The aim of this study was to examine the quality of life and to report on the utility and QALY measures in patients before and after coronary artery bypass grafting (CABG); to investigate whether the SF-12 is comparable with the SF-36 for measuring health-related quality of life of patients with CABG; and to determine the impact of individual predictors on poor quality of life assessment after rehabilitation. This prospective study was conducted between January 2017 and December 2018 at the University Hospital Center Osijek, at three time points: pre-operation, 1 month after surgery, and after rehabilitation. The study was conducted with the SF-36 and SF-12 health questionnaires on 47 participants. After rehabilitation, there was a significant improvement in all domains of quality of life. The highest score was given to the change in pain (BP); mean scores were 63.8 (95% CI 56.9 to 70.6) (p = 0.001). The lowest grade (the lowest quality) after rehabilitation was in the domain of limitations due to physical difficulties (RP); arithmetic mean was 48.5 (95% CI 41 to 55.9) (p < 0.001). Quality-adjusted life-year was 0.41 (95% CI 0.38–0.44) after the CABG. The results of this study show that patients with coronary heart disease have poor quality of life before surgery. One month after the surgery, the quality of life improved, but was still inadequate. One year after surgery, satisfactory results were obtained in almost all subscales. The SF-36, SF-12, and its components, can be used effectively in patients with CABG. Age, gender, lifestyle, and risk factors in our sample of participants are not predictors of poor quality of life assessment after rehabilitation.
BackgroundMeasuring the quality of life (QoL) of women with breast cancer is an important aspect of measuring treatment success. In Croatia, no QoL studies have been carried out with a focus on patients after mastectomy. The aim of this study was to examine QoL 1 month and 1 year after mastectomy.MethodsThis cross-sectional single-center study of quality of life was conducted in 101 patients, 50 of whom had undergone a mastectomy 1 month prior, and 51 of whom had undergone a mastectomy 1 year prior. The study was conducted from July 2015 to June 2016. The questionnaires used in the study were developed by the European Organisation for Research and Treatment of Cancer (EORTC). The questionnaire EORTC QLQ-C30 assesses the QoL of cancer patients, and the questionnaire EORTC QLQ-BR23 is a disease-specific breast cancer module. A chi square test, Fisher’s exact test, Kolmogorov-Smirnov test, Student’s t-test and Mann-Whitney U test were performed in the statistical analysis using the statistical program SPSS (Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.).ResultsPatients who had undergone a mastectomy a year earlier placed a higher value on their health state than did those who had undergone a mastectomy a month earlier. The most affected values of functional status on the EORTC QLQ-C30 scale were emotional functioning (37.5 [95% CI 33.3–61.6]) and sexual functioning (16.67 [95% CI 0–33.3]) 1 month and 1 year after mastectomy, respectively. The most affected symptoms on the EORTC QLQ-C30 scale were hair loss 66.67 [95% CI 33.3–100]) and fatigue 33.33 [95% CI 24–44]) 1 month and 1 year after mastectomy, respectively.ConclusionIn our study, both functional and symptom scales were more affected in women 1 month after mastectomy. QoL was considerably improved in women 1 year after the surgery compared to 1 month after mastectomy. The results of this study could contribute to the public awareness of the QoL of breast cancer patients.
Nutrition care should be an integral part of general practitioners’ (GPs’) daily work with patients. The aim of this study was to assess the attitudes of Croatian GPs toward nutrition and nutrition care, and to evaluate the interconnection between their attitudes and implementation of nutrition care in GPs offices. A cross-sectional study was conducted among 17.0% of randomly selected GPs, from May to July of 2013, via a specially designed anonymous questionnaire. The study showed that 36.0% of the Croatian GPs had satisfactory number of positive attitudes (5 or more) toward nutrition and nutrition care. There was statistically significant difference in the median number of positive attitudes based on the additional education of GPs in nutrition and their ailment from chronic diseases (p < 0.001 and p = 0.022, respectively). The Spearman rank correlation between GPs’ attitudes toward nutrition and nutrition care and their practice, i.e., the implementation of nutrition care in GPs’ everyday work with patients was rs = −0.235 (p < 0.001). In order to provide nutrition care in GPs’ offices in Croatia, strategies for changing GPs’ attitudes toward nutrition and nutrition care are needed.
Nutrition care delivered in primary health care setting is an effective and necessary preventive health care measure. General practitioners (GPs) nutrition knowledge is related to their nutrition care practice. The aim of this study was to explore the nutrition knowledge of Croatian GPs, and to investigate its connection with the implementation of nutrition care in GPs’ offices. A cross-sectional study was conducted among 17.0% of randomly selected GPs, from May to July 2013, via an anonymous questionnaire. The study showed that only 35.8% of the Croatian GPs had an adequate level of nutrition knowledge (five or more correct answers to nutrition questions). The study further revealed that females, GPs with additional education in nutrition and GPs who had not suffered from chronic diseases with poor nutrition posing as a risk factor had better nutrition knowledge (p = 0.029, p < 0.001 and p = 0.041, respectively). The Spearman rank correlation between GPs’ nutrition knowledge and the implementation of nutrition care in their offices during daily work with patients was rs = −0.190 (p < 0.001). To provide nutrition care in GPs’ offices in Croatia, strategies for improving GPs’ nutrition knowledge are needed.
It is obvious that malignant neoplasms of the skin, head and neck occur after decades of exposure, and as a cumulative effect of exposure to risk factors. A direct exposure to sun seems to play an important role, especially with regard to melanoma. Nevertheless, further research is needed.
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