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Education level and health-related quality of life after oesophageal cancer surgery: a nationwide cohort study.

ABSTRACT: The purpose of the study was to investigate whether low education level was associated with patients' health-related quality of life (HRQOL) after oesophageal cancer resection.A nationwide cohort study in Sweden.In total, 378 patients who underwent oesophageal cancer surgery in 2001-2005 were followed up 6 months and 3 years after surgery.HRQOL was assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and the oesophageal cancer-specific module. The association between level of education and HRQOL was calculated with linear regression models, providing mean score differences (MD) and 95% CIs. Data were analysed separately for women and men.Education level was not associated with HRQOL recovery after oesophageal cancer surgery. However, when data were stratified by sex, lower education was associated with worse emotional function (MD -13; 95%?CI -22 to -3), more symptoms of insomnia (MD 20; 95%?CI 8 to 32) and reflux (MD: 15; 95%?CI 3 to 26) for women, but not for men. Among women, low education was in general associated with worse functioning and more symptoms.Low education was not associated with worse HRQOL after oesophageal cancer surgery. However, when data were stratified for sex, low education level was associated with worse functioning and more symptoms in certain HRQOL domains for women, particularly in a short-term perspective. For men, no such association was found.

SUBMITTER: Schandl AR

PROVIDER: S-EPMC6112400 | biostudies-other | 2018 Aug

REPOSITORIES: biostudies-other

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Education level and health-related quality of life after oesophageal cancer surgery: a nationwide cohort study.

Schandl Anna Regina AR Johar Asif A Mälberg Kalle K Lagergren Pernilla P

BMJ open 20180823 8

<h4>Objective</h4>The purpose of the study was to investigate whether low education level was associated with patients' health-related quality of life (HRQOL) after oesophageal cancer resection.<h4>Setting</h4>A nationwide cohort study in Sweden.<h4>Participants</h4>In total, 378 patients who underwent oesophageal cancer surgery in 2001-2005 were followed up 6 months and 3 years after surgery.<h4>Outcome measures</h4>HRQOL was assessed by the European Organisation for Research and Treatment of C ...[more]

PMID: 30139895

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Project description:BackgroundThe concept of health-related quality of life and education integrates the bio-psychosocial perspective of health and the multidimensional potentialities of education for wellbeing. This present work is especially relevant to young people because understanding the interaction between health and education can facilitate the design of preventive policies. The research examines the way in which the educational level of young people from an urban district in the city of Zaragoza (Casablanca) has an influence on their health-related quality of life (HRQOL).MethodsA cross sectional survey was undertaken in the Casablanca district of Zaragoza (Spain). Participants were not randomly selected; their numbers reflected the areas where they lived with respect to age and sex distribution. It comprised 122 boys and 122 girls, aged between16 and 29, living in the neighbourhood are: Viñedo Viejo, Las Nieves and Fuentes Claras. These three residence zones are markedly different in terms of socioeconomic composition. The questionnaire included the following information: socioeconomic characteristics (sex, age, educational level, employment status, residence zone), an assessment of health (health problems, diagnosis and medication in the last 2?weeks) and HRQOL (WHOQOL-BREF dimensions: mental health; physical health; social relations; and environment). ANOVA and four regression models were used to assess the role, direction and intensity of educational level on HRQOL.ResultsThe results show that the higher the level of education, the better the level of HRQOL. The biggest impact of education was on the mental health dimension, but this influence was modulated by sex and residence zone. The value of the interaction of education and residence zone was more significant than educational level alone. HRQOL of girls is more sensitive to education, being a student and residence zone than the HRQOL of boys.ConclusionsThe dimensions of HRQOL are influenced by educational level. The influence is greatest among girls and the youngest members of the poorest area of the district. Public authorities should contemplate the development of an equitable education system from the beginning of the life cycle as a public health strategy.

Project description:OBJECTIVES:To assess the health burden of breast hypertrophy and the comparative effectiveness of breast reduction surgery in improving health-related quality of life. DESIGN:Prospective cohort study. SETTING:A major public tertiary care hospital in Australia. PARTICIPANTS:Women with symptomatic breast hypertrophy who underwent breast reduction surgery were followed for 12 months. A comparison control cohort comprised women with breast hypertrophy who did not undergo surgery. INTERVENTIONS:Bilateral breast reduction surgery for women in the surgical cohort. MAIN OUTCOME MEASURES:The primary outcome measure was health-related quality of life measured preoperatively and at 3, 6 and 12 months postoperatively using the Short Form-36 (SF-36) questionnaire. Secondary outcome measures included post-surgical complications. RESULTS:209 patients in the surgical cohort completed questionnaires before and after surgery. 124 patients in the control hypertrophy cohort completed baseline and 12-month follow-up questionnaires. At baseline, both groups had significantly lower scores compared with population norms across all scales (p<0.001). In the surgical cohort significant improvements were seen across all eight SF-36 scales (p<0.001) following surgery. Within 3 months of surgery scores were equivalent to those of the normal population and this improvement was sustained at 12 months. SF-36 physical and mental component scores both significantly improved following surgery, with a mean change of 10.2 and 9.2 points, respectively (p<0.001). In contrast, SF-36 scores for breast hypertrophy controls remained at baseline across 12 months. The improvement in quality of life was independent of breast resection weight and body mass index. CONCLUSION:Breast reduction significantly improved quality of life in women with breast hypertrophy. This increase was most pronounced within 3?months of surgery and sustained at 12-month follow-up. This improvement in quality of life is comparable to other widely accepted surgical procedures. Furthermore, women benefit from surgery regardless of factors including body mass index and resection weight.

Project description:ImportanceHealth-related quality of life (HRQOL) is regarded as a key outcome for evaluating treatment efficacy. However, it is uncertain how HRQOL evolves after epilepsy surgery compared with medical therapy, such as whether it continues to improve over time, improves and then remains stable, or deteriorates after a period of time.ObjectiveTo assess trajectory of HRQOL over 2 years in children with drug-resistant epilepsy (DRE) treated with surgery compared with medical therapy.Design, setting, and participantsProspective cohort study assessing HRQOL longitudinally over 2 years. Participants were children recruited from 8 epilepsy centers in Canada from 2014 to 2019 with suspected DRE aged 4 to 18 years who were evaluated for surgery. Data were analyzed from May 2014 to December 2021.ExposuresEpilepsy surgery or medical therapy.Main outcomes and measuresHRQOL was measured using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE)-55. HRQOL and seizure frequency were assessed at baseline, 6-month, 1-year, and 2-year follow-ups. Clinical, parent, and family characteristics were assessed at baseline. A linear mixed model was used to evaluate HRQOL over time, adjusting for baseline clinical, parent, and family characteristics.ResultsThere were 111 surgical and 154 medical patients (mean [SD] age at baseline was 11.0 [4.1] years; 118 [45%] were female). At baseline, HRQOL was similar among surgical and medical patients. HRQOL of surgical patients was 3.0 (95% CI, -0.7 to 6.8) points higher at 6-month, 4.9 (95% CI, 0.7 to 9.1) points higher at 1-year, and 5.1 (95% CI, 0.7 to 9.5) points higher at 2-year follow-ups compared with medical patients. Surgical patients experienced greater improvements in social functioning relative to medical patients, but not for cognitive, emotional, and physical functioning. At 2-year follow-up, 72% of surgical patients were seizure-free, compared with 33% of medical patients. Seizure-free patients reported higher HRQOL than those who were not.Conclusions and relevanceThis study provided evidence on the association between epilepsy surgery and children's HRQOL, with improvement in HRQOL occurring within the first year and remaining stable 2 years after surgery. By demonstrating that surgery improved seizure freedom and HRQOL, which has downstream effects such as better educational attainment, reduced health care resource utilization, and health care cost, these findings suggest that the high costs of surgery are justified, and that improved access to epilepsy surgery is necessary.

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Education level and health-related quality of life after oesophageal cancer surgery: a nationwide cohort study.

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Education level and health-related quality of life after oesophageal cancer surgery: a nationwide cohort study.

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