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Barriers to Exercise among Non-Exercising Type 2 Diabetes Mellitus Patients Visiting a Tertiary Care Hospital 非运动型2型糖尿病患者在三级医院的运动障碍
Pub Date : 2022-12-05 DOI: 10.5539/gjhs.v15n1p20
Vinod Kumar, Chander Kumar Lohana
Exercise is a crucial strategy for diabetes management. However, the majority of patients with Type 2 diabetes seem reluctant to do physical activity. It increases the need of investigating the factors that are responsible for their non-exercising routine. This study aims to recognize the psychological and social barriers that prevent patients with diabetes mellitus to do exercise. A cross-sectional study was conducted with a total of 275 patients with type 2 diabetes attending family medicine outpatient clinics for the last six months. The questionnaire has been designed to collect data regarding psychological and social barriers to exercise. A comparison of social and psychological barriers with general characteristics was performed. The findings of the study reveal that all the general characteristics were significantly associated with psychological and social barriers. The patients reported that lack of interest, no willpower, a feeling of depression, unaffordability, and time barriers were the most frequent barriers among social and psychological barriers to exercise.
运动是控制糖尿病的关键策略。然而,大多数2型糖尿病患者似乎不愿进行体育锻炼。这增加了调查导致他们不运动的因素的需要。本研究旨在了解阻碍糖尿病患者运动的心理和社会障碍。一项横断面研究对过去6个月在家庭医学门诊就诊的275例2型糖尿病患者进行了研究。该调查问卷的目的是收集有关运动的心理和社会障碍的数据。对具有一般特征的社会障碍和心理障碍进行了比较。研究结果表明,所有的一般特征都与心理和社会障碍显著相关。患者报告说,缺乏兴趣、没有意志力、感到沮丧、负担不起和时间障碍是社会和心理障碍中最常见的障碍。
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引用次数: 1
Reviewer Acknowledgements for Global Journal of Health Science, Vol. 14, No. 12 《全球健康科学杂志》第14卷第12期审稿人致谢
Pub Date : 2022-12-01 DOI: 10.5539/gjhs.v14n12p57
E. Grey
Reviewer Acknowledgements for Global Journal of Health Science, Vol. 14, No. 12, 2022.
《Global Journal of Health Science》,Vol. 14, No. 12, 2022。
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引用次数: 0
Sensitivity and Specificity of the HIV Risk Assessment Tool Used by PEPFAR Partners in Edo, Bayelsa and Lagos States, Nigeria 尼日利亚埃多州、巴耶尔萨州和拉各斯州PEPFAR合作伙伴使用的艾滋病毒风险评估工具的敏感性和特异性
Pub Date : 2022-12-01 DOI: 10.5539/gjhs.v14n12p39
Eale E. Kris, Nwafor S. Uchenna, Carole Metekoua, Mary P. Selvaggio, Ladi-Akinyemi Babatunde O
INTRODUCTION: Although HIV testing is a critical screening and entry point for accessing HIV treatment, HIV programs worldwide are strained by limited resources which require a practical and cost-effective strategy for screening and testing clients. Screening tools are becoming increasingly common given their presumed advantage of efficiency and cost-effectiveness in predicting and prioritizing clients who are most at risk of testing HIV positive. METHOD: This study assessed a Risk Assessment Tool (RAT) used by PEPFAR partners in Edo, Bayelsa, and Lagos states of Nigeria to determine the tool’s sensitivity and specificity for identifying HIV positivity. The assessment purposively selected the 20 most convenient health facilities. A penalized logistic regression model was also used to identify specific questions that predict True Positive. RESULT & CONCLUSION: The results indicate that the RAT used in the 3 states had poor accuracy, with a sensitivity of only 54%, meaning the RAT correctly identified 54% of the people who have HIV but failed to identify 46% of people who have HIV. The RAT’s specificity (77%) indicated that it correctly identified 77% of people who do not have HIV, but it also erroneously identified 23% of people as having HIV when they did not. The penalized logistic regression model demonstrated that clients who reported having unprotected sex in the previous 6 months accounted for 51% of those who tested positive to HIV. Likewise, those who reported having vaginal or urethral discharge accounted for 11%, while tuberculosis diagnosis or symptoms accounted for 8% of clients who tested positive to HIV. These three questions yielded the highest predictive values of clients who were likely to test positive.
导论:尽管艾滋病毒检测是获得艾滋病毒治疗的关键筛查和切入点,但全球艾滋病毒项目因资源有限而紧张,这需要一种实用且具有成本效益的筛查和检测客户策略。筛查工具正变得越来越普遍,因为它们在预测和优先考虑最有可能检测出艾滋病毒阳性的客户方面具有效率和成本效益的优势。方法:本研究评估了PEPFAR合作伙伴在尼日利亚埃多州、巴耶尔萨州和拉各斯州使用的风险评估工具(RAT),以确定该工具识别HIV阳性的敏感性和特异性。评估有目的地选择了20个最便利的卫生设施。惩罚逻辑回归模型也用于确定预测真阳性的具体问题。结果与结论:结果表明,3个州使用的RAT准确性较差,灵敏度仅为54%,这意味着RAT正确识别了54%的HIV感染者,但未能识别46%的HIV感染者。RAT的特异性(77%)表明,它正确地识别出了77%没有感染艾滋病毒的人,但它也错误地识别出了23%没有感染艾滋病毒的人。惩罚逻辑回归模型表明,报告在过去6个月内发生无保护措施性行为的客户占艾滋病毒检测呈阳性的客户的51%。同样,报告有阴道或尿道分泌物的占11%,而结核病诊断或症状占艾滋病毒检测呈阳性的客户的8%。这三个问题对可能呈阳性的客户产生了最高的预测值。
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引用次数: 0
Identifying Factors Which Enhance the Self-Management of Type 2 Diabetes: A Systematic Review with Thematic Analysis 识别提高2型糖尿病自我管理的因素:专题分析的系统综述
Pub Date : 2022-11-30 DOI: 10.5539/gjhs.v15n1p1
Keresi Rokorua Bako, A. Reynolds, Dianne Sika-Paotonu, L. Signal, M. Mohammadnezhad
BACKGROUND: Individuals with type 2 diabetes play a pivotal role in their health. Enhancing the self-management of diabetes can improve blood glucose control, and quality of life, and reduce diabetes-related complications. We have identified factors influencing the self-management of type 2 diabetes to inform strategies that may be applied in the long-term management of blood glucose control. METHODS: We conducted a systematic literature review of recent studies published between January 2010 to December 2020 to identify the available evidence on effective self-management strategies for type 2 diabetes. The databases used for the searchers were Scopus, PubMed, Science Direct, CINAHL, and Google Scholar. We assessed English language publications only. The screening of titles was duplicated by two researchers. We then conducted a thematic analysis of the key findings from eligible publications to identify reoccurring messages that may augment or abate self-management strategies. RESULTS: We identified 49 relevant publications involving 90,857 participants. Four key themes were identified from these publications: Individual drive, social capital, Knowledge base, and Insufficient health care. High motivation and self-efficacy enabled greater self-management. The importance of family, friends, and the health care professional was salient, as were the negative effects of stigma and labelling. Enablers to good self-management were the level of support provided and its affordability. Finally, the accessibility and adequacy of the health care services emerged as fundamental to permit diabetes self-management. CONCLUSIONS: Self-management of type 2 diabetes is an essential strategy given its global presence and impact, and the current resource constraints in health care. Individuals with type 2 diabetes should be empowered and supported to self-manage. This includes awareness raising on their role in self-health, engaging broader support networks, and the pivotal role of health care professionals to inform and support. Further research is needed into the capacity assessment of healthcare systems in diabetes medicine, targeted low-cost resources for self-management, and the financial requirements that enable self-management advice to be enacted.
背景:2型糖尿病患者在他们的健康中起着关键作用。加强对糖尿病的自我管理,可以改善血糖控制,提高生活质量,减少糖尿病相关并发症。我们已经确定了影响2型糖尿病自我管理的因素,为可能应用于血糖控制长期管理的策略提供信息。方法:我们对2010年1月至2020年12月期间发表的近期研究进行了系统的文献综述,以确定有效的2型糖尿病自我管理策略的现有证据。搜索者使用的数据库是Scopus、PubMed、Science Direct、CINAHL和Google Scholar。我们只评估了英文出版物。筛选题目的工作由两名研究人员重复进行。然后,我们对合格出版物的主要发现进行了专题分析,以确定可能增强或减弱自我管理策略的重复信息。结果:我们确定了49篇相关出版物,涉及90,857名受试者。从这些出版物中确定了四个关键主题:个人动力、社会资本、知识基础和卫生保健不足。高动机和自我效能使自我管理能力增强。家庭、朋友和保健专业人员的重要性是突出的,污名和标签的负面影响也是突出的。促进良好自我管理的因素是所提供的支持水平及其可负担性。最后,保健服务的可及性和充足性成为糖尿病自我管理的基础。结论:考虑到2型糖尿病在全球的存在和影响,以及目前卫生保健资源的限制,自我管理是一项必要的策略。2型糖尿病患者应该被授权和支持自我管理。这包括提高对她们在自我健康中的作用的认识,参与更广泛的支持网络,以及卫生保健专业人员在提供信息和支持方面的关键作用。需要进一步研究卫生保健系统在糖尿病药物方面的能力评估、自我管理的有针对性的低成本资源,以及使自我管理建议得以实施的财政需求。
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引用次数: 0
Assessment of Clinical and Laboratory Limits between Hashitoxicosis and Graves’ Disease 烟毒中毒与格雷夫斯病的临床和实验室界限评估
Pub Date : 2022-11-22 DOI: 10.5539/gjhs.v14n12p28
Juliana Delfino dos Reis, T. C. M. Feibelmann, B. P. Ferreira, M. A. Lima, Janaíne Machado Tomé, Flávia Alves Ribeiro, Beatriz Hallal Jorge Lara, M. Borges
BACKGROUND: Determine the clinical and laboratory features of Hashitoxicosis (Htx) and set standards that will help perform a differential diagnosis with Graves’Disease (GD). SUBJECTS & METHODS: we evaluated 45 patients with Htx (Hashi-group) diagnosed between January/1995 and July/2019 with autoimmune hyperthyroidism and cytology compatible with Hashimoto’s Thyroiditis (HT). The control group consisted of 51 patients with GD (Graves-group). RESULTS: clinical hyperthyroidism, free T4 (FT4), thyroid volume and need for antithyroid drugs were higher in the Graves-Group. Values of anti-thyroid antibodies and TSH were higher in the Hashi-Group. The definitive diagnostic criterion was cytology. Regarding the clinical course, 95% of the Hashi-Group had hyperthyroidism of short duration, while 84.3% of Graves-Group required radioactive iodine (RAI). CONCLUSION: hyperthyroidism due to HT was milder than that associated with GD. In most citology was able to distinguish HT from GD and predict spontaneous resolution preventing unnecessary RAI.
背景:确定Hashitoxicosis (Htx)的临床和实验室特征,并制定有助于Graves病(GD)鉴别诊断的标准。研究对象和方法:我们评估了1995年1月至2019年7月诊断为自身免疫性甲状腺功能亢进和细胞学与桥本甲状腺炎(HT)相容的45例Htx(桥本组)患者。对照组为GD患者51例(graves组)。结果:graves组临床甲状腺功能亢进、游离T4 (FT4)、甲状腺体积及抗甲状腺药物需要量均较高。抗甲状腺抗体和TSH值在hashi组较高。最终的诊断标准是细胞学。在临床病程方面,95%的hashi组有短期甲状腺功能亢进,而84.3%的graves组需要放射性碘(RAI)。结论:HT所致甲亢较GD所致甲亢轻。在大多数情况下,citology能够区分HT和GD,并预测自发消退,防止不必要的RAI。
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引用次数: 0
Adult Children as Caregivers: Preliminary Study on the Experiences and Coping Strategies of Adult Children as Primary Caregivers of Parents with Alzheimer’s Disease in Malaysia 成年子女作为照顾者:马来西亚成年子女作为阿尔茨海默病父母主要照顾者的经历及应对策略的初步研究
Pub Date : 2022-11-16 DOI: 10.5539/gjhs.v14n12p18
Khairun Nisya Binti Ali Hasmi Nizarl, Ong Shi Joe, Teoh Gaik Kin, Z. Khalaf
Alzheimer’s Disease (AD) is an irreversible brain disorder that affects thinking, memory, reasoning, and daily functioning. According to World Health Organization (2020), there are approximately 50 million people diagnosed with AD, and nearly 60% of them are living in low- and middle-income countries. In Malaysia, the prevalence of dementia is 8.5% among older adults aged 60 and above. Listed as one of the leading causes of death in 2020, curbing AD is not only a burden to the public health system but also brings perpetual stress to the family members who often undertake the primary caregiving role. The research has indicated that adult children as AD patients' primary caregivers (adult-child caregivers) experience higher psychological burdens than other caregiver groups. This qualitative study intended to explore the experiences and coping strategies of adult children as the primary caregivers of AD patients in Malaysia. The recruitment was conducted with the assistance of the Alzheimer’s Disease Foundation Malaysia, whereby eight participants took part in the in-depth interviews. Both face-to-face and telephone interviews were conducted to facilitate the full engagement of the participants in the research. Thematic analysis technique was used to analyze the data. The results showed that, at the personal level, adult children constantly felt emotional burnout, as they were overwhelmed by not knowing how to manage the stress they experienced. The findings reflected that caregiving for parents with AD involves a process that was depicted as the discovery of behavior changes, having difficulties accepting the diagnosis, making an adjustment to the role of a caregiver, and finally accepting their function and the reality of the disease. Recommendations for interventions and further research have been discussed.
阿尔茨海默病(AD)是一种不可逆转的脑部疾病,会影响思维、记忆、推理和日常功能。根据世界卫生组织(2020年)的数据,约有5000万人被诊断患有阿尔茨海默病,其中近60%生活在低收入和中等收入国家。在马来西亚,60岁及以上的老年人中痴呆症的患病率为8.5%。阿尔茨海默病被列为2020年的主要死亡原因之一,不仅是公共卫生系统的负担,而且给往往承担主要照顾角色的家庭成员带来了持久的压力。研究表明,成年儿童作为AD患者的主要照顾者(成人-儿童照顾者)的心理负担高于其他照顾者群体。本质性研究旨在探讨马来西亚成年子女作为AD患者主要照顾者的经历及应对策略。招募工作是在马来西亚阿尔茨海默病基金会的协助下进行的,其中8名参与者参加了深入访谈。面对面和电话访谈都进行了,以促进参与者充分参与研究。采用专题分析技术对数据进行分析。结果显示,在个人层面上,成年子女经常感到情绪倦怠,因为他们不知道如何管理他们所经历的压力。研究结果表明,照顾患有阿尔茨海默病的父母需要一个过程,这个过程被描述为发现行为变化,难以接受诊断,调整照顾者的角色,最终接受他们的功能和疾病的现实。讨论了有关干预措施和进一步研究的建议。
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引用次数: 0
Using Occupational Therapy Assistant Perspectives to Teach Occupational Therapy Supervisory Roles and Expectations 运用职业治疗助理的观点来教授职业治疗主管的角色和期望
Pub Date : 2022-11-10 DOI: 10.5539/gjhs.v14n12p11
John Damiao, C. Cavaliere, Charie Carroll, David Charneco, E. Volkov
Occupational therapy assistant (OTA) supervision is an expected skill and role of entry-level occupational therapists (OTRs). The purpose of this convergent mixed-methods study is to provide occupational therapy students (OTSs) with an interactive and collaborative educational opportunity, using an OTA-perspective panel discussion to improve the learning of effective supervision and role delineation. Participants consisted of OTSs (n = 11) in a graduate master’s program and a panel of OTAs (n = 10). All participants were provided with a standard lecture on the topic of supervision, followed by a pre-test survey. Then, they participated in a guided panel discussion followed by a post-test survey. Results suggest that an OTA-perspective panel discussion can enhance the learning of supervisory roles and expectations to OTSs, beyond what was provided in the standard lecture (p = 0.007). Further data was gathered of all participants consisting of qualitative perspectives. Thematic analysis resulted in enhanced learning of role-delineation, professional perspectives, and supervisory experiences. The results of this study suggest that occupational therapy programs would benefit from similar OTA-led perspective discussions to enhance OTSs understanding of skills needed to be effective supervisors as entry-level occupational therapists.
职业治疗助理(OTA)监督是初级职业治疗师(OTRs)所期望的技能和角色。本研究的目的是为职业治疗学生提供一个互动和合作的教育机会,使用职业治疗学生视角的小组讨论来改善有效监督和角色描述的学习。参与者包括研究生硕士项目的OTAs (n = 11)和OTAs小组(n = 10)。所有的参与者都被提供了一个关于监督主题的标准讲座,然后是一个测试前的调查。然后,他们参加了一个有指导的小组讨论,随后进行了测试后调查。结果表明,ota视角的小组讨论可以提高OTSs对监管角色和期望的学习,超出标准讲座(p = 0.007)。进一步收集所有参与者的数据,包括定性观点。专题分析促进了角色描述、专业视角和管理经验的学习。本研究的结果表明,职业治疗项目将受益于类似的由职业治疗师主导的观点讨论,以提高职业治疗师对作为入门级职业治疗师的有效监督者所需技能的理解。
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引用次数: 0
Spectrum of Substance Use, Reasons for Use and Perceived Effects on Treatment among People Living with Human Immunodeficiency Virus (PLWHIV) in Benue State, Nigeria; A Qualitative Study 尼日利亚贝努埃州人类免疫缺陷病毒(PLWHIV)感染者的物质使用谱、使用原因和治疗效果定性研究
Pub Date : 2022-11-10 DOI: 10.5539/gjhs.v14n12p1
G. C. Ezema, E. Aniwada, O. Ayemoba, U. Adekanye, Nathan AE. Okeji
INTRODUCTION: Substance use is on increase and a major public health problem contributing about 1.7 million deaths among teenagers globally. Ironically, some are socially acceptable and freely consumed during social activities. They are consumed commonly for social, religious and medicinal reasons. This study aims to assess substance use, types, reasons and its perceived effects among PLHIV in Benue State, Nigeria METHODS: The study was at Centre for Infectious Diseases Control (CIDC), 161 Nigerian Air Force Hospital, Makurdi at Benue state, Nigeria. Qualitative data was collected using Focus Group Discussions (FGDs) among five homogeneous groups involving 40 discussants [30 and 10 health care workers]. The recorded discussions were transcribed verbatim, coded based on predetermined themes and reported. RESULTS: The commonest psychoactive substance used by People living with Human Immunodeficiency Virus (PLWHIV) for both males and females was Alcohol followed by Kola nut and Bitter Cola. Others were; cannabis, overdose dose of Rohypnol, Tramadol and diazepam; paracitamol mixed with ‘la-cassera’ soft drink and codeine in cough syrup as well as Marijuana. Major reasons for use included to increase work, sexual performance, reading time and appetite; reduce nausea, vomiting and to manage stress or boredom. They perceived most substance to be safe though few expressed their concern on the possible interaction with Antiretroviral (ARV) medications and possibility of increasing Gastrointestinal tract (GIT) effect of some drugs. This they said depends on type and dose of consumption. CONCLUSION: Substance use among PLWHIV is common. Misconceptions and poor appreciation of effect of these substance use among these clients abound. Every effort should be made to tame this menace.
导言:药物使用正在增加,这是一个重大的公共卫生问题,在全球青少年中造成约170万人死亡。具有讽刺意味的是,有些是社会可以接受的,并在社交活动中自由消费。由于社会、宗教和医疗原因,它们通常被食用。本研究旨在评估尼日利亚贝努埃州PLHIV药物使用、类型、原因及其感知影响。方法:研究在尼日利亚贝努埃州马库尔迪161尼日利亚空军医院传染病控制中心(CIDC)进行。定性数据是通过焦点小组讨论(fgd)在五个同质小组中收集的,涉及40名讨论者[30名和10名卫生保健工作者]。讨论记录逐字抄录,根据预先确定的主题进行编码,并予以报告。结果:人类免疫缺陷病毒感染者(PLWHIV)男性和女性最常使用的精神活性物质是酒精,其次是可乐果和苦可乐。人;大麻、过量剂量的迷迭香、曲马多及安定;扑热息痛与“la-cassera”软饮料混合,止咳糖浆中的可待因以及大麻。使用的主要原因包括增加工作、性生活、阅读时间和食欲;减少恶心,呕吐和管理压力或无聊。他们认为大多数药物是安全的,但很少有人对可能与抗逆转录病毒(ARV)药物相互作用以及某些药物可能增加胃肠道(GIT)作用表示担忧。他们说,这取决于摄入的类型和剂量。结论:艾滋病病毒感染者药物滥用较为普遍。这些客户对这些物质使用的误解和不良评价比比皆是。应该尽一切努力遏制这种威胁。
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引用次数: 0
Reviewer Acknowledgements for Global Journal of Health Science, Vol. 14, No. 11 《全球健康科学杂志》第14卷第11期审稿人致谢
Pub Date : 2022-11-01 DOI: 10.5539/gjhs.v14n11p57
E. Grey
Reviewer Acknowledgements for Global Journal of Health Science, Vol. 14, No. 11, 2022.
《Global Journal of Health Science》,Vol. 14, No. 11, 2022。
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引用次数: 0
Perceptions of Postpartum Family Planning in Extended Postpartum Period among Men in Morogoro Municipality, Tanzania: A Qualitative Study 坦桑尼亚莫罗戈罗市男性在产后延长期对产后计划生育的看法:一项定性研究
Pub Date : 2022-10-31 DOI: 10.5539/gjhs.v14n11p47
Godfrey Kacholi, Asia Fadhil Msofe, Rogate Phinias Ibrahim, Mackfallen G. Anasel
INTRODUCTION: Several policies and programs have aimed to expand rates of extended postpartum family planning among women than among men in low- and middle-income countries and Tanzania is no exception. This study aimed to explore perceptions of men on postpartum family planning in extended postpartum period among men in Morogoro Municipality, Tanzania. METHODS: This qualitative study collected information using pretested interview guide from 28 male participants whose spouses were currently in the extended postpartum period. Participants were purposeful and conveniently enrolled in the study. The study was conducted in three primary health facilities in Morogoro Municipality in Tanzania from 22 February to 24 March 2021. RESULTS: The study found that most participants demonstrated a good understanding of postpartum family planning methods and their advantages. Male condoms were mostly preferred as their main postpartum family planning method; however, compliance with condom use was reported to be very low. Results on religious considerations and beliefs about postpartum family planning were mixed. CONCLUSION: The choice of postpartum family planning services among men is limited. Male involvement and strengthened accessibility of postpartum family planning services are key in accelerating progress in improving reproductive, maternal, newborn, and child health outcomes.
导读:在低收入和中等收入国家,一些政策和方案旨在提高妇女产后计划生育延长率,坦桑尼亚也不例外。本研究旨在探讨坦桑尼亚莫罗戈罗市男性在延长产后期间对产后计划生育的看法。方法:采用预先测试的访谈指南,对28名配偶目前处于产后延长期的男性参与者进行定性研究。参与者是有目的且方便地加入研究的。该研究于2021年2月22日至3月24日在坦桑尼亚莫罗戈罗市的三个初级卫生设施进行。结果:研究发现,大多数参与者对产后计划生育方法及其优点有很好的了解。男性避孕套是她们产后计划生育的主要方式;然而,据报道,遵守使用避孕套的情况非常低。关于产后计划生育的宗教考虑和信仰的结果好坏参半。结论:男性产后计划生育服务选择有限。男性的参与和加强产后计划生育服务的可及性是加快改善生殖、孕产妇、新生儿和儿童健康成果方面的进展的关键。
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引用次数: 0
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Global Journal of Health Science
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