scholarly journals Factors Associated with Free Hospital Outpatient Service Use among Middle-Aged and Older Urban Homeless Adults in Taipei

2021 ◽  
Vol 18 (10) ◽  
pp. 5330
Author(s):  
Lan-Ping Lin ◽  
Li-Yun Wang ◽  
Tai-Wen Wang ◽  
Yun-Cheng Chen ◽  
Jin-Ding Lin
Keyword(s):  
Logistic Regression ◽  
Depressive Symptoms ◽  
Chronic Diseases ◽  
Service Use ◽  
Outpatient Service ◽  
Homeless People ◽  
Cross Sectional Survey ◽  
Factors Associated ◽  
Hospital Outpatient ◽  
Outpatient Visits

Homeless individuals have many negative experiences with inequality regarding access to and the use of primary healthcare services, so policies to eliminate the disparities in and barriers to primary care access for these people are needed. The aim of this study was to explore the use and determinants of free hospital outpatient services for homeless people, in order to describe the provision of free healthcare policies for this vulnerable population in Taipei. One cross-sectional survey was conducted to recruit homeless people aged 45 years old and over in Taipei in 2018. A structured questionnaire was used, and face-to-face interviews were conducted by three social workers to collect the data. Finally, 129 participants were recruited in the study. The results show that 81.4% of the homeless people had made free hospital outpatient care visits (mean = 5.9 visits) in the last three months. An unadjusted logistic regression analysis showed that those homeless people who reported having usual healthcare providers, with higher depressive symptom scores, who used medication and had been hospitalized within one year, and had more chronic diseases, were significantly more likely to make free hospital outpatient visits. The adjusted logistic regression model indicates that homeless people with severe depressive symptoms (odds ratio (OR) = 9.32, 95% CI = 1.15–56.07), who had received medication (OR = 3.93; 95% CI = 1.06–14.52), and who had more than five chronic diseases (OR = 1.06, 95% CI = 1.35–13.27), were significantly more likely to make free hospital outpatient visits than their counterparts. The findings highlight that homeless people have higher healthcare requirements than the general population, and the healthcare system should pay more attention to factors associated with higher outpatient service use, such as homelessness, severe depressive symptoms, the receipt of medication and chronic diseases.

scholarly journals Factors Associated with Frailty According to Gender of Older Adults Living Alone

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 475
Author(s):  
Hye-Young Jang ◽  
Ji-Hye Kim
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Nutritional Status ◽  
Chronic Diseases ◽  
Multinomial Logistic Regression ◽  
Living Alone ◽  
Factors Associated ◽  
Chi Squared ◽  
Korean Elderly

This study was conducted to identify the factors associated with frailty according to gender of older adults living alone in Korea. Data from the National Survey of the Living Conditions of Korean Elderly in 2017 were used. Participants were 2340 older adults who live alone. Frailty was determined based on the frailty criteria developed by van Kan et al. that consist of fatigue, resistance, ambulation, and illness. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, Jonckheere–Terpstra test and multinomial logistic regression. Among the older men living alone, 47.7% were in the pre-frail and 5.1% were in the frail. On the other hand, 51.8% were in the pre-frail and 12.2% were in the frail among the older women living alone. The factors associated with frailty according to gender are as follows. In males, depressive symptoms, limitation in IADL, and number of medications in pre-frail; BMI, limitation in IADL, and number of chronic diseases in frail. In females, depressive symptoms, number of chronic diseases, age, and nutritional status in pre-frail; limitation in IADL, depressive symptoms, age, number of chronic diseases, number of medications, nutritional status in frail. Based on the findings of this study, it is considered necessary to approach frailty management considering gender as well as the classification of frailty.

scholarly journals Corona virus fear among health workers during the early phase of pandemic response in Nepal: a web-based cross-sectional study

2020 ◽  
Author(s):  
Pratik Khanal ◽  
Navin Devkota ◽  
Minakshi Dahal ◽  
Kiran Paudel ◽  
Shiva Raj Mishra ◽  
...  
Keyword(s):  
At Risk ◽  
Family Member ◽  
Chronic Diseases ◽  
Early Phase ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Factors Associated

AbstractBackgroundHealth workers involved in COVID-19 response might be at risk of developing fear and psychological distress. This study aimed to identify factors associated with COVID-19 fear among health workers in Nepal during the early phase of pandemic.MethodsA web-based cross-sectional survey was conducted in the month of April-May 2020 among 475 health workers directly involved in COVID-19 management. The Fear Scale of COVID 19 (FCV-19S) was used to measure the status of fear. Scatter plots were used to observe the relationship between fear and other psychological outcomes: anxiety, depression and insomnia. Multivariable logistic regression was done to identify factors associated with COVID fear.ResultsCOVID-19 fear score was moderately correlated with anxiety and depression, and weakly correlated with insomnia (p<0.001). Nurses (AOR=2.29; 95% CI: 1.23-4.26), health workers experiencing stigma (AOR=1.83; 95% CI: 1.12-2.73), those working in affected district(AOR=1.76; 95% CI: 1.12-2.77) and presence of family member with chronic diseases (AOR=1.50; 95% CI: 1.01-2.25) was associated with higher odds of developing COVID-19 fear as compared to other health workers, health workers not experiencing stigma, working in non-affected district and not having family member with chronic diseases respectively.ConclusionNurses, health workers facing stigma, those working in affect district and having family member with chronic diseases were more at risk of developing COVID-19 fear. It is thus recommended to improve work environment to reduce fear among health workers, employ stigma reduction interventions, and ensure personal and family support for those having family member with chronic diseases.

scholarly journals Risk and Protective Factors for Suicide Attempt Among Indigenous Māori Youth in New Zealand: The Role of Family Connection

2013 ◽  
Vol 7 (1) ◽  
pp. 16 ◽  
Author(s):  
Terryann C. Clark ◽  
Elizabeth Robinson ◽  
Sue Crengle ◽  
Theresa Fleming ◽  
Shanthi Ameratunga ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Depressive Symptoms ◽  
New Zealand ◽  
Suicide Attempt ◽  
Protective Factors ◽  
Suicide Attempts ◽  
Risk And Protective Factors ◽  
Factors Associated ◽  
The Relationship ◽  
Family Connection

The purpose of this study was to (1) describe risk and protective factors associated with a suicide attempt for Māori youth and (2) explore whether family connection moderates the relationship between depressive symptoms and suicide attempts for Māori youth. Secondary analysis was conducted with 1702 Māori young people aged 12–18 years from an anonymous representative national school-based survey of New Zealand (NZ) youth in 2001. A logistic regression and a multivariable model were developed to identify risk and protective factors associated with suicide attempt. An interaction term was used to identify whether family connection acts as a moderator between depressive symptoms and a suicide attempt. Risk factors from the logistic regression for a suicide attempt in the past year were depressive symptoms (OR = 4.3, p &lt; 0.0001), having a close friend or family member commit suicide (OR = 4.2, p &lt; 0.0001), being 12–15 years old (reference group: 16–18 years) (OR = 2.7, p &lt; 0.0001), having anxiety symptoms (OR = 2.3, p = 0.0073), witnessing an adult hit another adult or a child in the home (OR = 1.8, p = 0.001), and being uncomfortable in NZ European social surroundings (OR = 1.7, p = 0.0040). Family connection was associated with fewer suicide attempts (OR = 0.9, p = 0.0002), but this factor did not moderate the relationship between depressive symptoms and suicide attempt (χ2 = 2.84, df = 1, p = 0.09). Family connection acts as a compensatory mechanism to reduce the risk of suicide attempts for Māori students with depressive symptoms, not as a moderating variable.

scholarly journals Prevalence of and Factors Associated With Depressive Symptoms Among College Students in Wuhan, China During the Normalization Stage of COVID-19 Prevention and Control

2021 ◽  
Vol 12 ◽  
Author(s):  
Jincong Yu ◽  
Ziyun Yang ◽  
Yuqin Wu ◽  
Ming Ge ◽  
Xuemei Tang ◽  
...  
Keyword(s):  
College Students ◽  
Logistic Regression ◽  
Online Learning ◽  
Depressive Symptoms ◽  
Prevention And Control ◽  
Psychological Intervention ◽  
Binary Logistic Regression ◽  
Factors Associated ◽  
And Control ◽  
At Home

Objectives: The 2019 coronavirus disease (COVID-19) epidemic has led to persistent negative psychological effects on the general public, especially on college students, who are highly susceptible to psychological difficulties, such as fear, anxiety, and depression. Little information is known about depressive symptoms among college students during the normalization stage of COVID-19 prevention and control in China. This study aimed to understand the prevalence of and factors associated with depressive symptoms after a long quarantine time and online learning at home among college students in Wuhan, China.Materials and Methods: A web-based survey was conducted from July to August 2020 during the Chinese summer holiday to collect data on sociodemographic variables, depressive symptoms, and their potential associated factors using an electronic questionnaire among college students in Wuhan, China. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Binary logistic regression was used to explore the factors associated with depressive symptoms.Results: A total of 9,383 college students were included in the analysis. The prevalence of depressive symptoms was 15.8% (1,486/9,383) among college students. The binary logistic regression showed that the experience of being quarantined for observation or treatment, family members or friends dying of COVID-19, rarely or never seeking help from others, fewer supportive relatives or friends, less support from family in the past month, a worse relationship with parents at home, a longer time spent daily on electronic devices except for online learning, and feeling anxious in the face of returning to school were independently associated with a higher risk of depressive symptoms. Academic stress and concern about the epidemic were the main reasons for their anxiety.Conclusions: Targeted psychological intervention measures are recommended for college students to improve their mental health during the normalization stage of COVID-19 prevention and control.

scholarly journals AB0118 REMISSION OF ANXIETY AND DEPRESSIVE DISORDERS IMPROVES HAQ TREATMENT RESPONSE IN RHEUMATOID ARTHRITIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1088.1-1088
Author(s):  
A. Abramkin ◽  
T. Lisitsyna ◽  
D. Veltishchev ◽  
O. Seravina ◽  
O. Kovalevskaya ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Depressive Symptoms ◽  
Treatment Response ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Functional Limitations ◽  
Minor Depression ◽  
Factors Associated ◽  
Lower Baseline

Background:Anxiety and depressive disorders (ADD) significantly affect disease activity and functional disability in rheumatoid arthritis (RA) patients. Psychopharmacotherapy (PPT) of ADD attempts to improve RA disease activity and lower progression of functional limitations.Objectives:To determine factors associated with HAQ treatment response in antidepressants-treated RA-patients at five years endpoint.Methods:128 RA-patients (pts) were enrolled, 86% were women with a mean age of 47,4±11,3 (M±SD) yrs. All patients met the full ACR/EULAR 2010 criteria for RA. Functional limitations were assessed using Health Assessment Questionnaire (HAQ), mean HAQ was 1,42±0,78 at baseline. 69,4% RA-pts were already taking prednisone (9 [5; 10] mg/day (Me (25%; 75%)), 84,4% - cDMARDs, 7,8% - bDMARDs (anti-TNF-α – 6,3%, rituximab – 1,6%). ADD were diagnosed by psychiatrist in 123 (96,1%) of RA-pts in accordance with ICD-10 in semi-structured interview. Severity of depression and anxiety was evaluated with Montgomery–Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A). RA-pts with ADD were divided into the following treatment groups: 1 – сDMARDs (n=39), 2 – сDMARDs + PPT (sertraline or mianserine) (n=43), 3 – сDMARDs + bDMARDs (n=32), 4 – сDMARDs + bDMARDs + PPT (sertraline or mianserine) (n=9). Biologics treatment duration varied from 1 to 6 years, antidepressants – from 6 to 96 weeks. Baseline HAQ scores were 1,39±0,75, 1,42±0,9, 1,58±0,76 and 1,38±0,83 in groups 1-4, respectively. At 5-yrs endpoint in 83 RA-pts differences between baseline and endpoint HAQ scores (Δ HAQ = endpoint HAQ – baseline HAQ) were assessed as HAQ treatment response with minimal clinically important difference (MCID) (Δ HAQ ≥ 0,22). HAQ response rates were 4,2%, 65,5%, 47,6% and 76,7% in groups 1-4, respectively, with the lowest response rate in group 1 (p<0,0001). Logistic regression analysis was conducted to determine factors associated with RA remission rate.Results:By univariate logistic regression, anxiety and depressive symptoms remission at 5-yrs endpoint, baseline HAQ and major depression, lower baseline age, BMI and DAS28, no minor depression and cardiovascular diseases at baseline were significantly (p≤0,2) associated with HAQ treatment response (table 1). These variables were subjected to multivariate stepwise logistic regression. Only remission of anxiety and depressive symptoms at 5-yrs endpoint (OR 6,6 (95%CI 1,78 – 24,43), p=0,005), higher baseline HAQ (OR 2,61 (95%CI 1,12 – 6,11), p=0,027) and lower baseline BMI (OR 0,9 (95%CI 0,85 – 0,96), p=0,001) were independently associated with HAQ treatment response at 5-years follow-up.Table 1.Factors associated with RA remission at 5 years (univariate logistic regression).FactorpOR95%CIlowupAnxiety and depressive symptoms remission at 5-yrs endpoint0,0075,01,56116,016Baseline HAQ0,012,6571,2645,588Baseline major depression0,1422,0820,7825,542Baseline age0,0980,9920,9821,002Body mass index (BMI)0,0480,9810,9631,0Baseline minor depression0,1670,5630,2491,273Cardiovascular diseases0,10,4170,1471,183Baseline DAS280,0080,0771,0712,096Conclusion:higher HAQ and lower BMI at baseline and remission of anxiety and depressive symptoms at 5-yrs endpoint are independently associated with HAQ treatment response (MCID) at 5-years follow-up.Disclosure of Interests:None declared

Cannabis Use in Persons With Inflammatory Bowel Disease and Vulnerability to Substance Misuse

2019 ◽  
Vol 26 (9) ◽  
pp. 1401-1406 ◽  
Author(s):  
Tawnya M Hansen ◽  
Brigitte C Sabourin ◽  
Banke Oketola ◽  
Charles N Bernstein ◽  
Harminder Singh ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Logistic Regression ◽  
Depressive Symptoms ◽  
Bowel Disease ◽  
Substance Misuse ◽  
Cannabis Use ◽  
Factors Associated ◽  
Inflammatory Bowel

Abstract Background It is unknown whether cannabis users self-medicating their inflammatory bowel disease (IBD) symptoms are more likely to have comorbid mental health or personality risk factors associated with an increased potential for substance misuse compared with recreational cannabis users. Methods We surveyed individuals with IBD about their cannabis use, their mental health symptoms, and personality risk factors associated with substance misuse. We compared risk factors for substance misuse between individuals using cannabis to manage IBD symptoms and those using cannabis recreationally. Results Of 201 persons with IBD who completed the questionnaire, 108 reported lifetime cannabis use. Of those, a larger proportion of Crohn’s disease patients used cannabis to manage IBD symptoms (53% [34/64] vs 28% [12/43]; P = 0.010). Individuals self-medicating with cannabis were more likely to use cannabis for coping reasons (P = 0.016) and demonstrated higher levels of impulsivity (P = 0.004) and depressive symptoms (P = 0.012) when compared with individuals using cannabis recreationally. Logistic regression revealed that cannabis was 4.1 times (P = 0.05) and 3.7 times (P = 0.05) more likely to be used for IBD symptoms by smokers and individuals with moderate–severe depressive symptoms, respectively. Individuals high in impulsivity were 4.1 times more likely to use cannabis for their IBD symptoms than those low in impulsivity (P = 0.005). Conclusions Persons with IBD self-medicating with cannabis have characteristics associated with increased vulnerability to substance misuse when compared with those using cannabis recreationally. Screening for mental health comorbidities and vulnerability to substance misuse should be undertaken if cannabis is to be used to treat IBD symptoms.

Risk factors associated with depressive symptoms in older people based on comprehensive geriatric assessment in Chongqing China

2020 ◽  
Author(s):  
Jingxi Duan ◽  
Xia Wang ◽  
Weihua Yu ◽  
Yongtao Deng ◽  
Qi Tu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Chronic Diseases ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
The Elderly ◽  
Geriatric Syndrome ◽  
Geriatric Depression ◽  
Factors Associated ◽  
Reported Health

Abstract Background As a common geriatric syndrome in the elderly, depression is often associated with many risk factors. The occurrence of depression shows cultural and geographical differences. Aims To explore the prevalence of depression and risk factors associated with depressive symptoms in the elderly peoples in Chongqing, China. Methods A cross-sectional study based on comprehensive geriatric assessment questionnaire was conducted among 925 participants aged 60 years or older. Depressive symptoms were evaluated using the 30-item Geriatric Depression Scale. Risk factors related to depression were evaluated, including gender, age, education, marital status, type of work, living status, chronic diseases, disability, self-reported health, smoking, alcohol, exercise, and current working status. Results 219 (23.67%) of elderly participants suffered from depressive symptoms. Unmarried status, older age, poor self-reported health, disability, irregular exercise and chronic diseases were significantly associated with depressive symptoms in the elderly (P < 0.05). Multivariate logistic regression analysis showed that independent predictors of geriatric depression included unmarried status, poor self-reported health and disability. Conclusions The prevalence of depressive symptoms is high in Chinese old people. Risk factors of depression are mainly social support- and lifestyle- associated. Evaluation of risk factors is a vital strategy for preventing depression and taking interventions.

scholarly journals Lab-based and diagnosis-based chronic kidney disease recognition and staging concordance

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Clarissa J. Diamantidis ◽  
Sarah L. Hale ◽  
Virginia Wang ◽  
Valerie A. Smith ◽  
Sarah Hudson Scholle ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Kidney Disease ◽  
Multiple Chronic Conditions ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Factors Associated ◽  
Outpatient Visits ◽  
Ckd Stage ◽  
Core Areas

Abstract Background Chronic kidney disease (CKD) is often under-recognized and poorly documented via diagnoses, but the extent of under-recognition is not well understood among Medicare beneficiaries. The current study used claims-based diagnosis and lab data to examine patient factors associated with clinically recognized CKD and CKD stage concordance between claims- and lab-based sources in a cohort of Medicare beneficiaries. Methods In a cohort of fee-for-service (FFS) beneficiaries with CKD based on 2011 labs, we examined the proportion with clinically recognized CKD via diagnoses and factors associated with clinical recognition in logistic regression. In the subset of beneficiaries with CKD stage identified from both labs and diagnoses, we examined concordance in CKD stage from both sources, and factors independently associated with CKD stage concordance in logistic regression. Results Among the subset of 206,036 beneficiaries with lab-based CKD, only 11.8% (n = 24,286) had clinically recognized CKD via diagnoses. Clinical recognition was more likely for beneficiaries who had higher CKD stages, were non-elderly, were Hispanic or non-Hispanic Black, lived in core metropolitan areas, had multiple chronic conditions or outpatient visits in 2010, or saw a nephrologist. In the subset of 18,749 beneficiaries with CKD stage identified from both labs and diagnoses, 70.0% had concordant CKD stage, which was more likely if beneficiaries were older adults, male, lived in micropolitan areas instead of non-core areas, or saw a nephrologist. Conclusions There is significant under-diagnosis of CKD in Medicare FFS beneficiaries, which can be addressed with the availability of lab results.

scholarly journals Factors associated with psychological distress among Myanmar residents during COVID-19 pandemic crises

2021 ◽  
Author(s):  
Roy Rillera Marzo ◽  
Soe Soe Aye ◽  
Thein Win Naing ◽  
Thin Mon Kyaw ◽  
Myat Thida Win ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Psychological Distress ◽  
Capital City ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Social Media Platforms ◽  
The Government ◽  
Peritraumatic Distress ◽  
Structured Questionnaire

Background: COVID-19 pandemic reached a public health emergency status of international concern. The impacts and events associated with this were associated with adverse psychological impacts among the general public globally. This study aimed to determine the prevalence of psychological distress and to identify predictors associated with psychological distress due to the COVID-19 pandemic among the population in Myanmar.Design and Methods: A cross-sectional survey was conducted from March to April 2020 among adults, 18 years old and above, who reside in Myanmar through a structured questionnaire distributed in social media platforms. Univariate and Bivariate analyses were used to estimate the prevalence of COVID-19 Peritraumatic Distress Index (CPDI) symptoms and to test the associations between CPDI and the exposure variables. Logistic Regression Analysis was done to identify significant predictors of distress.Results: There were 530 participants in this study.37.4% of them did not have psychological distress,55.6% experienced mild to moderate psychological distress, and 7% experienced severe psychological distress due to COVID-19 pandemic. Simple and Multiple Logistic Regression Analyses were performed to determine the factors associated with psychological distress due to COVID-19.Conclusions: It was shown that the self-employed group and age group older than 45 years old had more psychological distress than others. However, Buddhists and people from the capital city had less distress than other religions and districts. This study recommends the government to develop better strategies for self-employed groups, elders, and the poor for a support, relief, and resettlement of their ruined status.

scholarly journals Mental Health Disorders and Associated Risk Factors in Quarantined Adults During the COVID-19 Outbreak in China: Cross-Sectional Study

10.2196/20328 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e20328 ◽  
Author(s):  
Yan Guo ◽  
Chao Cheng ◽  
Yu Zeng ◽  
Yiran Li ◽  
Mengting Zhu ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Depressive Symptoms ◽  
Chronic Diseases ◽  
Psychosocial Factors ◽  
Family Members ◽  
Mental Health Disorders ◽  
Cross Sectional ◽  
Factors Associated ◽  
Health Disorders

Background People undergoing mass home- and community-based quarantine are vulnerable to mental health disorders during outbreaks of coronavirus disease (COVID-19), but few studies have evaluated the associated psychosocial factors. Objective This study aimed to estimate the prevalence of anxiety and depressive symptoms and identify associated demographic and psychosocial factors in the general Chinese population during the COVID-19 pandemic quarantine period. Methods Participants aged 18 years or above were recruited in a cross-sectional online survey using snowball sampling from February 26-29, 2020. The survey included questions on demographics, family relationships, chronic diseases, quarantine conditions, lifestyle, COVID-19 infection, and anxiety and depressive symptoms. Logistic regression analyses were conducted to identify factors associated with elevated anxiety or depressive symptoms. Results Out of 2331 participants, 762 (32.7%) experienced elevated anxiety or depressive symptoms. Nine risk factors associated with anxiety or depressive symptoms included younger age, reduced income, having cancer or other chronic diseases, having family members living with cancer, concerns related to COVID-19 infection for themselves or family members, living alone, having family conflicts, having <3 or >8 hours of sedentary time per day, and worsened sleep quality. Conclusions The findings highlight an urgent need for psychological support for populations at high risk for elevated anxiety or depressive symptoms during the COVID-19 pandemic.

Sign in / Sign up

Export Citation Format

Share Document