BackgroundFalls are an increasing health problem and are more frequent in females. Beliefs and behaviour are known to influence the health status.ObjectivesTo evaluate the influence of beliefs on health-related quality of life (HRQL) in women aged ≥65 years who had suffered falls in the previous 6 months.MethodsObservational study. Sociodemographic and clinical variables were collected. Beliefs were determined using the Falls Efficacy Scale-International (FES-I), which evaluates the fear of falling, and a question on self-efficacy with respect to health: “Do you believe that your behaviour can influence your health status?” This was measured on a 5-point Likert scale: 1) Totally agree: 2) Quite agree; 3) Don't know; 4) Quite disagree; 5) Totally disagree. HRQL was measured using the SF-36 and WOMAC questionnaires. Gait and balance was evaluated using the Tinetti test. Statistical analysis: Correlations between HRQL and beliefs were calculated. Linear multiple regression was used to evaluate the association between significant independent variables and the physical component of the SF-36 (PC) and the total WOMAC score (TW).Results46 women (mean age 75.4 years (SD 6.8), BMI 30.3 (5.7), number of comorbidities 6.1 (SD 2.4), of which 75% were taking ≥4 medications (mean 6.1 [SD 2.4]) were included. Mean Tinetti score was 23.1 points (SD14.6), mean FES-I was 29.9 points (SD 20.6): 69.6% of patients believed their behaviour influenced their health, PC 34.2 points (SD 8.1) and TW 45.3 points (SD 24.7).Significant correlations were found between the fear of falling (FES-I) and HRQL. Correlations were 61% (p<0.001) with the PC, 58% (p<0.001) with the TW, and 45% (p=0.006) with the Tinetti test. Patients who agreed their behaviour could influence their health had significantly better HRQL (TW score [40.4 vs 56.5 p=0.029] and the Tinetti score [23.39 vs 11.36 p=0.002]). Regression analysis showed that 36% of the variability in the PC was explained by the fear of falling. The variability in the TW was explained by the fear of falling (35%) and the BMI (11%). Age, number of comorbidities and number of medications had no influence on the two models.ConclusionsPatients who believed their behaviour influenced their health had a better HRQL and a lower risk of suffering falls than those who did not. Health professionals should take patients' beliefs into account when planning and introducing interventions to prevent falls and improve HRQL.ReferencesWorld Health Organization. Falls 2012. Informe de salud 2013. Generalitat de Catalunya. 2014.Bandura A. Self-efficacy: Toward a Unifying theory of behavioral change. Psychological Rev 1977;84(2):191-215.AcknowledgementsThe FATE project has been funded by CIPICT-PSP-2011-5 297178Disclosure of InterestNone declared
BackgroundStudies report that sleep disturbances are often associated with chronic musculoskeletal disease. There is no agreed definition of sleep health, but some characteristics, such as sleep duration (number of hours daily) and sleep quality or satisfaction (subjective evaluation of good or poor sleep) are used to evaluate sleep health. In a previous study in patients with severe osteoarthritis awaiting total knee replacement (TKR), patients reporting good quality sleep had better health-related quality of life (HRQL) measured by the specific WOMAC and generic SF-36 questionnaires.ObjectivesTo measure sleep health in patients included on a waiting list for TKR and 12 months after TKR.MethodsProspective study with a 12-month follow up. Sociodemographic and clinical variables were determined. Sleep health: hours of sleep and reparative sleep (RS) were examined using the question “How well do you usually sleep?” measured on a Likert scale (1=good [RS], 2=regular, 3=badly, 4=with medication/treatment (non-reparative sleep [NRS]). Function and pain were measured using the WOMAC and SF-36 questionnaires. Comparisons were made using t-tests (paired samples) and McNemar's test. Linear regression models were used to analyze associations. Dependent variables: WOMAC and SF-36 pain and function dimensions; independent variables: sleep quality, age, sex, BMI, number of comorbidities, depression/anxiety.Results105 patients (79% female, mean age 69.39 years [SD 8.3]) were included. 80% had ≥2 comorbidities (mean 2.71 [SD 1.8]), mean BMI was 33.68 (SD 6.7), 32 had depression/anxiety, and mean sleep duration was 6.63 hours (SD 1.4). 12 months after TKF there were significant improvements in WOMAC dimension scores (mean >25 points, p<0.001) and SF-36 scores (mean >19). At study inclusion, 23% reported RS with a mean sleep duration of 7.5 hours (SD 1.1) vs. 6.24 hours (SD 1.5) in NRS patients (p=0.002). 12 months after TKR, 40% of patients had RS (p=0.029). Patients with RS had better scores in all quality of life dimensions (<10 points) than those with NRS (p<0.05) at baseline and at 12 months. Multivariate analysis showed RS was independently associated with pain and function (WOMAC and SF-36) (p<0.007).ConclusionsSleep health was associated with better HRQL before and after TKR. Although more patients had RS after TKR, 60% of patients continued not to have sleep health. Although often undervalued clinically, sleep health is closely associated with the health status.AcknowledgementsThis work was funded by project PI/13/00948, integrated in the Plan Nacional I+D+I and cofounded by ISCIII-Subdirecciόn General de Evaluaciόn and European Regional Development Fund (ERDF).References Buysse DJ. Sleep health: can we define it? Does it matter? Sleep. 2014 Jan 1;37(1):9–17. doi: 10.5665/sleep.3298. Disclosure of InterestNone declared
BackgroundKnee osteoarthritis (OA) is a degenerative disease in which pain and functional disability progression tend to increase with reducing the health-related quality of life (HRQOL). Factors related to healthy lifestyles, such as physical activity and sleep, are known to have restorative benefits on function and pain in these patients. A previous study found that patients with reparative sleep achieved better WOMAC and SF-36 HRQOL questionnaire dimension scores.ObjectivesTo determine the influence of physical activity and sleep on functional capacity and pain in patients with long-term knee OA.MethodsCross-sectional study. Sociodemographic and clinical variables, physical activity (PA) (regular physical exercise ≥3 times a week ≥30 minutes per session (PE) and sitting ≤6 hours/day [S]) and sleep quality/reparative sleep (RS) were determined using the question: How do you usually sleep? (1=well [RS], 2=regular, 3=badly, 4 =with medication/treatment [NRS]). Functional capacity and pain were evaluated using the WOMAC (specific) and SF-36 (generic) HRQOL questionnaires. Associations were analysed using multiple regression models.Results453 patients (84.3% female), mean age 69.73 (8.4), BMI 35.27 [SD 6.3], comorbidities 2.43 (SD 1.5), 78.6% with obesity (BMI 33.68 [SD 6.7]), depression/anxiety in 36.4%, PE 60.5%, S 72.2% and PA 48.6%, were included. 22.5% reported RS. Bivariate analysis showed patients with PA and those with RS had better functional capacity and less pain intensity (>10, p>0.001, in both WOMAC and SF-36). The four multiple regression showed that patients with PA and SR had better scores, both in functional capacity (dependent variables, WOMAC and SF-36) and pain (dependent variables, WOMAC and SF-36), p<0.006. Age, gender, number of comorbidities and obesity were included in the models as potential confounders. Obesity was associated with worse function and more pain in the four models (p<0.05). Being female and greater comorbidity were associated with poorer functional capacity and pain assessed by the SF-36.ConclusionsPhysical activity and sleep were associated with less pain and better functional capacity, suggesting these variables should be determined systematically in clinical practice due to their significant relationship with HRQOL. Obesity was negatively associated with function and pain. There was also a negative relationship between female gender and comorbidity according to the SF-36. Differences in generic and specific questionnaires mean they should be used together to provide more detailed information.AcknowledgementsThis work was funded by project PI/13/00948, integrated in the Plan Nacional I+D+I and cofounded by ISCIIISubdirecciόn General de Evaluaciόn and European Regional Development Fund (ERDF).References Uthman OA, van der Windt DA, Jordan JL, Dziedzic KS, Healey EL, Peat GM, et al. Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis. BMJ. 2013;347:f5555.Abad VC, Sarinas PS, Guilleminault C. Sleep and rhe...
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