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Barman P, Rahut DB, Mishra R. Mediating role of social disengagement and loneliness in the nexus between functional health and mental well-being in older individuals. Sci Rep 2024; 14:16232. [PMID: 39004615 PMCID: PMC11247097 DOI: 10.1038/s41598-024-66919-9] [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: 02/05/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024] Open
Abstract
Few studies have focused sufficiently on the intricate link between functional health and depression among older people aged 60 and above in India. Therefore, the current study investigates the association between functional health and depression among older Indian adults through the mediating role of social disengagement and loneliness and the moderating role of living arrangements using recent data from the Longitudinal Aging Study in India (LASI: 2017-2018). Composite International Diagnostic Interview-Short Form (CIDI-SF) for depression, the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) for functional health, and the indoor/outdoor activities, visits, and religious events for social disengagement were used. The feelings of loneliness and living arrangements were measured using single-item questions and surveys/interviews of household members. Bivariate analysis, logistic regression, and a Partial Least Squares-Structural Equation Model were adopted. The results show that older persons with functional health had 1.85 times higher odds of depression; similarly, those not engaging in social activities and experiencing loneliness were more likely to feel depressed. Living with someone was negatively linked to depression. A significant moderation by living arrangements in the functional health-depression relationship was also observed. The results also indicate significant mediating roles of social disengagement and loneliness, with 22.0% and 3.08% mediation effects, respectively. Therefore, this study recommends the provision of housing and social interaction among older people.
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Affiliation(s)
- Papai Barman
- International Institute for Population Sciences, Mumbai, 400088, India.
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Mahaur G, Dwivedi A, Joshi D, Dwivedi N. A Study on Quality of Life among the Elderly at Urban Health Center in North Delhi. J Midlife Health 2023; 14:246-251. [PMID: 38504734 PMCID: PMC10946680 DOI: 10.4103/jmh.jmh_82_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 03/02/2023] [Accepted: 03/12/2023] [Indexed: 03/21/2024] Open
Abstract
Background Elderly population in India is growing around 3% annually and is supposed to triple by 2050 than that at the time of 2011 census, according to a country report published by the UN Population Fund (UNFPA, 2017). A better quality of life (QOL) of the elderly has become a major public health challenges of the 21st century, so timely emphasis on maintenance of physical health and psychological issues is crucial. Therefore, the aim of the present study is to measure QOL among the elderly population and to find out the association with sociodemographic factors. Materials and Methods This is a cross-sectional study done among the elderly population of an urban health training center. The study includes the World Health Organization Quality of Life Questionnaire-Brief version and a questionnaire for sociodemographic variables. Univariate and multivariate analyses were used to determine associations and P value. Results The overall QOL scores ranged between 52 and 110, with a mean score of 78.59 ± 12.6. Good QOL was observed among 64.9%of the elderly, excellent was observed among 19.8%; and the rest 15.3% had fair/average, while none of the elderly had poor QOL. Determinants significantly associated with QOL with P < 0.05 are age, educational status, professional status, marital status, and behavior of children with them and the elderly with comorbidities. Conclusion This study shows the association of multiple factors with QOL among the elderly. Factors such as age, educational status, professional status, marital status, and behavior of children with them and the elderly with comorbidities significantly affect the QOL of the elderly. Hence, strengthening the health-care system, increase in level of education, encouraging social interaction, social security systems, and better environmental infrastructure could potentially increase QOL of the elderly population.
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Affiliation(s)
- Gunjan Mahaur
- Department of Community Medicine, North DMC Medical College, Delhi, India
| | - Archana Dwivedi
- Department of Neurology, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Deepika Joshi
- Department of Neurology, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Nidhi Dwivedi
- Department of Community Medicine, North DMC Medical College, Delhi, India
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Senjam SS, Manna S, Kishore J, Kumar A, Kumar R, Vashist P, Titiyal JS, Jena PK, Christian DS, Singh US, Kamath R. Assistive technology usage, unmet needs and barriers to access: a sub-population-based study in India. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 15:100213. [PMID: 37614348 PMCID: PMC10442958 DOI: 10.1016/j.lansea.2023.100213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 08/25/2023]
Abstract
Background Assistive technology (AT) is essential to minimize functional limitations. The current study aimed to estimate the prevalence of needs, met and unmet needs for AT, and barriers to accessing AT among a subnational population in India. Methods This cross-sectional study was conducted in eight districts, representing four zones of India, using the WHO Rapid Assistive Technology Assessment (rATA) tool. The tool was administered by trained staff using read aloud technique. Multi-stage cluster random sampling was used, as well as the probability proportional to size, to select smaller administrative units from the larger ones. Findings In total, 8486 participants were surveyed out of 8964 individuals enumerated with a response rate of 94.6%. The sample prevalence of at least one difficulty was 31.8% (2700), with 6.3% (532) having severe or total difficulties. The sample prevalence for AT need was 27.8% (2357) with an estimated population prevalence of 24.5% (95% CI: 23.5-25.4). Similarly, the sample prevalence of unmet needs was 9.7% (823) with an estimated population unmet needs of 8.0% (95% CI: 7.43-8.60). The unmet needs among persons with severe or total difficulties was 52.3% (278/532), and was higher among females, rural residents, and older persons. Spectacles were the most used products, followed by canes/sticks, tripods, and quadripods. Nearly two-thirds of AT users purchased assistive products at their own expense, particularly from the private sector. The inability to afford AT (36.9%) was the most common barrier. Interpretation The results show that the need for AT was substantial in the study population, the highest being for seeing difficulties. The unmet needs are higher in females, older population, rural residents, and persons having serious difficulties. While the majority of users have to make out-of-pocket payments to obtain AT, inability to afford and limited availability were the common barriers among those with unmet needs. Funding This research is non-commercial, and was conducted in the interest of public health. The authors have not declared any specific grant for this research.
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Affiliation(s)
- Suraj Singh Senjam
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Souvik Manna
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jugal Kishore
- Department of Community Medicine, VMMC & Safdarjung Hospital, New Delhi, India
| | - Anil Kumar
- Ministry of Health and Family Welfare, Directorate General Health Services, Government of India, New Delhi, India
| | - Rajesh Kumar
- Ministry of Health and Family Welfare, Directorate General Health Services, Government of India, New Delhi, India
| | - Praveen Vashist
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jeewan Singh Titiyal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Pratap Kumar Jena
- School of Public Health, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, Odisha, India
| | - Donald S. Christian
- Department of Community Medicine, GCS Medical College, Ahmedabad, Gujarat, India
| | - Uday Shankar Singh
- Department of Community Medicine, Medical College & Shree Krishna Hospital, Bhaikaka University, Anand, Gujarat, India
| | - Ramachandra Kamath
- Department of Community Medicine, Kodagu Institute of Medical Sciences, Government of Karnataka, Madikeri, Karnataka, India
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Ruben JP, Ekstrand ML, Heylen E, Srinivasan K. Correlates for the severity of suicidal risk in participants with common mental disorders with comorbid chronic medical conditions in rural primary healthcare settings in India. Indian J Psychiatry 2023; 65:687-693. [PMID: 37485404 PMCID: PMC10358822 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_41_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/29/2023] [Accepted: 05/16/2023] [Indexed: 07/25/2023] Open
Abstract
Context Suicide is on the rise in low- and middle-income countries (LMICs), including India. There are limited studies assessing factors linked to the severity of suicidal risk in patients with depression and comorbid chronic medical disorders in primary healthcare (PHC) settings. Aim This study examines factors linked to suicidal risk among participants in a cluster randomized controlled trial of collaborative care intervention (Healthier Options through Empowerment (HOPE Study)). Settings and Design The setting was at 49 PHC in the rural Ramanagara District of Karnataka State in southern India. Study eligibility criteria included being ≥30 years with at least mild depression or generalized anxiety disorder and at least one medical condition (cardiovascular disorder or type 2 diabetes mellitus). Methods and Material The severity of suicidal risk at baseline was assessed using the Mini International Neuropsychiatric Interview (MINI), and other measures included the severity of depression (Patient Health Questionnaire-9-items (PHQ-9)), the severity of anxiety (Generalized Anxiety Disorder Scale-7-items (GAD-7)), disability, social support, quality of life, number of comorbid chronic medical illnesses, and body mass index (BMI). Statistical Analysis Used Chi-square tests and independent-samples t-tests were used to compare the demographic and clinical characteristics of the no-low and mod-high suicidal risk groups. Logistic regression analysis was used to identify correlates associated with the mod-high suicidal risk group. Results Mod-high suicidal risk was significantly positively associated with the severity of depression and disability and significantly negatively associated with social support. Conclusion The severity of depression, higher disability scores, and lower social support were found to be independent correlates of mod-high suicidal risk. Screening, managing depression, and facilitating social support for patients with chronic medical illness in PHC settings may reduce suicidal risk.
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Affiliation(s)
- Johnson-Pradeep Ruben
- Department of Psychiatry, St. John’s Medical College, Bengaluru, Karnataka, India
- Division of Mental Health and Neurosciences, St. John’s Research Institute, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Maria L. Ekstrand
- Division of Mental Health and Neurosciences, St. John’s Research Institute, St. John’s Medical College, Bengaluru, Karnataka, India
- Division of Prevention Sciences, University of California, San Francisco, USA
| | - Elsa Heylen
- Division of Prevention Sciences, University of California, San Francisco, USA
| | - Krishnamachari Srinivasan
- Department of Psychiatry, St. John’s Medical College, Bengaluru, Karnataka, India
- Division of Mental Health and Neurosciences, St. John’s Research Institute, St. John’s Medical College, Bengaluru, Karnataka, India
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Senjam SS, Mannan H. Assistive technology: The current perspective in India. Indian J Ophthalmol 2023; 71:1804-1809. [PMID: 37203033 PMCID: PMC10391423 DOI: 10.4103/ijo.ijo_2652_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
The world, today, recognizes the increasing importance of assistive technology (AT) that can reduce the functional limitations of persons with disabilities, individuals with chronic debilitating diseases, and elders. This indicates that at some point, everyone, either temporary or permanent, will require AT to improve their physical and functional abilities, thus contributing to independent living, social inclusion, and education. Besides this, the need for AT will be growing with a majority from low-middle-income countries. The same is true for India though we are not sure how many people have met a need, and unmet need for AT to date, but the requirement will continue to increase. There is a significant gap between needs and access to AT. Recently, the WHO has led many initiatives related to AT services after the 71st World Health Assembly's resolution in 2018, to improve access to AT for its member states. The UN Sustainable Development Goals (SDGs) have pledged that no one should be left behind irrespective of personal characteristics. India, a ratified member state, needs to align with various initiatives undertaken by the WHO and the UN. Despite many challenges, India needs to formulate evidence-based AT policy, planning within the purview of the healthcare delivery system in collaboration with various government and nongovernment sectors, including industries. This article explores the need, access, and potential challenges associated with AT services in India. Finally, we discussed various initiatives on AT in the country and possible recommendations to improve AT services across.
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Affiliation(s)
- Suraj S Senjam
- Assistive Technology, Vision Rehabilitation, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Hasheem Mannan
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Ganesh GS, Gedamkar G, Rami MA, Patel MD, Patel DP. Disability prevalence: comparing four types of disability measures in the community. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2023. [DOI: 10.1186/s43161-022-00114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
There is no general consensus on how to measure disability and disability prevalence rates. The results of previous estimates could not be compared due to the varied nature of the methodologies used and the lack of standardization in the measurement of disability. The primary objective of the study was to estimate the prevalence of disability using a population-based disability survey and questions selected by the National Center for Promotion of Employment for Disabled People (NCPEDP). The secondary objective is to determine whether there was any relationship between the severity of disability and essential sociodemographic factors.
The survey was carried out in the Indian state of Gujarat’s Piplag village. Eight final-year physiotherapy students gathered sociodemographic data and answers to the four disability-related questions—disability question asked in India census 2011, Washington Group (WG)-suggested question, United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)-based question, and National Sample Survey Organization (NSSO)-based question.
Results
A greater percentage of the population was classified as having a functional limitation in the questions based on the UNCRPD (28.29%) (95% CI 25.1–31.3%) and the WG (29.69%) (95% CI 26.0–34.4%). Our findings demonstrated that there were significant relationships between the questions in different questionnaires (p < 0.01). Female gender strongly influences how people self-identify as having a disability (by 5.7 to 12.07 times), and the predictor variables based on the Indian census 2011 questions explained 61.7% of the variation in prevalence of disability.
Conclusions
The prevalence statistics may vary based on the questions used to gather information about disabilities. As gender and socioeconomic status can impact the prevalence of disabilities, it is important to focus on ways to improve economic growth, especially for women.
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Soltani S, Moghadam MM, Amani S, Akbari S, Shiani A, Soofi M. Socioeconomic disparities in using rehabilitation services among Iranian adults with disabilities: a decomposition analysis. BMC Health Serv Res 2022; 22:1449. [PMID: 36447232 PMCID: PMC9708139 DOI: 10.1186/s12913-022-08811-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/08/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Persons with disabilities (PWD) generally experience various barriers in using health care compared to the general population, and these problems are more worsened for those with disabilities in lower socioeconomic status. The study aimed to estimate socioeconomic inequality in using rehabilitation services (URS) in adults with disabilities in Iran. METHODS This cross-sectional study was conducted at a national level in Iran. 786 PWD (aged 18 years and older) participated in the study between September and December 2020. Socioeconomic-related inequality in URS was estimated by the Concentration Index (C). The C was decomposed to identify factors explaining the variability within the socioeconomic inequality in URS. RESULTS In the present study 8.10% (N = 61) of the study population used rehabilitation services during the past three months. In this study, the value of the C was estimated 0.25 (p-value = 0.025) that shows URS was unequally distributed, and concentrated among the higher SES groups. The results of decomposition analysis indicated that the wealth index was the largest contributor (94.22%) to the observed socioeconomic inequalities in URS among PWD. Following the wealth index, Age and marital status were the major contributors to the unequal distribution of URS among the study population. CONCLUSIONS Our findings revealed that socioeconomic inequality in using rehabilitation services was concentrated among well-off PWD. Accordingly, rehabilitation financing through appropriate mechanisms for individuals with low SES is suggested.
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Affiliation(s)
- Shahin Soltani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Shiva Amani
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Akbari
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Shiani
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Dorjee K, Kathirvel S, Jeyashree K, Dorji T, Choeda T, Pelzom D, Gurung MS, Tenzin K, Wangmo S, Penjor T. Prevalence, Pattern, and Factors Associated With Self-reported Disability Among the Bhutanese Population: A Secondary Data Analysis of Population and Housing Census. Asia Pac J Public Health 2021; 34:221-229. [PMID: 34696620 DOI: 10.1177/10105395211049856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We analyzed the Population and Health Census of Bhutan (PHCB) 2017 to assess the prevalence and pattern of self-reported disability among people aged ≥15 years and the associated factors. The PHCB 2017 used the Washington Group Short Set on Functioning questionnaire to assess the disability ("lot of difficulty" or "cannot do at all") in seeing, hearing, mobility, cognition, self-care, and communication. Of the 536 443 persons included in the analysis, 384 101(71.6%) were aged <45 years, 283 453(52.8%) were men, and 206 103(38.4%) were from the rural area. The prevalence of any self-reported disability was 2.8%, among whom 34.2% reported multiple disabilities. The disability prevalence (any) was significantly higher among people aged ≥65 years, illiterate, economically inactive, permanent residents, residing in a rural area, and from central and eastern regions of the country compared with their respective counterparts. Further research on access to rehabilitation and linking with social protection schemes for the disabled is required in this country.
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Affiliation(s)
- Kinley Dorjee
- Sustainable Development, Health Management Information System and Research Unit, Ministry of Health, Thimphu, Bhutan
| | - Soundappan Kathirvel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, Chandigarh, India
| | | | - Thinley Dorji
- Kidu Medical Unit, His Majesty's People's Project, Thimphu, Bhutan
| | - Tshering Choeda
- Gyesar Gyalpo University of Medical Sciences, Royal Government of Bhutan, Thimphu, Bhutan
| | - Dorji Pelzom
- Health Management Information System and Research Unit, Ministry of Health, Thimphu, Bhutan
| | - Mongal Singh Gurung
- Health Management Information System and Research Unit, Ministry of Health, Thimphu, Bhutan
| | - Karma Tenzin
- Gyesar Gyalpo University of Medical Sciences, Royal Government of Bhutan, Thimphu, Bhutan
| | | | - Tashi Penjor
- Policy and Planning Division, Ministry of Health, Bhutan
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Péntek M, Poór G, Gulácsi L, Zrubka Z, Brodszky V, Rencz F, Dobos Á, Farkas M, Kovács L, Baji P. Musculoskeletal health and capability wellbeing: Associations between the HAQ-DI, ICECAP-A and ICECAP-O measures in a population survey. Musculoskelet Sci Pract 2021; 55:102420. [PMID: 34271413 DOI: 10.1016/j.msksp.2021.102420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/26/2021] [Accepted: 06/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The capability approach has received increasing attention in wellbeing measurement in the past years, but it has still remained an underexplored area in musculoskeletal (MSK) health. OBJECTIVE We aimed to explore the capability wellbeing in relation to MSK health, by measuring the associations between the Health Assessment Questionnaire Disability Index (HAQ-DI) physical functioning and the ICECAP-A and ICECAP-O capability wellbeing measures. DESIGN A cross-sectional survey was performed in 2019 on a representative sample of the Hungarian general adult population. METHOD Capability wellbeing was measured by the ICECAP-A (age-group 18-64) and ICECAP-O (age group 65+) questionnaires. MSK health was defined by the HAQ-DI, the mobility domain of the EQ-5D-3L/-5L health status measures, self-reported walking problems and MSK diagnosis (neck/back/low back defects, hip/knee arthrosis, osteoporosis). RESULTS Altogether 2021 individuals (female: 50.1%) participated in the survey with mean (SD) age of 48.7 (17.9) years and HAQ-DI of 0.138 (0.390). ICECAP-A (N = 1568, 77.6%) and ICECAP-O (N = 453, 22.4%) scores were on average (SD) 0.894 (0.126) and 0.828 (0.150), respectively. Spearman correlations between the HAQ-DI and ICECAP-A/-O index scores were moderate (r = -0.303 and -0.496; p < 0.05). Both the ICECAP-A/-O index scores differed significantly (ANOVA test, p < 0.05) across all MSK subgroups. In the ordinary least square regressions, marginal effects of ICECAP-A/-O scores on HAQ-DI were significant (-0.149 and -0.123) when controlling for socio-demographic characteristics. CONCLUSIONS MSK health problems are associated with lower capability wellbeing. ICECAP-A/-O might capture effects of MSK conditions not measured by the HAQ-DI or the EQ-5D-5L. Further studies should test these associations in disease-specific samples.
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Affiliation(s)
- Márta Péntek
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary; Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary.
| | - Gyula Poór
- I. Department of Rheumatology, National Institute of Rheumatology and Physiotherapy; Frankel Leó út 62., H-1023, Budapest, Hungary
| | - László Gulácsi
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary; Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary; Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary; Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Nádor U. 7, H-1051, Budapest, Hungary
| | - Ágota Dobos
- Corvinus Center for Teaching Foreign Language Education and Research, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Miklós Farkas
- Department of Accounting and Finance, University of Bristol, Priory Road Complex, Bristol BS8 1TU, UK
| | - Levente Kovács
- Physiological Controls Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
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Marmamula S, Modepalli SB, Kumbham TR, Challa R, Keeffe JE. Prevalence of disabilities and non-communicable diseases in an elderly population in the Telangana state, India: a population-based cross-sectional study. BMJ Open 2021; 11:e041755. [PMID: 33608399 PMCID: PMC7898867 DOI: 10.1136/bmjopen-2020-041755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India. DESIGN Population-based cross-sectional study using a cluster random sampling method to select the study clusters. SETTING Elderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities. PARTICIPANTS 1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education. PRIMARY OUTCOME MEASURE Prevalence of disabilities and NCDs. RESULTS Overall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2). CONCLUSION Every fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry & Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- Wellcome Trust /DBT India Alliance fellow, L V Prasad Eye Institute, Hyderabad, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Rajesh Challa
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Jill E Keeffe
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
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Medhi GK, Visi V, Bora PJ, Sarma J, Borah P, Mahanta J, Bhattacharyya H, Pala S. A Community-Based Study on Functional Disability and Its Associated Factors Among Elderly Individuals in a Rural Setting in Northeastern India. Cureus 2021; 13:e13309. [PMID: 33732564 PMCID: PMC7955953 DOI: 10.7759/cureus.13309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Functional disability in older adults is common and adversely impacts the quality of life. Given the paucity of population-based data, the present analysis attempted to determine the prevalence and factors associated with functional disability in basic activities of daily living (ADLs) among the elderly population in a rural setting of Northeastern state of India Methods A total of 430 elderly were recruited in a population-based cross-sectional study among elderly individuals (≥60 years) during the period 2013-2016 in rural areas of the Dibrugarh district of Northeastern India. The Barthel index was used to measure ADL. Anyone with a Barthel index score <100 (or having limitations in one or more ADL items) were considered as having a functional disability. The analysis of variance (ANOVA) test and the binary logistic regression analysis were used to examine the factors associated with functional disability. Results Overall, 43.7% % (Male 42.9%, Female 44.5%) of the participants had a functional disability. Increasing age, being widowed, having no formal education, being underweight (body mass index (BMI)<18.5 kg/m2), and increasing numbers of morbidities were significantly associated with functional disability among the elderly in this study in age and gender-adjusted logistic regression analysis. Being ≥80 years was associated with a three-fold greater risk (OR=31.72, 95% CI=1.3-6.91) of functional disability than the youngest age group (60-69 years). On the other hand, the presence of more than five morbidities was associated with a nearly 20 times increased risk (OR=19.61, 95% CI=9.01-42.68) than those with zero to two morbidities. Conclusion A high proportion of the rural elderly residents of Dibrugarh had a functional disability. The study provides epidemiological evidence of the risk factors of functional disability in this setting. This epidemiological information may be useful for developing prevention strategies to reduce the burden of functional disability.
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Affiliation(s)
- Gajendra K Medhi
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Vizovonuo Visi
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Parash J Bora
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Jogesh Sarma
- Pulmonary Medicine, Gauhati Medical College, Guwahati, IND
| | - Prasanta Borah
- Epidemiology and Nutrition, Indian Council of Medical Research (ICMR) - Regional Medical Research Centre, North-Eastern (NE) Region, Dibrugarh, IND
| | - Jagdish Mahanta
- Internal Medicine: Infectious Disease, Indian Council of Medical Research (ICMR) - Regional Medical Research Centre, North-Eastern (NE) Region, Dibrugarh, IND
| | - Himashree Bhattacharyya
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Star Pala
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
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Dambal A, Gururaj H, Aithal KR, Kalasuramath Dharwad M, Sherkhane R, Siddanagoudra S, Kanabur DR, Ahmed Mulla S. Delivering disability competencies of MCI's revised competency based curriculum at a medical university in North Karnataka. Med J Armed Forces India 2021; 77:S65-S72. [PMID: 33612934 PMCID: PMC7873704 DOI: 10.1016/j.mjafi.2020.12.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/31/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND India has ratified with the United Nations Convention on the Rights of Persons with Disabilities and has passed the Rights of People with Disabilities Act in 2016. There is need for training healthcare professionals in disability competencies as people with disabilities are many and marginalized. Disability competencies were introduced in the foundation course of revised competency based medical curriculum for Indian medical graduates by the Medical Council of India (MCI) just prior to the rollout of the programme. We intend describing our center's experience in implementing the same. METHODS FC 4.5.1 TO 4.5.8 of MCI foundation course guidelines were resource material. Eight faculty members participated. Setting was the lecture theatre. The suggested and actual teaching learning methods are compared for each competency. Notes made from delivering disability competencies, photographs, videos and reflections from students were source of data. RESULTS We used sensitizing lectures of 15 min each for FC 4.5.1, 4.5.2 and 4.5.4 [cognitive] with interesting set induction, student narratives of family members with disability, buzz groups for interaction and self-directed learning activity using mobile phones. We facilitated FC 4.5.3 and 4.5.5 [skill/affective domain] demonstrating unacceptable and acceptable disability etiquettes using standardized patients and role play. We conducted a forum theatre of the oppressed for FC 4.5.6. We introduced our learners to universal design in our campus for teaching 4.5.7. As a part of the principle of inclusivity we involved two staff members with motor disabilities for delivering FC 4.5.8 in an interview. We assessed the learners using written reflections and obtained feedback on a rating scale.
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Affiliation(s)
- Archana Dambal
- Professor (General Medicine) & Curriculum Committee Member, SDMCMS&H, Sattur, Dharwad, India
| | | | - Kiran R. Aithal
- Professor & Head (General Medicine), SDMCMS&H, Sattur, Dharwad, India
| | | | - Radhika Sherkhane
- Professor & Head (Pharmacology) & Coordinator, Medical Education Unit, SDMCMS&H, Sattur, Dharwad, India
| | - Savitri Siddanagoudra
- Professor (Physiology) & Curriculum Committee Member, SDMCMS&H, Sattur, Dharwad, India
| | - Deepak R. Kanabur
- Professor (Physiology) & Curriculum Committee Member, SDMCMS&H, Sattur, Dharwad, India
| | - Sameer Ahmed Mulla
- Associate Professor (General Surgery) & Curriculum Committee Member, SDMCMS&H, Sattur, Dharwad, India
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Poplas Susič A, Klemenc-Ketiš Z, Blagus R, Ružić Gorenjec N. Factors that determine dependence in daily activities: A cross-sectional study of family practice non-attenders from Slovenia. PLoS One 2021; 16:e0245465. [PMID: 33481824 PMCID: PMC7822267 DOI: 10.1371/journal.pone.0245465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 12/30/2020] [Indexed: 12/05/2022] Open
Abstract
Background Independence in daily activities is defined as the ability to perform functions related to daily living, i.e. the capacity of living independently in the community with little or no help from others. Objective We focused on non-attenders as a subgroup of patients whose health status is not well known to family practice teams. Our goal was to estimate the prevalence of dependence and its severity level in the daily activities of patients, and to determine the factors that are associated with the occurrence of dependence. Design Cross-sectional observational study. Settings and participants Data was obtained in family medicine settings. Participants in the study were adults living in the community (aged 18 or over) who had not visited their chosen family physician in the last 5 years (non-attenders) and who were able to participate in the study. Through the electronic system, we identified 2,025 non-attenders. Community nurses collected data in the participants’ homes. The outcome measure was dependence in daily activities, assessed through eight items: personal hygiene; eating and drinking; mobility; dressing and undressing; urination and defecation; continence; avoiding hazards in the environment; and communication. Results The final sample consisted of 1,999 patients (98.7% response rate). The mean age was 59.9 (range 20 to 99). Dependence in daily activities was determined in 466 or 23.3% (95% CI: [21.5, 25.2]) of the patients. Older patients (over 60 years), with at least one chronic disease, increased risk of falling, moderate feelings of loneliness and a lower self-assessment of health were statistically significantly more likely to be dependent in their daily activities, according to our multivariate model. Conclusions A considerable proportion of family practice non-attenders were found to be dependent in daily activities, though at a low level. We identified several factors associated with this dependence. This could help to identify people at risk of being dependent in daily activities in the general adult population, and enable specific interventions that would improve their health status.
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Affiliation(s)
- Antonija Poplas Susič
- Ljubljana Community Health Centre, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Zalika Klemenc-Ketiš
- Ljubljana Community Health Centre, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- * E-mail:
| | - Rok Blagus
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nina Ružić Gorenjec
- Ljubljana Community Health Centre, Ljubljana, Slovenia
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Goswami AK, S. R, Kalaivani M, Nongkynrih B, Kant S, Gupta SK. Disability and its association with sociodemographic factors among elderly persons residing in an urban resettlement colony, New Delhi, India. PLoS One 2019; 14:e0222992. [PMID: 31550291 PMCID: PMC6759158 DOI: 10.1371/journal.pone.0222992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 09/11/2019] [Indexed: 11/18/2022] Open
Abstract
Disability prevents an individual from performing to the fullest potential. It is multidimensional. Disability may be physical, mental, social, personal, and environmental or a combination of these. The elderly experience an increased burden of disability, especially in areas where there are limited resources and rapid urbanization. Comparison of reported disability is difficult because several definitions and scales are in use. We used the World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0) to study the prevalence of disability, and its association with sociodemographic factors among elderly persons residing in an urban resettlement colony, New Delhi, India. The WHODAS 2.0 provides continuous summary scores, where higher scores indicate higher disability, and vice versa. Elderly persons aged 60 years and above were selected by simple random sampling in this community-based cross-sectional study. Trained interviewers administered the semi-structured interview schedule and WHODAS 2.0. The prevalence of disability was 7.4% (5.8% - 9.3%) among the 931 participants. The prevalence was higher among females than males. Female sex, elderly aged 70 years and above, and those who were illiterate had increased risk of higher disability scores. Participants who were in government or private service had 50% decreased risk of having higher disability scores. The burden of disability was high among elderly persons residing in this resettlement colony. Community-based holistic interventions are required to mitigate the disability, and to improve the functioning of elderly persons.
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Affiliation(s)
- Anil Kumar Goswami
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ramadass S.
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Baridalyne Nongkynrih
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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