scholarly journals A Cross Sectional Survey of Factors Influencing Healthcare Access in Older Women of South India

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Sreejith Sudhakar ◽  
Justin Jose ◽  
Shanuga Cherayi

Abstract We examined the determinants of healthcare access barriers, treatment-seeking, and self-medication in older women aged 60 years and more, using a cross-sectional survey design. Using a structured interview format, we interviewed 1005 older women from 7 out of 14 districts in the state through a stratified random sampling procedure. Multiple linear regression analysis results reveal that older women's healthcare access barriers significantly increased when they experienced a long duration of multimorbidity alongside poor recognition of autonomy and basic amenities available at health facilities. However, confidentiality, the ability to pay for healthcare expenditure, and the type of health care significantly improved healthcare access. In factors influencing older women's delay in treatment-seeking, optimal instrumental functionality in daily living, optimal quality of life and access to healthcare services significantly reduced delay in treatment initiation. Whereas poor health-seeking behaviors, long duration of multimorbidity, and the quality of basic amenities at hospitals significantly increased treatment initiation delay and explained 13.6% of the variance. In factors influencing older women's use of self-medication, advancing age, living in rural areas, optimal functionality, perception of providers' respect for confidentiality were associated with increased self-medication frequency. Whereas, better wealth status, prompt attention to older women's health needs, and basic amenities at hospitals significantly reduced their self-medication practice. Therefore, the optimal functional abilities, fewer morbidities, and optimal health system responsiveness significantly reduce healthcare access barriers and self-medication while improving older women's treatment-seeking behaviors.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rui Huang ◽  
Jian-Gao Fan ◽  
Jun-Ping Shi ◽  
Yi-Min Mao ◽  
Bing-Yuan Wang ◽  
...  

Abstract Background Health Related Quality of Life (HRQL) is a multi-dimensional construct that can comprehensively evaluate the patient’s health status, including physical, emotional, mental and social well-being. In this study, we aimed to evaluate the impact of non-alcoholic fatty liver disease (NAFLD) on HRQL in a Chinese population. Methods In this national multicenter cross-sectional survey, patients with NAFLD were enrolled. Chronic Liver Disease Questionnaire (CLDQ)-NAFLD was used to qualify HRQL. Univariate and multivariate analysis were used to identify independent risk factors of HRQL. Results A total of 5181 patients with NAFLD from 90 centers were enrolled in this study (mean age, 43.8 ± 13.3 years; male, 65.8%). The overall CLDQ score was 5.66 ± 0.89. Multivariate logistic regression analysis showed that body mass index (BMI: HR, 1.642; 95% CI, 1.330–2.026), alanine transaminase (ALT: HR, 1.006; 95% CI, 1.001–1.011), triglyceride (HR, 1.184; 95% CI, 1.074–1.305), disease severity (HR, 3.203; 95% CI, 1.418–7.232) and cardiovascular disease (HR, 4.305; 95% CI, 2.074–8.939) were independent risk factors for overall CLDQ score. In the logistic analyses of individual domain, BMI and triglyceride were independent risk factors of all domains. ALT, disease severity, diabetes, depression and cardiovascular disease were influencing factors for the CLDQ score of several domains. Conclusions This national multicenter cross-sectional survey in China indicated that the HRQL in patients with NAFLD was impaired. HRQL was found to be significantly associated with sociodemographic and clinical factors. Attention should be paid to the optimally managing care of patients with NAFLD to improve their HRQL.


Author(s):  
Danielle LoRe ◽  
Christopher Mattson ◽  
Dalia M. Feltman ◽  
Jessica T. Fry ◽  
Kathleen G. Brennan ◽  
...  

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points


2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.


2018 ◽  
Vol 21 ◽  
pp. S199-S200 ◽  
Author(s):  
DT Gold ◽  
SA Williams ◽  
RJ Weiss ◽  
Y Wang ◽  
C Watkins ◽  
...  

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