scholarly journals Functional recovery after cesarean delivery: a prospective cohort study in rural Rwanda

2021 ◽  
Author(s):  
Anne Niyigena ◽  
Saidath Gato ◽  
Barnabas Alayande ◽  
Elizabeth Miranda ◽  
Bethany Hedt-Gauthier ◽  
...  
Keyword(s):  
Physical Health ◽  
Functional Status ◽  
Functional Recovery ◽  
Low Income ◽  
Rural Women ◽  
Post Partum ◽  
Intraoperative Complications ◽  
Physical Health Outcomes ◽  
Income Status ◽  
Poor Functional Status

Abstract Background Women who deliver via cesarean section (c-section) experience short- and long-term complications that may affect their physical health and their ability to function normally. While physical health outcomes are routinely assessed and monitored, postpartum functional outcomes are not well understood from a patient’s perspective or characterized by clinicians. In Rwanda, 11% of rural women deliver via c-section. This study explores the functional recovery of rural Rwandan women after c-section and assesses factors that predict poor functionality at postoperative day (POD) 30. Methods Data were collected prospectively on POD 3, 11, and 30 from women delivering at Kirehe District Hospital between October 2019 and March 2020. Functionality was measured by self-reported overall health, energy level, mobility, self-care ability, and ability to perform usual activities. We computed composite mean scores with a maximum score of 4.0 and scores ≤ 2.0 reflected poor functionality. We assessed functionality with descriptive statistics and logistic regression. Results Of 617 patients, 54.0%, 25.9%, and 26.8% reported poor functional status at POD3, POD11, and POD30, respectively. At POD30, the most self-reported poor functionality dimensions were poor or very poor overall health (48.1%), and inability to perform usual activities (15.6%). In the adjusted model, women whose surgery lasted 30–45 minutes had higher odds of poor functionality (aOR = 1.85, p = 0.01), as did women who experienced intraoperative complications (aOR = 4.12, p = 0.037). High income patients had incrementally lower significant odds of poor functionality (aOR = 0.62 for every US$100 increase in monthly income, p = 0.04). Conclusion We found a high proportion of poor functionality 30 days post-c-section and while surgery lasting > 30 minutes and experiencing intra-operative complications was associated with poor functionality, a reported higher income status was associated with lower odds of poor functionality. Functional status assessments, monitoring and support should be included in post-partum care for women who delivered via c-section. Effective risk mitigating intervention should be implemented to recover functionality after c-section, particularly among low-income women and those undergoing longer surgical procedures or those with intraoperative complications.

scholarly journals Welfare, work, and health care access predictors of low-income children's physical health outcomes

2007 ◽  
Vol 29 (6) ◽  
pp. 782-801 ◽  
Author(s):  
Kristen Shook Slack ◽  
Jane L. Holl ◽  
Joan Yoo ◽  
Laura B. Amsden ◽  
Emily Collins ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Physical Health ◽  
Low Income ◽  
Health Care Access ◽  
Welfare Work ◽  
Care Access ◽  
Physical Health Outcomes ◽  
Work And Health

scholarly journals Predictors of Utilisation of Skilled Maternal Healthcare in Lilongwe District, Malawi

2019 ◽  
Vol 8 (12) ◽  
pp. 700-710 ◽  
Author(s):  
Isabel Kazanga ◽  
Alister C. Munthali ◽  
Joanne McVeigh ◽  
Hasheem Mannan ◽  
Malcolm MacLachlan
Keyword(s):  
Low Income ◽  
Rural Women ◽  
Secondary Data ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Maternal Healthcare ◽  
Skilled Attendant ◽  
Income Status ◽  
Poor Women ◽  
Skilled Health

Background: Despite numerous efforts to improve maternal and child health in Malawi, maternal and newborn mortality rates remain very high, with the country having one of the highest maternal mortality ratios globally. The aim of this study was to identify which individual factors best predict utilisation of skilled maternal healthcare in a sample of women residing in Lilongwe district of Malawi. Identifying which of these factors play a significant role in determining utilisation of skilled maternal healthcare is required to inform policies and programming in the interest of achieving increased utilisation of skilled maternal healthcare in Malawi. Methods: This study used secondary data from the Woman’s Questionnaire of the 2010 Malawi Demographic and Health Survey (MDHS). Data was analysed from 1126 women aged between 15 and 49 living in Lilongwe. Multivariate logistic regression was conducted to determine significant predictors of maternal healthcare utilisation. Results: Women’s residence (P=.006), education (P=.004), and wealth (P=.018) were significant predictors of utilisation of maternal healthcare provided by a skilled attendant. Urban women were less likely (odds ratio [OR] = 0.47, P=.006, 95% CI = 0.28–0.81) to utilise a continuum of maternal healthcare from a skilled health attendant compared to rural women. Similarly, women with less education (OR = 0.32, P=.001, 95% CI = 0.16–0.64), and poor women (OR = 0.50, P=.04, 95% CI = 0.26–0.97) were less likely to use a continuum of maternal healthcare from a skilled health attendant. Conclusion: Policies and programmes should aim to increase utilisation of skilled maternal healthcare for women with less education and low-income status. Specifically, emphasis should be placed on promoting education and economic empowerment initiatives, and creating awareness about use of maternal healthcare services among girls, women and their respective communities.

THE EFFECT OF PHYSICAL HEALTH AND FUNCTIONAL STATUS ON COGNITIVE FUNCTIONS IN WOMEN AGED 55-64 YEARS OLD

2021 ◽  
pp. 345-351
Author(s):  
О.Н. Ткачева ◽  
Н.К. Рунихина ◽  
Э.А. Мхитарян ◽  
Н.В. Шарашкина ◽  
Н.М. Воробьева ◽  
...  
Keyword(s):  
Physical Health ◽  
Functional Status ◽  
Low Income ◽  
Cognitive Functions ◽  
Protective Factor ◽  
Cognitive Status ◽  
Economic Factors ◽  
Common Causes ◽  
Social Demographic

Когнитивные нарушения являются одной из частых причин снижения качества жизни пожилых людей. Целью исследования была оценка взаимосвязи когнитивных функций, функционального статуса и состояния физического здоровья у женщин 55 64 лет. В исследование были включены 250 женщин 55 64 лет (средний возраст 59,3±2,9 года). Проанализированы социальнодемографические и экономические факторы, функциональный и когнитивный статусы, изучены наличие и распространённость гериатрических синдромов и их ассоциация с социальными, демографическими и экономическими характеристиками, факторами риска развития хронических неинфекционных заболеваний. Полученные данные выявили комплекс факторов, независимо ассоциированных с недементными (лёгкими и умеренными) когнитивными нарушениями: уровень образования, низкий доход пациентов, наличие сахарного диабета, СКФ, диаметр позвоночной артерии. При этом протекторным фактором являлся уровень образования. Cognitive impairment is one of the most common causes of reduced quality of life in older people. The aim of the study to evaluate impact of functional status, physical health and cognitive functions in women aged 55 64 years old. The study included 250 women aged 55-64 years (mean age 59,3±2,9 years). Socio-demographic and economic factors, functional and cognitive status were analyzed, the presence and prevalence of geriatric syndromes and their association with social, demographic and economic characteristics, risk factors for the development of chronic non-communicable diseases were studied. The prevalence of cognitive impairments was independently associated with education level, low income of patients, diabetes mellitus, glomerular filtration rate, and vertebral artery diameter. In this case, the level of education was a protective factor.

Combat Experiences and Postwar Physical Health Outcomes

2011 ◽  
Author(s):  
Robin L. Toblin ◽  
Brian Kok ◽  
Lyndon A. Riviere ◽  
Charles W. Hoge
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Physical Health Outcomes

Diagnostic Study of Barriers for Strengthening Livelihoods of Low-Income Rural Women in Uzbekistan

10.1596/28484 ◽  
2017 ◽  
Author(s):  
Ekaterina Romanova ◽  
Nina Kolybashkina ◽  
Bradley Todd Hiller ◽  
Evgeny Kochkin
Keyword(s):  
Low Income ◽  
Rural Women ◽  
Diagnostic Study

Health-Related Quality of Life in Patients with Ankylosing Spondylitis: Relationship with Disease-Related Variables

2020 ◽  
Vol 16 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Gehan Elolemy ◽  
Ahmed Aboughanima ◽  
Sahar Ganeb ◽  
Haytham Elziat
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Physical Health ◽  
Disease Activity ◽  
Functional Status ◽  
Spinal Mobility ◽  
Peripheral Arthritis ◽  
Radiographic Severity ◽  
Sf 36

Background: Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease leading to functional limitations and subsequently impaired quality of life (QoL). Despite the fact that QoL was recognized as a significant perception, it was excluded from the core domains (defined by the Assessment of Spondyloarthritis International Society), because of ambiguity of measurement choice. Aim: To assess QoL in patients with AS using a generic; Short Form-36 (SF-36) and a diseasespecific; Ankylosing Spondylitis quality of life (ASQoL) instruments and to explore its relationship to the clinical characteristics, disease activity, functional status, and radiographic severity. Methods: A total of 47 AS patients who fulfilled modified New York criteria were included. Disease activity, functional status, spinal mobility, and radiographic severity were assessed by Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI) and Bath AS Radiology Index (BASRI) respectively. SF-36 and ASQoL instruments evaluated Qol. Results: Physical health was more affected especially in patients with peripheral arthritis by SF-36 (p=0.008) and ASQoL (p=0.022) scores. Both SF-36 total and ASQoL scores correlated significantly with BASDAI (r = -0.329, p = 0.024 and r = 0.420, p = 0.003), BASFI (r = -0.399, p = 0.005 and r = 0.513, p=0.001) and BASMI (r = -0.382, p = 0.008 and r = 0.482, p= 0.001) respectively. Conclusion: QoL was impaired in AS patients with highest impact on physical health especially in association with peripheral arthritis. SF-36 and ASQol have a comparable achievement in the evaluation of QoL in AS patients and both physical function and spinal mobility were identified as predictors of poor QoL.

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