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Factors Associated With Health-Related Quality of Life among Hypertensive Patients in Kathmandu, Nepal.

ABSTRACT: Introduction:Nepal has a high prevalence of hypertension. While improving the overall health-related quality of life (HRQOL) is a central tenet to public health plans in developed nations, this focus has yet to be articulated in Nepal. Therefore, this study aims to identify the factors associated with HRQOL among hypertensive patients in Nepal. Method:The EuroQol-5Dimension HRQOL survey was administered to 180 hypertensive patients, attending the outpatient clinic at Shahid Gangalal National Heart Center in Kathmandu, Nepal. Multiple linear regression models, adjusted for age and sex, were used to identify factors associated with HRQOL. Results:The mean age and EuroQol visual analytic scale of the participants were 53.2?years and 63.7, respectively. Age [??=?-0.56; 95% confidence interval (CI): -0.75 to -0.37], income (??=?0.02; 95% CI: 0.01, 0.03), family size (??=?-0.98; 95% CI: -1.89, -0.07), number of antihypertensive drugs use (??=?4.62; 95% CI: 1.33, 7.90), and compliance to dietary salt advise (??=?4.86; 95% CI: 0.29, 9.43) were significant factors associated with HRQOL among participants. In addition, levels of education and self-perceived health were associated in a positive gradient to HRQOL. In mediation analysis, both, dietary low salt compliance and use of antihypertensive drugs, had a significant direct effect on HRQOL, and the use of antihypertensive drugs did not significantly mediate the relationship between dietary salt compliance and HRQOL. Conclusion:Various factors were found to be associated with HRQOL among hypertensive patients in Kathmandu. Assessing HRQOL is a valuable technique to identify populations in need of services and interventions. This assessment can serve as a baseline, and in conjunction with multiple stakeholders, can guide public health policy, planning, and practices, especially those aimed toward improving the HRQOL of Nepalese with hypertension.

SUBMITTER: Ghimire S

PROVIDER: S-EPMC5681715 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Factors Associated With Health-Related Quality of Life among Hypertensive Patients in Kathmandu, Nepal.

Ghimire Saruna S Pradhananga Praful P Baral Binaya Kumar BK Shrestha Naveen N

Frontiers in cardiovascular medicine 20171106

<h4>Introduction</h4>Nepal has a high prevalence of hypertension. While improving the overall health-related quality of life (HRQOL) is a central tenet to public health plans in developed nations, this focus has yet to be articulated in Nepal. Therefore, this study aims to identify the factors associated with HRQOL among hypertensive patients in Nepal.<h4>Method</h4>The EuroQol-5Dimension HRQOL survey was administered to 180 hypertensive patients, attending the outpatient clinic at Shahid Gangal ...[more]

PMID: 29164136

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Project description:Health-related quality of life (HRQOL) is often reduced with glaucoma, but associated factors are poorly understood.To determine factors associated with reduced HRQOL in medically and surgically treated patients with glaucoma.Prospective cohort study at a tertiary referral glaucoma practice, with 160 consecutive, prospectively enrolled medically or surgically treated adult patients with glaucoma.All patients completed 2 HRQOL questionnaires (the 25-item National Eye Institute Visual Function Questionnaire and the Adult Strabismus-20 questionnaire [AS-20]). Thirty-six patients had undergone glaucoma drainage device surgery, 51 underwent trabeculectomy, and 73 were medically treated. Factors considered for association with HRQOL in multiple regression analyses were age, sex, best-eye and worst-eye mean deviation on Humphrey visual fields, treatment modality, best-eye and worst-eye visual acuity, and diplopia.The mean (SD) age of participants was 69 (13) years, 63% were female, 97% were white, 93% were not Hispanic, and the mean deviation (SD) was -13 (10) dB. Reduced HRQOL was associated with worse diplopia (Diplopia Questionnaire score) on 6 subscales (range of partial r2 [rp2], 0.207-0.069). Reduced HRQOL was associated with lower best-eye mean deviation on 5 of 6 subscales (rp2 range, 0.379-0.027), lower worst-eye mean deviation on 4 of 6 (rp2 range, 0.242-0.046), treatment group on 3 of 6 (rp2 range, 0.190-0.025), lower worst-eye visual acuity on 5 of 6 (rp2 range, 0.063-0.025), lower best-eye visual acuity on 2 of 6 (rp2 range, 0.032-0.017), and younger age on 2 of 6 (rp2 range, 0.021-0.014). In adjusted analyses, glaucoma drainage device was associated with worse HRQOL in 3 AS-20 subscales compared with trabeculectomy and 2 AS-20 subscales compared with medical. Differences ranged from -14.7 to -7.4, with half the absolute magnitude of the full range of the 95% CI ranging from 9.2 to 5.7.Our findings support the assertion that reduced HRQOL is common in surgically and medically treated patients with glaucoma. Overall, poor HRQOL in patients with glaucoma is moderately associated with worse diplopia, lower mean deviation on visual field testing in either eye, poorer visual acuity in either eye, treatment type, and younger age. Previous glaucoma drainage device surgery was specifically associated with poorer HRQOL compared with trabeculectomy or medical treatment. Psychosocial effects of glaucoma drainage device should be considered when counseling patients with glaucoma.

Project description:BackgroundBreast cancer burden is increasing in low-income countries (LICs). Increasing incidence and delayed presentation of breast cancer are mainly responsible for this burden. Many women do not participate in breast cancer screening despite its effectiveness. Moreover, studies are limited on the barriers associated with low utilization of breast cancer screening in LICs. This study identified breast cancer screening behavior and factors associated with breast cancer screening intention among women in Kathmandu Valley, Nepal.MethodsA cross-sectional study was conducted among 500 women living in five municipalities of Kathmandu Valley, Nepal. Data were collected from July to September 2018, using a structured questionnaire. Interviews were conducted among women selected through proportionate random household sampling. This study was conceptualized using the theory of planned behavior, fatalism, perceived susceptibility, and perceived severity. The outcome variables included: the intention to have mammography (MMG) biennially, the intention to have clinical breast examination (CBE) annually, and the intention to perform breast self-examination (BSE) monthly. Analysis was conducted separately for each outcome variable using partial proportional odds model.ResultsOut of 500 women, 3.4% had undergone MMG biennially, 7.2% CBE annually, and 14.4% BSE monthly. Women with a positive attitude, high subjective norms, and high perceived behavioral control were more likely to have the intention to undergo all three screening methods. Similarly, women were more likely to have intention to undergo CBE and MMG when they perceived themselves susceptible to breast cancer. Conversely, women were less likely to have intention to undergo CBE when they had high fatalistic beliefs towards breast cancer.ConclusionWomen in this study had poor screening behavior. The practice of breast self-examination was comparatively higher than clinical breast examination and mammography. Multidimensional culturally sensitive interventions are needed to enhance screening intentions. Efforts should be directed to improve attitude, family support, and fatalistic belief towards cancer. Furthermore, the proper availability of screening methods should be ensured while encouraging women to screen before the appearance of symptoms.

Project description:IntroductionPsoriatic arthritis (PsA) is considered a multifaceted disease, with patients reporting low health-related quality of life (HRQoL). Data on disease burden are substantial and there exists a need for properly designed studies to learn more about the evolution of HRQoL in this condition. This study aims to identify factors associated to HRQoL evolution in PsA patients followed-up in a real-world setting in Spain.MethodsWe conducted a retrospective longitudinal observational study including incident patients from the rheumatology outpatient clinic of Hospital Clínico San Carlos (Madrid, Spain), diagnosed for the first time of PsA, defined as having received any ICD9/ICD10 diagnosis code of PsA, from 2007 to 2016, and followed-up until loss of follow-up, death, or November 2017. The influence of demographic and clinical variables in baseline HRQoL [assessed with the Rosser Classification Index (RCI)] was analyzed using bivariable and multivariable generalized linear models. The influence of those variables and of treatment-related factors in repeated measures of HRQoL was analyzed using bivariable and multivariable generalized estimating equations (GEE) models nested by patient.ResultsTwo hundred and thirty patients were included in the analysis, with 3384 registered visits. At baseline, older age, a previous diagnosis of obesity, and the presence of enthesitis were significantly associated with worse HRQoL. During follow-up, using an exchangeable working correlation structure, the presence of enthesitis was also associated with worse HRQoL, coefficient (95% CI) - 0.006 (- 0.01 to - 0.002), p = 1.00E-03; conversely, treatment with methotrexate or antimalarials was associated with better HRQoL with 0.007 (0.001-0.014), p = 0.020 and 0.003 (0.001-0.005), p = 3.00E-03, respectively.ConclusionsMusculoskeletal manifestations and comorbidities exert a deleterious effect in HRQoL of PsA patients. Therefore, the optimal management of this condition needs to also address these manifestations in order to try to restore the QoL of these patients.

Project description:BackgroundAssessing the health-related quality of life in patients with type 2 diabetes mellitus is important for evaluation of treatment outcome. The purpose of this study was to evaluate the health-related quality of life in type 2 diabetes mellitus patients and its related factors in Yazd.MethodsData were gathered by using the EuroQoL-five-dimension-5 level instrument as well as using medical records of 734 outpatients with type 2 diabetes mellitus who were referred to the largest governmental diabetes center in South of Iran, Yazd province. When appropriate, the Kruskal-Wallis test or the Wilcoxon test was used to test the difference in the health-related quality-of-life scores in each factor. Finally, the adjusted limited dependent variable mixture model was developed to investigate factors associated with health-related quality-of-life scores.ResultsThe mean and median of the EuroQoL-five-dimension-5 level index values of 717 patients who completed the questionnaires were 0.75 ± 0.006 and 0.72 ± 0.20, respectively, and those of the Visual Analogue Scale scores were 69.25 ± 0.63 and 75 ± 30, respectively. The mean scores for health-related quality of life were significantly higher for employed, educated, single, and male patients, as well as patients without comorbidities, diabetes-related complications, and hemoglobin A1c level >7%. Adjusted limited dependent variable mixture model showed that gender, age, marital status, and diabetes-related complications are significant independent predictors of EuroQoL-five-dimension-5 level index value.ConclusionThe mean scores for health-related quality of life in patients with type 2 diabetes mellitus were moderate in this study, and this finding is consistent with health-related quality-of-life scores reported in other studies conducted in the Middle East region. Therefore, health-related quality of life should be the most important consideration in the management of patients. In parallel, some factors, especially gender, should be considered to improve health-related quality of life.

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Factors Associated With Health-Related Quality of Life among Hypertensive Patients in Kathmandu, Nepal.

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Factors Associated With Health-Related Quality of Life among Hypertensive Patients in Kathmandu, Nepal.

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