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Objectives: To determine the effect of peer-led group education on the quality of life and depression in patients with ankylosing spondylitis (AS)., Methods: Eighty patients with definite AS were allocated randomly to either the education or control group. The education group (n = 40) was subjected to a peer-led group education program about disease and was given an educational booklet, while the control group (n = 40) was given the educational booklet only. Levels of quality of life and depression were measured at baseline, immediately after education (fourth week) and at 6 months in both groups., Results: The results are based on 56 (n = 27, education group; n = 29, control group) patients. The level of quality of life and depressive symptoms were not changed except for a deterioration in the social functioning subgroup of Short From (SF)-36 in both groups. When the groups were compared, there were no significant differences between changes in social functioning scores., Conclusions: Peer-led education did not alter quality of life levels and depression scores. However, because of the maintainance of quality of life levels, this type of intervention may be considered as a supplementary intervention to the standard medical care for management of AS., (© 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.)

Aim: The aim of this study was to assess the quality of life (QoL) in patients with multiple sclerosis (MS), and to evaluate its association with disability and psychosocial factors especially depression and fatigue., Methods: Demographic characteristics, education level, disease severity, and disease duration were documented for each patient. QoL, fatigue level, cognitive status, and depression level of patients were assessed by Multiple Sclerosis Quality of Life-54, Fatigue Severity Scale, Mini Mental State Scale, and Beck Depression Inventory, respectively., Results: Seventy-nine patients with MS were included in the study. There was a moderate degree of impairment in the QoL scores of MS patients. The most affected parts of QoL were included: role limitation-related physical and emotional problems and physical and social functions. Both physical and mental health components of QoL showed a positive correlation with the educational level and employment status; a negative correlation with the level of disability, fatigue, and depression. Depression, disability level, and fatigue were the strongest variables associated with QoL, and the most important predictor of QoL was depression., Conclusion: Our results have shown that both physical and mental health components of QoL were negatively affected by MS. The most important predictor of QoL was depression followed by disability and fatigue. To improve the QoL for MS patients, in addition to physical disability, the influences of depression and fatigue on QoL should be taken into consideration.

The aim of this study was to determine the quality of life (QoL) at the third month after stroke and to identify the factors related with and determinants of QoL in geriatric stroke patients. Eighty of 122 patients who were assessed within the first week after stroke were reevaluated at the third month. Patients were divided into two groups as those of ≥65 years old (geriatric group) and those of <65 years old (non-geriatric group). The stroke severity, functional status, and ambulation level were assessed by the Canadian neurological scale (CNS), the functional independence measure (FIM), and the functional ambulation classification scale (FACS) within the first week of stroke, respectively. Depression and QoL levels were also determined at the third month using the Zung self-rating depression scale (ZDS) and both the Short Form-36 (SF-36) survey and the stroke-specific quality of life (SSQoL) scale, respectively. The QoL of 80 patients according to the SF-36 were lower than those of general population. No significant difference was found in stroke severity, functional status at baseline and third month, depression and QoL between geriatric and non-geriatric patients (p>0.05). The most influenced subscale of QoL was work/productivity in geriatric patients, and the main determinant of QoL was the functional status during the assessment. Stroke patients had an impaired QoL, and geriatric patients did not demonstrate a difference in terms of QoL compared to non-geriatric patients. The fact that the main determinant of QoL was functional status has been suggested that improving of physical function may be helpful to provide a better QoL for stroke patients., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

We previously reported the efficacy of a 4-week home-based exercise therapy for patients with rheumatoid arthritis (RA). In this study, we aimed to investigate whether short-term improvements in the functional status and quality of life were maintained at 1 year. Patients who completed 4-week home-based exercise program were advised to maintain the same exercises for 1 year duration. Changes of functional status and quality of life in patients with RA were evaluated by the Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Quality of Life Scale (RAQoL). The change of the variables at the different time points (baseline, 4 weeks, and 1 year) was assessed by the repeated measure of ANOVA test with Geisser-Greenhouse correction. Pairwise ANOVA comparisons adjusted using the Bonferroni correction were conducted. Twenty-eight (63.6%) of 44 patients were available for follow-up at 1 year. The results of repeated measure ANOVA showed that there was a statistically significant difference between three assessments in the HAQ (P = 0.015) and RAQoL (P = 0.037) scores at the end of the follow-up. Improvements in the functional status and health-related quality of life at 4 weeks were maintained at 1-year follow-up. In conclusion, we observed significant improvements in the functional status and health-related quality of life by 4-week home-based exercise program. Furthermore, these improvements were maintained at 1-year follow-up. Further studies are needed to confirm the usefulness of the home-based exercise therapy.

Background: The aim of this study was to determine the prevalence of impairments relevant to upper extremity following breast cancer surgery and its impact on disability and health-related quality of life., Methods: Sixty-seven female patients being treated with modified radical mastectomy or breast conserving surgery were included. They were evaluated for impairments (arm edema, loss of handgrip strength, limited shoulder joint range of motion, and pain), physical disability using the disabilities of the arm, shoulder, and hand (DASH) questionnaire, and for health related quality of life by means of the functional assessment of cancer therapy-breast+4 (FACT-B+4)., Results: The most common impairment observed was arm pain on motion; the cause of 20% variance in disability score (r = 0.203, P = 0.000). Arm pain on motion, anterior chest wall pain, loss of grip strength, and shoulder flexion were significant factors in different domains of quality of life according to the FACT-B+4 questionnaire., Conclusion: Pain relief should be the priority of treatment along with the prevention of joint movement restriction to ensure a sufficient quality of life for surgically treated breast cancer patients.

The goal of our study was to develop a Turkish version of the Rheumatoid and Arthritis Outcome Score (RAOS) in patients with rheumatoid arthritis (RA) and to assess its reliability, validity, and sensitivity to change. The Turkish version of RAOS was developed according to cross-cultural guidelines by using the "translation-back translation" method. Fifty-eight patients with RA were assessed with it. To assess its validity, patients were also evaluated with Turkish versions of the Health Assessment Questionnaire, five subscales of Arthritis Impact Measurement Scales, and the Rheumatoid Arthritis Quality of Life questionnaire. Test-retest reliability of the RAOS questionnaire was calculated on 58 patients within 1 week. Construct validity was investigated with use of Spearman's rank correlation coefficient. Test-retest reliability was assessed with use of the intraclass correlation coefficient (ICC) and Cronbach's alpha score. Sensitivity to change after the 4-week home-based exercise program was evaluated with paired t test comparisons. The Turkish version of the RAOS met set criteria of reliability and validity. The random ICC for the five subscales ranged from 0.76 to 0.94. Interitem correlation measured by Cronbach's alpha ranged from 0.81 to 0.94. Correlations were found between RAOS subscales and all of the evaluation parameters (p < 0.01). RAOS subscales showed significant improvements after the 4-week home exercise program except for the symptom and quality of life subscales (p < 0.05). The effect sizes were ranged from 0.20 to 0.37 and were considered small. The results of this study showed that the Turkish version of RAOS was reliable, valid, and responsive in patients with rheumatoid arthritis.

Aim: The aim of this study was to assess the quality of life (QoL) in patients with multiple sclerosis (MS), and to evaluate its association with disability and psychosocial factors especially depression and fatigue. Methods: Demographic characteristics, education level, disease severity, and disease duration were documented for each patient. QoL, fatigue level, cognitive status, and depression level of patients were assessed by Multiple Sclerosis Quality of Life-54, Fatigue Severity Scale, Mini Mental State Scale, and Beck Depression Inventory, respectively. Results: Seventy-nine patients with MS were included in the study. There was a moderate degree of impairment in the QoL scores of MS patients. The most affected parts of QoL were included: role limitation-related physical and emotional problems and physical and social functions. Both physical and mental health components of QoL showed a positive correlation with the educational level and employment status; a negative correlation with the level of disability, fatigue, and depression. Depression, disability level, and fatigue were the strongest variables associated with QoL, and the most important predictor of QoL was depression. Conclusion: Our results have shown that both physical and mental health components of QoL were negatively affected by MS. The most important predictor of QoL was depression followed by disability and fatigue. To improve the QoL for MS patients, in addition to physical disability, the influences of depression and fatigue on QoL should be taken into consideration.

Objective: Loss of proprioception and balance disorders are commonly observed in patients with knee osteoarthritis. In this study, we aimed to investigate the effects of balance and proprioception exercises in patients with knee osteoarthritis. Design: A single-center randomized trial with three parallel arms. Setting: A tertiary health care facility in Turkey. Participants: Female patients with knee osteoarthritis aged 40–70 years. Interventions: Ten-week exercise program in Biodex training, classical balance training and isometric strengthening groups. Main measures: Dynamic balance (overall stability index and the modified Clinical Test of Sensory Interaction and Balance), pain (visual analogue scale), physical function (30-s chair stand test and 40-meter fast-paced walk test) and quality of life (Knee Injury and Osteoarthritis Outcome Score). Results: Eighty-nine patients enrolled in the study. The Biodex training group, the classical training group, and the control group had overall stability index values of 1.0 ± 0.07, 1.4 ± 0.07 and 1.4 ± 0.07, and the Modified Clinical Test of Sensory Interaction and Balance – Condition-3 values of 0.7 ± 0.04, 0.9 ± 0.04 and 0.9 ± 0.04 respectively, at the end of treatment. In terms of pain scores on movement, each group showed significant improvement compared to their baseline, and the classical balance training group had better scores than the control group. No other significant difference was found between the groups. Physical function and quality of life outcomes showed significant main effects only in the time factor. Conclusions: Balance and proprioception exercises may have positive effects on dynamic balance and pain. The effects on physical function and quality of life should be investigated in further studies with larger sample. [ABSTRACT FROM AUTHOR]

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Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue ( p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS. [ABSTRACT FROM AUTHOR]

We previously reported the efficacy of a 4-week home-based exercise therapy for patients with rheumatoid arthritis (RA). In this study, we aimed to investigate whether short-term improvements in the functional status and quality of life were maintained at 1 year. Patients who completed 4-week home-based exercise program were advised to maintain the same exercises for 1 year duration. Changes of functional status and quality of life in patients with RA were evaluated by the Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Quality of Life Scale (RAQoL). The change of the variables at the different time points (baseline, 4 weeks, and 1 year) was assessed by the repeated measure of ANOVA test with Geisser-Greenhouse correction. Pairwise ANOVA comparisons adjusted using the Bonferroni correction were conducted. Twenty-eight (63.6%) of 44 patients were available for follow-up at 1 year. The results of repeated measure ANOVA showed that there was a statistically significant difference between three assessments in the HAQ ( P = 0.015) and RAQoL ( P = 0.037) scores at the end of the follow-up. Improvements in the functional status and health-related quality of life at 4 weeks were maintained at 1-year follow-up. In conclusion, we observed significant improvements in the functional status and health-related quality of life by 4-week home-based exercise program. Furthermore, these improvements were maintained at 1-year follow-up. Further studies are needed to confirm the usefulness of the home-based exercise therapy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of disease activity, functional capacity and several dimensions of health status on the level of quality of life in patients with rheumatoid arthritis. Patients and Methods: Thirty-two patients (F/M=30/2) who fulfilled the American College of Rheumatology diagnostic criteria for rheumatoid arthritis were included in this study. Demographic characteristics of patients were recorded. Functional status, health status and quality of life were respectively measured by using Health Assessment Questionnaire (HAQ), Arthritis Impact Measurement Scale2 (AIMS2) and Rheumatoid Arthritis Quality of Life (RAQoL). Results: The mean of ages and disease duration were 51.0±11.8 (28-70) and 11.8±10.0 (1-40) years. There was a statistically significant relation between RAQoL and HAQ (r= 0.472, p= 0.008), mobility (r= 0.379, p= 0.039), walking (r= 0.515, p= 0.004), self care (r= 0.640, p<0.001) and household tasks (r= 0.640, p<0.001) subscales of AIMS2. HAQ correlated with mobility, self care and household tasks and pain subscales of AIMS2 (respectively r= -0.364, -0.559, 0.456, -0.671; p= 0.040, 0.001, 0.009, 0.001). The most important determinants of quality of life were determined as HAQ and walking subscale of AIMS2 (respectively β= 4.013, 1.041 p= 0.021, 0.031). Conclusion: It was shown that rather than disease activity, functional and health status were associated with quality of life. According to our data, amelioration of functional status must be the essential target while controlling pain and disease activity in the treatment of rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Background: Patient education programmes, whether health professional-led or peer-led, may be beneficial to improve health status for many diseases. One of the management strategies in various diseases, is interaction between patients by generating support groups. The aim of this study was to determine the effect of peer-led education on the quality of life and level of patients’ knowledge about their disease in patients with ankylosing spondylitis (AS).Methods: Fourty-six patients with definite AS were allocated randomly to either intervention or control group. The intervention group (n=22) was subjected to peer-led education program about disease one hour weekly for four weeks and was given an educational booklet while control group (n=24) was given educational booklet only. Level of quality of life (SF-36 and ASQoL) and patients’ knowledge about disease (Patient Knowledge Questionnaire) were measured at baseline and at the end of the four-week period in both groups. Non-parametric methods were used in the statistical analysis. Level of significance was set at 0.05.Results: Patient Knowledge Questionnaire scores were increased in both groups at the end of the four-week period (p=0.000, 0.007 respectively). In contrast to baseline results, there was significant difference (p=0.029) between groups in favour of intervention group, when comparing Patient Knowledge Questionnaire scores at the end of four-week period. SF-36 and ASQoL scores were not changed in both groups (p>0.05).Conclusions: Both peer-led education and booklets on the disease seem have positive effects on knowledge about disease. However, quality of life level was not changed in this short period of time. This may be related to the fact that quality of life is multidimensional and affected by multiple factors other than health status. This study is going on and the effect of peer-led education on the level of quality of life will be evaluated at sixth month of intervention. [ABSTRACT FROM AUTHOR]