Purpose To compare patients’ self-reported health-related quality of life (HRQoL) before and after total knee arthroplasty (TKA) and determine factors contributing to any heterogeneity in HRQoL. Patients and Methods This prospective multicenter observational study included 404 patients with knee osteoarthritis who underwent TKA between April 1, 2019 and December 30, 2019 and whose HRQoL was assessed preoperatively and 7 days and 1, 3, and 6 months postoperatively. Sociodemographic characteristics were assessed using a General Information Questionnaire, disability using the Knee Injury and Osteoarthritis Outcome Score (KOOS-PS), resting pain using the visual analogue scale (Pain-VAS), and HRQoL using the European Quality of Life Five Dimension Five Level (EQ-5D-5L) scale. The growth mixture model was used to identify group heterogeneity in the developmental trajectories of KOOS-PS, Pain-VAS, and EQ5D5L. Logistic regression was used to explore the factors influencing the developmental trajectories of factors affecting the developmental trajectory of HRQoL. Results The mean EQ-5D-5L score improved from 0.69 preoperatively to 0.90 at 6 months postoperatively. Longitudinal heterogeneity in HRQoL was observed in patients during recovery: 1) patients with a small and slow improvement in HRQoL and 2) patients who showed marked and rapid improvement in HRQoL. The main characteristics of the latter group were decreasing VAS pain scores, a monthly family income >2000 CNY (100 CNY equals approximately 14.9 USD), exercising for <30 min daily, and better knee function at baseline. Baseline knee function and change in knee function were significantly associated with the percentage change in HRQoL. Conclusion HRQoL improved considerably after TKA. However, there was heterogeneity in the changes in HRQoL depending on patients’ socioeconomic status, exercise, and baseline knee function. Dynamic tracking of the HRQoL of TKA patients and timely provision of rehabilitation guidance will promote continuous improvement of the HRQoL of TKA patients.

Background: The coronavirus disease 2019 (COVID-19) pandemic is a worldwide public health emergency that began in late 2019 and is still ongoing. Medical staff are at a particularly high risk of mental stress due to their close contact with infected patients. This study aimed to assess medical staff anxiety and depression levels from different risk-level areas in China during the early period of the COVID-19 outbreak and identify the main factors that might affect their mental health. Methods: From February 22 to March 9, 2020, we conducted a 4-part online questionnaire to survey medical staff across different Chinese provinces about their anxiety and depression levels during the initial COVID-19 outbreak. The survey considered different demographic characteristics, anxiety (General Anxiety Disorder-7) scores, depression (Patient Health Questionnaire-9) scores, and occupational protection scores.Snowball sampling via a WeChat TM group was performed to collect the data.Results: Among the 7,413 respondents, the rates of anxiety and depression reported among medical staff were 33.74% (2,501) and 27.65% (2,050), respectively. The odds of being assessed with severe anxiety were higher among nurses, those who were widowed, those in poor physical health, those working in COVID-19 designated facilities, and those receiving more than 50% negative/false information every day; the odds decreased by 5.8% with every 1-point increase in occupational protection. The odds of being assessed with moderate to severe depression or above were higher for the 18-30-year-old group, divorcees, those in poor physical health, and those receiving more than 50% of negative/false information every day; these odds decreased by 4.5% with every 1-point increase in occupational protection. Medical staff working in areas with a low exposure risk were at high risk of both anxiety and depression.Conclusions: During the outbreak of COVID-19 in China, a significant proportion of medical staff faced psychological problems, even those in areas with a low exposure risk. Targeted interventions should focus more on nurses, widowed /divorced, and medical staff with poor physical health, less clinical experience, or insufficient occupational protection. The authenticity and orientation of media also showed a correlation with the mental state of medical staff.

Purpose The purpose of this study was to investigate the current state of eHealth literacy among cancer patients in a grade A tertiary hospital in Guangzhou, Guangdong Province, and to identify the factors that influence it, in order to provide a basis for improving the eHealth literacy of cancer patients. Patients and Methods From September to November 2021, a convenience sampling method was employed to survey cancer patients in the oncology department of a grade A tertiary hospital in Guangzhou, using a self-administered general information questionnaire and the eHealth literacy scale (eHEALS). A total of 130 questionnaires were distributed, and 117 valid questionnaires were returned. Results The mean total score of eHealth literacy among cancer patients was 21.32±8.35. Multiple linear regression analysis revealed that the frequency of searching for health information and education level were significant factors influencing eHealth literacy (p<0.05). Specifically, the education level (junior high school vs primary school or below) was found to have a significant association with eHealth literacy (beta=0.26, p=0.039). Conclusion The results of this study suggest that the eHealth literacy of cancer patients is relatively low, with low scores on the dimensions of judgment and decision-making ability. The government and relevant regulatory authorities should focus on strengthening the reliability of online health information and implementing targeted e-interventions to enhance the eHealth literacy of cancer patients.

Background: To identify patients’ self-reported health-related quality of life (HRQoL) before and after total knee arthroplasty (TKA) and determine factors contributing to any heterogeneity in HRQoL. Methods: This prospective multicentre study included 404 patients with knee osteoarthritis who underwent TKA between 1 April and 30 December 2019 and in whom HRQoL was assessed preoperatively and at 7 days and 1, 3, and 6 months postoperatively. Sociodemographic characteristics were assessed using a general information questionnaire; disability, using the Knee Injury and Osteoarthritis Outcome Score; pain, using the visual analogue scale (VAS) score; and HRQoL, using the European Quality of Life Five Dimension Five Level (EQ-5D-5L) score. Potential heterogeneity and factors influencing longitudinal changes in HRQoL were analysed using a growth mixture model.Results: The mean EQ-5D-5L score improved from 0.69 preoperatively to 0.90 at 6 months postoperatively. Two types of longitudinal heterogeneity were identified: (1) a group of patients with a small and slow improvement in HRQoL and (2) a group of patients who showed marked and rapid improvement in HRQoL. The main characteristics of the latter group were a monthly family income >2000 yuan, exercising for approximately 30 min daily, and better knee function at baseline. Baseline knee function and change in knee function were significantly associated with the percentage change in HRQoL.Conclusions: HRQoL improved considerably after TKA. However, there was some heterogeneity in the changes in HRQoL depending on certain patient characteristics. Targeted interventions should focus on these differences to optimise the outcomes of TKA.

Purposes To investigate health-related quality of life (HRQoL) of patients with knee osteoarthritis (KOA) in Guangzhou, China, and examine its association with selected sociodemographic characteristics as well as knee function. Methods This multicenter cross-sectional study included 519 patients with KOA in Guangzhou from April 1 to December 30, 2019. Data on sociodemographic characteristics were obtained using the General Information Questionnaire. The disability was measured using the KOOS-PS, resting pain using the Pain-VAS, and HRQoL using the EQ-5D-5L. The association of selected sociodemographic factors, KOOS-PS and Pain-VAS scores with HRQoL (EQ-5D-5L utility and EQ-VAS scores) were analyzed using linear regression analyses. Results The median (interquartile range [IQR]) of EQ-5D-5L utility and EQ-VAS scores were 0.744 (0.571–0.841) and 70 (60–80) respectively, lower than the average HRQoL in the general population. Only 3.661% of KOA patients reported no problems in all EQ-5D-5L dimensions, with Pain/Discomfort being the most frequently affected dimension (78.805%). The correlation analysis showed that the KOOS-PS score, Pain-VAS score and HRQoL were moderately or strongly correlated. Patients with cardiovascular disease, no daily exercise, and high KOOS-PS or Pain-VAS scores had lower EQ-5D-5L utility scores; and patients with body mass index (BMI) > 28 ,high KOOS-PS or Pain-VAS scores had lower EQ-VAS scores. Conclusions Patients with KOA had relatively low HRQoL. Various sociodemographic characteristics as well as knee function were associated with HRQoL in regression analyses. Providing social support and improving their knee function through methods such as total knee arthroplasty might be crucial to improve their HRQoL.