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RCT-based Social Return on Investment (SROI) of a Home Exercise Program for People With Early Dementia Comparing In-Person and Blended Delivery Before and During the COVID-19 Pandemic 基于 RCT 的早期痴呆症患者家庭锻炼计划的社会投资回报率 (SROI),比较 COVID-19 大流行之前和期间的亲身参与和混合交付方式
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-23 DOI: 10.1177/00469580241246468
Kodchawan Doungsong, Ned Hartfiel, John Gladman, Rowan Harwood, Rhiannon Tudor Edwards
Regular exercise and community engagement may slow the rate of function loss for people with dementia. However, the evidence is uncertain regarding the cost-effectiveness and social return on investment (SROI) of home exercise with community referral for people with dementia. This study aimed to compare the social value generated from the in-person PrAISED program delivered before March 2020 with a blended PrAISED program delivered after March 2020. SROI methodology compared in-person and blended delivery formats of a home exercise program. Stakeholders were identified, a logic model was developed, outcomes were evidenced and valued, costs were calculated, and SROI ratios were estimated. Five relevant and material outcomes were identified: 3 outcomes for patient participants (fear of falling, health-related quality of life, and social connection); 1 outcome for carer participants (carer strain), and 1 outcome for the National Health Service (NHS) (health service resource use). Data were collected at baseline and at 12-month follow-up. The in-person PrAISED program generated SROI ratios ranging from £0.58 to £2.33 for every £1 invested. In-person PrAISED patient participants gained social value from improved health-related quality of life, social connection, and less fear of falling. In-person PrAISED carer participants acquired social value from less carer strain. The NHS gained benefit from less health care service resource use. However, the blended PrAISED program generated lower SROI ratios ranging from a negative ratio to £0.08:£1. Compared with the blended program, the PrAISED in-person program generated higher SROI ratios for people with early dementia. An in-person PrAISED intervention with community referral is likely to provide better value for money than a blended one with limited community referral, despite the greater costs of the former.Trial registration: ISRCTN Registry ISRCTN15320670.
定期锻炼和社区参与可减缓痴呆症患者功能丧失的速度。然而,有关痴呆症患者通过社区转介进行家庭锻炼的成本效益和社会投资回报率(SROI)的证据尚不确定。本研究旨在比较 2020 年 3 月前提供的面对面 PrAISED 计划与 2020 年 3 月后提供的混合式 PrAISED 计划所产生的社会价值。SROI 方法比较了家庭锻炼计划的面对面和混合交付形式。确定了利益相关者,制定了逻辑模型,证明并评估了结果,计算了成本,并估算了 SROI 比率。确定了五项相关的重要成果:患者参与者的 3 项结果(害怕跌倒、与健康相关的生活质量和社会联系);护理参与者的 1 项结果(护理人员的压力);以及国民健康服务(NHS)的 1 项结果(健康服务资源使用)。在基线和 12 个月的随访中收集了数据。亲自参与的 PrAISED 计划每投入 1 英镑就能产生 0.58 英镑到 2.33 英镑不等的 SROI 比率。亲自参与 PrAISED 计划的患者通过改善与健康相关的生活质量、社会联系以及减少对跌倒的恐惧获得了社会价值。亲自参加 PrAISED 的护理人员因减轻护理压力而获得了社会价值。国家医疗服务体系因减少了医疗服务资源的使用而受益。然而,混合式 PrAISED 项目产生的 SROI 比率较低,从负比率到 0.08 英镑:1 英镑不等。与混合式项目相比,PrAISED 面对面项目为早期痴呆症患者带来的 SROI 比率较高。带有社区转介功能的PrAISED面对面干预可能比带有有限社区转介功能的混合干预更物有所值,尽管前者的成本更高:ISRCTN 注册号:ISRCTN15320670。
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引用次数: 0
Letter: Importance of Neurosurgeons at Earthquake-Prone Countries—Learning After Earthquakes at Syria and Turkey and Correspondence on Urgent Call for Actions 信函:神经外科医生在地震多发国家的重要性--叙利亚和土耳其地震后的经验教训以及关于紧急行动呼吁的信函
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-22 DOI: 10.1177/00469580241246477
Soumya Pahari, Sumitaksha Banerjee, Harendra Kumar, Dattatreya Mukherjee
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引用次数: 0
Impact of Long COVID on Health-Related Quality of Life Among Patients After Acute COVID-19 Infection: A Cross-Sectional Study 长期 COVID 对急性 COVID-19 感染后患者健康相关生活质量的影响:横断面研究
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-22 DOI: 10.1177/00469580241246461
Chengyao Sun, Ziwei Liu, Sixuan Li, Yuqi Wang, Guoxiang Liu
Concerns have been raised globally regarding the long-term effects of the novel coronavirus disease 2019 (COVID-19). This study aimed to investigate the impact of long COVID on the health of patients recovering from acute COVID-19 in China. We conducted a cross-sectional questionnaire survey from 1 February to 9 March 2023. Propensity score matching (PSM) was used to understand the differences in health utility values between individuals with and without long COVID. Factors associated with health-related quality of life (HRQoL) were determined using a multiple linear regression model. A chi-square test was used to compare differences between the 2 groups for each dimension of the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) scale. In total, 307 participants were included in the analysis, of which 40.39% exhibited at least 1 persistent symptom. The common symptoms of long COVID were fatigue/weakness, coughing, memory decline, poor concentration, and phlegm in the throat. Most patients with long COVID reported mild effects from their symptoms. After propensity score matching, the long-COVID group had lower health utility scores than the non-long-COVID group (0.94 vs 0.97). In the multivariable linear regression analysis, persistent symptoms and low annual household income were associated with lower health utility values ( P < .05). Anxiety/depression and pain/discomfort were the major problems experienced by the participants with long COVID. Long-COVID symptoms following acute COVID-19 infection have a serious impact on health-related quality of life. Therefore, it is necessary to implement interventions to improve patient health after the recovery from acute COVID-19.
新型冠状病毒病2019(COVID-19)的长期影响已引起全球关注。本研究旨在调查长期COVID对中国急性COVID-19康复患者健康的影响。我们于2023年2月1日至3月9日进行了横断面问卷调查。我们采用倾向得分匹配法(PSM)来了解患有和未患有长COVID的个体在健康效用值上的差异。采用多元线性回归模型确定了与健康相关生活质量(HRQoL)相关的因素。采用卡方检验比较两组患者在欧洲生活质量五级量表(EQ-5D-5L)各维度上的差异。共有 307 名参与者参与了分析,其中 40.39% 的参与者表现出至少一种持续性症状。长期慢性阻塞性肺气肿的常见症状是疲劳/乏力、咳嗽、记忆力下降、注意力不集中和喉咙有痰。大多数长期慢性阻塞性肺气肿患者表示症状影响轻微。经过倾向得分匹配后,长COVID组的健康效用得分低于非长COVID组(0.94 vs 0.97)。在多变量线性回归分析中,持续性症状和低家庭年收入与较低的健康效用值相关(P < .05)。焦虑/抑郁和疼痛/不适是长期 COVID 患者遇到的主要问题。急性 COVID-19 感染后出现的长期 COVID 症状严重影响了与健康相关的生活质量。因此,有必要实施干预措施,以改善急性 COVID-19 康复后患者的健康状况。
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引用次数: 0
Supporting Stabilization: A Qualitative Evaluation of a Pilot Program to Integrate Personal Caregiving Services Into Housing Settings 支持稳定:将个人护理服务纳入住房设置试点计划的定性评估
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-20 DOI: 10.1177/00469580241248084
Sarah E. Roth, Katherine Marsi, Natalie Kenton, Hannah Cohen-Cline
Three organizations in Clark County, WA, partnered together to implement a pilot program to expand access to personal caregiving services in the homeless crisis response system. The aim of this study is to describe staff and clients’ experiences of the program and its impact on clients’ daily living activities, health and wellbeing, and housing stability. Using a qualitative descriptive design, semi-structured, in-depth interviews were conducted with 12 clients and 5 pilot staff, representing 4 housing service providers. Interviews were analyzed descriptively to examine staff and clients’ perspectives and experiences with the personal care services pilot program. Caregivers helped clients establish routines, find companionship, and connect to health and social services both logistically and socioemotionally, supporting clients’ stabilization and reducing barriers to healthcare. Hiring and retaining caregivers remained difficult due to the challenging nature of the work. Staff interviews highlight the need for additional supports to better retain caregivers. Findings from the evaluation have important implications for addressing the needs of individuals exiting homelessness and suggest that personal caregivers can play an important role in supporting the stabilization process. However, employing strategies such as training and increasing wages and benefits that support the needs of the caregiving workforce is essential to sustain this type of service delivery model.
华盛顿州克拉克县的三个组织合作实施了一项试点计划,以扩大无家可归者危机应对系统中个人护理服务的可及性。本研究的目的是描述工作人员和客户对该计划的体验,以及该计划对客户日常生活活动、健康和福利以及住房稳定性的影响。采用定性描述设计,对代表 4 家住房服务提供商的 12 名客户和 5 名试点员工进行了半结构化深入访谈。我们对访谈内容进行了描述性分析,以研究工作人员和客户对个人护理服务试点计划的看法和体验。护理人员帮助服务对象建立生活常规、寻找陪伴,并在后勤和社会情感方面与医疗和社会服务机构建立联系,从而支持服务对象的稳定,减少医疗保健方面的障碍。由于工作性质具有挑战性,雇用和留住护理人员仍然很困难。工作人员的访谈强调,需要提供更多支持,以更好地留住护理人员。评估结果对满足摆脱无家可归者的需求具有重要意义,并表明个人护理人员在支持稳定过程中可以发挥重要作用。然而,采用培训、提高工资和福利等策略来支持护理人员的需求,对于维持这种服务提供模式至关重要。
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引用次数: 0
Value per Statistical Life at the Sub-National Level as a Tool for Assessing Public Health and Environmental Problems 作为评估公共卫生和环境问题工具的国家以下各级单位统计寿命值
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-20 DOI: 10.1177/00469580241246476
Luis Armando Becerra-Pérez, Roberto Alonso Ramos-Alvarez, Juan J. DelaCruz, Benjamín García-Páez
This article aims to estimate the Value per Statistical Life (VSL) and Value per Statistical Life Year (VSLY) at the sub-national level, which can be used to calculate the economic impact of health and environmental problems. We estimate the value of life for Mexico and its 32 states, grouped into 5 regions for 2021. We used the OECD’s guidelines on “Mortality Risk Valuation in Environment, Health and Transport Policies,” which applies the measure of Willingness to Pay (WTP) and Cost-Benefit Analysis (CBA). Mexico’s overall VSL of $2 000 000 USD in 2021 showcases the value placed on human life. The variation in VSL across the 32 states, with Chiapas having the lowest VSL of $400 000 USD and Mexico City boasting the highest VSL of $3 300 000 USD highlights the different levels of regional development and people’s willingness to pay to reduce the risk of mortality. Our estimates of VSL and VSLY have the potential to contribute to the evaluation of public policies in the fields of health and the environment. Monetizing human life through these estimates can offer valuable insights to policymakers at both the national and sub-national levels. By quantifying the economic value placed on human life, this paper helps decision-makers prioritize investments, assess the cost-effectiveness of interventions, and allocate resources to maximize societal well-being.
本文旨在估算次国家一级的每统计生命价值(VSL)和每统计生命年价值(VSLY),可用于计算健康和环境问题的经济影响。我们估算了 2021 年墨西哥及其 32 个州(分为 5 个地区)的生命价值。我们采用了经合组织的 "环境、健康和交通政策中的死亡率风险评估 "指南,该指南采用了支付意愿 (WTP) 和成本效益分析 (CBA) 的衡量标准。墨西哥 2021 年的总体 VSL 为 2 000 000 美元,这表明了对人类生命的重视。32 个州的 VSL 存在差异,恰帕斯州的 VSL 最低,为 400 000 美元,而墨西哥城的 VSL 最高,为 3 300 000 美元,这凸显了不同的地区发展水平和人们为降低死亡风险而支付的意愿。我们对 VSL 和 VSLY 的估算可能有助于评估健康和环境领域的公共政策。通过这些估计值将人的生命货币化,可以为国家和次国家层面的政策制定者提供有价值的见解。通过量化人类生命的经济价值,本文可帮助决策者确定投资的优先次序、评估干预措施的成本效益以及分配资源,从而最大限度地提高社会福祉。
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引用次数: 0
The Impact of Behavioral Lifestyle Intervention on Inflammatory Cytokines in Older Adults Living With Type 2 Diabetes: A Feasibility Study 行为生活方式干预对 2 型糖尿病老年患者炎性细胞因子的影响:可行性研究
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-20 DOI: 10.1177/00469580241248126
Rozmin Jiwani, Monica Serra, Sara Espinoza, Andrea Berndt, Darpan Patel
Objective:This study investigates the effects of a behavioral lifestyle intervention on inflammatory cytokines and frailty in older adults (≥ 65 years) with type 2 diabetes (T2D).Method:We conducted a single-arm, 6-month intervention supplemented with diet and activity self-monitoring technology. We assessed frailty using Fried criteria and quantified inflammatory cytokines (interleukin [IL]-2, IL-4, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating-factor [GM-CSF], interferon [IFN-γ], tumor necrosis factor [TNF-α]) using a multiplex assay. We used paired t-tests with significance at P < .05. We calculated the Spearman correlation and evaluated the relationship between frailty, BMI, and inflammatory cytokines.Results:Eighteen participants completed the study (mean ± SD: 71.5 ± 5.3 years; BMI: 34 ± 6 kg/m2). At baseline, we had 4 frail, 13 pre-frail, and 1 non-frail participant. At 6 months, we observed the therapeutic effects of the intervention on frailty score, BMI, IL-2, IFN-y, and GM-CSF.Discussion:The study highlights the importance of behavioral lifestyle intervention in improving inflammatory cytokines and frailty in older adults.
目的:本研究探讨了行为生活方式干预对患有 2 型糖尿病(T2D)的老年人(≥ 65 岁)的炎性细胞因子和虚弱的影响。方法:我们开展了一项为期 6 个月的单臂干预,并辅以饮食和活动自我监测技术。我们采用弗里德标准对虚弱程度进行了评估,并使用多重检测法对炎症细胞因子(白细胞介素 [IL]-2、IL-4、IL-6、IL-8、IL-10、粒细胞-巨噬细胞集落刺激因子 [GM-CSF]、干扰素 [IFN-γ]、肿瘤坏死因子 [TNF-α])进行了量化。我们采用配对 t 检验,显著性为 P <.05。我们计算了斯皮尔曼相关性,并评估了虚弱、体重指数和炎症细胞因子之间的关系。结果:18 名参与者完成了研究(平均值±标准差:71.5±5.3 岁;体重指数:34±6 kg/m2)。在基线期,我们有 4 名体弱者、13 名前期体弱者和 1 名非体弱者。6 个月后,我们观察到干预对虚弱评分、BMI、IL-2、IFN-y 和 GM-CSF 的治疗效果。讨论:该研究强调了行为生活方式干预对改善老年人炎症细胞因子和虚弱的重要性。
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引用次数: 0
Prevalence, Correlates, and Trends of Intimate Partner Violence Against Women in Cambodia: Findings From 2014 and 2021-22 Cross-Sectional Demographic and Health Surveys 柬埔寨亲密伴侣暴力侵害妇女行为的发生率、相关因素和趋势:2014 年和 2021-22 年横断面人口与健康调查的结果
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-20 DOI: 10.1177/00469580241246465
Masood Ali Shaikh
Intimate partner violence (IPV) is globally endemic and a gross violation of human rights, in addition to abuse of intimacy by some men against their female intimate partners. Based on literature review, attitudinal, socio-demographic, and experiential attributes of 15 to 49 year old ever partnered women in the heterosexual relationships were identified. This study used the anonymized 2020-21Cambodia Demographic and Health Survey (CDHS) data to compute the IPV prevalence and its correlates, in addition to computing the changes in IPV prevalence at the urban, rural, and at the national levels using data from the 2014 CDHS. Identified attitudinal, socio-demographic, and experiential attributes were used in the bivariate and multivariable analysis. Simple and multiple logistic regression models were used for computing the bivariate and multivariate associations with IPV; additionally, trend analysis was done to compute changes in IPV prevalence between the 2 surveys. Lifetime prevalence of IPV was 20.70%, while the most common subtype was emotional IPV at 18.70%. Ten out of 12 correlates studied were found to be statistically significantly associated with IPV in the bivariate analysis. These were added in the multivariable model and 7 were found to be statistically significantly associated with IPV. Which included educational attainment of women and their intimate partners, number of living children, women’s IPV acceptance, male partner’s alcohol use, knowledge of physical beating of mother by one’s father, and controlling behavior exercised by partner. During the intervening period between the 2 CDHSs, IPV and its subtypes were decreased in both urban and rural areas, as well as nationally. IPV decrease between the 2 DHSs and lower IPV rates in 2021-22 augur well for the health and human rights of Cambodian women. However, the ultimate target of eliminating IPV against women, will require measures that ensure economic and gender empowerment, and gender equality.
亲密伴侣暴力(IPV)是一种全球流行的严重侵犯人权的行为,此外,一些男性还对其女性亲密伴侣实施亲密行为。根据文献综述,我们确定了 15 至 49 岁异性关系中曾经有伴侣的女性的态度、社会人口和经历特征。本研究使用匿名的 2020-21 年柬埔寨人口与健康调查(CDHS)数据计算 IPV 发生率及其相关因素,并使用 2014 年 CDHS 的数据计算城市、农村和全国 IPV 发生率的变化。双变量和多变量分析中使用了已识别的态度、社会人口和经历属性。简单和多元逻辑回归模型用于计算 IPV 的二元和多元关联;此外,还进行了趋势分析,以计算两次调查之间 IPV 发生率的变化。IPV的终生发生率为20.70%,而最常见的亚型为情感型IPV,占18.70%。在所研究的 12 个相关因素中,有 10 个在双变量分析中发现与 IPV 有显著的统计学关联。将这些因素加入多变量模型后,发现其中 7 个因素与 IPV 有明显的统计学相关性。这些因素包括妇女及其亲密伴侣的教育程度、在世子女数量、妇女对 IPV 的接受程度、男性伴侣酗酒情况、对父亲殴打母亲的了解程度以及伴侣的控制行为。在两次人口与健康调查之间的间隔期内,城市和农村地区以及全国的 IPV 及其子类型都有所减少。两次人口与健康调查之间的 IPV 下降以及 2021-22 年 IPV 发生率的降低,都是柬埔寨妇女健康和人权的好兆头。然而,要实现消除针对妇女的 IPV 这一最终目标,还需要采取措施确保经济赋权、性别赋权和性别平等。
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引用次数: 0
Prevalence of Pre-Hypertension/Hypertension and Its Associated Factors Among Adults in the Wolaita Zone of Southern Ethiopia: A Cross-Sectional Study 埃塞俄比亚南部 Wolaita 地区成人高血压前期/高血压患病率及其相关因素:横断面研究
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-20 DOI: 10.1177/00469580241246968
Eshetu Elfios Endrias, Teketel Tesfaye Mamito, Temesgen Geta Hardido, Bizuayehu Atinafu Ataro
Preventing the development of high blood pressure and resulting complication requires estimating the prevalence of prehypertension/hypertension and identifying associated risk factors. Information about pre-hypertension/hypertension in Ethiopia, especially in the southern region, is scarce, and limited knowledge exists regarding the prevalence and risk factors associated with pre-hypertension/hypertension. Objective of this study was to assess prevalence of pre-hypertension/hypertension and its associated factors among adults in Wolaita Zone of Southern Ethiopia, 2023. This cross-sectional study was conducted among adults attending outpatient departments in governmental hospitals in South Ethiopia in 2023. Face-to-face interviews were used to gather information on sociodemographic data, dietary and behavioral patterns, and medical history. Digital weighing scales, Stadiometers, and digital sphygmomanometers were used to measure height, blood pressure, and weight, respectively. Epi-Data version 3.1 was used to enter the data before exporting it to SPSS version 25 for analysis. To find factors associated with prehypertension/hypertension, binary logistic regressions were conducted and odds ratios with 95% confidence intervals were computed. The overall prevalence of prehypertension/hypertension was 42.8% (95% confidence interval: 39.56, 49.47). Factors associated with prehypertension/hypertension in this study were older age, male gender, obesity, diabetes mellitus comorbidity, alcohol drinking, and family history of hypertension. Lifestyle modification is demanded for pre-hypertensive/hypertensive patients to prevent progression to severe complications, including premature death and permanent disabilities.
要预防高血压及其并发症的发生,就必须估计高血压前期/高血压的发病率,并确定相关的风险因素。在埃塞俄比亚,尤其是在南部地区,有关高血压前期/高血压的信息很少,对高血压前期/高血压的患病率和相关风险因素的了解也很有限。本研究旨在评估 2023 年埃塞俄比亚南部 Wolaita 区成年人中高血压前期/高血压的患病率及其相关因素。这项横断面研究的对象是 2023 年在埃塞俄比亚南部政府医院门诊部就诊的成年人。研究人员通过面对面访谈收集了有关社会人口学数据、饮食和行为模式以及病史的信息。数字体重秤、血压计和数字血压计分别用于测量身高、血压和体重。使用 Epi-Data 3.1 版输入数据,然后导出到 SPSS 25 版进行分析。为了找出与高血压前期/高血压相关的因素,研究人员进行了二元逻辑回归,并计算了几率比和 95% 的置信区间。高血压前期/高血压的总体患病率为 42.8%(95% 置信区间:39.56, 49.47)。在本研究中,与高血压前期/高血压相关的因素有年龄偏大、男性、肥胖、合并糖尿病、饮酒和高血压家族史。高血压前期/高血压患者需要改变生活方式,以防止恶化为严重并发症,包括过早死亡和终身残疾。
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引用次数: 0
Knowledge, Attitude and Practice Related to Chemotherapy Among Cancer Patients 癌症患者对化疗的认识、态度和做法
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-15 DOI: 10.1177/00469580241246460
Muzna Suhail, Fabeha Saulat, Hira Khurram, Farzeen Fatima, Atia Zenab, Mehak Wasim, Noor-ul-ain Sadia, Fasiha Afzaal, Hamid Latif, Muhammad Nasrullah
Cancer is a leading cause of death, with a rapidly increasing global burden. Chemotherapy is the most effective cancer treatment, and with its benefits, there exist potential problems. The present study assesses cancer patients’ knowledge, attitude, and practice toward chemotherapy use. A descriptive cross-sectional study was conducted in the oncology wards of various tertiary care hospitals and cancer care centers in Lahore, Pakistan. Patients were included in the study based on convenient sampling. A structured questionnaire with 25 (close-ended) questions and a demographic profile was used to collect data. Descriptive statistics was used to analyze frequencies and percentages. Independent sample t-test and ANOVA were used to calculate the mean and standard deviation. Most patients were females (54%) and married (52.6%), with an unemployment rate of 39%. Patients with higher education depicted significantly higher scores in knowledge (9.61 ± 2.65), attitude (19.37 ± 2.70), and practice (3.89 ± 1.03) domains. Surprisingly, throughout the whole KAP domain, the patient’s attitude (18.42 ± 3.31) toward chemotherapy use, showed higher values, as compared to their knowledge (7.78 ± 3.26) and practice (3.66 ± 1.08) scores. The majority of the study participants had a positive attitude toward chemotherapy use, with limited knowledge, and practice.
癌症是导致死亡的主要原因之一,其全球负担正在迅速加重。化疗是最有效的癌症治疗方法,在带来好处的同时,也存在潜在的问题。本研究对癌症患者使用化疗的知识、态度和做法进行了评估。本研究在巴基斯坦拉合尔多家三甲医院和癌症护理中心的肿瘤病房进行了一项描述性横断面研究。研究以方便抽样的方式纳入了患者。研究使用了一份包含 25 个(封闭式)问题的结构化问卷和一份人口统计学概况来收集数据。描述性统计用于分析频率和百分比。独立样本 t 检验和方差分析用于计算平均数和标准差。大多数患者为女性(54%),已婚(52.6%),失业率为 39%。受过高等教育的患者在知识(9.61 ± 2.65)、态度(19.37 ± 2.70)和实践(3.89 ± 1.03)方面的得分明显更高。令人惊讶的是,在整个 KAP 领域中,患者对化疗的态度(18.42 ± 3.31)得分高于其知识(7.78 ± 3.26)和实践(3.66 ± 1.08)得分。大多数研究参与者对化疗持积极态度,而对化疗的了解和实践有限。
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引用次数: 0
Healthcare Access Worsened for Women in Precarious Housing During the COVID-19 Pandemic: A Qualitative Study 在 COVID-19 大流行期间,居住在危房中的妇女获得医疗保健的机会减少了:定性研究
IF 1.7 4区 医学 Q3 Medicine Pub Date : 2024-04-11 DOI: 10.1177/00469580241246478
Irem Sevik, Meltem Ciceklioglu
This research aims to gain an in-depth understanding of precariously housed women’s experiences related to health and access to health care during the COVID-19 pandemic using a grounded theory approach. Qualitative data were obtained through interviews with 17 precariously housed women from Izmir, Turkey. Poor health among most participants was primarily attributed to unfavorable living conditions and weakened community networks. The COVID-19 pandemic exacerbated existing health issues due to barriers in accessing basic needs. Food insecurity was widespread during the pandemic and the critical role of aid and the inadequacy of social assistance in securing food were emphasized. Women’s health perceptions were significantly shaped by gender, and gendered caregiving duties have restricted women’s healthcare access. Access to healthcare was also limited by financial challenges, with health insurance being a crucial determinant. Longer waiting times, often exacerbated by the appointment system, and language were significant barriers to healthcare access. The findings propose that the participants were precarized by the blindness of COVID-19 measures to vulnerabilities, which resulted in deeper inequalities in housing, food, employment, and healthcare access. This research addresses the political, commercial, and social determinants of precariously housed women’s health. Improving precariously housed women’s health and wellbeing requires implementation of public policies targeting to improve housing quality, provide targeted assistance to food insecurity, promote gender inclusiveness, and foster gender empowerment.
本研究旨在采用基础理论方法,深入了解在 COVID-19 大流行期间,窘迫住房妇女在健康和获得医疗服务方面的经历。本研究通过对土耳其伊兹密尔的 17 名危房妇女进行访谈,获得了定性数据。大多数参与者的健康状况不佳主要归因于不利的生活条件和社区网络的削弱。由于在获取基本需求方面存在障碍,COVID-19 大流行加剧了现有的健康问题。在大流行病期间,粮食无保障的情况十分普遍,与会者强调了援助的关键作用以及社会援助在确保粮食供应方面的不足。妇女的健康观念在很大程度上受到性别的影响,性别照料责任限制了妇女获得医疗保健的机会。获得医疗保健的机会也受到经济困难的限制,医疗保险是一个重要的决定因素。较长的等待时间(往往因预约制度而加剧)和语言是获得医疗服务的重大障碍。研究结果表明,由于 COVID-19 测量方法对脆弱性视而不见,导致参与者在住房、食品、就业和获得医疗服务方面存在更深层次的不平等。这项研究探讨了住房岌岌可危妇女健康的政治、商业和社会决定因素。要改善住房岌岌可危的妇女的健康和福祉,就必须实施以提高住房质量为目标的公共政策,针对粮食不安全问题提供有针对性的援助,促进性别包容,并推动性别赋权。
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Inquiry-The Journal of Health Care Organization Provision and Financing
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