1
|
Wu C, Chu X, Tang K, Cheng D, Ren L. Caregiving experiences of caregivers of children with rare diseases: A qualitative meta-synthesis. J Pediatr Nurs 2024; 75:31-40. [PMID: 38101309 DOI: 10.1016/j.pedn.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
PROBLEM Most rare diseases occur in childhood and are difficult to diagnose and treat. The caregivers are faced with the challenge of providing care to the children afflicted with these rare diseases, resulting in a significant burden of care and an altered family dynamic. ELIGIBILITY CRITERIA A meta-synthesis review was conducted to explore the caregivers' experience of children with rare diseases using eight electronic databases PubMed, Web of Science, the Cochrane Library, EMBASE, VIP database, Wan Fang, Chinese BioMedical Literature Database, and China National Knowledge Infrastructure from each database's inception to October 5, 2023. SAMPLE 4207 records were identified and 20 eligible studies were included. RESULTS Three themes emerged: (1) Life is changed by "rare"; (2) many unmet needs; (3) Strive to adapt and grow. CONCLUSIONS Caregivers of children with rare diseases are full of stress and challenges in the process of caring for them, and their lives have changed greatly due to "rare". Appropriate measures need to be taken to reduce the burden on caregivers. IMPLICATIONS According to the findings, both the medical and health systems, as well as society, should pay attention to the care load and unmet requirements of carers of children with rare diseases, and offer them with practical supportive services. Finally, it can improve the quality of life for caregivers and families of children with rare diseases, as well as stimulate the development of rare diseases.
Collapse
Affiliation(s)
- Chenxi Wu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Chu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Kexin Tang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongmei Cheng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liangjuan Ren
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
2
|
Xiang Z, Jiang H, Jiang W, Wang Y, Zheng H. Knowledge and Attitudes of Clinical Trials among Patients with Rare Diseases and the Guardians in China. Ther Innov Regul Sci 2024; 58:53-62. [PMID: 37721697 DOI: 10.1007/s43441-023-00571-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 08/09/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Conducting of clinical trials for rare diseases faces multiple challenges. Patients' cognition and attitude toward clinical trials are crucial, which may affect their participation and compliance, and affect the schedule of clinical trials eventually. OBJECTIVE AND METHOD This study aims to explore the knowledge and attitudes of clinical trials of patients with rare diseases or patients' guardians. An anonymous cross-sectional survey was conducted from November 1, 2021, to November 30, 2021. A total of 1131 valid questionnaires were included. Among them, 417 were filled in by the patients themselves, and 714 were answered by the patients' guardians. RESULTS The average score of clinical trial knowledge of the patients (8.25) was lower than that of the guardians (8.85). The willingness of the patients to participate in clinical trials was high (4.28), and the willingness of the patients' guardians was also high for patients to participate in clinical trials (4.35). The main promoting factors of clinical trial participation were the possibility of curing the disease. The main hindering factors of participation in clinical trials were lack of access to clinical trial information and concern about the safety and effectiveness of the trial drug. CONCLUSIONS In conclusion, most respondents had some basic knowledge of clinical trials and high willingness to participate in clinical trials. But there were some cognitive deficiencies about clinical trials and many hindering factors to participate in clinical trials. Clinical trials of rare diseases should be patient-centered and truly meet the unmet clinical, psychological, and social needs of patients with rare diseases.
Collapse
Affiliation(s)
- Ziling Xiang
- School of Pharmacy, Chongqing Medical University, Yuanjiagang Campus, Chongqing Medical University, Shiyou Road Street, Yuzhong District, Chongqing, China
| | - Hui Jiang
- Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou, China
| | - Wengao Jiang
- School of Pharmacy, Chongqing Medical University, Yuanjiagang Campus, Chongqing Medical University, Shiyou Road Street, Yuzhong District, Chongqing, China
| | - Yali Wang
- Department of Neurology, Guangzhou First People's Hospital, Guangzhou, China
| | - Hang Zheng
- School of Pharmacy, Chongqing Medical University, Yuanjiagang Campus, Chongqing Medical University, Shiyou Road Street, Yuzhong District, Chongqing, China.
| |
Collapse
|
3
|
Song T, Ma R, Zhang X, Lv B, Li Z, Guo M, Yuan M, Tang Z. Analysis of the current status and influencing factors of cross-regional hospitalization services utilization by basic medical insurance participants in China - taking a central province as an example. Front Public Health 2023; 11:1246982. [PMID: 38164453 PMCID: PMC10757919 DOI: 10.3389/fpubh.2023.1246982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Background The geographically uneven distribution of healthcare resources has resulted in a dramatic increase of cross-regional hospitalization services in China. The over-use of cross-regional hospitalization services may hinder the utilization and improvement of local hospitalization services. It is of great practical significance to study the utilization of cross-regional hospitalization services and its influencing factors in order to effectively allocate medical resources and guide patients to seek medical treatment rationally. Therefore, this study aims to analyze the current situation and influencing factors of the utilization of cross-regional hospitalization services by patients insured by basic medical insurance in China. Methods A total of 3,291 cross-provincial inpatients were randomly selected in a central province of China in 2020. The level of medical institutions, hospitalization expenses and actual reimbursement rate were selected as indicators of hospitalization service utilization. Exploratory factor analysis was used to assess the dimensionality of influencing factors and reduce the number of variables, and binomial logistic regression analysis and multiple linear regression analysis to explore the influencing factors of the utilization of cross-regional hospitalization services. Results The proportion of cross-provincial inpatients choosing tertiary hospitals was the highest with average hospitalization expenses of 24,662 yuan and an actual reimbursement rate of 51.0% on average. Patients insured by Urban Employees' Basic Medical Insurance (UEBMI) were more frequently (92.9% vs. 88.5%) to choose tertiary hospitals than those insured by Urban and Rural Residents' Basic Medical Insurance (URRBMI), and their average hospitalization expenses (30,727 yuan) and actual reimbursement rate (68.2%) were relatively higher (p < 0.001). The factor "income and security," "convenience of medical treatment" and "disease severity" had significant effects on inpatients' selection of medical institution level, hospitalization expenses and actual reimbursement rate, while the factor "demographic characteristics" only had significant effects on hospitalization expenses and actual reimbursement rate. Conclusion Cross-provincial inpatients choose tertiary hospitals more frequently, and their financial burdens of medical treatment are heavy. A variety of factors jointly affect the utilization of cross-provincial hospitalization services for insured patients. It is necessary to narrow down the gap of medical treatment between UEBMI and URRBMI patients, and make full use of high-quality medical resources across regions.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Zhiru Tang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| |
Collapse
|
4
|
Laksono AD, Megatsari H, Senewe FP, Latifah L, Ashar H. Policy to expand hospital utilization in disadvantaged areas in Indonesia: who should be the target? BMC Public Health 2023; 23:12. [PMID: 36597082 PMCID: PMC9808954 DOI: 10.1186/s12889-022-14656-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 11/17/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The disadvantaged areas are one of the government's focuses in accelerating development in Indonesia, including the health sector. The study aims to determine the target for expanding hospital utilization in disadvantaged areas in Indonesia. METHODS The study employed the 2018 Indonesian Basic Health Survey data. This cross-sectional study analyzed 42,644 respondents. The study used nine independent variables: residence, age, gender, marital, education, employment, wealth, insurance, and travel time, in addition to hospital utilization, as a dependent variable. The study employed binary logistic regression to evaluate the data. RESULTS The results found that average hospital utilization in disadvantaged areas in Indonesia in 2018 was 3.7%. Urban areas are 1.045 times more likely than rural areas to utilize the hospital (95% CI 1.032-1.058). The study also found age has a relationship with hospital utilization. Females are 1.656 times more likely than males to use the hospital (95% CI 1.639-1.673). Moreover, the study found marital status has a relationship with hospital utilization. The higher the education level, the higher the hospital utilization. Employed individuals have a 0.748 possibility to use the hospital compared with those unemployed (95% CI 0.740-0.757). Wealthy individuals have more chances of using the hospital than poor individuals. Individuals with all insurance types are more likely to utilize the hospital than those uninsured. Individuals with travel times of ≤ 1 h are 2.510 more likely to use the hospital than those with > 1 h (95% CI 2.483-2.537). CONCLUSION The specific targets to accelerate the increase in hospital utilization in disadvantaged areas in Indonesia are living in a rural area, being male, never in a union, having no education, being employed, being the poorest, uninsured, and having a travel time of > 1 h. The government should make a policy addressing the problem based on the research findings.
Collapse
Affiliation(s)
- Agung Dwi Laksono
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Hario Megatsari
- grid.440745.60000 0001 0152 762XFaculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | | | - Leny Latifah
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Hadi Ashar
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| |
Collapse
|
5
|
Tan S, Wang Y, Tang Y, Jiang R, Chen M, Chen H, Yang F. Societal preferences for funding orphan drugs in China: An application of the discrete choice experiment method. Front Public Health 2022; 10:1005453. [PMID: 36579068 PMCID: PMC9790908 DOI: 10.3389/fpubh.2022.1005453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives To explore whether a societal preference for orphan drugs exists in Chinese general public and to quantitatively measure the personal trade-off between essential attributes of orphan drugs through a discrete choice experiment. Methods A labeled discrete choice experiment was employed to measure public preference. Six attributes (impact of diseases on life-years, impact of diseases on quality of life, availability of alternative drug treatments, annual cost per patient paid by medical insurance, expected increases in life-expectancy, and improvements to the quality of life) were identified through a literature review, experts' suggestions, and stakeholders' semi-structured interviews, then refined through a pre-survey. The current study used a D-efficient design to yield 27 choice sets divided into three blocks with nine questions containing the labeled treatment (either orphan drugs or common drugs). Information on sociodemographic characteristics and individual preferences was collected through a web-based questionnaire using convenience sampling. A mixed logit model was used to test societal preferences for orphan drugs over common drugs, while a binary logit model was used to measure the relative importance of each attribute in orphan drug access for the National Reimbursement Drug List and its willingness to pay. Results A total of 323 persons participated in this study. Respondents largely had indifferent attitudes toward orphan drugs and common drugs. The binary logit model results showed that 5 of the 6 attributes were significant, except for the availability of alternative drug treatments. The most impacted factor was the annual cost per patient paid by medical insurance (β = -1.734, odds ratio [OR] = 0.177). Among non-economic attributes, the impact of diseases on life-years-with no treatment, the patient will die in the prime of life (β = 0.523, OR = 1.688, willingness to pay = 301,895)-was most concerning, followed by significant improvements to the quality of life (β = 0.516, OR = 1.676, willingness to pay = 297,773). Conclusion The general public in China does not value rarity as a sufficient reason to justify special consideration in funding orphan drugs. When making orphan drug coverage decisions, the public prioritized the annual cost, disease severity, and drug effects.
Collapse
Affiliation(s)
- Shuoyuan Tan
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China,Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Yu Wang
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China,Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Yuqing Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rong Jiang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China,The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, China
| | - Mingsheng Chen
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China,Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Haihong Chen
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China,Center for Global Health, Nanjing Medical University, Nanjing, China,*Correspondence: Haihong Chen
| | - Fan Yang
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China,Center for Global Health, Nanjing Medical University, Nanjing, China,Fan Yang
| |
Collapse
|
6
|
Zhang H, Chen S, Dong D. Association of migration status with quality of life among rural and urban adults with rare diseases: A cross-sectional study from China. Front Public Health 2022; 10:1030828. [PMID: 36438276 PMCID: PMC9686420 DOI: 10.3389/fpubh.2022.1030828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/26/2022] [Indexed: 12/15/2022] Open
Abstract
Background A considerable proportion of rare disease patients decide to migrate to access a definitive diagnosis or appropriate care, which could affect their quality of life in a long term. Objective To compare quality of life (QoL) between migrants and residents and explore the possible mechanism of how migration influence the QoL among rural and urban adults with rare diseases, respectively. Methods A cross-sectional study at national level was conducted in a study sample of 1,150 adult patients in China. Migration was defined as being away from one's original place of residence for at least 12 months. Patients who remained in their place of residence in the past 12 months ("resident") were treated as a comparison group for "migrants". Original area of residence (rural vs. urban) for both residents and migrants was used for comparison. The brief version of the World Health Organization Quality of Life instrument was used to measure QoL. Multiple linear regression analyses were adopted to assess the direct association between migration status and QoL after controlling for the confounders that affect QoL. The indirect associations between migration status and QoL, mediated by potential mediators including number of family members living together, individual income, catastrophic health expenditure, and social support, were estimated using the mediation model. Results Among the group of rural participants, migration was directly associated with physical QoL (β = 5.07, 95% CI 2.01-8.13) and environmental QoL (3.95, 1.37-6.53), indirectly associated with physical QoL (0.58, 0.05-1.28) and social QoL (0.50, 0.01-1.16) via individual income, and also indirectly associated with environmental QoL (-0.47, -1.12 to -0.50) via tangible support. On the other hand, neither direct nor indirect associations of migration with four domain scores of QoL were significant among the group of urban participants. Conclusion Among rural adults with rare diseases, migration was found to have positive direct effect on physical and environmental QoL, positive indirect effect on physical and social QoL through increased individual income, and negative indirect effect on environmental QoL via reduced tangible support. By contrast, neither direct nor indirect associations of migration with QoL were significant among the group of urban participants.
Collapse
Affiliation(s)
- Huanyu Zhang
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Shanquan Chen
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Dong Dong
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China,*Correspondence: Dong Dong
| |
Collapse
|
7
|
Analysis of the Characteristics of Cross-Regional Patient Groups and Differences in Hospital Service Utilization in Beijing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063227. [PMID: 35328918 PMCID: PMC8950230 DOI: 10.3390/ijerph19063227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/28/2022]
Abstract
When medical diagnostic difficulties occur at local hospitals, seeking high-quality services across regions becomes a priority for many patients. Traditional statistical methods in health care are unable to account for spatial characteristics such as outflow place or distributions of disease type and patient ages in the context of an increasing number of cross-regional groups; thus, these methods are incapable of studying service utilization differences among hospitals. From a geographic perspective, we analyzed the spatial characteristics of cross-regional patient groups who travelled from other places to Beijing and the spatial decay patterns in the actual service utilization of different hospitals in Beijing by using geographic calculations, geographic visualizations, and distance decay functions. We found the following results: (1) It is feasible to study patients’ cross-regional mobility from a geographical perspective. Through interdisciplinary integration, we can explore laws and conclusions that cannot be examined by traditional statistical methods in health care. (2) The characteristics of cross-regional patients who travelled from other places to Beijing were as follows: (a) Most patients came from northern China, and neoplasm treatment was the main demand of cross-regional patients; (b) patients 40–65 years old were the main cross-regional treatment group, and the average age of patients from northern regions and certain eastern coastal cities was relatively high. (3) The exponential distance decay function was the best of all five distance decay functions in fitting the distribution of cross-regional patient mobility to hospitals of different levels, types, and functional areas. The results of applying this function and the centrality calculation method showed that hospital service utilization was least affected by distance and that average radial distances (AR) were greatest in tertiary hospitals (distance decay coefficient β = 0.0786, AR = 664.70 km), traditional Chinese medicine hospitals (β = 0.0752, AR = 743.52 km), and hospitals in urban extension areas (β = 0.0782, AR = 693.29 km). Our results can serve as a reference for research concerning the allocation of medical resources and patients’ choices regarding medical treatment.
Collapse
|
8
|
Zhang H, Xiao Y, Zhao X, Tian Z, Zhang SY, Dong D. Physicians’ knowledge on specific rare diseases and its associated factors: a national cross-sectional study from China. Orphanet J Rare Dis 2022; 17:120. [PMID: 35248110 PMCID: PMC8898513 DOI: 10.1186/s13023-022-02243-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/10/2022] [Indexed: 11/12/2022] Open
Abstract
Background Rare disease patients often experience diagnosis delays or misdiagnosis, which may be due to lack of knowledge on rare diseases among physicians. Objective To assess Chinese physicians’ knowledge on specific rare diseases and identify its associated factors. Methods Thirty-four patient organizations with a unique disease of interest were invited to develop 3 knowledge questions for each rare disease to assess physicians’ knowledge on the disease that they felt most experienced in. The total knowledge score for each participant ranged from a score of 0 to 3. A national cross-sectional study conducted in a cohort of 3197 physicians from 6 provinces across western, central and eastern China. The demographic information of the participants was collected including gender, age, birthplace, income, education, hospital class, working title, working years, and specialty. A multiple linear regression analysis was performed to assess the independent associations between the physician variables and the total knowledge score. Results Two thousand, one hundred and fifteen (66.16%) of the involved physicians obtained a total knowledge score of 2 or 3. The median knowledge scores of 10 (29.4%) rare diseases were a score of 1.5 or below. Physicians with female gender (β = 0.08, p < 0.05 for females vs. males), and a monthly income of 5000–10,000 RMB (β = 0.11, p < 0.01 for 5000–10,000 vs. < 5000) and 10,000–30,000 RMB (β = 0.14, p < 0.05) were associated with a higher score. Specialties of physicians who received a relatively higher score included internal medicine, obstetrics and gynecology, radiology, intensive care unit, and surgery. Conclusions Almost two thirds of the participants had an average or good level of knowledge on the specific rare disease that they felt most experienced in. Physicians with female gender, a monthly income of 5000–10,000 RMB and 10,000–30000 RMB, and specialties of internal medicine, obstetrics and gynecology, radiology, intensive care unit, and surgery, were associated with a relatively higher knowledge score. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02243-7.
Collapse
|
9
|
Li L, Zhou Q, Yin T, Ji Z, Zhang L. Does the Direct Settlement Policy of Trans-Provincial Outpatient Expenses Aggravate the Siphoning Effect? An Empirical Study on Yangtze River Delta, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910001. [PMID: 34639302 PMCID: PMC8507957 DOI: 10.3390/ijerph181910001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022]
Abstract
To solve the problem of reimbursing trans-regional medical expenses, using only cross-regional manual reimbursement but not direct medical insurance card settlement, China implemented a pilot policy of direct settlement of trans-provincial outpatient expenses (DSTOE) in the Yangtze River Delta region. Due to the differences in inter-regional medical development, patients often migrate from areas with low-level medical resources to the high-level areas, a phenomenon that we define as the “siphoning” of trans-regional patients, which can cause a variety of problems. To study whether DSTOE aggravates the siphoning effect, we analyzed the changes in the volume of trans-provincial outpatient visits and conducted a questionnaire survey and factor analysis on the willingness of trans-provincial medical treatment under DSTOE. Results showed that manual reimbursement was gradually replaced by direct settlement, while the total volume was not increased significantly, and the ratio of outpatient visits flowing into and out from Shanghai decreased. The majority of questionnaire respondents confessed that their willingness toward trans-regional medical treatment increased, while their first choice of medical location was still mainly local, with only a few indicating that they would directly choose a cross-regional, higher-level medical institution. Spatial accessibility significantly restricted the seeking of trans-regional medical treatment, whereas age, education level, and policy awareness served as significant protective factors for the choice of medical location. In conclusion, due to space accessibility constraints, insufficient policy coverage, and the rationale for choice of location, DSTOE did not aggravate the siphoning effect of trans-regional patients.
Collapse
Affiliation(s)
- Li Li
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200032, China; (L.L.); (T.Y.); (Z.J.)
| | - Qingyu Zhou
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China;
| | - Ting Yin
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200032, China; (L.L.); (T.Y.); (Z.J.)
| | - Zisheng Ji
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200032, China; (L.L.); (T.Y.); (Z.J.)
| | - Lufa Zhang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200032, China; (L.L.); (T.Y.); (Z.J.)
- Correspondence:
| |
Collapse
|
10
|
Chen S, Wang J, Zhu J, Chung RYN, Dong D. Quality of life and its contributors among adults with late-onset Pompe disease in China. Orphanet J Rare Dis 2021; 16:199. [PMID: 33933104 PMCID: PMC8088713 DOI: 10.1186/s13023-021-01836-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/20/2021] [Indexed: 01/04/2023] Open
Abstract
Background Pompe disease (PD) is a rare inherited disorder caused by the deficiency of acid-α glucosidase, which leads to the impairment of organ and tissue functions and causes disabilities. As the first national survey on patients with late-onset PD (LOPD) in China, this study investigated the quality of life (QOL) of adult patients with LOPD in China and explored its contributors. Methods Data were derived from a nation-based, cross-sectional, self-response survey on rare diseases (RDs) in early 2018. Answers from 68 adult Chinese patients with LOPD were used for data analysis. QOL was measured using the World Health Organization Quality of Life: Brief Version. Covariates included age, gender, education, employment, reliance on assistive devices, medication history, social support, and disease economic burden. Data were analyzed using linear regression in R. Results For adult patients with LOPD, the average scores and standard deviations (SD) of the four dimensions of QOL were physical health = 33.77 (SD = 18.28), psychological health = 43.81 (SD = 21.70), environmental health = 39.43 (SD = 16.93), and social relationship = 46.20 (SD = 19.76); the scoring for each dimension was evaluated on a scale of 0 to 100. At the significance level of p < 0.05, with increasing age, the patients experienced a significant decrease in physical health QOL (β = − 0.75) and environmental health QOL (β = − 0.79). Those who relied heavily on assistive devices had lower perceived physical health (β = − 17.8), psychological health (β = − 22.76), environmental health (β = − 17.8), and social relationships (β = − 22.12) than those who did not. A one-unit increase in the amount of social support, as a form of social interaction, led to a significant increase in physical health (β = 0.28), psychological health (β = 0.71), environmental health (β = 0.72), and social relationships (β = 0.70). Conclusion Adult Chinese patients with LOPD had a lower physical health and QOL compared to their counterparts with other RDs. Being employed was found to affect the QOL of adult Chinese patients with LOPD in almost all dimensions. Encouraging adult Chinese patients with LOPD to be socially active and help them become more involved in social life might improve their QOL.
Collapse
Affiliation(s)
- Shanquan Chen
- The School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Jingxuan Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, 4/F School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianfeng Zhu
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Roger Yat-Nork Chung
- JC School of Public Health and Primary Care, Faculty of Medicine, 4/F School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.,CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, Faculty of Medicine, 4/F School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
| |
Collapse
|