scholarly journals NCOG-23. PATTERNS OF DISTRESS IN OLDER PATIENTS WITH GLIOBLASTOMA: A FOLLOW-UP TO A SINGLE INSTITUTION CROSS-SECTIONAL STUDY OF DISTRESS IN PRIMARY BRAIN TUMOR PATIENTS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii134-ii134
Author(s):  
Margaret Johnson ◽  
James Herndon ◽  
Eric Lipp ◽  
Mary Affronti ◽  
Annick Desjardins ◽  
...  

Abstract INTRODUCTION We previously reported to SNO, high levels of psychosocial distress in adult patients with primary brain tumors (PBTs), particularly during the first 6 months following diagnosis. The purpose of this follow-up study was to identify patterns of distress among older (≥ 65 years) patients with glioblastoma (GBM) compared to their younger (ages 18-64) counterparts. METHODS In our initial cross-sectional study, we collected the National Comprehensive Cancer Network’s Distress Thermometer (NCCN-DT) and problem list from adult patients with PBTs (WHO grades I-IV) seen at our institution between December 2013 and February 2016. We performed subsequent analyses on a subset of patients with GBM. RESULTS We identified 343 patients with GBM from the original dataset, of which 23.0% (n= 78) were ≥ 65 years old. The proportion of patients ≥ 65 years old with elevated distress (i.e. DT ≥ 4) was greater than the proportion of younger patients reporting elevated distress (47.4% vs 30.6%; p= 0.0068). Elevated distress was significantly greater during the first 6 months post diagnosis for all ages (p= 0.008). In subgroup analyses, a decrease in distress beyond 6 months was seen in younger patients (45.7% vs 27.4%; p= 0.021), but not in older patients. In older patients, a greater number of problems were selected on the NCCN DT and problem list tool: emotional and physical concerns were reported more frequently compared to their younger counterparts. Older patients were more likely to report difficulty with “bathing” and “getting around” (p= 0.009, p< 0.001, respectively). There were no differences in older versus younger GBM patients with regard to housing, transportation, treatment decisions, depression, fatigue, or memory. CONCLUSIONS In contrast to their younger counterparts, older patients with GBM experienced elevated levels of distress and a greater absolute number of specific psychosocial problems, mostly related to emotional and physical concerns.

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Berhe Beyene Gebrezgiabher ◽  
Teklehaymanot Huluf Abraha ◽  
Etsay Hailu ◽  
Hailay Siyum ◽  
Getachew Mebrahtu ◽  
...  

Background. Depression is consistently associated with increased risk of Human Immunodeficiency Virus infection and poor antiretroviral treatment adherence. Though many factors have been reported as determinant factors of depression, site-specific evidence is needed to identify factors associated with depression among adults on antiretroviral treatment. Methods. An institution based cross-sectional study was carried out from March to May 2015 among 411 adults HIV/AIDS patients on ART clinic follow-up. Participants were selected using systematic random sampling techniques. Data were collected using chart review and interviewer- administered techniques. Both bivariable and multivariable logistic regressions were used to compute the statistical test associations by SPSS version-20. Variables with p value < 0.05 were considered as statistically significant. Results. Four hundred eleven patients with a mean age ± Standard Deviation of 36.1±9.2 years and with a total response rate of 97.6% were enrolled in the study. The prevalence of depression was 14.6% (95% CI, 10.90-18.2). Factors independently associated with depression were nonadherence to ART, eating two meals per day or less, having side effect of ART medication, being in the WHO Stage II or above of HIV/AIDS, and living alone with AOR (95% CI) of 3.3 (1.436, 7.759), 2.8 (1.382, 5.794), 4.7 (1.317, 16.514), 2.8 (0.142, 0.786), and 2.4 (1.097, 5.429), respectively. Conclusion. Though the magnitude of depression was found relatively low, it was commonly observed as a mental health problem among adult patients with HIV/AIDS on ART. Programs on counseling and close follow-up of adherence to ART, drug side effects, and nutrition should be strengthened. Health facilities should link adult patients with HIV/AIDS who live alone to governmental and nongovernmental social supporter organizations.


2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Desalew Tilahun ◽  
Abebe Abera ◽  
Gugsa Nemera

Abstract Background Health literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia. Methods A cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations. Result Descriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains. Conclusion The overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S120-S120
Author(s):  
G O Yeabyo

Abstract Introduction/Objective Cancer is one of a great public health problem in developing countries like Ethiopia and scarcity of histopathology laboratory is another burden for diagnosis and follow up of cancer diseases. The main purpose of this study is to evaluate the accessibility of histopathology services in Ethiopia. Methods Cross sectional study design were used to analyze the status of histopathology services in Ethiopia. Results There are 13 histopathology laboratories in the nation and a survey was conducted at these institutions. Out of these 13 Histopathology services seven are located in the capital, Addis Ababa and six found out of the capital located in four different regions. About 40,239,100 habitants have no histopathology service around their catchment area. Conclusion There are very limited histopathology laboratories, as a result diagnosis and prevention of cancer diseases are inadequate throughout the country.


2021 ◽  
pp. 095646242110240
Author(s):  
Genesis S Huerta-Vera ◽  
Manuel A Amarista ◽  
Fernando A Mejía ◽  
Ana B Graña ◽  
Elsa V Gonzalez-Lagos ◽  
...  

Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.


2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Oliver Okoth Achila ◽  
Millen Ghebretinsae ◽  
Abraham Kidane ◽  
Michael Simon ◽  
Shewit Makonen ◽  
...  

Objective. There is a dearth of relevant research on the rapidly evolving epidemic of diabetes mellitus (particularly Type 2 diabetes mellitus) in sub-Saharan Africa. To address some of these issues in the Eritrean context, we conducted a cross-sectional study on glycemic and lipid profiles and associated risk factors. Methods. A total of 309 patients with diabetes mellitus on regular follow-up at the Diabetic and Hypertensive Department at Halibet Regional Referral Hospital, Asmara, were enrolled for the study. Data on specific clinical chemistry and anthropomorphic parameters was collected. Chi-squared (χ2) test or Fischer’s exact test was used to evaluate the relationship between specific variables. Multivariate logistic regression (backward: conditional) was undertaken to identify the factors associated with increased odds of suboptimal values in glucose and specific lipid panel subfractions. Results. High proportions of patients (76.7%) had suboptimal levels of HbA1c with a mean±SD of 8.6%±1.36, respectively. In multivariate regression analysis, the likelihood of HbA1c≥7% was higher in patients with abnormal WHR (AOR=3.01, 95% CI, 3.01 (1.15–7.92=0.024)) and in patients without hypertension (AOR=1.97, 95% CI (1.06–3.56), p=0.021). A unit reduction in eGFR was also associated with HbA1c≥7% (AOR=0.99, 95% CI (0.98–1=0.031)). In a separate analysis, the data shows that 80.9% of the patients had dyslipidemia. In particular, 62.1% of the patients had TC≥200 mg/dL (risk factors: sex, hypertension, and HbA1c concentration), 81.6% had LDL‐C≥100 mg/dL (risk factors: sex and hypertension), 56.3% had TG≥150 (risk factors: sex, HbA1c, and waist circumference), 62.8% had abnormal HDL-C (risk factors: waist circumference), 78.3% had non‐HDL<130 mg/dL (risk factors: duration of disease, reduced estimated glomerular filtration rate, and HbA1c), and 45.3% had abnormal TG/HDL (risk factors: sex, age of patient, FPG, and waist circumference). Conclusions. The quality of care, as measured by glycemic and specific lipid targets, in this setting is suboptimal. Therefore, there is an urgent need for simultaneous improvements in both indicators. This will require evidence-based optimization of pharmacological and lifestyle interventions. Therefore, additional studies, preferably longitudinal studies with long follow-up, are required on multiple aspects of DM.


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