Looking into the life of technology-dependent children and their caregivers in Korea: lifting the burden of too many responsibilities

Abstract Background The number of technology-dependent children (TDC) is increasing in South Korea, but available healthcare services after their discharge are poor. This study aimed to examine how TDC and caregivers live at home and identify their difficulties and needs regarding home care with few services to support them. Methods This cross-sectional study was conducted in a tertiary hospital for children in South Korea. A self-reported questionnaire was completed by primary caregivers of TDC who were younger than 19 years and had been dependent on medical devices for more than 3 months. Technologies included home mechanical ventilation, oxygen supplementation, suction equipment, enteral feeding tube, and home total parenteral nutrition. Patterns of healthcare use and home care of TDC and caregivers’ perception toward child were assessed. Results A total of 74 primary caregivers of TDC completed a self-reported questionnaire. About 60% children were aged under 5 years. There were 31.1% children who required both respiratory and nutritional support. On average, caregivers took care of a child for 14.4 (±6.1) hours, slept for 5.6 (±1.6) hours, and spent 2.4 h per day on personal activities. Children used hospital services for 41.3 (±45.6) days in 6 months, and most (78.1%) were transported through private car/ambulance. Participants (75.6%) reported taking more than an hour to get to the hospital. More than 80% of caregivers responded that child care is physically very burdensome. The only statistically significant relationships was between economic status and financial burden (p = 0.026). Conclusions Caregivers of TDC reported having significant time pressure regarding childcare-related tasks, insufficient time for personal activities, and inefficient hospital use because of inadequate medical services to support them in South Korea. Thus, it is necessary to support caregivers and develop a home care model based on current medical environment.

Download Full-text

Gestational Age Specific Postnatal Growth Curves for Singleton Babies in Tertiary Hospital of Western Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.3105 ◽

2017 ◽

Vol 56 (207) ◽

pp. 325-330

Author(s):

Santosh Pathak ◽

Nagendra Chaudhary ◽

Prativa Dhakal ◽

Shyam Kumar Mahato ◽

Sandeep Shrestha ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Economic Status ◽

Tertiary Care ◽

Growth Curves ◽

Tertiary Hospital ◽

Care Hospital ◽

Cross Sectional ◽

Intrauterine Growth ◽

Geographical Regions

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods: This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.

Download Full-text

Prevalence and correlates of depression among Nigerian stroke survivors

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v25i0.1252 ◽

2019 ◽

Vol 25 ◽

Cited By ~ 2

Author(s):

Olushola Olibamoyo ◽

Abiodun Adewuya ◽

Bolanle Ola ◽

Olurotimi Coker ◽

Olayinka Atilola

Keyword(s):

Social Support ◽

Cognitive Impairment ◽

Economic Status ◽

Binary Logistic Regression ◽

Clinical History ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Stroke Severity ◽

Stroke Survivors ◽

Cross Sectional

Background: There is mixed evidence for the hypothesis that the risk of depression after stroke is influenced by the location of lesions in the hemispheres, demographic and clinical factors, and disability of stroke survivors.Aim: The current study determined the prevalence of depression and its socio-demographic and clinico-pathological correlates among stroke survivors in a tertiary hospital in Lagos, Nigeria.Method: The cross-sectional study was carried out among 112 adult patients with a clinical history of stroke confirmed by neuroimaging. Depression was diagnosed using Mini International Neuropsychiatric Interview. The socio-demographic profile was obtained, and cognitive impairment was assessed using the Mini-Mental State Examination. Stroke severity was assessed retrospectively using the National Institute of Health Stroke Scale and current disability was measured using the Modified Rankin Scale.Results: There were 48 (42.9%) stroke survivors with a clinical diagnosis of depression. Using binary logistic regression, the independent determinants of depression were younger age, unemployment, perceived poor social support, increasing number of previous admissions because of stroke, cognitive impairment, severity of stroke and current disability status. However, there was no significant association between depression and lesion location.Conclusion: Depression is a common associate of stroke, and there is a need for sustained focus on young stroke survivors with severe stroke, especially those who do not have social support and have low socio-economic status, who may have a higher risk of developing depression following stroke.

Download Full-text

Influence of trust on two different risk perceptions as an affective and cognitive dimension during Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea: serial cross-sectional surveys

BMJ Open ◽

10.1136/bmjopen-2019-033026 ◽

2020 ◽

Vol 10 (3) ◽

pp. e033026 ◽

Cited By ~ 8

Author(s):

Won Mo Jang ◽

Un-Na Kim ◽

Deok Hyun Jang ◽

Hyemin Jung ◽

Sanghyun Cho ◽

...

Keyword(s):

Risk Perception ◽

Middle East ◽

General Population ◽

South Korea ◽

Risk Perceptions ◽

Economic Status ◽

Cross Sectional ◽

Cognitive Risk ◽

Household Economic Status ◽

The Government

ObjectivesThis study aimed to assess the affective and cognitive risk perceptions in the general population of Middle East respiratory syndrome (MERS) during the 2015 MERS coronavirus (MERS-CoV) outbreak in South Korea and the influencing factors.DesignSerial cross-sectional design with four consecutive surveys.SettingNationwide general population in South Korea.ParticipantsOverall 4010 respondents (aged 19 years and over) from the general population during the MERS-CoV epidemic were included.Primary and secondary outcome measuresThe main outcome measures were (1) affective risk perception, (2) cognitive risk perception, and (3) trust in the government. Multivariate logistic regression models were used to identify factors (demographic, socioeconomic, area and political orientation) associated with risk perceptions.ResultsBoth affective and cognitive risk perceptions decreased as the MERS-CoV epidemic progressed. Proportions of affective risk perception were higher in all surveys and slowly decreased compared with cognitive risk perception over time. Females (adjusted OR (aOR) 1.72–2.00; 95% CI 1.14 to 2.86) and lower self-reported household economic status respondents were more likely to perceive the affective risk. The older the adults, the higher the affective risk perception, but the lower the cognitive risk perception compared with younger adults. The respondents who had low trust in the government had higher affective (aOR 2.19–3.11; 95 CI 1.44 to 4.67) and cognitive (aOR 3.55–5.41; 95 CI 1.44 to 9.01) risk perceptions.ConclusionsThis study suggests that even if cognitive risk perception is dissolved, affective risk perception can continue during MERS-CoV epidemic. Risk perception associating factors (ie, gender, age and self-reported household economic status) appear to be noticeably different between affective and cognitive dimensions. It also indicates that trust in the government influences affective risk perception and cognitive risk perception. There is a need for further efforts to understand the mechanism regarding the general public’s risk perception for eﬀective risk communication.

Download Full-text

Lifestyle patterns on prevention of coronary artery disease among hypertensive clients, attending a tertiary hospital, Kathmandu

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i2.28172 ◽

2019 ◽

Vol 8 (2) ◽

pp. 96-102

Author(s):

Anju Kumari Mahato ◽

Mandira Onta ◽

Tulashi Adhikari Mishra

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Tobacco Use ◽

Fruits And Vegetables ◽

Healthy Lifestyle ◽

Economic Status ◽

Tertiary Hospital ◽

Cross Sectional ◽

Lifestyle Pattern ◽

Artery Disease

Background: Hypertension is one of the major risk factors for cardiovascular disease, especially for coronary artery disease. Healthy lifestyles will delay the progression of coronary artery disease.Objectives: To find out the life style pattern on prevention of coronary artery disease among hypertensive clients.Methodology: This is a descriptive; cross sectional research design based on quantitative approach. Non probability purposive sampling was used to select 202 respondents attending Outpatient Department at Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu. Data was collected by interview technique using semi-structured questionnaire by researcher herself. Descriptive and inferential statistics were used to analyze the data.Results: Findings of the study showed that 7.90% of hypertensive clients consumed ≥ 5 servings of fruits and vegetables per day, whereas 97.52% were engaged in vigorous intensity work and current tobacco and alcohol consumers were 28.57% and 33.80% respectively. Adherence to all four healthy lifestyle pattern (Diet, Physical Activity, Tobacco Use and Alcohol Consumption) was 32.7%, whereas more than half (58.9%) of the clients adhered to three lifestyle pattern. There was significant association between dietary pattern and economic status (p = 0.018) and ethnicity (p = <0.001); and tobacco use and sex (p = <0.001).Conclusion: Adherence to healthy lifestyle pattern of hypertensive clients was inadequate. Thus, health education and other interventions to promote healthy lifestyle pattern are suggested.

Download Full-text

Caregivers’ Knowledge and Attitude on Breastfeeding Practices and its Influence on Primiparous Mothers

Nepal Medical College Journal ◽

10.3126/nmcj.v22i4.34191 ◽

2020 ◽

Vol 22 (4) ◽

pp. 243-247

Author(s):

Smriti Mathema ◽

S Shrestha ◽

M Pokhrel

Keyword(s):

Infant Health ◽

Primary Caregivers ◽

Tertiary Hospital ◽

Correlation Study ◽

Cross Sectional ◽

Face To Face ◽

Breastfeeding Practices ◽

Inadequate Knowledge ◽

Knowledge And Attitude ◽

And Training

The role of primary caregiver is crucial in the mother’s continuity of care and in improving the health of families by supporting breastfeeding. A comprehensive understanding of the relationship between caregiver knowledge of breastfeeding and its influence on the mother has not been established. Findings from this study hope to provide improvisation of existing breastfeeding programs to include advocacy, counselling and training of caregivers. This study was a cross-sectional, correlation study of the level of knowledge of caregivers about breastfeeding and its influence on primiparous mothers. The participants were recruited from a tertiary hospital located in Kathmandu and a one-one face-to-face interview using a self-constructed structured questionnaire was conducted in the postnatal and private ward where the patients were admitted. A total of 238 caregivers of primiparous mothers participated in this study. The collected qualitative data were then analyzed with descriptive statistics. Most of the primary caregivers who were interviewed were mothers of the patient (30.2%), followed by other relatives (22.3%), spouse (21.4%), mother-in-law (20.2%) and siblings (5.9%). Among the 238 participants, it was found that the level of caregiver’s knowledge of breastfeeding was low in 74 (31%), moderate in 128 (54%) and good in 36 (15%). Overall, the study showed a fairly inadequate knowledge towards various correct breastfeeding practices. There is a huge gap in knowledge and an urgent need to include primary caregivers of pregnant women in counselling and training of breastfeeding practices in order to improve infant health.

Download Full-text

The impact of out-of pocket payments of households for dental healthcare services on catastrophic healthcare expenditure in Iran

BMC Public Health ◽

10.1186/s12889-021-11209-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abraha Woldemichael ◽

Satar Rezaei ◽

Ali Kazemi Karyani ◽

Mohammad Ebrahimi ◽

Shahin Soltani ◽

...

Keyword(s):

Dental Care ◽

Rural Areas ◽

Healthcare Expenditure ◽

Financial Burden ◽

Healthcare Services ◽

Dental Services ◽

Cross Sectional ◽

Care Services ◽

Out Of Pocket Payments ◽

The Impact

Abstract Background Dental healthcare is the costliest and single most source of the financial barrier to seeking and use of needed healthcare. Hence, this study aims to analyses impact of out-of-pocket (OOP) payments for dental services on prevalence catastrophic healthcare expenditure (CHE) among Iranian households during 2018. Methods We performed a cross-sectional analysis to determine the prevalence rate of CHE due to use of dental healthcare services among 38,858 Iranian households using the 2018 Household Income and Expenditure Survey (HIES) survey data of Iran. The WHO approach was used to determine the CHE due to use of dental care services at the 40% of household capacity to pay (CTP). Multiple logistic regression models were used to obtain the odds of facing with CHE among households that paid for any dental healthcare services over the last month while adjusting for covariates included in the model. These findings were reported for urban, rural areas and also for low, middle and high human development index HDI across provinces. Results The study indicated that the prevalence of CHE among households that used and did not used dental services over the last month was 16.5% (95% CI: 14.9 to 18.3) and 4.3% (95% CI: 4.1 to 4.6), respectively. The adjusted odds ratio (AOR) for the covariates revealed that the prevalence of CHE for the overall households that used dental healthcare service was 6.2 times (95% CI: 5.4 to 7.1) than those that did not use dental healthcare services. The urban households that used dental healthcare had 7.8 times (95%CI: 6.4–9.4) while the rural ones had 4.7 times (95% CI: 3.7–5.7) higher odds of facing CHE than the corresponding households that did not use dental healthcare services. Conclusions The study indicates that out-of-pocket costs for dental care services impose a substantial financial burden on household’s budgets at the national and subnational levels. Alternative health care financing strategies and policies targeted to the reduction in CHE in general and CHE due to dental services in particular are urgently required in low and middle income countries such as Iran.

Download Full-text

Inequalities in socioeconomic status, behaviors, healthcare services and vulnerability to HIV/STIs between brothel-based and street-based female sex workers in Yunnan, China

10.21203/rs.3.rs-60058/v1 ◽

2020 ◽

Author(s):

Guoxi Cai ◽

Yufen Liu ◽

Yixiao Lu ◽

Jiwen Wu ◽

Jinman Zhuang ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Economic Status ◽

Critical Role ◽

Healthcare Services ◽

Healthcare Intervention ◽

Binary Logistic Regression Model ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Female Sex

Abstract BackgroundCommercial sex plays a critical role in the transmission of HIV/STI infections in mainland China because female sex workers (FSWs), who tend to be either street-based (SSWs) or brothel-based (BSWs), are extremely prevalent. These two groups had different behaviors and treatment. Few studies investigated due to SSWs group is difficult to reach. MethodsA cross-sectional survey was conducted in Yunnan Province of China with 129 street-based and 185 brothel-based participants. Peer educators conducted anonymous, face-to-face interviews to collect data on socio-demographic characteristics, HIV/STIs-related knowledge, sex work history, sex behaviours, experience of receiving healthcare service, and experience of abuse from clients. Blood samples were taken for HIV and syphilis testing. Urine samples were taken for gonorrhoea and chlamydia testing. ResultsSignificant differences on socio-economic characters and HIV/STIs prevalence are found between the two types of FSWs. SSWs are older than BSWs; have less education, more dependents, and more clients in one week; receive less healthcare services; and have a higher prevalence of HIV/STIs. Binary logistic regression model results showed that venue for sex trade and experience of HIV testing were significantly associated with the prevalence of HIV/STIs ConclusionsThe SSWs are at lower socio-economic status and have high HIV/STIs mobility, who are more marginalized, receive less healthcare and are, thus, more vulnerable. China’s next step in healthcare intervention should focus on the most hard-to-reach-marginalised groups. HIV/STIs testing and socio-psychological support programmes are urgent needed for these neglected people.

Download Full-text

Dental Caries in Relation to Sugar Consumption among Children - A Study from Southern Punjab, Pakistan

BioMedica ◽

10.51441/biomedica/5-273 ◽

2021 ◽

Vol 37 (2) ◽

pp. 110-113

Author(s):

Rabia Zafar ◽

Amna Urooj ◽

Sehrish Masood

Keyword(s):

Dental Caries ◽

Statistical Tests ◽

Economic Status ◽

Financial Burden ◽

Local Population ◽

Paediatric Population ◽

Cross Sectional Study ◽

Cross Sectional ◽

Sugar Intake ◽

Age Range

Background and Objective: Dental caries is one of the most prevalent diseases among children around the world. It has a complex aetiology and different factors like sugar intake, brushing habits, body mass index, and socio-economic status may play a significant role. Apart from dental pain, caries affects children’s over all body functions, body growth, and pose a financial burden on families. The objective of the study was to determine the association between sugar intake and dental decay among local paediatric population. Methods: This cross-sectional study was conducted at the Ibn-e-Sina Hospital Multan, Pakistan from July, 2019 to December, 2019. Data were collected on a specifically designed questionnaire. A total of 540 participants of age range between 5 and 12 years were selected for this study after taking consent from their parents. The data were analysed using statistical tests of significance. Results: Female children were predominantly affected as compared to males (56.7% vs. 43.3%) caries was seen more frequently in children brushing teeth once than those doing it twice (p = 0.01). Children taking cariogenic food between meals and 2 hours before sleep showed a significant association with caries development (p = 0.02; p = 0.01). Primary teeth were affected more (74.18%) than the secondary teeth (11.92%). Conclusion: Irregular brushing habits and frequency and timing of cariogenic food intake are the leading causes of caries in children from local population.

Download Full-text

Determinants of Facility-Based Childbirth in Indonesia

The Scientific World JOURNAL ◽

10.1155/2019/9694602 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Ferry Efendi ◽

Ani Rihlatun Ni’mah ◽

Setho Hadisuyatmana ◽

Heri Kuswanto ◽

Linlin Lindayani ◽

...

Keyword(s):

Decision Making ◽

Antenatal Care ◽

Economic Status ◽

Statistical Significance ◽

Monitoring And Evaluation ◽

Healthcare Services ◽

Bivariate Analysis ◽

Wealth Creation ◽

Cross Sectional ◽

Healthcare Facilities

Background. Reducing maternal mortality remains a significant challenge in Indonesia, especially for achieving the country’s Sustainable Development Goals (SDGs) by 2030. One of the challenges is increasing delivery at healthcare facilities to ensure safe and healthy births. In Indonesia, research on factors affecting women’s use of facility-based childbirth services is scarce.Objective. This study was conducted to identify the determinants of facility-based deliveries in Indonesia.Methods. This study used data from the Indonesia Demographic and Health Survey of 2012, with a cross-sectional design. An odds ratio with 95% confidence intervals (CI) was employed to outline the independent variables for the determinants, including maternal age and education, place of residence, involvement in decision-making, employment status, economic status, and number of antenatal care visits. The dependent variable in this study was the place of delivery: whether it took place in healthcare or nonhealthcare facilities. The statistical significance was set at p<0.05 using bivariate analysis and binary logistic regression.Results. This study showed that a high level of education (OR: 3.035, 95% CI: 2.310–3.987), high economic status (OR: 6.691, 95% CI: 5.768–7.761), urban residence (OR: 2.947, 95% CI: 2.730–3.181), working status (OR: 0.853, 95% CI: 0.793–0.918), involvement in decision-making (OR: 0.887, 95% CI: 0.804–0.910), and having more than four visits to antenatal care centers (OR: 1.917, 95% CI: 1.783–2.061) were significant determinants of delivery at healthcare facilities.Conclusion. Efforts to improve facility-based childbirth in Indonesia must strengthen initiatives that promote women’s education, women’s autonomy, opportunities for wealth creation, and increased uptake of antenatal care, among others. Any barriers related to maternal healthcare services and cultural factors on the use of health facilities for childbirth in Indonesia require further monitoring and evaluation.

Download Full-text

Low Self-Rated Health as A Risk Factor for Depression in South Korea: A Survey of Young Males and Females

Healthcare ◽

10.3390/healthcare9040452 ◽

2021 ◽

Vol 9 (4) ◽

pp. 452

Author(s):

Yunyoung Kim ◽

Eunsu Jang

Keyword(s):

Risk Factor ◽

South Korea ◽

Economic Status ◽

Cross Sectional Study ◽

General Information ◽

Cross Sectional ◽

Young Males ◽

Self Rated Health ◽

Significant Difference ◽

Males And Females

This is a cross-sectional study aimed to examine whether low self-rated health (SRH) is a risk factor for depression among young males and females. Data from the SRH, quality of life (QoL) and depression questionnaires as well as general information, were collected from 512 males and females aged 20–29 years in South Korea. Chi-square test was used to analyze the distribution of depression between the high and low SRH groups. Logistic regression was used to analyze the relationship between SRH and depression after adjusting for covariates. There were 32.6% males and 30.1% females who were at risk for depression. A significant difference in the distribution of depression between the low and high SRH groups in both males and females was found. The low SRH group had a higher prevalence of depression than the high SRH group in both males and females in the crude analysis. However, when the BMI, economic status, and mental component score were adjusted, the OR of the low SRH group was still significant in males. Low SRH may be a risk factor for depression especially in males. Further studies to improve SRH by developing preventive measures against depression status while considering gender characteristics are needed.

Download Full-text