Browsing by Author "Gunnarsson, Julia"

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    Effect of Shunt Surgery on Life Satisfaction and Health-related Quality of Life in Patients with Idiopathic Normal Pressure Hydrocephalus
    (2020-04-29) Gunnarsson, Julia; University of Gothenburg / Institute of Medicine; Göteborgs universitet / Institutionen för medicin
    Abstract BACKGROUND Idiopathic normal pressure hydrocephalus (iNPH) is a condition causing gait- and balance disturbance, neurocognitive impairment and urinary incontinence in the elderly. After treatment with shunt surgery, up to 80% of patients improve. Life satisfaction (LS) has not been reported in patients with iNPH, but their health-related quality of life (HRQoL) is poorer than in the healthy population, improving after shunt surgery. However, HRQoL has only been scarcely studied in these patients. AIM To research LS and HRQoL in patients with iNPH before and after shunt surgery and to explore how these measures are related to how patients are dependent on others in daily life and severity of clinical symptoms. METHODS One hundred and twenty-two iNPH-patients (49 female; mean age 74 years) had their clinical symptoms evaluated according to the iNPH-scale, dependence on others according to the modified Rankin Scale (mRS) and LS, and HRQoL using the LiSat-11 and EQ5D-5Lquestionnaires at baseline and three months post-surgery. RESULTS Before surgery, 32% were satisfied with life as a whole, increasing to 47% after (p = .004). Patients also improved in leisure, self-care, physical, and psychological health LS (p < .001). Satisfied patients scored higher on the iNPH-scale (p = .002). Postoperative improvement on EQ5D-5L 0-100 visual analogue scale was seen in 73% of patients (p < .001). Dependent patients (mRS 3-5) had poorer LS (p = .008) and lower grades on the EQ5D-5L visual analogue scale (p = .003) than independent patients (mRS 0-2). CONCLUSION A majority of iNPH-patients experience their life as a whole unsatisfactory. After treatment both LS and HRQoL improves but around 50% of the patients are still unsatisfied with their life as a whole which should be assessed further. Pronounced symptoms and dependence are associated with worse LS and HRQoL, implying that altered function plays an essential role regarding these measures.