Dimensions Of Health Status Research Articles

The mediating impact of exercise frequency and duration on the relationship between digital health literacy and health among older adults: A cross-sectional study.

Although several studies have discussed the relationships among digital health literacy, health, and exercise behavior, few have integrated these 3 factors into a single model. This study aims to address this research gap. This article aims to analyze the impact of digital health literacy on the health of older adults, as well as the mediating mechanisms related to exercise frequency and duration. A cross-sectional survey was conducted in Luoyang and Zhengzhou urban areas from December 2023 to January 2024. Utilizing random sampling methods, data were collected from 661 older adults through the "digital health literacy scale," "health scale," and "count of exercise duration and frequency" questionnaires. The data were processed by employing SPSS 20 and Process, v3.0, and analyzed through independent samples t test, 1-way ANOVA (F-test), and mediation testing methods. The results indicate that no statistical significance (P > .05) is observed in terms of the 3 dimensions of digital health literacy, exercise behavior, and health status among older adults with different genders, living conditions, educational backgrounds, and economic status. In contrast, statistical significance (P < .05) is observed in terms of exercise frequency and health status among older adults with varying levels of smoking and drinking. The 3 dimensions of digital health literacy among older adults statistically impact (P < .05) their exercise duration, frequency, and health. The dimension of access and assessment exerts the most significant influence on exercise duration (β = 0.415) and a considerable impact on health (β = 0.214). Furthermore, the impact of exercise duration and frequency on health status is statistically significant (P < .05). In terms of the interactive capability dimension, exercise frequency exerts the most significant influence (β = 0.199). Digital health literacy has a significant impact on the health of older adults. The duration and frequency of exercise play a partial mediating role between older adults' digital health literacy and their physical health status. Digital health literacy can encourage older adults to increase the duration and frequency of exercise, which, in turn, promotes their physical health.

Examining multidimensional health poverty and determining factors among rural women of childbearing age in ningxia, china

BackgroundThe multidimensional health poverty afflicting rural women of reproductive age bears profound implications for the sustainable development of families, societies, and healthy villages. Elucidating vulnerable groups at risk of multidimensional health poverty and delineating its determinants can inform refinements and implementation of health-poverty alleviation policies.MethodsBased on the 2022 "Health Status and Health Service Utilization" survey data in rural Ningxia, China, this study analyzes the dimension of health status, capacity for health service utilization, health expenditure and security using the A-F dual-threshold method, logit model, and probit model. It comprehensively evaluates multidimensional health poverty and analyzes its determining factors among rural women of childbearing age.ResultsWith k set at 0.3, the health multidimensional poverty index, incidence, and intensity among rural women of reproductive age were 0.021, 0.053, and 0.392, respectively. Chronic illness, capacity for free gynecological examination utilization, health examination utilization, and borrowing due to illness contributed significantly to multidimensional health poverty. Risk factors for multidimensional health poverty among rural women of childbearing age include age, unemployment, family size, and lack of sanitary toilets. Protective factors include being married, educational level, non-farm or student occupation, receiving government support, separate housing and kitchen, owning a television and computer.ConclusionsEven with the elimination of absolute poverty, the multidimensional health poverty situation among rural women remains important from a gender perspective. It is recommended to strengthen economic assistance and health service support for these groups, improve the level of rural health services from a gender perspective, and enhance housing structure and sanitation toilet usage in rural areas. Efforts should be made to narrow the digital divide in rural areas and promote digital health education. Pre-interventions on multidimensional health poverty can provide new pathways for the development, empowerment, and well-being of rural women of childbearing age.

Associations between initial heart rhythm and self-reported health among cardiac arrest survivors − A nationwide registry study

BackgroundNon-shockable initial rhythm is a known risk factor for high mortality at cardiac arrest (CA). However, knowledge on its association with self-reported health in CA survivors is still incomplete. AimTo examine the associations between initial rhythm and self-reported health in CA survivors. MethodsThis nationwide study used data from the Swedish Register for Cardiopulmonary Resuscitation 3–6 months post CA. Health status was measured using EQ-5D-5L and psychological distress by the Hospital Anxiety and Depression Scale (HADS). Kruskal-Wallis test was used to examine differences in self-reported health between groups of different initial rhythms. To control for potential confounders, age, sex, place of CA, aetiology, witnessed status, time to CPR, time to defibrillation, and neurological function were included as covariates in multiple regression analyses for continuous and categorical outcomes. ResultsThe study included 1783 adult CA survivors. Overall, the CA survivors reported good health status and symptoms of anxiety or depression were uncommon (13.7% and 13.9% respectively). Survivors with PEA and asystole reported significantly more problems in all dimensions of health status (p = 0.037 to p < 0.001), anxiety (p = 0.034), and depression (p = 0.017) compared to VT/VF. Overall, these differences did not remain in the adjusted regression analyses. ConclusionsInitial rhythm is not associated with self-reported health when potential confounders are controlled. Initial rhythm seems to be an indicator of unfavourable factors causing the arrest, or factors related to characteristics and treatment. Therefore, initial rhythm may be used as a proxy for identifying patients at risk for poor outcomes such as worse health status and psychological distress.

Exploring the Factors Influencing Coronary Heart Disease Prevalence in the US Population: A Retrospective Observational Study.

Coronary heart disease (CHD) remains a significant global health concernand is characterized by inadequate blood supply to the myocardium due to the accumulation of plaque in the coronary arteries. Despite therapeutic advancements, prevalence disparities persist across various segments of the U.S. population, posing a significant challenge to healthcare systems. This study aims to find the prevalence disparities of CHD using Behavioral Risk Factor Surveillance System (BRFSS) data. A retrospective observational study was done using the 2022 BRFSS dataset on January 17, 2024. The study examined the presence of CHD as the dependent variable and investigated various independent variables. Descriptive and logistic regression analyses were conducted using the BRFSS Web Enabled Analysis Tool (Centers for Disease Control and Prevention, Atlanta, GA). Data management and storage utilized Microsoft Excel, and graphical analysis employed GraphPad Prism, version 9.4.1 (GraphPad Software, Inc., San Diego, CA). In demographics, respondents aged 65+ had higher CHD odds, while females exhibited lower risk than males. Hispanics had the lowest odds of CHD among all races. Socioeconomically, inability to work and retirees had higher CHD odds, as did income below $20,000 but ≥$15,000. Poor physical health increased CHD odds, as did having multiple healthcare providers. Medicare users had the highest CHD odds among insurance options. Significant disparities in CHD prevalence were seen across demographic, socioeconomic, health status, and healthcare access dimensions in the United States, emphasizing the urgent need for targeted interventions to address these disparities and improve overall public health outcomes.

Effects of a ‘Rebuilding Myself’ intervention on enhancing the adaptability of cancer patients to return to work: a randomized controlled trial

ObjectivesTo explore the effects of a ‘Rebuilding Myself’ intervention on enhancing the adaptability of cancer patients to return to work.MethodsA single-center, single-blind, randomized controlled trial design was used. Eligible patients who were receiving routine hospital treatment were recruited from the university-affiliated hospital in our city. Patients in the control group only received usual care, while patients in the intervention group received additional ‘Rebuilding Myself’ intervention. Adaptability to return to work, self-efficacy of returning to work, mental resilience, quality of life and work ability were measured at baseline, the 6th and 12th of the intervention. The general estimation equations were used to compare the overall changes of each outcome index between the two groups at different time points. Considering that there may be patient shedding and rejection, Per-Protocol and Intention-to-Treat analysis were used to analyze the data in this study.ResultsThere were statistically significant differences between the two groups of patients in the cancer patients’ adaptability to return to work, self-efficacy to return to work, mental resilience, work abilities, the physical, emotional, cognitive function, fatigue, insomnia and overall health status dimensions of quality of life (P < 0.05). And no significant difference was found in other dimensions (P > 0.05). The group effect, time effect, and interaction effect of patients’ return to work adaptability and return to work self-efficacy were statistically significant in both groups (P < 0.05). Mental resilience, working ability, and quality of life had obvious time effect and interaction effect (P < 0.05).ConclusionThis intervention could improve cancer patients’ adaptability to return to work, self-efficacy to return to work, mental resilience, work abilities and quality of life. And it can be further expanded to improve the adaptability of patients to return to work, then to help patients achieve comprehensive rehabilitation.Implications for cancer survivorsThe application of ‘Rebuilding Myself’ interventions can effectively improve the adaptability of cancer patients returning to work.Trial registrationThis study was registered at the Chinese Clinical Trial Registry (Registration number: ChiCTR2200057943) on 23 March, 2022.

Impact of smart phone use on adolescence health in India.

Smart phone use is on the rise globally, which may have an impact on people's health. The second-largest country in terms of mobile phone usage is India. However, there aren't many studies that have been done in India to evaluate its health impacts. Therefore, it is of interest to assess the effectiveness of codex on the impact of smart phone use on various dimensions of health status among adolescence. The pre-test mean score for knowledge regarding the impact of smart phones on physical health was 1.92, while the post-test mean score was 3.75. The pre-test and post-test standard deviations were 0.91 and 0.93, respectively, and the mean deviation score was the 't'-value that was 11.000 and Significant at the p<0.001*** level. The research was conducted in higher secondary school, and 60 students participated. The research design was a pre-experimental design; a self-administered questionnaire was used to assess the knowledge of Students on the Impact of mobile phone use on various dimensions of health. Most people, on average, spend 3 hours and 15 minutes on their phones each day. As adolescents are engaged in smartphone use, it disturbs their sleep patterns, adversely impacting their short-term memory.

Association between oral hypofunction and general health: a systematic review

BackgroundOral hypofunction comprises 7 oral function conditions, including mastication, swallowing, pronouncing, oral hygiene, and oral dryness. However, it remains unresolved whether having oral hypofunction and each individual condition adversely affect general health. This study aimed to investigate the association between oral hypofunction and general health, encompassing physical, psychological, and social dimensions.MethodsOral hypofunction was diagnosed following the criteria proposed by the 2016 Japan Society of Gerodontology, comprising 7 oral function conditions. Oral hypofunction was diagnosed when at least 3 conditions presented. The selected studies eligible for reviewing were based on the PI(E)CO criteria: P (population), adult and older adults; I/E (intervention/exposure), having oral hypofunction by considering overall and individual 7 oral function conditions; C (comparator), not having oral hypofunction; O (outcome), the general health status, encompassing physical, psychological, and social dimensions. Electronic search limited to English articles was performed through PubMed, Scopus, and Cochrane Database of Systematic Reviews databases from January 2016 to June 2023. The included studies were assessed for quaility and risk of bias using the modified Newcastle-Ottawa scale. Qualitative analyses were performed on the general outcome, and having oral hypofunction considering overall and individual oral function conditions.ResultsTen studies were included in the final syntheses. One was a prospective cohort, one was a case-control, and the others were cross-sectional studies. All included studies were high quality. General health outcomes were mostly frailty, sarcopenia, and malnutrition, whereas mild cognitive impairment,social withdrawal, and gastric cancer prognosis were identified in one of the included studies. The association between general health and having oral hypofunction was stronger than when considering an individual condition. The health outcomes were predominantly associated with mastication and swallowing, whereas their relationships with oral hygiene and dryness were less likely to be reported.ConclusionsThe present review found an association between the presence of oral hypofunction and impaired general health. However, the specific impact on individual physical, psychological, and social dimensions cannot be distinctly delineated. Further prospective studies are required to clarify the causal-effect relationship between oral and general health.

Mentalizing, Resilience, and Mental Health Status among Healthcare Workers during the COVID-19 Pandemic: A Cross-Sectional Study.

The COVID-19 pandemic has caused unprecedented stress on healthcare professionals worldwide. Since resilience and mentalizing capacity play very important preventive roles when it comes to mental health, the main goal of this study was to determine whether the capacity for mentalizing and resilience could explain the levels of depression, anxiety, and stress among healthcare workers during the COVID-19 pandemic. The study was conducted in Serbia on a sample of 406 healthcare workers (141 doctors and 265 nurses) aged 19 to 65 (M = 40.11, SD = 9.41). The participants' mental health status was evaluated using the Depression, Anxiety, and Stress Scale-DASS-42. The Reflective Functioning Questionnaire was used to evaluate the capacity for mentalizing. Resilience was assessed using the Brief Resilience Scale. The results of the correlation analysis showed that there were negative correlations between resilience and all three dimensions of mental health status: depression, anxiety, and stress. Hypermentalizing was negatively correlated with depression, anxiety, and stress, while hypomentalizing was positively correlated. Hierarchical linear regression analysis showed that both resilience and hypermentalizing were significant negative predictors of depression, anxiety, and stress, and that hypomentalizing was a significant positive predictor of depression, anxiety, and stress. Furthermore, socioeconomic status was a significant negative predictor of depression, anxiety, and stress. Marital status, number of children, and work environment were not statistically significant predictors of any of the three dimensions of mental health status among the healthcare workers in this study. There is an urgent need to establish and implement strategies to foster resilience and enhance the capacity for mentalizing among healthcare workers in order to minimize the devastating effects of the COVID-19 pandemic on mental health.

The impact of informal social support on the health poverty vulnerability of the elderly in rural China: based on 2018 CHARLS data

ObjectiveFrom the perspective of informal social support, this paper analysed the impact of factors such as “Relationship with spouse”, “Relationship with Children”, “Financial support from children”, “Sibling support”, “Support from other friends and relatives” and “Borrowing costs” on the health poverty vulnerability of elderly people in rural China.MethodsBased on the data of the China Health and Retirement Longitudinal Study (CHARLS) in 2018, the vulnerability of the rural elderly to health poverty was measured from two dimensions of health status and influencing factors of health status by the three-stage feasible generalized least square method. A quantile regression model was used to analyse the impact of six variables in the informal social support network on health poverty vulnerability: “Relationship with spouse”, “Relationship with children”, “Financial support from children”, " Sibling support”, " Support from other friends and relatives”, and “Borrowing costs”.ResultsWhen the poverty line standards were 2995 CNY/year and 4589 CNY/year, the health poverty vulnerability of the elderly population in rural China was 0.397 and 0.598 in 2018. In the analysis of informal social support, factors such as the relationship with spouse, relationship with children, borrowing costs, support from other friends and relatives, and sibling support had different impacts on the health poverty vulnerability of the rural elderly, who were classified into three groups according to their different vulnerabilities.ConclusionAccording to the analysis of the 2018 CHARLS database, the health poverty vulnerability of the elderly population was related to the informal social support network, and it is necessary to pay attention to the role of informal channels such as children, spouses, relatives and friends in daily care and financial support for rural elderly individuals. Meanwhile, the government and other formal organizations should also give full play to their supporting role for elderly individuals, who are highly vulnerable to health poverty, and their families.

Risk Perception and Health Precautions Towards COVID-19 Among Older Culturally and Linguistically Diverse Adults in South Australia: A Cross-Sectional Survey.

BackgroundRisk perceptions and precaution-taking against COVID-19 are affected by individuals’ health status, psychosocial vulnerabilities and cultural dimensions. This cross-sectional study investigates risk perceptions associated with COVID-19 and specifically the problem- and emotion-focused health precautions of older, culturally and linguistically diverse (CALD) South Australians.MethodsCross-sectional research involving self-administration of an online survey. Participants were CALD adults living in South Australia, aged 60 years and above (n = 155). Multi-indicator surveys were analyzed using Stata/MP version 13.0 and multiple linear regression models fitted to examine associations between risk perceptions and problem- and emotion-focused health precautions.ResultsDread risk returned the highest mean score; COVID-19 was perceived as a catastrophe. Mean scores for fear showed that participants were worried about COVID-19 and scared of becoming infected. Participants followed health advice as they were worried [β 0.15; 95% CI 0.07, 0.23] and realized the effect of COVID-19 on them [β 0.15; 95% CI 0.02, 0.28], or worried and had trust in experts’ knowledge and managing capacity [β 0.17; 95% CI 0.06, 0.28]. Age was negatively associated with sum-score of problem-focused coping: compared to participants aged 60–69 years, 80+ years revealed a decrease in problem-focused health precautions. Variables like education (primary schooling [β 2.80; 95% CI 0.05, 5.55] and bachelor degree [β 3.16; 95% CI 0.07, 6.25] versus no formal education), self-confidence in reducing risk, and fear [β 0.84; 95% CI 0.31, 1.36] significantly affected emotional-focused health precautions.ConclusionThis local study has global implications. It showed that COVID-19 has psychosocial and environmental implications for older CALD adults. When many CALD populations have existing vulnerabilities to intersecting disadvantage, cultural-tailoring of interventions and pandemic response plans may buffer the effects of compounding disaster. Larger studies are needed to compare risk perception and health response patterns across countries and cultural groupings.

Quality of life of Iranian and Afghan pregnant women in rural Iran.

Pregnancy is a unique experience in a woman's life, which comes with physiological, metabolic, social, and psychological changes. The combination of these changes along with migration, may reduce the quality of life of pregnant women and mothers. This study aims to determine the quality of life in rural pregnant women. A cross-sectional study was conducted. Three hundred pregnant Iranian and Afghan women who attended the public health centers in regional Tehran, Iran, were systematically selected and included in the study. Different dimensions of health status were investigated using the standard health-related quality of life questionnaire (SF-26) through interviews. SPSS version 23 was used for data analysis. The psychological health subscale (38.00) in the Iranian pregnant women and the physical health subscale (38.83) in the Afghan pregnant women had the highest scores. The lowest score was in social functioning subscale in both groups (20.59 in Iranian and 21.22 in Afghans). In general, Iranian mothers had lower scores compared to Afghan mothers. There was a relationship between the quality of life of Iranian pregnant women, their level of education and family's monthly income (P <0.05), and between the quality of life of Afghan pregnant women with the lesser number of pregnancies (P <0.05). In rural Iran, the quality of life score and its subscales is comparably low in both Iranian and Afghan pregnant women. Interventions are needed to improve the quality of life in this vulnerable population.

Cost-Utility Analysis of Malaysian Elderlies Living in Public Long-Term Care Institutions

This research compares the quality of life of Malaysian elderlies living in public formal long-term care institutions, including residential care and nursing home care. It provides evidence of the cost-effectiveness of both programs. The sample of Malaysian elderlies aged 60 years and above was collected from the World Health Survey, including five dimensions of health status: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Each of the dimensions has three levels, including 1 (“no problems”), 2 (“some problems”) and 3 (“major problem”). The quality-adjusted life-years (QALYs) of elderlies living in both institutions are estimated using a generic health-related measurement method, EQ-5D. In addition, cost-utility analysis is adopted to compare the effectiveness of programs in allocating resources. The QALY of those living in nursing home care is reasonably lower than those in residential care due to their worse chronic health conditions. The majority are categorised as severely disabled. The cost-effectiveness evaluation of each public long-term care model suggests that the residential care program is cost-effective, with the cost per QALY being MYR22 945. At the same time, a nursing home for disabled people is not effective as the cost per QALY is MYR57 822, falls outside the willingness to pay (WTP) range between (MYR 19,929–MYR 28,470).

Comparative analysis of quality of life for three different adjuvant treatment modality in early stage cervical cancer: an analysis from STARS study

<h3>Objectives:</h3> This analysis aimed to compare the quality of life (QoL) of patients with different adjuvant treatment modalities in STARS study for cervical cancer. <h3>Methods:</h3> QoL assessment was done at the baseline and then longitudinally after completing of radiation or chemotherapy assigned in STARS study. In the study, post-operative FIGO stage IB to IIA cervical cancer patients with adverse pathological factors were randomized in 1:1:1 to receive adjuvant radiation alone, concurrent chemoradiation weekly cisplatin or sequential chemoradiation (with cisplatin plus paclitaxel in 21-day cycle, given 2 cycles before and 2 cycles after radiotherapy respectively). QoL was assessed with EORTC QLQ-C30 questionnaires at baseline (1 week after the surgery), during the treatment period (in the 5th week receiving pelvic irradiation), 12 months and 24 months after the completion of treatment. Analysis of variance by one-way repeated measures analyses of variance (ANOVA) was used to compare differences in QoL measures among treatment groups. <h3>Results:</h3> Totally, 816, 633, 360 and 254 patients had completed QoL assessment at baseline, during treatment period, 12 month and 24 month after the completion of treatment. At baseline, a lowest global health status (GH) and functional dimensions including physical, emotional, role, cognitive and social functioning, and lowest scores of symptom and single item scales were presented among the 3 groups with balance (p > 0.05). During treatment period, GH and other functional dimension scores were elevated, with symptom item scores declined in RT group. While in CCRT or SCRT group, an elevated scores of symptom scales including of nausea and vomiting (30.93±25.5 vs 20.8±25.0 in SCRT group, 31.0±28.1 vs 16.5±24.3 in CCRT group), and appetite loss (39.6±30.9 vs 34.8±32.1 in CCRT group) was noted when comparing with that in baseline. The score of item concerning financial difficult declined in CCRT and SCRT group, which was similar as RT group. The scores of GH, functional dimensions and other symptom scales were not different compared with baseline in these two groups. During treatment period, a highest score of global health, functional dimensions including physical, role, cognitive, social functioning, and lowest scores of symptom including fatigue, nausea and vomit, insomnia, appetite loss, constipation and diarrhea was presented in the RT group than the other two groups (GH score 66.5±16.4 in RT group, 60.7±17.9 in CCRT group and 61.9±17.5 in SCRT group, p=0.001). No differences between CCRT and SCRT group regarding GH, functional dimensions and symptom scores. In 12 and 24 months after the completion of treatments, further improved GH, functional dimension scores and declined symptom scores were observed in the whole population, with no significant differences among the 3 treatment groups. <h3>Conclusions:</h3> In CCRT and SCRT group, adding chemotherapy in adjuvant treatment had negative effects on GH, physical, cognitive, social and role function, as well as symptoms related to QoL during the treatment period compared with RT. While the symptoms resolved, functioning and general QoL improved after 12 months of treatment, indicating a transient impact on QoL of patients receiving adjuvant treatment.

43-LB: Evaluating Health Status in the PRONTO-Pump-2 Study

Background: In PRONTO-Pump-2, a Phase 3, 16-week, randomized, double-blind clinical trial in patients with type 1 diabetes on continuous subcutaneous insulin infusion, ultra rapid lispro (URLi) showed superior postprandial glucose control and noninferior HbA1c reduction, with less hypoglycemia compared to Humalog® (Lispro). Although primarily reported as mild in severity, incidence of infusion site reactions was higher with URLi compared to Humalog (37.7% vs. 10.1%). We assessed patient-reported health status in the PRONTO-Pump-2 trial as an exploratory measure. Methods: The EQ-5D-5L (which includes a visual analogue scale rating perceived health [VAS; 0-100 from worst to best imaginable health state]) was administered at baseline and endpoint (week 16 or early discontinuation) to patients on URLi (N=215) or Humalog (N=217). The EQ-5D-5L assesses 5 dimensions of health status (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) for which a health state index score ranging from less than 0 (worse than death) to 1 (perfect health) is calculated. Change from baseline to endpoint (last observation carried forward) in scores was analyzed using an ANCOVA model. Results: At endpoint, mean health state index scores showed no significant differences between treatments (URLi, 0.88 [standard error 0.009]; Humalog, 0.89 [0.009]) with an increase from baseline of +0.01 (0.009) within each treatment. On the dimension of pain/discomfort, distribution of responses was similar between treatments. Endpoint VAS scores were also similar between URLi and Humalog (80.2 [0.82] and 80.8 [0.78], respectively) but decreased from baseline within each treatment: URLi, -1.1 (0.82); Humalog -0.5 (0.78). Conclusion: In PRONTO-Pump-2, the EQ-5D-5L indicated no differences in health status, including the pain/discomfort dimension, between patients on URLi versus Humalog, despite more frequent reports of infusion site reactions with URLi treatment. Disclosure R. Paczkowski: Employee; Self; Eli Lilly and Company, Employee; Spouse/Partner; Amgen Inc., Stock/Shareholder; Self; Eli Lilly and Company, Stock/Shareholder; Spouse/Partner; Amgen Inc. C. Piras de oliveira: Employee; Self; Eli Lilly and Company, Stock/Shareholder; Self; Eli Lilly and Company. J. Cho: None. A. Goldyn: Employee; Self; Eli Lilly and Company. J. Poon: Employee; Self; Eli Lilly and Company. E. R. Hankosky: Employee; Self; Eli Lilly and Company, Stock/Shareholder; Self; Eli Lilly and Company. D. A. Ignaut: Employee; Self; Eli Lilly and Company. Funding Eli Lilly and Company

Cost-effectiveness of valbenazine compared with deutetrabenazine for the treatment of tardive dyskinesia

Aims To evaluate clinical and economic outcomes associated with valbenazine compared with deutetrabenazine in patients with tardive dyskinesia (TD) using a model that accounts for multiple dimensions of patient health status. Materials and methods A discretely integrated condition event model was developed to evaluate the cost-effectiveness of treatment with valbenazine and deutetrabenazine in a synthetic cohort of 1,000 patients with TD who were receiving antipsychotic medication to treat an underlying psychiatric disorder. Clinical inputs were derived from relevant clinical trials or from publicly available sources. Patients were assessed over 1 year using ≥50% improvement from baseline in Abnormal Involuntary Movement Scale (AIMS) total score as the primary definition of response. Response at 1 year using Clinical Global Impression of Change (CGIC) score ≤2 was also assessed. Health outcomes included quality-adjusted life years (QALYs), life years, proportion responding to treatment at 1 year, and number of psychiatric relapses. Results Regardless of the definition used for response, patients treated with valbenazine were more likely to have responded to treatment at 1 year, lived longer, and accrued more QALYs than patients who received deutetrabenazine. Using the AIMS response criterion, the incremental cost-effectiveness ratio was $9,951/QALY for valbenazine compared with deutetrabenazine. By comparison, using the CGIC response criterion valbenazine dominated deutetrabenazine with valbenazine-treated patients accumulating more QALYs (3.4 vs 3.3 years) and incurring lower lifetime costs ($252,311 vs $283,208) than deutetrabenazine-treated patients. Limitations There are no head-to-head trials of valbenazine and deutetrabenazine, so probabilities of response used in the model were calculated based on an indirect treatment comparison of results from individual trials with one drug or the other, using only those metrics reported across trials. Conclusions In patients with TD, treatment with valbenazine is highly cost-effective compared with deutetrabenazine.

Multiple factors associated with life satisfaction in older adults.

IntroductionThe population of older adults is increasing as science progresses and health conditions improve. Social, psychological and behavioral factors will influence life satisfaction in older adults. We aimed to assess multiple factors associated with life satisfaction in older adults in Qom city, Iran.Material and methodsIt was a descriptive-analytical study which has conducted on 679 older adults through convenience sampling from Qom city, Iran during 2018. The data were collected using demographic characteristics, life satisfaction, well-being, cognitive status, social support, and daily activities of life questionnaire. Data were analyzed by SPSS version 22 software and independent t-test, ANOVA, Pearson’s correlation coefficient and multiple regression analysis.ResultsThe mean older adult’s age was 70.43 ± 7.62 years. The mean life satisfaction score was 13.77 ± 3.73. The results showed a significant relationship of job and education with life satisfaction (p < 0.001). The results also showed that social support (p = 0.001) and daily activities (p = 0.017) significantly predict the level of life satisfaction, and the dimensions of health (p = 0.001) and cognitive status (p = 0.007) have a larger share in predicting the satisfaction of older adults’ life.ConclusionsWe found that some parts of life changes in older adults can be predicted with the help of social support, health status, cognitive status, and everyday life activities. Therefore, in order to increase the level of life satisfaction of older adults, it is suggested that promotion of social support, health status, and cognitive status be provided.

Effect of Empowering Education on Refined Nursing of Patients with Internal Double J Tubes after Surgery for Ureteral Stricture

Objective: To investigate the effect of the theory of enabling education on the fine management of patients with internal double J tubes after ureteral stricture. Methods: Eighty patients with built-in double J tubes after ureteral stricture were selected from the urology department of a grade a hospital in Guangzhou. The patients were divided into control group and observation group by random number method, with 40 patients in each group. The control group received refined nursing after surgery, while the observation group received refined nursing including the theory of empowerment education after surgery on the basis of the control group. Results: After the intervention, the observation group had a higher standard rate of quality indicators, higher self-efficacy score than the control group (P ≤ 0.05), lower scores of ureteral stent-related symptoms, urinary system symptoms, pain symptoms, total health status, job performance, additional problems and total scores than the control group (P ≤ 0.05), and statistically significant differences were found in the total health status dimension and total scores (P ≤ 0.01). The nursing satisfaction survey, the scores of clinical nursing, health education, psychological counseling and nurse-patient communication were all higher than those in the control group (P ≤ 0.05), and the differences in health education and nurse-patient communication were statistically significant (P ≤ 0.01). Conclusion: The theory of enabling education can improve patients’ self-nursing level, promote the implementation of refined nursing quantitative indicators and nursing measures, relieve the poor symptoms of ureteral stricture patients, and improve patients’ satisfaction with nursing work.

HOme-based Longitudinal Investigation of the multidiSciplinary Team Integrated Care (HOLISTIC): protocol of a prospective nationwide cohort study

BackgroundThe use of home health care (HHC) is increasing worldwide. This may have an impact not only on patients and their caregivers’ health but on care resource utilization and costs. We lack information on the impact of HHC on the broader dimensions of health status and care resource utilization. More understanding of the longitudinal HHC impact on HHC patients and caregivers is also needed. Moreover, we know little about the synergy between HHC and social care. Therefore, the present study aims to observe longitudinal changes in health, care resource utilization and costs and caregiving burden among HHC recipients and their caregivers in Taiwan.MethodsA prospective cohort study “Home-based Longitudinal Investigation of the Multidisciplinary Team Integrated Care (HOLISTIC)” will be conducted and 600 eligible patient-caregiver dyads will be recruited and followed with comprehensive quantitative assessments during six home investigations over two years. The measurements include physical function, psychological health, cognitive function, wellbeing, shared decision making and advance care planning, palliative care and quality of dying, caregiving burden, continuity and coordination of care, care resource utilization, and costs.DiscussionThe HOLISTIC study offers the opportunity to comprehensively understand longitudinal changes in health conditions, care resource utilization and costs and caregiving burden among HHC patients and caregivers. It will provide new insights for clinical practitioners and policymakers.Trial registrationClinicalTrials.gov Identifier is NCT04250103 which has been registered on 31st January 2020.

The importance of objectively measuring functional tests in complement to self-report assessments in patients with knee osteoarthritis

BackgroundOsteoarthritis (OA) is a chronic degenerative disease which can result in chronic pain, loss of joint function and consequently decline in quality of life. Research questionA variety of instruments that measure the different dimensions of health status in patients with OA are available. However, despite the fact that WOMAC and other questionnaires and scales may provide additional understanding regarding the patient’s condition, some studies have reported discrepancies between patients’ perceptions and their actual ability to perform the task. The aim of the present study was investigate the physical capabilities with the function domain of WOMAC. MethodsThis study has a cross-sectional design including patients diagnosed with moderate to severe knee OA (i.e., grades II, III and IV) according to the Kellgren-Lawrence. These patients were submitted to the battery of functional tests recommended by the OARSI group (30-second chair stand test, 40 m fast paced walking test, Stair climb test, timed “Up and Go”, and Six-minute walking test) and filled the WOMAC. Pearson’s correlation and multiple linear regression was applied. ResultsA total of 153 patients were included. A significant and weak correlation was observed between WOMAC and the 40-meter walking test, TUG, stair-climbing test, and the 6MWT. In addition, 30-second chair stand test demonstrated a significant and moderate correlation (r=-0.503). The multiple regression analysis results indicated that only 30-second chair stand test was a significant (p = 0.001) predictor of WOMAC. This result remains significant even after adjusting for age, BMI, total muscle mass, and number of knees affected SignificanceThe 30-second chair stand test is associated with the WOMAC function domain. There is no correlation of this domain with any other functional tests, emphasizing the importance of including other tests for a global evaluation.

Impact of Quality of Primary Health Care Centers Upon Adolescents’ Health Status With Chronic Diseases in Kirkuk City

Background: The primary health care centers initiatives are designed to improve patient care and health outcomes. A process failed to address the impact on health outcomes, patient satisfaction, and costly of chronic diseases expected to adolescents. This study aimed to determine the role of quality of primary health care centers (PHCCs) on adolescents’ health status with chronic diseases in kirkuk city. Methodology: A descriptive (quantitative design ) was conducted through (18) PHCCs in Kirkuk city. Two questionnaires were designed for the purpose of the study. A simple random sample of (180) health professional (manager) were selected through the use of probability sampling approach. The sample of study was divided into two groups which include organization structure (PHC )centers (18) and (162) adolesents with chronic diseases. .Data analysis is performed through the use of descriptive statistical data analysis approach. Results: the overall evaluation for the quality of PHCCs is adequate on (59% ; N=11), and fair on (41% ; N=7) respectively. The quality of PHCCs is adequate relative to all of its dimensions of general health status, tangibles, accreditation, responsiveness, assurance and empathy. The experienced good level for the general, physical, mental, relationships and emotional dimensions of health status with chronic diseases Inadequate on Adequate on (44.%: n=71 ) ,Fair on (34.% :n= 55 ) ,and Inadequate (23. % :n=36 ) , level of evaluation . except that of the quality of life dimension of health status Adequate on Fair on (37.%: n = 60 ), Inadequate (n 30 %: =49 ),and Adequate (33.% n=53 ) does not impose any effect on adolescents’ general health status. Conclusion: The study findings depict that the quality of PHCCs is adequate relative to all of its dimensions of general health status, tangibles, accreditation, responsiveness, assurance, and empathy. Adolescents’ health status is good regardless of their age groups as being early, middle and late age adolescents except that of the quality of life dimension of health status which has a fair level of evaluation. The study confirms that the Impact of quality of PHCCs does not execute an impact on adolescents’ health status.