Josune Martín

Background: This study sought to appraise health-related quality of life (HRQoL) one year after admission in persons with digestive cancer and chronic digestive diseases, stratified by nutritional status on hospital admission, and to identify clinical predictors of HRQoL. Methods: HRQoL questionnaires were completed on admission and after 12 months by a prospective cohort of 560 persons with digestive cancers and digestive chronic diseases. Between 2020 and 2021, among the 926 patients admitted to the study, a prospective cohort of 560 persons with digestive cancers or digestive chronic diseases completed HRQoL questionnaires at admission and after 12 months. Nutritional status was assessed using MUST and GLIM criteria. Multiple correspondence analyses were used to identify clinically meaningful subgroups of patients. Multivariate analyses were performed to identify HRQoL predictors. Results: Participants had a mean age of 63.4 years; 60.7% were male and 39.3% female. At baseline, 34.81% of participants were classified as malnourished. Scores for mental health (SF-36 MH), role-emotional (SF-36 ER), and vitality (SF-36 VT) were significantly lower among persons with severe malnutrition and colorectal cancer (CRC) (p = 0.001, p = 0.004 and p = 0.009, respectively). Regarding changes in HRQoL over one year, persons with severe malnutrition at baseline showed the greatest improvement in mental health (SF-36 MH) within the CRC group (p = 0.01). Among persons with cancer, polypharmacy was consistently associated with poorer outcomes, with significant negative associations across EuroQoL (p < 0.001), SF-36 Social Functioning (p < 0.001), and General Health (p < 0.001). In persons with digestive diseases, length of admission was inversely associated with Physical Role (p < 0.05) and Body Pain (p < 0.05). Finally, GLIM status displayed limited associations, only significant in the case of Vitality and Body Pain (p < 0.05 in both). Conclusions: HRQoL in patients with oncological and digestive diseases is shaped by a complex interplay of clinical and sociodemographic factors.

Purpose: We evaluated changes in health-related quality of life (HRQoL) twelve months after admission among three groups of patients with digestive and oncological pathologies by nutritional status and nutritional intervention. We also sought to identify factors influencing those changes, taking into account the patients’ baseline status. Methods: This pragmatic effectiveness trial study comprised 619 hospitalized patients who completed HRQoL instruments on admission and twelve months later. Of these, 365 were classed as non-malnourished and 254 as malnourished (of whom 59 underwent nutritional intervention). Sociodemographic and clinical data were gathered. Patients completed the Short-Form 36; the EuroQol generic health-related quality of life questionnaire and the Barthel Index. Descriptive, univariate and multivariate linear regression models were applied to identify factors associated with changes in HRQoL. Results: Participants had a mean age of 63.5 years; 61.6% were male. Malnourished patients showed significant improvement in mental, social and physical components at the change. In the multivariate analysis, several variables affected the HRQoL of hospitalized patients one year after admission, such as level of malnutrition, pathology on admission, gender, age, Charlson Comorbidity Index, number of drugs prescribed, length of stay or surgical intervention. The nutritional intervention provided during the days of admission was not found to be associated with better HRQoL, except for role physical and body pain. Conclusion: Identifying the factors influencing changes in HRQoL amongst patients one year after their admission could help determine how important it is to improve these factors, when possible, for example through nutritional intervention prior to admission for surgery.

Background: Breast cancer diagnosis and treatment increase the potential psychological impact on breast cancer survivors (BCS). The objective of this study was to assess the effects of an interdisciplinary intervention during follow‐up in BCS and identify variables related to improvements in HRQoL.Materials and Methods: In a non‐randomised quasi‐experimental design performed on an outpatient basis in a hospital gynaecology and oncology unit, 60 BCS were assigned to an interdisciplinary experimental group (EG) or a usual care group (CG). The EG underwent 12 sessions of an interdisciplinary program which included Mindfulness and physiotherapy, for 120 min per day, once a week for 6 weeks. At baseline, at 6 weeks and at 3 months after the intervention, participants of EG and CG completed an assessment of HRQoL (EuroQol and EORTC‐QLQ‐C30) and symptomatology of anxiety and depression. Additionally, EG completed an assessment of satisfaction with the treatment. For data analysis, we used descriptive statistics, Wilcoxon test, Kruskal–Wallis test, Chi‐square and Fisher tests and generalised linear models.Results: After 6 weeks, statistically significant differences were apparent in global and cancer‐related health symptoms such as fatigue and pain in the EORTC QLQ‐C30 and in anxiety and depression, among the EG (n = 30) compared with the CG (n = 30). Patients receiving the intervention reported a high degree of satisfaction with the treatment. Three months after the intervention, patients in the EG continued to show statistically significant improvements compared with the CG. In addition, allocation to the EG was identified as a variable related to improvement of HRQoL (EORTC QLQ‐C30) in the multivariable model.Conclusions: The results of our study suggest that a 6‐week interdisciplinary intervention may improve HRQoL and symptomatology of anxiety and depression in BCS patients at 3 months. The study presents data that the intervention for BCS appears promising and warrants further study in a randomised controlled trial.

Background: The characteristics of this pandemic increase the potential psychological impact on care homes workers (CHWs). The aims of this study were to analyse the mental health and health‐related quality of life (HRQoL) of a broad sample of CHWs in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL.Method: This descriptive study comprised 210 CHWs who completed the Generalized Anxiety Disorder 7‐item Scale, the Patient Health Questionnaire‐9, the Impact Event Scale‐Revised, the Insomnia Severity Index, and the Health‐related Quality of Life Questionnaire. Sociodemographic and clinical data in relation to COVID‐19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL.Results: Of total, 86.19% of participants were female; 86.67% were aged under 55 years; 11% were physicians and 64.19% were nurses or auxiliaries; 77.62% have themselves tested positive for Covid‐19; and 67.94% of CHWs have directly treated patients with Covid‐19. 49.28% had clinical depression; over half (58.57%) had clinical anxiety; 70.95% had clinical stress; and 28.57% had clinical insomnia. Increased use of tranquilizers/sedatives appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our CHWs.Conclusions: Our study confirms that symptomatology of anxiety, depression, stress, insomnia and HRQoL were affected amongst CHWs during the Covid‐19 pandemic.

Grouping eating disorders (ED) patients into subtypes could help improve the establishment of more effective diagnostic and treatment strategies. To identify clinically meaningful subgroups among subjects with ED using multiple correspondence analysis (MCA). A prospective cohort study was conducted of all outpatients diagnosed for an ED at an Eating Disorders Outpatient Clinic to characterize groups of patients with ED into subtypes according to sociodemographic and psychosocial impairment data, and to validate the results using several illustrative variables. In all, 176 (72.13%) patients completed five questionnaires (clinical impairment assessment, eating attitudes test-12, ED-short form health-related quality of life, metacognitions questionnaire, Penn State Worry Questionnaire) and sociodemographic data. ED patient groups were defined using MCA and cluster analysis. Results were validated using key outcomes of subtypes of ED. Four ED subgroups were identified based on the sociodemographic and psychosocial impairment data. ED patients were differentiated into well-defined outcome groups according to specific clusters of compensating behaviours.

Background The aims of this study were to analyse the mental health and health-related quality of life (HRQoL) of a broad sample of healthcare workers (HCWs) in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL. Method This prospective cohort study comprised 2089 HCWs who completed the Generalized Anxiety Disorder 7-item (GAD-7) Scale, the Patient Health Questionnaire-9 (PHQ-9), the Impact Event Scale-Revised (IES-R), the Insomnia Severity Index (ISI), and the health-related quality of life Questionnaire (EQ-5D). Sociodemographic and clinical data in relation to Covid-19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL. Results 80.87% of participants were female and 19.13% male; 82.38% were aged under 55 years; 39.13% were physicians and 50.17% were nurses or auxiliaries; 80.42% of the health workers have directly treated patients with Covid-19 and 12.28% have themselves tested positive for Covid-19. 38.58% of HCWs had clinical depression; over half (51.75%) had clinical anxiety; 60.4% had clinical stress; and 21.57% had clinical insomnia. Older professionals (>55 years) reported lower rates of anxiety, depression, insomnia, and stress. Having worked directly with Covid-19 patients appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our HCWs. The group of HCWs suffering the worst mental state were nursing home workers. Conclusions Our study confirms that symptomatology of anxiety, depression, stress, insomnia, and HRQoL were affected amongst HCW during the Covid-19 pandemic.

Objective: The goal of this study is to identify potential factors that have a significant effect on anxiety and depression of patients with eating disorders (ED) using the beta‐binomial regression (BBR) approach on a broad sample of patients.Method: This cross‐sectional study involved 520 ED patients. The effect of sociodemographics, core symptoms, general health outcomes, and medical comorbidities in anxiety and depression were analysed jointly using the beta‐binomial mixed‐effects model.Results: Two hundred fifty‐five (49.4%) patients had anorexia nervosa, 173 (33.3%) patients had bulimia nervosa, and 92 (17.7%) had ED not otherwise specified. A high level of anxiety was associated, among other variables, with having a restrictive ED subtype as compared with purgative and binge ED subtypes (β = −0.2, p < 0.001, OR = 0.82 and β = −0.16, p < 0.03, OR = 0.85, respectively), with having a high level of ED symptomatology or with living not alone (β = −0.23, p = 0.002, OR = 0.80). A high level of depression was associated, among other variables, with older age (β = 0.74, p < 0.001, OR = 2.1).Conclusions: The results of our study suggest that depressive and anxiety symptoms are related to ED symptoms, health status, ED subtype, medical comorbitidy, and educational level. In addition, another interesting finding is the inverse association between symptomatology of anxiety and living alone. Finally, BBR may be a useful approach in interpreting patient‐reported outcome as odds.