Living in uncertainty due to floods and pollution: the health status and quality of life of people living on an unhealthy riverbank

Socio-demographic disparities in health-related quality of life in hypertensive patients in Bangladesh: a comprehensive survey analysis

PURPOSE

Hypertension is a major health concern in Bangladesh. Assessing the health-related quality of life (HRQoL) among hypertensive patients in Bangladesh can highlight the broad impacts of the condition on morbidity and mortality. Such insights are essential for developing targeted healthcare and prevention strategies to reduce complications, including heart disease, stroke, and kidney failure.

METHODS

In this cross-sectional study, 5,086 hypertensive patients aged between 18 and 80 were recruited from 75 pharmacies in Bangladesh. We assessed the participants' health using the EQ-5D-5 L descriptive system and the EQ-VAS. Utility scores were calculated using the Indian EQ-5D-5 L value set. Regression models were employed to identify factors associated with overall HRQoL and individual health dimensions.

RESULTS

Study participants were mean aged 52 years old, with average systolic and diastolic blood pressures of 140.79 mmHg and 85.98 mmHg, respectively. The average EQ-index and EQ-VAS score were 0.83 and 67.47, respectively. 39% reported difficulties with self-care, 43.5% had mobility problems, 80.6% had pain, and 61.2% had anxiety. HRQoL scores decreased significantly with age, according to the multilevel model. Higher education levels, however, were associated with better HRQoL scores. Male respondents reported fewer problems with mobility, self-care, activity, pain, and anxiety. A decrease in HRQoL scores was observed among older individuals, those without formal education, those in lower quintiles, those unemployed, and those with poor blood pressure control, obesity, or fasting glucose.

CONCLUSION

Study findings indicate disparities in HRQoL based on age, gender, education, and socioeconomic status, highlighting the need for targeted policy interventions.

Evaluating the General Health Risk Factors (Physical, Psychological, and Social Functions) of Hospital Staff a Year after COVID-19 Outbreak in 2020-2021, Isfahan Iran

Background

Healthcare workers are the first to be exposed to the virus and are at greater risk than the general public. This study aimed to examine the risk factors that affected hospital staff's general health during the COVID-19 pandemic in Isfahan, Iran.

Materials and Methods

This cross-sectional study was conducted on the staff of all hospitals in Isfahan one year after the COVID-19 outbreak (2021-2022). The General Health Questionnaire (GHQ) was used to determine social functioning, while the Patient Health Questionnaire (PHQ) was employed to assess physical and psychological health status.

Results

There was a significant positive relationship between work experience in the COVID-19 ward and the scores of physical health (r = 0.26, df = 298, p < 0.01), depressive symptoms (r = 0.24, df = 298, p < 0.01), and anxiety (r = 0.17, df = 298, p < 0.01). The job and income satisfaction score was negatively related to the scores of social function variables (r = -0.25, df = 298, p < 0.01) and depressive syndrome (r = -0.12, df = 298, p < 0.05). The fear of COVID-19 was related to social functioning (r = 0.12, df = 298, p < 0.01), physical health (r = 0.31, df = 298, p < 0.001), depressive symptoms (r = 0.36, df = 298, p < 0.001), panic attacks (r = 0.15, df = 298, p < 0.01), and generalized anxiety (r = 0.23, df = 298, p < 0.001). Gender and age significantly predicted general health.

Conclusions

The COVID-19 pandemic negatively affected all dimensions of hospital staff's health, particularly those with underlying physical conditions.

Financial strain among West-Javanese parents: its association with marital satisfaction and quality of life, and the role of dyadic coping

In the past decade, the concept of dyadic coping as a buffer against stress in romantic relationships has received much attention in Western countries, but it has rarely been studied in non-Western countries and among parents with school-aged children. The aim of the present study was to investigate the moderating effect of dyadic coping on the link between financial strain and marital satisfaction, as well as the mediating effect of marital satisfaction on the relationship between financial strain and quality of life. There were 751 heterosexual couples whose eldest child aged 7-12 years in West Java, Indonesia (mean age husband = 37.53 SD = 5.09; mean age wife = 34.42 SD = 4.85) fulfilled the paper and pencil questionnaires in the study. The moderated mediated model illustrated that (1) greater levels of dyadic coping weakened the negative association between financial strain and marital satisfaction for husbands and for wives (2) for both husbands and wives, there were no mediation effect (3) for both husbands and wives, financial strain was negatively associated with quality of life; and marital satisfaction was positively associated with quality of life. We discuss both the theoretical and practical implications of these findings.

Determining the factors impacting the quality of life among the general population in coastal communities in central Vietnam

People living in coastal areas are frequently affected by natural disasters, such as floods and storms. This study aimed to assess the quality of life (QoL) of people living in disadvantaged coastal communes (subdivision of Vietnam) and identify their associated factors by using the World Health Organization's quality of life instrument (WHOQOL-BREF). To achieve this, a cross-sectional descriptive study was conducted on 595 individuals aged 18 years and above living in the coastal communes in Thua Thien Hue province, Vietnam, from October 2022 to February 2023. The results showed that the mean overall QoL (mean ± SD) was 61.1 ± 10.8. Among the four domains of QoL, the physical health (57.2 ± 12.3) domain had a lower score than the psychological health (61.9 ± 13.0), social relations (63.4 ± 13.4), and environment (61.9 ± 13.3) domains. The QoL score of the domains for participants affected by flooding was significantly lower than that of those not affected, except for social relations. Multivariable logistic regression showed that subjects with not good QoL had the educational background with no formal education (Odds ratio (OR) = 2.63, 95% CI 1.19-5.83), fairly poor/poor households (OR = 2.75, 95% CI 1.48-5.12), suffered Musculoskeletal diseases (OR = 1.61, 95% CI 1.02-2.56), unsatisfaction with health status (OR = 5.27, 95% CI 2.44-11.37), family conflicts (OR = 4.51, 95%CI 2.10-9.69), and low levels of social support (OR = 2.62; 95% CI 1.14-6.02). The analysis also revealed that workers (OR = 0.17, 95% CI 0.04-0.66) had a better QoL than farmer-fisherman. QoL in disadvantaged coastal communes was low, with the lowest scores in the physical health domain. Based on the socioeconomic factors associated with not good QoL identified here, it is recommended that local authorities take more appropriate and practical measures to increase support, including measures for all aspects of physical health, psychological health, social relations, and the living environment, especially for people affected by floods.

Psychometric properties of the World Health Organization WHOQOL-AGE Scale in Singapore

WHOQOL-AGE is a promising quality of life (QOL) tool that has not been fully validated in Asia. The present study aimed to verify its factor structure and psychometric properties among community-dwelling older adults in Singapore. This study was cross-sectional and used data (N = 593) from the Community Health and Intergenerational study that interviewed older adults between 2018 and 2021. Confirmatory factor analysis (CFA) was used to examine the factor structure of the WHOQOL-AGE, and Cronbach's alpha coefficients were employed to examine internal consistency. Spearman's rho correlations coefficients between WHOQOL-AGE and other related scales (Satisfaction with Life and the Friendship) examined convergent validity. A Pearson's correlation coefficient between WHOQOL-AGE and compassion scale examined discriminant validity. An independent t test was used to demonstrate known-groups validity, examining differences in QOL scores between individuals with and without chronic medical conditions. Findings supported a bifactor model with more satisfactory goodness-of-fit indices than the original two-factor model and the two-correlated factor model. WHOQOL-AGE showed adequate internal consistency (Cronbach's alpha coefficients > .70). Good convergent validity was demonstrated by moderate-to-large correlations between WHOQOL-AGE and satisfaction with life (rs = .54) as well as social connectedness (rs = .33). Discriminant validity was shown by low correlations between WHOQOL-AGE and compassion (r = .19). Findings also indicated good known-groups validity (p < 0.01). The WHOQOL-AGE showed promising psychometric properties using an Asian convenience sample and can be useful in large-scale studies or busy clinical settings.

Factors associated with adherence to HIV testing guidelines among HIV-negative female sex workers in Kampala, Uganda

Background

Frequent human immunodeficiency virus (HIV) testing is recommended among female sex workers. This study examined the extent to which HIV-negative female sex workers (FSWs) in Kampala adhere to the HIV testing guidelines, and identified associated factors.

Methods

This cross-sectional study used a simple random sampling method to select 12 sex work hotspots. Two hundred participants were allocated proportionally in each hotspot. Frequencies were used to describe categorical characteristics of FSWs, and a multivariable logistic regression model was used to determine the factors associated with adherence to the HIV testing guidelines.

Results

Eighty-eight percent of the 200 study participants reported their HIV testing status; of these, 56% had tested three or more times in the 12 months preceding the survey. Attaining a secondary education was associated with adherence to the HIV testing guidelines [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.01-3.44; P=0.047]. Sexually transmitted infection testing in the preceding 3 months (OR 2.13, 95% CI 0.95-4.74; P=0.065) and accessing HIV testing at a drop-in centre (OR 5.90, 95% CI 0.71-49.1; P=0.101) were associated with higher odds of adherence to the HIV testing guidelines.

Conclusion

Adherence to the HIV testing guidelines was suboptimal, indicating the need to scale up interventions to improve access to HIV testing, including rigorous behaviour change communication.

Estimation of Health-Related Quality of Life Losses Owing to a Technological Disaster in Brazil Using EQ-5D-3L: A Cross-Sectional Study

OBJECTIVES

In 2015, a dam collapsed at Samarco iron ore mine in the municipality of Mariana, Brazil, and contaminated more than 600 km of watercourses and destroyed almost 1600 acres of vegetation. Nineteen people died and more than 600 families lost their homes. This study aimed to estimate health-related quality of life (HRQoL) losses owing to this disaster.

METHODS

We collected data from a probabilistic sample of 459 individuals aged 15 years or older. Household face-to-face interviews were conducted in December 2018. Pre-event data were not available for this population, so respondents were asked to evaluate at present and in retrospect their health status using EQ-5D-3L. The Minas Gerais societal value sets for EQ-5D-3L health preferences, estimated in 2011, were used to calculate utility losses. The health loss estimation from EQ-5D will form the basis for the calculation of compensation payments for the victims.

RESULTS

Approximately 74% of the study population suffered some HRQoL loss. On average, EQ-5D index values decreased from 0.95 to 0.76. The greatest effects were observed for the anxiety/depression dimension, followed by pain/discomfort. Before the tragedy, the proportion of individuals with severe anxiety/depression and pain/discomfort was equal to 1% rising to 23% and 11%, respectively.

CONCLUSIONS

Catastrophic losses owing to the Samarco disaster were found. The EQ-5D-3L instrument showed feasibility and sensitiveness to measure HRQoL losses owing to a negative health shock in a low-income Brazilian population.

Targeting the DPP-4-GLP-1 pathway improves exercise tolerance in heart failure patients: a systematic review and meta-analysis

BACKGROUND

The most significant manifestation of heart failure is exercise intolerance. This systematic review and meta-analysis was performed to investigate whether dipeptidyl peptidase-4 (DPP-4) inhibitors or glucagon-like peptide 1 receptor agonists (GLP-1 RAs), widely used anti-diabetic drugs, could improve exercise tolerance in heart failure patients with or without type 2 diabetes mellitus.

METHODS

An electronic search of PubMed, EMBASE and the Cochrane Library was carried out through March 8th, 2019, for eligible trials. Only randomized controlled studies were included. The primary outcome was exercise tolerance [6-min walk test (6MWT) and peak O2 consumption], and the secondary outcomes included quality of life (QoL), adverse events (AEs) and all-cause death.

RESULT

After the literature was screened by two reviewers independently, four trials (659 patients) conducted with heart failure patients with or without type 2 diabetes met the eligibility criteria. The results suggested that targeting the DPP-4-GLP-1 pathway can improve exercise tolerance in heart failure patients [MD 24.88 (95% CI 5.45, 44.31), P = 0.01] without decreasing QoL [SMD -0.51 (95% CI -1.13, 0.10), P = 0.10]; additionally, targeting the DPP-4-GLP-1 pathway did not show signs of increasing the incidence of serious AEs or mortality.

CONCLUSION

Our results suggest that DPP-4 inhibitors or GLP-1 RAs improve exercise tolerance in heart failure patients. Although the use of these drugs for heart failure has not been approved by any organization, they may be a better choice for type 2 diabetes mellitus patients with heart failure. Furthermore, as this pathway contributes to the improvement of exercise tolerance, it may be worth further investigation in exercise-intolerant patients with other diseases.