Higher Self-reported Health Status Research Articles

The benefits of care: treated HIV infection and health-related quality of life among older-aged people in Uganda

Objectives The objective of this study is to explore how HIV care affects health-related quality of life (HRQoL) among older people in Uganda. Methods We enrolled older-aged (≥49 years) people with HIV receiving HIV care and treatment, along with age- and sex-similar people without HIV. We measured health-related quality of life using the EQ-5D-3L scale. Results People with HIV (n = 298) and people without HIV (n = 302) were similar in median age (58.4 vs. 58.5 years), gender, and number of comorbidities. People with HIV had higher self-reported health status (b = 7.0; 95% confidence interval [CI], 4.2–9.7), higher EQ-5D utility index (b = 0.05; 95% CI, 0.02–0.07), and were more likely to report no problems with self-care (adjusted odds ratio [AOR], 2.0; 95% CI, 1.2–3.3) or pain/discomfort (AOR = 1.8, 95% CI, 1.3–2.8). Relationships between HIV serostatus and health-related quality of life differed by gender, but not age. Conclusions Older people with HIV receiving care and treatment reported higher health-related quality of life than people without HIV in Uganda. Access to primary care through HIV programs and/or social network mobilization may explain this difference, but further research is needed to elucidate the mechanisms.

Association between dual smoking and dyslipidemia in South Korean adults.

Dyslipidemia increases the risk of serious cardiovascular disease; and conventional cigarette smoking is widely recognized as a risk factor. Thus, as electronic cigarettes were introduced, many smokers utilized them for smoking cessation. However, due to the lack of researches scrutinized the relationship between dual smoking and dyslipidemia, a lot of those who failed in cessation end up utilizing both types of cigarettes (dual smoking). Therefore, this study aimed to examine the effect of dual smoking on dyslipidemia in South Korean adults. Data were included from the 2013, 2014, 2015, 2016, and 2019 Korean National Health and Nutrition Examination Survey of 8,398 Korean men. The KNHANES is conducted by a national institution based on random cluster sampling, and therefore, the data gained from it is statistically reliable and representative in comparison to surveys performed by private institutions. Cigarette use status was the main independent variable. Cigarette use status was categorized as one of the four status: dual smoker, single smoker, non-smoker, and ex-smoker. The dependent variable, presence of dyslipidemia, was defined according to the National Cholesterol Education Program as displaying one or more of the following criteria: total cholesterol: ≥240 ㎎/dL, LDL cholesterol: ≥160 ㎎/dL, triglyceride: ≥200 ㎎/dL, or HDL cholesterol: ≤40 ㎎/dL. Multiple logistic regression analysis was performed to examine target association. Current and former users of either electronic or conventional cigarettes presented with a higher odd ratio of dyslipidemia compared to non-smokers. (ex-smoker: OR = 1.60, 95% CI = 1.41-1.83; single smoker: OR = 1.21, 95% CI = 1.06-1.38). More importantly, those who smoke both conventional and electronic cigarettes were also, at high risk of dyslipidemia (dual smoker: OR = 1.66, 95% CI = 1.26-2.20). Along with smoking status, those who did not exercise had a higher risk of dyslipidemia than those who exercised regularly and higher self-reported health status was also related to a lower risk of dyslipidemia. This study suggests that along with conventional cigarettes, dual smoking negatively impacts dyslipidemia, and smoking cessation of evert types is necessary for a healthy life.

Determinants of Workforce Preparedness during Pandemics Among Healthcare Workers at the U.S. Department of Veterans Affairs.

Objective:An infectious disease outbreak can place a significant burden on healthcare systems, however, our understanding of the broader healthcare workforce’s preparedness during a pandemic is limited. This study examines factors that influence perceived workforce preparedness at the U.S. Department of Veterans Affairs (VA) during a pandemic.Methods:The VA Preparedness Survey was a random, anonymous, web-based survey fielded nationwide October to December 2018. Multivariate statistical analyses examined the effects of study relevant factors (sociodemographic, work-related, general health, and household-related characteristics of VA employees) on perceptions of workforce preparedness, including institutional readiness and understanding of individual roles during a pandemic.Results:Four thousand and twenty-six VA employees responded. Overall, 55% were confident in their VA medical facility’s ability to respond; 49% understood their role; and 68% reported their role to be important during a pandemic. After controlling for study-relevant factors, household preparedness, having plans that address the health care needs of family members, and higher self-reported health status were associated with all 3 workforce preparedness variables. Clinical staff (compared to non-clinical staff) were less likely (OR:0.80, 95% CI:0.68-0.94, P < .01) to have confidence in their medical facility’s ability to respond but more likely (OR:1.77, 95% CI:1.49-2.10, P < .001) to believe their role was important. Employees who have been at the VA longer (OR:1.07, 95% CI:1.01-1.14, P < .05) or have experienced a disaster while working at the VA (OR:1.29, 95% CI:1.04-1.59, P < .05) were more likely to understand their role during a pandemic.Conclusion:The findings from this study suggest the need for identifying ways to increase VA employees’ confidence in their medical facility’s ability to respond to a pandemic; develop trainings to improve understanding of their different yet critical roles, for both clinical and non-clinical staff, during a pandemic; create different workforce trainings for newly hired employees; and identify ways to improve household preparedness for a pandemic outbreak.

Exploring health literacy and its associated factors among Palestinian university students: a cross-sectional study.

SummaryHealth literacy plays an important role in personal and community health. Since university is a turning point when young adults begin to take responsibility for their own health, understanding university students’ health literacy levels is crucial. To this end, we aimed to explore health literacy and its associated factors among Palestinian university students. We conducted a cross-sectional study at Birzeit University in the Ramallah district. We recruited 472 students using convenience sampling at six on-campus cafeterias. The 44-item Arabic version of the Health Literacy Questionnaire was used to measure students’ health literacy levels, while a locally developed distress scale was used to measure students’ distress levels. We stratified the multiple regression model for the health literacy score by gender. Students’ average total health literacy score was 135.3 (SD 20.9), with male students scoring significantly higher than female students. A higher health literacy score was significantly associated with having a father with a higher level of education, a higher frequency of medical checkups, higher self-reported health status, and consulting a higher number of sources for health-related information. High distress levels were associated with lower levels of health literacy, especially among female students. This study provides the first evidence on Palestinian university students’ health literacy levels. Tailored health education and promotion are required for students with low parental education and moderate to high distress. Future research is required to explain the gender differences in health literacy and distress among university students.

Patterns of Marijuana Use and Health Impact: A Survey Among Older Coloradans.

Access to recreational and medical marijuana is common in the United States, particularly in states with legalized use. Here, we describe patterns of recreational and medical marijuana use and self-reported health among older persons using a geographically sampled survey in Colorado. The in-person or online survey was offered to community-dwelling older persons aged above 60 years. We assessed past-year marijuana use including recreational, medical, or both; methods of use; marijuana source; reasons for use; sociodemographic and health factors; and self-reported health. Of 274 respondents (mean age = 72.5 years, 65% women), 45% reported past-year marijuana use. Of these, 54% reported using marijuana both medically and recreationally. Using more than one marijuana method or preparation was common. Reasons for use included arthritis, chronic back pain, anxiety, and depression. Past-year marijuana users reported improved overall health, quality of life, day-to-day functioning, and improvement in pain. Odds of past-year marijuana use decreased with each additional year of age. The odds were lower among women and those with higher self-reported health status; odds of use were higher with past-year opioid use. Older persons with access to recreational and medical marijuana described concurrent use of medical and recreational marijuana, use of multiple preparations, and overall positive health impacts.

Healthcare experience among older cancer survivors: Analysis of the SEER-CAHPS dataset.

Little is known about factors affecting medical care experiences of cancer survivors. This study examined experience of care among cancer survivors and assessed associations of survivors' characteristics with their experience. We used a newly-developed, unique data resource, SEER-CAHPS (NCI's Surveillance Epidemiology and End Results [SEER] data linked to Medicare Consumer Assessment of Healthcare Providers and Systems [CAHPS] survey responses), to examine experiences of care among breast, colorectal, lung, and prostate cancer survivors age >66years who completed CAHPS >1year after cancer diagnosis and survived ≥1year after survey completion. Experience of care was assessed by survivor-provided scores for overall care, health plan, physicians, customer service, doctor communication, and aspects of care. Multivariable logistic regression models assessed associations of survivors' sociodemographic and clinical characteristics with care experience. Among 19,455 cancer survivors with SEER-CAHPS data, higher self-reported general-health status was significantly associated with better care experiences for breast, colorectal, and prostate cancer survivors. In contrast, better mental-health status was associated with better care experience for lung cancer survivors. College-educated and Asian survivors were less likely to indicate high scores for care experiences. Few differences in survivors' experiences were observed by sex or years since diagnosis. The SEER-CAHPS data resources allows assessment of factors influencing experience of cancer among U.S. cancer survivors. Higher self-reported health status was associated with better experiences of care; other survivors' characteristics also predicted care experience. Interventions to improve cancer survivors' health status, such as increased access to supportive care services, may improve experience of care.

Maternal Health-Seeking on Behalf of Low-Income Children.

Women receiving Medicaid account for almost one-third of the childbearing population in the United States, an extensive investment for federal and state governments. Gaps and conflicting research results exist that explain/predict maternal health-seeking behavior for vulnerable children. Public health nurses (PHN) need evidence to design interventions that improve maternal health-seeking and child health outcomes. The purpose of this study was to examine factors: maternal (key influences), child, and household that contribute to maternal health-seeking behavior. The design was a descriptive, correlational, longitudinal study (n=1,141 mother-child dyads). Children were more likely to receive preventive medical care if they had a medical condition (OR: 1.60, p<.01) and had access to private transportation (OR: 1.49, p<.05). Children of married mothers (OR: 1.51, p<.01) and access to private transportation (OR: 1.47, p<.05) received more preventive dental care. African-American mothers (OR: 0.61, p<.01) and mothers with higher self-reported health status (OR: 0.84, p<.05) sought less illness-related medical child health services (CHS). Maternal health-seeking behavior in low-income households is complex. Predictors may depend on whether care is preventive or illness-related, medical, or dental. Further study should clarify what factors predict what type of CHS use to better specify PHN interventions.

Prevalence and correlates of depression among college nursing students in China

This study aims to assess the prevalence of depression and examine potential risk factors correlated to depression among nursing college students in China. Between September and November 2012, a total of 763 college nursing students were randomly selected to participate in a survey, which included the Center for Epidemiologic Studies Depression Scale (CES-D). The result showed that 22.9% (95% CI: 20.0%-25.9%) of participants reported high score on the CES-D (16 or above). Risk factors significantly associated with depression in the univariate analysis were academic performance, academic stress, interest in majors, occupational future, interpersonal relationship, frequency of exercise, self-reported health status, social support, educational level of father, relationship with parents and making decisions without interference by parents. Backward multivariate logistic regression analysis revealed that lower academic stress, and better occupational future were strongly related to lower risk of depression, followed by active use of social support, full making decision power, better relationship with father and higher self-reported health status. The findings suggested that in order to prevent depression among college nursing students, school- and family-based strategies should be developed and implemented.

P04.52. Alternative and complementary health practices among college students: implications for health promotion in higher education

Results For comparison respondents were dichotomized into ACHP users and non-users – based on their response to a frequency of use survey item. This produced a group of 531 (31.3%) ACHP-users and 1,164 non-users. ACHP students were significantly more likely to be female (71.4% users versus 63.0% non-users, p=.001) and older (24.4 versus 23.3, p=.001). There were no statistically significant differences between the two groups in terms of past 30 day use of alcohol, tobacco, or marijuana, binge drinking, or perceived risks from binge drinking. ACHP students were significantly more likely to report engaging in conventional health practices (p=.001), and having a higher self-reported health status (p=.007). They also reported experiencing more mental health symptoms during the school year (p=.012). Finally, ACHP students were significantly more likely to report identification with postmodern social values including interest in the environment (p=.001) and social justice (p=.001), and to having a somewhat more liberal political orientation.

Psychosocial and sexual functioning in women with Turner syndrome.

Survey data on the sexual and social functioning of 80 adult women with Turner syndrome are described, as well as data regarding health status and self-concept. Each woman completed the Tennessee Self-Concept Scale, sections of the Derogatis Sexual Functioning Inventory, and a questionnaire covering a wide range of demographic and medical information. The women with Turner syndrome reported lower self-concept compared to a normative sample. Sexual attitudes, gender role identity, and body image were assessed. The women with Turner syndrome tended to exhibit more conservative sexual attitudes and a more negative body image. In contrast to a normative sample, the women with Turner syndrome were less likely to have been sexually active. In addition, those currently involved in a stable relationship reported a lower frequency of sexual intercourse compared to a normative sample, although they generally reported moderate to high levels of sexual satisfaction. Regression analyses revealed that health status was associated with self-concept, and that sexual satisfaction was related to both a higher frequency of intercourse and a higher self-reported health status.