Chronic Illness最新文献

Objective: Type 1 diabetes is one of the most common chronic conditions in young children and adolescents. During the period of adolescence, young people with diabetes often struggle with self-management and have compromised health-related quality of life. This often leads to familial conflicts affecting all family members negatively. The aim of this study is to provide qualitative insight into the everyday life of families with adolescents with type 1 diabetes.

Methods: The data consisted of participatory family workshops conducted using interactive dialogue tools. The total number of participants was 33 (adolescents n = 13, parents n = 20). The adolescents were between 15 and 17 years. The data were analyzed using systematic text condensation.

Results: The results showed two main themes. The first theme, Diabetes-friendly and unfriendly social contexts, highlighted how the (dis)comfortability of disclosing diabetes was a significant factor in achieving optimal metabolic control. For parents, it affected their perception of social support. The second theme, incongruent illness representations among family members, dealt with the extended family conflict during the period of adolescence.

Discussion: Insights from our study could help healthcare professionals apply a family-centered approach minimizing family conflict and supporting metabolic control when consulting families with adolescents with type 1 diabetes.

Objective: To explore the care experiences of spouses as long-term and primary caregivers for disabled older adults in China.

Methods: A descriptive phenomenological method was used in this study, as well as purposive and convenient sampling. Semi-structured interviews were conducted with 15 spousal caregivers in Guangdong, China, from March to December 2021. Interview audio-recordings were transcribed verbatim and data were analyzed using Colaizzi's phenomenological analysis method.

Results: We identified four themes from the data: spousal care motivation; sacrifices in caregiving; obstacles in caregiving; spousal caregivers' positive experiences.

Conclusions: Spouses took responsibility for providing care for their disabled partners regardless of their willingness. They had positive experiences while providing care, but negative experiences were dominant, especially for spouses of severely disabled older adults. Spouses are always perfect in caregiving roles, although they may also need medical assistance. To prevent a decline in spousal caregivers' quality of life and relieve their care burdens, health care providers should support them as soon as possible or offer formal care for disabled older adults. It is necessary to intervene considering disabled older adults and their spousal caregivers as a unit to empower their confidence in coping with life together.

Background: Having meaning in life is a protective factor for psychological well-being. Accurate assessment of this construct needs a valid and reliable tool.

Purpose: This study aims to evaluate the psychometric properties of the Farsi version of the meaning of life questionnaire in patients with cancer.

Method: In this cross-sectional study, after translating the questionnaire to Farsi, in a sample of 212 patients with cancer, feasibility, content and convergent validity, exploratory and confirmatory factor analysis, internal consistency, stability, and responsiveness were evaluated.

Results: The results show that the content validity ratio of all ten items was greater than 0.49. Also, the modified Kappa coefficient of each item was greater than 0.6. The maximum likelihood exploratory factor analysis extracted one factor, which explains 76.13% of the total variance of the sample. Item nine was removed. The confirmatory factor analysis results show that the one-factor model had good fit indices. The Cronbach's alpha, McDonald's omega, composite reliability, MaxR, and intraclass correlation coefficient were 0.96, 0.96, 0.96, 0.96, and 0.98, respectively. The questionnaires had responsiveness and its response time was 3 s.

Conclusion and policy summary: The nine-item Farsi version of the meaning of life questionnaire has good validity and reliability and responsiveness.

Objectives: To assess the prevalence and determinants of cardiometabolic disease (CMD), and the factors associated with healthcare utilisation, among people with CMD.

Methods: Using a cross-sectional design, 11,657 participants were recruited from randomly selected villages in 3 regions located in Kerala and Andhra Pradesh from 2014 to 2016. Multivariable logistic regression was used to identify factors independently associated with CMD and healthcare utilisation (public or private).

Results: Thirty-four per cent (n = 3629) of participants reported having ≥1 CMD, including hypertension (21.6%), diabetes (11.6%), heart disease (5.0%) or chronic kidney disease (CKD) (1.6%). The prevalence of CMD was progressively greater in regions of greater socio-economic position (SEP), ranging from 19.1% to 40.9%. Among those with CMD 41% had sought any medical advice in the last month, with only 19% utilising public health facilities. Among people with CMD, those with health insurance utilised more healthcare (age-gender adjusted odds ratio (AOR) (95% confidence interval (CI)): 1.31 (1.13, 1.51)) as did those who reported accessing private rather than public health services (1.43 (1.23, 1.66)).

Discussion: The prevalence of CMD is high in these regions of rural India and is positively associated with indices of SEP. The utilisation of outpatient health services, particularly public services, among those with CMD is low.

Objectives: While most individuals infected with COVID-19 recover completely within a few weeks, some continue to experience lingering symptoms. This study was conducted to identify and describe the clinical and subclinical manifestations of adult patients from the long-term effects of COVID-19.

Methods: The study analyzed 205 medical records of inpatients (age ≥ 16 years, ≥ 4 weeks post-COVID-19 recovery, and a negative SARS-CoV-2 status at enrollment) at Thong Nhat Hospital, Vietnam, from 6 September 2021 to 26 August 2022, using R language software.

Results: The majority of patients hospitalized with long COVID-19 symptoms (92.68%) had normal consciousness. The most common symptoms on admission were fatigue (59.02%), dyspnea (52.68%), and cough (42.93%). In total, 80% of patients observed respiratory symptoms, primarily dyspnea, while 42.44% reported neurological symptoms, with sleep disturbance being the most common. Noticeably, 42.93% of patients experienced respiratory failure in the post-COVID-19 period, resembling acute respiratory distress syndrome.

Discussion: These findings provide crucial insights into the epidemiology, clinical, and subclinical aspects of post-COVID-19 conditions, shedding light on the prevalence of common symptoms and the demographic distribution of affected patients. Understanding these manifestations is vital for patient well-being, improved clinical practice, and targeted healthcare planning, potentially leading to better patient care, management, and future interventions.

Objective: The aim of this study was to assess and compare knowledge of the health consequences of heavy alcohol consumption among individuals with different substance use statuses.

Methods: We used a cross-sectional study design to analyze the Health Information National Trends Survey (HINTS) 5, Cycle 3 (2019). Participants were classified into four categories based on their substance use status: (a) nonsmoker and nondrinkers; (b) nonsmokers but drinkers; (c) smokers but nondrinkers; and (d) smokers and drinkers. Weighted logistic regression models were utilized to evaluate the association between knowledge of heavy alcohol consumption and health conditions by participants' substance use status.

Results: More than 79% of participants were aware that drinking too much alcohol causes liver disease. However, less than 40% of them realized that heavy alcohol consumption also contributes to cancer. The odds of correctly identifying heavy alcohol consumption as a risk factor for diabetes were 3.00 times (95% confidence interval (CI): 1.29,7.00) higher among smokers but nondrinkers than smokers and alcohol drinkers. Education level was significantly associated with participants' awareness of risk factor (p < 0.01).

Discussion: There is an urgent need for targeted educational campaigns and interventions to increase understanding of the impact of heavy alcohol consumption on cancer risk.

Introduction: Despite the effect of coronary artery disease on sexual function and the relation between sexual function and marital satisfaction, few studies have investigated the effect of treatment adherence on marital satisfaction. The present study aims to investigate the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease.

Methodology: In this cross-sectional study, 385 women with coronary artery disease in Bushehr-Iran, 2021, were selected using a convenient sampling method. The data were collected using the demographic form, Seyed Fatemi medication adherence scale, female sexual function index, and evaluation and nurturing relationship issues, communication, and happiness marital satisfaction scale. The data was analyzed using univariate and multivariate logistic regression tests.

Results: The mean (± standard deviation) age of the participants was 52.19 ± 12.15 years old. Considering the effect of demographic variables, treatment adherence (β = 0.164, P = 0.001) and sexual function (β = 0.156, P = 0.001) were positive predictors of marital satisfaction.

Conclusion: Treatment adherence was a positive predictor of marital satisfaction. Healthcare providers should pay attention to the family consequences of non-adherence to treatment. Moreover, when counseling patients to adhere to the treatment, they should mention the physical benefits as well as psychological and family outcomes in order to motivate patients to follow their treatment.

Objectives: The COVID-19 pandemic has left many suffering from long COVID, an episodic and debilitating chronic condition affecting people's ability to work and manage medical expenses. Though the Biden Administration has committed to conducting research and building support programs to alleviate the strain on those affected, in practice, static eligibility criteria for unemployment and disability benefits, patchy insurance coverage, and insufficient paid leave programs have left many people vulnerable. Given the magnitude of long COVID and the dearth to date of large-scale studies about its financial consequences, a focused qualitative analysis of lived experiences is warranted to understand and highlight gaps in the policy landscape.

Methods: We conducted in-depth semi-structured interviews from 2020 to 2022 with 25 people with experience of long COVID living predominately in the Midwest.

Results: Our inductive analysis revealed ways people became financially exhausted by uncertain medical care costs and precarious employment that left them trying, often alone, to access benefits. People described both experiences with workplace benefits and attempts to access federal benefits to address unstable employment situations created by protracted and uncertain functional impairments.

Discussion: We explore pre- and post-pandemic era unemployment, disability, and insurance policies and offer recommendations for better supporting people with long COVID.

Objective: The aim of the current study was to better understand if perceived parental distress moderates the effects of having a chronic illness and poor physical quality of life on psychological problems reported by emerging adults.

Methods: Participants consisted of 538 college-attending emerging adults (53.5% women; 46.5% men). Participants completed an online study that was composed of questions regarding chronic illness, the World Health Organization Quality of Life - Brief, the Adult Self-Report scale, and the Adult Behavior Checklist.

Results: In both emerging adult women and men, endorsing a chronic illness is significantly associated with psychological problems. Psychological problems in both emerging adult women and men were significantly predicted by the three-way interaction between endorsing a chronic illness, physical quality of life, and perceived maternal distress. Specifically, increased perceived maternal distress was associated with higher psychological problems in both emerging adult women and men with chronic illnesses and low physical quality of life.

Discussion: For emerging adult women and men with a chronic illness, higher perceived maternal distress was associated with poorer psychological adjustment, while lower perceived maternal distress was associated with better psychological adjustment.