thus, may benefit from health-related interventions. However, to the authors' knowledge, little is known regarding the health behaviors of older cancer survivors and the associations of those behaviors with quality-of-life outcomes, especially during the long-term post-treatment period. METHODS: In total, 753 older (aged ≥65 years) long-term survivors (≥5 years postdiagnosis) of breast, prostate, and colorectal cancer completed 2 baseline telephone interviews to assess their eligibility for a diet and exercise intervention trial. The interviews assessed exercise, diet, weight status, and quality of life. RESULTS: Older cancer survivors reported a median of 10 minutes of moderate-to-vigorous exercise per week, and only 7% had Healthy Eating Index scores >80 (indicative of healthful eating habits relative to national guidelines). Despite their suboptimal health behaviors, survivors reported mental and physical quality of life that exceeded age-related norms. Greater exercise and better diet quality were associated with better physical quality-of-life outcomes (eg, better vitality and physical functioning; P < .05), whereas greater body mass index was associated with reduced physical quality of life (P < .001). CONCLUSIONS: The current results indicated a high prevalence of suboptimal health behaviors among older, long-term survivors of breast, prostate, and colorectal cancer who were interested in lifestyle modification. In addition, the findings pointed to the potential negative impact of obesity and the positive impact of physical activity and a healthy diet on physical quality of life in this population. Cancer 2009.Item A behavioral rating system predicts weight loss and quality of life after bariatric surgery(Elsevier, 2018-08) Hilgendorf, William; Butler, Annabelle; Timsina, Lava; Choi, Jennifer; Banerjee, Ambar; Selzer, Don; Stefanidis, Dimitrios; Pediatrics, School of MedicineBackground Bariatric surgery represents the most effective intervention for severe obesity available today; however, significant variability in postoperative outcomes exists. Effective tools that predict postoperative outcomes are needed for decision-making and patient counseling. Objectives We hypothesized that a validated behavioral assessment tool, the Cleveland Clinic Behavioral Rating Scale (CCBRS), would predict excess weight loss, health-related quality of life, depression, anxiety, and alcohol use after bariatric surgery. Setting Hospital in the United States. Methods A prospective observational study with 2-year planned follow-up was conducted with patients who completed a psychological clinical interview, the Short Form 36 (SF-36) v.2 Health Survey and brief self-report questionnaires measuring depression (PHQ-9), anxiety (GAD-7), and alcohol use (AUDIT) preoperatively. At the conclusion of the preoperative psychological evaluation, the psychologist completed the CCBRS. All questionnaires were readministered at 6, 12, 18, and 24 months after surgery. Generalized estimating equations were used to assess whether any CCBRS ratings predicted surgery outcomes. Results One hundred seventy-nine patients (113 Roux-en-Y gastric bypass and 66 sleeve gastrectomy) were included in the analyses. SF-36 scores, PHQ-9 scores, and the AUDIT total scores improved significantly after surgery, while GAD-7 scores did not change appreciably. Higher preoperative CCBRS ratings predicted higher SF-36 scores, and lower PHQ-9, GAD-7 and AUDIT scores. The CCBRS social support rating predicted higher postoperative percent excess weight loss. Conclusion A behavioral rating scale (CCBRS) completed before bariatric surgery predicted postoperative weight loss, quality of life, depression, and anxiety. Therefore, this tool may prove useful in patient counseling and expectation management before surgery.Item Burden of Seizure Clusters on Patients With Epilepsy and Caregivers: Survey of Patient, Caregiver, and Clinician Perspectives(Lippincott, Williams & Wilkins, 2017-11) Penovich, Patricia E.; Buelow, Janice; Steinberg, Kathy; Sirven, Joseph; Wheless, James; School of NursingObjectives: To characterize the burden of seizure clusters (SC) on patients and caregivers, a large internet-based survey was conducted. Methods: The Seizure Cluster Burden of Illness US Survey was conducted online by Harris Poll on behalf of The Epilepsy Foundation in September 2014. Respondents included adult patients 18 years and above with epilepsy or a seizure disorder who had experienced SC in the past year (defined as ≥2 seizures within 24 h outside the patient’s typical seizure pattern), caregivers providing current care for a patient with SC (adult or child), and clinicians (neurologists, epileptologists) who treat adult or pediatric patients. Responses to a wide range of topics, including emotional well-being, daily function, productivity, and approach to clinical practice, were collected. Results: There were 861 respondents (259 adult SC patients, 263 caregivers, and 339 clinicians). A majority of all respondent groups felt SC have a moderate/major negative impact on patient and caregiver quality of life, including emotional, financial, and social components. Responses indicated possible overutilization of emergency room services and underutilization of rescue treatment. Only 30% of patients reported having a seizure emergency plan. Some responses showed discrepancies between clinicians and patients/caregivers in the perceived degree of negative impact of SC and management practices for SC. Conclusions: These results suggest the need for increased education on managing SC. Clinicians need to develop seizure emergency plans and discuss rescue therapies, whereas patients and caregivers need to ask for and utilize these management strategies.Item A cohort study of quality of life in partners of young breast cancer survivors compared to partners of healthy controls(Springer, 2020-03-06) Cohee, Andrea A.; Storey, Susan; Winger, Joseph; Cella, David; Stump, Timothy; Monahan, Patrick; Champion, VictoriaBackground Partners of young breast cancer survivors (BCS) are at increased risk for deficits in quality of life (QoL). To intervene effectively, it is important to understand how the breast cancer experience impacts partners. The purpose of this study was to compare QoL between partners of young BCS and partners of healthy acquaintance controls. Methods Partners of young BCS (3–8 years post treatment and ≤ 45 years old at diagnosis) and partners of age-matched healthy acquaintance controls completed questionnaires on overall, physical (physical function, sexual difficulty), social (personal resources, sexual enjoyment, marital satisfaction, partner social support, social constraints, parenting satisfaction), psychological (depressive symptoms), and spiritual (behaviors, beliefs, and activities) QoL. Analyses included descriptive statistics and one-way ANOVA to compare partner groups on all study variables. Results Although partners of young BCS (n = 227) reported fewer social constraints (p < .001), they reported lower overall QoL (p < .001), fewer personal resources (p < .001), more sexual difficulty (p = .019), less sexual enjoyment (p = .002), less marital satisfaction (p = .019), more depressive symptoms (p = .024), and fewer spiritual behaviors (p < .001), beliefs (p = .001) and activities (p = .003) compared to partners of healthy acquaintance controls (n = 170). Additional analysis showed that perceptions that the relationship changed for the better since cancer, social constraints, partner social support, and depression predicted marital satisfaction among partners of young BCS. Conclusions Partners of young BCS are at risk for poorer overall, physical, social, psychological, and spiritual QoL compared to partners of healthy women. Interventions targeting QoL domains may enable partners to effectively support their partner and improve their QoL.Item A Comparison of Quality of Life Measures in Husbands of Women with Breast Cancer(Springer, 2016-09) Wagner, Christina D.; Bigatti, Silvia M.; Social and Behavioral Sciences, School of Public HealthThe Quality of Well-Being Scale (QWB-SA) and Medical Outcome Study SF-36 short form (SF-36) are popular health-related quality of life (HRQOL) assessment tools; however, it is unclear whether these measures overlap enough to be interchangeable, and if not, which might be a better choice. This study examined conceptual overlap, validity, and relation with psychosocial functioning of the QWB-SA and SF-36 in a sample of partners of women undergoing adjuvant treatment for breast cancer. Partners (n = 79) of breast cancer patients, recruited in a chemotherapy infusion clinic, completed the QWB-SA and SF-36 and additional psychosocial measures. Descriptive content review shows that both instruments provide a breadth of HRQOL coverage including physical health, mental health, social functioning, role functioning and general health perceptions; however, more QWB-SA scales suffered floor effects. Subscales correlated, with the strongest correlations between the QWB-SA total score and the mental health scales of the SF-36. The QWB-SA and the SF-36 Mental Health Component Summary score, but not the SF-36 Physical Component Summary score were strongly correlated to measures of mood, satisfaction with life, burden, and social support. The QWB-SA and SF-36 measure distinct aspects of HRQOL. Each instrument presents distinct advantages and disadvantages in coverage of particular domains. Labels assigned to SF-36 scales more accurately reflect what they measure. The SF-36 appeared more sensitive to the impact that psychological health played on overall assessment of HRQOL in these partners.Item Complications And Stoma Care Self-Efficacy Are Associated With Ostomy Adjustment In People With An Intestinal Or Urinary Ostomy(Office of the Vice Chancellor for Research, 2016-04-08) Lopez, Erika I.; Pittman, Joyce; Rawl, Susan M.More than 120,000 new ostomies, or surgically created openings through the abdomen for bowel or urinary elimination, are created annually in North America. Up to 80% of patients with a new ostomy experience ostomy-related complications that can interfere with adjustment to living with an ostomy and diminish quality of life. The purpose of this study was to examine relationships among ostomy complications, stoma care self-efficacy, and ostomy adjustment in people living with an intestinal or urinary ostomy. Examining relationships is important to identify people at risk for poor adjustment and to allow for early intervention to improve outcomes for these patients. Data were collected from 202 participants by trained telephone interviewers. Eligible participants: 18 years of age or older, had ostomy surgery within the past 24 months, currently have an ostomy, and were able to speak English. The Ostomy Adjustment Inventory-23 was used to assess adjustment to living with an ostomy and the Stoma Self- Efficacy Scale measured confidence in caring for an ostomy. Univariate analyses were conducted using t-tests, ANOVA, and correlations using the Statistical Package for the Social Sciences. Higher ostomy adjustment scores were observed in participants with permanent versus temporary ostomies (p=.002). Compared to those who did not experience ostomy complications, participants who developed peristomal dermatitis (p=.005), parastomal hypergranulation (p=.003), stomal bleeding (p=.004), and stomal retraction (p=.015) had lower ostomy adjustment scores. Stoma care self-efficacy scores were significantly correlated with ostomy adjustment scores (r=0.534, p=.000). Ostomy complications that may be modifiable influence ostomy adjustment. Additional support and education to reduce complications and enhance stoma care self-efficacy are needed for people at risk for poor adjustment. Future research is needed to develop and test the effectiveness of interventions to enhance self-efficacy and ostomy adjustment.Item Constipation and GI diagnoses in children with solid tumours: prevalence and management(BMJ, 2022-08-30) Belsky, Jennifer; Stanek, Joseph; Yeager, Nicholas; Runco, Daniel; Pediatrics, School of MedicineObjectives Despite continued development of targeted therapies for children with cancer, patients continue to experience an array of unwanted side effects. Children with solid tumours may experience constipation as a result of vinca alkaloid therapy, psychological stressors, periods of inactivity and opioid use. Our objective was to investigate the prevalence and treatment of constipation in hospitalised children with solid tumours treated with chemotherapy. Methods We retrospectively analysed data from 48 children’s hospitals in the Pediatric Health Information System, extracting patients 0–21 years of age with a solid tumour diagnosis hospitalised from October 2015 through December 2019. Results We identified 13 375 unique patients with a solid tumour diagnosis receiving chemotherapy. Constipation was the most common gastrointestinal complaint with 8658 (64.7%; 95% Cl: 63.9% to 65.5%) having a constipation diagnosis or having received at least two laxatives during admission. Bone cancers had the highest percentage (69.9%) of patients with constipation, while Hodgkin’s lymphoma had the lowest, although 52.1% of patients were affected. A total of 44% (n=35 301) of encounters received an opioid at some point during admission. Of patients receiving constipation medications, the most commonly prescribed was polyethyl glycol (n=25 175, 31.7%), followed by docusate (n=11 297, 14.2%), senna (n=10 325, 13.0%) and lactulose (n=5501, 6.9%). Conclusions Constipation is the most common gastrointestinal issue that children with solid tumours experience while receiving chemotherapy in the inpatient setting. Increased attention should be given to constipation prophylaxis and treatment in children with solid tumours undergoing chemotherapy, particularly those identified as high risk.Item Department of Music and Arts Technology's Music Therapy Program(Office of the Vice Chancellor for Research, 2010-04-09) Burns, Debra; Mauskapf, Phillip; Lee, Key HwaThe Music Therapy Program in the Department of Music and Arts Technology as two main goals: to improve the quality of life of individuals through the use of music-based interventions and to use rigorous, scientific methods to determine the best use of music-based interventions for individuals with medical and developmental needs.Item Design and rationale of a randomized trial: Using short stay units instead of routine admission to improve patient centered health outcomes for acute heart failure patients (SSU-AHF)(Elsevier, 2018-09) Fish-Trotter, Hannah; Collins, Sean; Danagoulian, Shooshan; Hunter, Benton; Li, Xiaochun; Levy, Phillip D.; Messina, Frank; Pressler, Susan; Pang, Peter S.; School of NursingNearly 85% of acute heart failure (AHF) patients who present to the emergency department (ED) with acute heart failure are hospitalized. Once hospitalized, within 30 days post-discharge, 27% of patients are re-hospitalized or die. Attempts to improve outcomes with novel therapies have all failed. The evidence for existing AHF therapies are poor: No currently used AHF treatment is known to improve long-term outcomes. ED treatment is largely the same today as 40 years ago. Admitting patients who could have avoided hospitalization may contribute to adverse outcomes. Hospitalization is not benign; patients enter a vulnerable phase post-discharge, at increased risk for morbidity and mortality. When hospitalization is able to be shortened or avoid completely, certain risks can be mitigated, including risk of medication errors, in-hospital falls, delirium, nosocomial infections, and other iatrogenic complications. Additionally, patients would prefer to be home, not hospitalized. Furthermore, hospitalization and re-hospitalization for AHF predominantly affects patients of lower socioeconomic status (SES). Avoiding hospitalization in patients who do not require admission may improve outcomes and quality of life, while reducing costs. Short stay unit (SSU: <24 h, also referred to as an ‘observation unit’) management of AHF may be effective for lower risk patients. However, to date there have only been small studies or retrospective analyses on the SSU management for AHF patients. In addition, SSU management has been considered ‘cheating’ for hospitals trying to avoid 30-day readmission penalties, as SSUs or observation units do not count as an admission. However, more recent analyses demonstrate differential use of observation status has not led to decreases in re-admission, suggesting this concern may be misplaced. Thus, we propose a robust clinical effectiveness trial to demonstrate the effectiveness of this patient-centered strategy.