Existence Of Chronic Diseases Research Articles

Psychometric properties of the Chinese version of the Hypertension Belief Assessment Tool

BackgroundHypertension is prevalent in China. Hypertensive patients suffer from many health problems in life. Hypertension is a common chronic disease with long-term and lifelong characteristics. In the long run, the existence of chronic diseases will affect the patient’s own health beliefs. However, people’s health beliefs about Hypertension are not explicit. Therefore, it is vital to find a suitable instrument to comprehend and improve the health beliefs of hypertensive patients, thus, better control of blood pressure and improvement of patient’s quality of life are now crucial issues. This study aimed to translate the Hypertension Belief Assessment Tool (HBAT) into Chinese and examine the psychometric properties of the Chinese version of the Hypertension Belief Assessment Tool in hypertensive patients.MethodsThis is a cross-sectional study. We translated the HBAT into Chinese and tested the reliability and validity of the Chinese version among 325 hypertensive patients.ResultsThe Chinese version of the scale contains 21 items. The Exploratory Factor Analysis (EFA) revealed six factors and explained 77.898% of the total variation. A six-factor model eventually showed acceptable fit indices in the Confirmatory Factor Analysis (CFA). With modified Confirmatory Factor Analysis, the fit indices were Chi-square/Degree of Freedom (CMIN/DF) = 2.491, Comparative Fit Index (CFI) = 0.952, Incremental Fit Index (IFI) = 0.952, Root-mean-square Error of Approximation (RMSEA) = 0.068, Tucker Lewis Index (TLI) = 0.941. The HBAT exhibits high internal consistency reliability (0.803), and the scale has good discriminant validity.ConclusionThe results suggest that the HBAT is a reliable and valid instrument for assessing the beliefs of Chinese hypertensive patients.

Conflicts of interest among patients: do they exist and can they bias patient-reported outcome measures? A survey of shoulder and elbow patients.

Potential conflicts of interest (COIs) are common among physicians and may bias physician-reported outcome assessment in orthopedic research. It is unclear whether patients have COIs and whether these COIs could affect patient-reported outcome measures (PROMs). The purposes of this study were to investigate (1) the existence of COIs among patients and (2) the potential of these COIs to bias PROMs with a pseudonymized survey among consecutive shoulder and elbow patients. Between February and May 2021, 144 shoulder and elbow patients who underwent consultation at our outpatient clinic were included in the survey study. Of these patients, 79.2% (n=114) completed the 11-item questionnaire. Variables including sex, existence of chronic diseases, level of education, and economic status were also assessed to investigate any association between these variables and patients' perceptions of COIs. Whereas 33.3% of respondents (n=38) believe that COIs exist among patients and 28.1% (n=32) believe that COIs could bias PROMs in general, fewer patients admit to personal COIs (24.6%, n=28) and COIs biasing their self-assessment (23.7%, n=27). Patients more frequently suggest COIs in their personal environment, such as among family members or friends (27.2%, n=31), than in their own medical treatment. Financial factors such as sick pay (34.2%, n=39) are thought to be the most likely reason for having COIs, followed by interpersonal reasons such as maintaining medical affection or bonds (29.8%, n=34). Of respondents, 42.1% (n=48) believe that sole usage of PROMs poses risks in treatment evaluation and only 21% (n=24) consider PROMs reliable. In addition, 43% of respondents (n=49) believe that patients should disclose COIs routinely in medical treatment. Multinomial logistic regression analysis revealed that wealthier patients are more likely to believe COIs could bias PROMs (odds ratio for poor vs. middle class, 0.23 [95% confidence interval, 0.053-0.963]; odds ratio for lower-middle class vs. middle class, 0.19 [95% confidence interval, 0.052-0.677]). Although the majority of shoulder and elbow patients deny having self-experienced COIs and deny biased PROMs due to COIs in their own medical treatment, a considerable number of patients admit to having experienced both. Further studies might be justified to investigate the actual clinical relevance of patients' COIs and their impact on value-based health care.

Factors associated with common mental disorders: a study based on clusters of women.

ABSTRACTOBJECTIVE to identify factors associated with common mental disorders (CMD) in a sample of adult women in Southern Brazil.METHODS This population-based study, composed of 1,128 women, investigated socioeconomic, behavioral and health/disease explanatory demographic variables. Five response groups were explored: one group with common mental disorders – cut-off point 6/7 in the Self-Reporting Questionnaire 20 (SRQ-20) – and four others corresponding to the different clusters found using the latent class clustering technique, also from the SRQ-20. These four clusters (low, medium-depressive, medium-digestive and high) were named (denominated) based on the mean scores in the SRQ-20 in each group and on the response patterns of the variables and factorial characteristics. The “low” cluster comprised women with lower SRQ-20 scores and, therefore less likely to present CMD. The “high” cluster, with high mean values in the SRQ-20, was related to higher psychiatric morbidity. We used the Poisson regression technique to compare the findings of the different groups.RESULTS We identified ten variables as factors associated with CMD. Age, education, smoking, physical activity, perception of health and number of medical appointments were the common variables for the cut-off point and cluster-based analyses. Heavy alcohol use was associated only when the sample was evaluated as a cut-off point. Social class, work situation and existence of chronic diseases were associated only when the sample was analyzed by clusters. There was a significant association in the “high” cluster with lower classes (D or E), smoking, physical inactivity, existence of chronic diseases and negative perception of health.CONCLUSION We identified different associated factors according to the response groups considered. New approaches allowing identification of subgroups of individuals with specific characteristics and associated factors may contribute for a more accurate understanding of CMD and provide the basis for health interventions.

Improving the patient's experience in the emergency department during COVID-19 pandemic: a community-based analysis from Western Saudi Arabia.

Background Patient satisfaction is an important measure of the health care encounter. It is challenging to achieve a perfect patient experience during the current COVID-19 pandemic, especially from an emergency department visit. Aim This study aimed to assess the factors that improve patient experience during an emergency department (ED) visit in the western region of Saudi Arabia. Methods This is a cross-sectional study, conducted over a month from January to February 2021. Via an electronic survey tool, we used the de en (EQS-H) to measure patients’ satisfaction with their ED encounter. Results The total level of satisfaction was high in 43.66% (n=224) of participants, moderate in 37.04% (n=190), and 19.29% (n=99) were unsatisfied. We noted significant predictors of dissatisfaction, including increasing age, higher educational level, and the existence of chronic diseases. A clear treatment plan and discharge instructions were important determinants for improving patient satisfaction. Conclusion The determinants of patient satisfaction during an ED visit are an important quality marker of the emergency department encounter. Such findings should be used as a benchmark for future programs aiming to improve patients’ experience during ED visits.

Risk Factors for Depression in Hospitalized Elderly Patients with Malnutrition

Background: There is a lack of information about the factors that affect depression in hospitalized geriatric patients with malnutrition. We aimed to determine the risk and influencing factors of depression in these patients. Methods: The prospective, descriptive study was conducted on 125 elderly patients with malnutrition in Istanbul, Turkey in 2018. The Mini Nutritional Assessment-short form was used in determining the nutritional statuses of the participants, and the Geriatric Depression Scale-short form was used for the status of depression. Results: A negative relationship was found between nutritional status and risk of depression in the study (p: 0.000; r: -0.558). Depression was detected in 52.8% of the patients. 60.8% were women and 39.2% were men. It was also found that BMI scores, gender, marital status, level of education, lifestyle and location, the existence of chronic diseases, chronic medication use, hospital stay period, and mobilization affect the emergence and severity of depression in geriatric patients (p ＜ 0.005). Multivariate regression analysis showed that increased risk of depression occurs with female gender (OR: 24.665, 95% CI: 5.83-104.34), marital status (OR = 11.97, 95% CI: 3.51-40.86), mobilization (OR: 9.52, 95% CI: 1.79-50.71) and malnutrition (OR = 0.49, 95% CI: 0.27-0.89). Conclusions: Depression was frequent in elderly patients with malnutrition. Also, many factors (e.g. low BMI, female gender, mobilization etc.) affect it in hospital. Therefore, close follow-up of patients is important.

Depression Among Elderly Users of Open and Closed Care Facilities in a Rural Region of Greece: an Important Public Health Issue.

Introduction:It is estimated that 5.7% of the total Greek population suffers from depressive disorders. Elderly may be particularly prone to depression compared to younger people. In Greece, there is a paucity of literature regarding the correlation between the existence of chronic diseases, sociodemographic features, participation in open/ closed structures, and the presence of depression or depressive symptoms, among seniors. The purpose of this study was to explore potential correlations between the above- mentioned variables, as a whole.Methods:This was a cross- sectional, questionnaire survey of 200 elderly aged 65 or above and were members of 12 Open Care Centers for the Elderly (OCCE) or residents in 2 nursing homes located in the rural region of Epirus, in Greece. Data collection took place in the form of structured individual interviews. For the identification of independent factors associated with the existence of depressive symptoms, stepwise logistic regression analysis was performed.Results:A total of 81 (40.5%) seniors experienced depressive symptoms, though only 39 of them (19.5%) had been diagnosed for depression. Depression rates were higher for those with more chronic diseases (p=0.01) and at divorced, widowed and single seniors compared to married ones (50.5% vs. 28.1% respectively, p=0.002). The prevalence of depression was higher among the elderly who lived in nursing homes compared to the participants who were registered members of the OCCE (50% vs. 35.6% respectively, p=0.049), while elderly who often participated in the social activities of OCCE, had significantly lower rates of depressive symptoms compared to those who scarcely were involved in these activities (23% vs. 46.2% respectively, p=0.019). Participants who suffered from osteoporosis were more likely of displaying depressive symptoms compared to those who didn’t; OR (95% Confidence Interval) = 2.61 (1.28-5.33), p=0.009.Conclusions:The existence of an action plan that includes education and training of health professionals on mental health of the elderly and the satisfactory operation of public facilities to promote the wellbeing of seniors and offer more incentives for activity participation, may reduce depression rates and the under-diagnosis of the disease.

Frailty and Related Factors Based On A Multidimensional Assessment In People 70 Years Old Or Over

1.1 Introduction: The Healthcare Plan for the Elderly (PAM) of the Basque Public Health Service (Osakidetza) determines different typologies of people ≥ 70 years of age based on a multidimensional assessment. The objective is to learn about the prevalence of frailty and its relationship with other variables of the assessment. 1.2 Material and methods: Cross-sectional study with a sample of 666 people (569 with a certain typology determined) ≥70 years of age from 7 healthcare centres, selected by random sampling. Different typologies were determined based on functionality (Instrumental Activities of Daily Living - IADL, Lawton-Brody Index; Basic Activities of Daily Living - BADL, Barthel Index), existence of chronic diseases, and life expectancy 59, life expectancy > 6 months), ‘dependent’, and ‘at the end of life’. 1.3 Results: The 19.2% (95% CI 16.1-22.6%) were frail. Frailty was significantly related (p 80 years old versus 27.2% non-frail), physical inactivity (57.1 versus 15.4%), previous falls (58.4% versus 34.2%) and number of chronic medications (median 13 versus 8). It was also related to certain pathologies (cardiovascular, osteoarticular) and visual deficit. Detection through the assessment of IADL is closely related to the Timed Up and Go Test (p < 0.001). 1.4 Conclusions: In order to detect frailty, it is important to consider older age, physical inactivity, certain comorbidity (cardiovascular, osteoarticular, sensory) and polypharmacy. IADL and performance-based tests show very good correlation.

Приверженность к инициальной и поддерживающей терапии у пациентов с гастроэзофагеальной рефлюксной болезнью

Aim of investigation. To analyze treatment compliance at initial course and maintenance treatment by proton pump inhibitors at gastroesophageal reflux disease (GERD). Material and methods. Overall 84 GERD patients with took part in prospective study: 50 (59.5%) men and 34 (40.5%) women aged from 18 to 74 years. By results of esophagogastroduodenoscopy and morphological investigation of mucosal biopsies non-erosive reflux disease (NERD) was diagnosed in 32 (38.1%) patients, reflux esophagitis was found in 52 cases (61.9%). Total period of patients monitoring was 12 months at which patients made five visits to the research center: initial, through 1.5, 3, 6 and 12 months with filling in of questionnaires of Spielberger-Khanin, Beck, SF-36 and abridged multifactorial questionnaire of the personality (AMQP). Treatment compliance was established according to duration of study participation, along with that patients self-estimated it on 2, 3, 4 and 5 visits by Morisky-Green test and 5-score analog scales of pharmaceutical treatment compliance and lifestyle verification. The first visit patients underwent 1:1 randomization to the educational program devoted to reflux disease. Results. Of all patients 17.9% missed the second visit, the logistic regression analysis revealed no factors associated to the early low compliance; 38% of patients made all five visits for 12 months. The latter differed significantly from those who dropped out of the study at different stages: they had high number of chronic diseases (р<0.01), received higher quantity of drugs on the constant basis (р<0.01), got lower scores by the paranoid trait scale of AMQP (р<0.05). Logistic regression is revealed factors associated to the low level of treatment compliance: number of chronic concomitant diseases (OR=1.64; р=0.0033), quantity of the received drugs (OR=1.63; р=0.0158), scores by paranoid trait AMQP scale (OR=0.95; р=0.042). Conclusion. Single course educational program in GERD patients increases treatment compliance for initial course while does not affect maintenance therapy compliance. Following predictors of high treatment motivation were found: existence of chronic diseases and intake of medications on the regular basis for concomitant diseases, minimal intensity of rigidity of affect personality trait. Constant maintenance therapy is optimal for GERD patients in the Russian population, at the same time in NERD patients without low compliance markers the course maintenance therapy can be applied.

Research on Sleep Quality and the Factors Affecting the Sleep Quality of the Nursing Students.

Purpose: This research has been conducted in order to examine the quality of sleep and the factors affecting the sleep quality.Material/Methods: The sample of this descriptive research is comprised of 223 volunteer students studying at Uludağ University Faculty of Health Sciences Department of Nursing. Research datas have been collected through personal features survey and Pittsburg Sleep Quality Index(PSQI). Results: The average result derived from the sample is 6.52±3.17. To briefly explain the average of the component scores: subjective sleep quality 1.29±0.76, sleep latency 1,55±0.94, sleep duration 0.78±0.99, habitual sleep activity 0.47±0.90, sleep disturbances 0.99±0.09, use of sleeping medication 0.12±0.48, daytime dysfunction 1.29±0.90. It has been observed that there is a meaningful discrepancies between average PSQI results and smoking habits of the students, total daily sleeping hours, efficient waking up times, average daily coffee consumption(p<0.05). According to the analyses there is no meaningful discrepancies between the age,gender, where the students live,snoozing during the morning classes, the existence of chronic diseases and daily average tea consumption.(p>0.05)Conclusions: According to the findings in the light of this research; nursing students have low sleep quality.

Health Status and Health Service Utilization: Barriers and Facilitators for Korea Medicaid Beneficiaries

Purpose: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. Methods: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents’ perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. Results: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. Conclusion: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.

Acidentes domésticos em idosos atendidos em um hospital de urgência

Estudo transversal realizado em hospital de referência em urgência com amostragem por conveniência cujos dados foram coletados de junho a julho de 2014. Objetivou analisar os acidentes domésticos em idosos atendidos em hospital público de urgência. Do total de 83 entrevistados, 77,1% eram mulheres, possuíam 80 a 89 anos (32,5%), analfabetos (32,5%), viúvos (44,6%), residindo com cônjuge e outros familiares (73,5%), aposentados (84,4%), recebiam um a dois salários mínimos (88%). A prevalência de acidentes domésticos foi de 6,4%, com predominância de queda (84,4%), da própria altura (55,6%). Descuido na observação do ambiente foi auto referido como principal causa (45,8%). A não associação entre a ocorrência de quedas, existência de doença crônica, medicação de uso contínuo e realização de atividade no instante do acidente foi um achado relevante. Recomenda-se cuidado multiprofissional com avaliação funcional ampla identificando as deficiências dos idosos e limitações ambientais visando orientação comunitária e planejamento de intervenções integradas.

Factors affecting unmet healthcare needs of older people in Korea

Despite the fact that the National Health Insurance programmes have ensured universal coverage for Koreans, disparities in access to health care and unmet healthcare needs still exist in Korea. The purpose of this study was to analyse factors affecting unmet healthcare needs of older people in Korea. This study had a cross-sectional, descriptive design using secondary data taken from the Korean National Health and Nutrition Survey conducted in 2007-2009. A complex sampling design was used, and the participants included a nationally representative sample of 3943 people older than 64 years. Socio-demographic variables, subjective health, existence of chronic diseases, quality of life and unmet healthcare needs were included in the study instruments. Logistic regression analyses were performed in order to examine the relationship between unmet healthcare needs and independent variables. According to the results, 29.4% of older women and 14.0% of older men had not visited clinics or hospitals when they needed to obtain healthcare services (unmet healthcare needs) during the past 12 months. Older women [odds ratio (OR) = 1.831, 95% confidence interval (CI) = 1.428-2.347] and those with poor subjective health (OR = 1.708, 95% CI = 1.371-2.126) and arthritis (OR = 1.278, 95% CI = 1.029-1.586) were more likely to have unmet healthcare needs than their counterparts. Efforts to decrease unmet healthcare needs, targeting high-risk groups (especially for older women), are needed in order to prevent disability, decrease mortality and promote the quality of life of older people.

일부 성인과 노인의 삶의 질 비교

Objectives : This study was examine a relationship those variables with health-related quality(HRQOL) of life in the elderly and provide basic information on HRQOL and evidence for establishing effective health policies for old ages ultimately. Methods : This research was conducted through individual interviews using a structured questionnaire and oral status examinations of 600 residents The data have been analyzed using -test through PASW Statistics 18.0.0(SPSS Korea Datasolution Inc.) and Structural Equation Modeling through LISREL ver8.8. Results : According to the Structural Equation Modeling, independent variables which influence the health-related quality of life are as follows: sex the highest, followed by existence of chronic diseases, perceived health, age, perceived oral health the lowest. Parameters are as follows: oral health-related quality of life the highest, followed by subjective oral symptoms, and oral health status the lowest. Conclusions : In order to improve the quality of life of olds, it is not only necessary to improve perceived health through reduce of chronic diseases, but is also required to regular tooth check-up to reduce subjective oral symptoms for increase oral health-related quality of life.

The level of health in Elementary School Students in Training and Research Areas and Evaluation of School Screening Examination Results

AIM: The research was planned in order to evaluate the level of health’s elementary schools located in Eskisehir Osmangazi University School of Medicine Public Health Department Training and Research Areas and the school health services they have been receiving for the last eight years. METHOD: 1st, 2nd, 7th and 8th grade students studying in 12 elementary schools located in the Training and Research Areas in 2009-2010 academic year were enrolled to the study. On days of the screenings, a total of 1405 students available (1405/1569: %89.5) in the schools were reached. Growth, seeing, hearing, mouth-teeth health, systemic physical examination and by consulting to the teachers, state of mind and existence of chronic diseases were researched. For each child, information containing the existence of school enrolment examination, the number of periodic examinations that have been conducted on the child, and also the results of the examination of the same year was inquired. RESULTS: 1.0 % of the students were detected as very weak, 4.8 % as weak, 75.9 % as normal, 15.8 % as overweight and 2.5 % as obese. In eye examinations, 10.5% of the students had refractive error, 6.2 % had amblyopia and 3.1% had diplopia. In the ear examination, it was determined that 48.7 % of the students had plug, 2.5 % had perforated tympanum, and 3.1 % had hearing loss. In mouth and teeth examination, it was detected that 64.8% of the students had tooth decay. All of the students who were claimed to have undergone school enrolment examination were first grade students and that examinations included examination results of this year. Health forms containing the results of school enrolment examination and periodic examinations of 2nd, 7th and 8th grade students were not found. School screening were conducted only in two district elementary schools. The eye examination results reported in the records appeared to be inconsistent with screning results. CONCLUSION: It was shown that school age children had significant undiagnosed health problems. It is concluded that school health services are inadequate in the research area and further researches are required to be conducted in this subject.

Using WHOQOL-BREF to evaluate quality of life among Turkish elders in different residential environments

ObjectiveThis study used the Brief Version of The World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF) to assess and compare the quality of life in older people who live at home and older people who live in public assisted-living facilities for the elderly. DesignCross-sectional. SettingData were collected by a research nurse in each home and in the assisted living facility. ParticipantsParticipants were 60 years old and older. The sample included 37 people who were living in a public assisted-living facility and 37 elderly people living in their own homes. MeasurementThe WHOQOL-BREF was used to measure participants' quality of life. ResultsThe groups were similar according to gender, literacy, existence of chronic diseases, and general perceived health. However, quality of life scores for social relationships and environment domains were lower in those living in an assisted living facility than those living in their own homes. The scores for elderly females staying in the assisted living facility were lower compared to the scores of males in the facility. ConclusionThe results suggest that social and environmental domains of life quality are low in elderly assisted living facilities. Social activities should be diversified for elderly people staying in assisted living facilities to improve social relationships. Physical and psychological health of females in assisted living facilities should be comprehensively supported by professionals. Alternatively, elderly people may be professionally supported to live in their own homes.

Factors influencing the outcome after the operative treatment of cerebral aneurysms of anterior circulation.

The influence of various factors on the outcome after the operative occlusion of the cerebral aneurysm was to be defined through the retrospective study on 111 surgically treated patients with aneurysm of anterior cerebral circulation. Preoperative clinical condition was graded from 0 to V, according to Hunt & Hess. Postoperative outcome, defined as good or bad according to modified Glasgow Outcome Scale, was correlated in homogenous experimental groups with the following factors: gender, age, aneurysmal size, preoperative interval, nimodipine therapy, experience of surgical team and existence of chronic vascular diseases. Surgical outcome was good in 74.4% of males and 71.4% of females (p > 0.05); in 83.3% of patients with and 41.2% of patients without chronic diseases (p < 0.01); in 71.4% of patients underwent early, 83.3% of ones underwent postponed and 85% of those underwent late surgery (p > 0.05); in 81.5% of patients treated by nimodipine and in 41.7% of those untreated by the same drug (p < 0.01); in 78.9% of patients operated by the experienced surgical team and in 40% of those operated by less experienced surgical team (p < 0.01). In patients with both good and bad outcome, the mean age was 50.6 and 47.6 years (p > 0.05), and the mean aneurysmal size was 12.3 mm and 13.3 mm, respectively (p > 0.05). Before rupture, the mean size for aneurysms on the bifurcation of the middle cerebral artery was 14.3 mm, and for posterior communicating artery aneurysms only 9.7 mm (p < 0.05). Surgical outcome was significantly influenced by the existence of chronic diseases, nimodipine therapy and experience of surgical team, whereas gender, age, timing for surgery and aneurysmal size were not of significant influence.