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Thai TT, Jones MK, Harris LM, Heard RC, Bui HHT. The effect of mental health screening and referral on symptoms of depression among HIV positive outpatients in Vietnam: Findings from a three-month follow up study. AIDS Care 2019; 31:1447-1453. [PMID: 30884957 DOI: 10.1080/09540121.2019.1595510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study investigated whether screening for symptoms of mental disorders and referral to mental health services was associated with decreased depression symptoms among people living with HIV/AIDS (PLHIV) in Vietnam. Four hundred PLHIV (63.5% male, mean age 34.8 (SD = 6.8) years) at two outpatient clinics in Ho Chi Minh City were interviewed by psychiatrists and also completed the Center for Epidemiologic Studies-Depression scale (CES-D). One hundred and seventy-four (43.5%) were identified with symptoms of a range of mental illnesses, including depression, anxiety, alcohol use disorder, substance use disorder and HIV associated dementia and were referred to mental health services. Of the 174 PLHIV referred, 162 (93%) returned and completed the CES-D three months later and 125 of these 162 (77%) had attended a mental health service and undertaken treatment. A significant improvement was found in the mean CES-D scores of the 125 attenders from baseline (M = 19.0, SD = 7.5) to month three (M = 11.7, SD = 7.9, p < 0.001). PLHIV who had attended a mental health service and undertaken treatment demonstrated a greater reduction of mean scores on the CES-D compared to PLHIV who had either received a referral but not attended a mental health service to undertake treatment, or not been referred initially.
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Affiliation(s)
- Truc Thanh Thai
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City , Vietnam.,Department of Training and Scientific Research, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City , Vietnam
| | - Mairwen K Jones
- Behavioural and Social Sciences in Health, Faculty of Health Sciences, University of Sydney , Sydney , Australia
| | - Lynne M Harris
- Discipline of Psychological Sciences, Australian College of Applied Psychology , Sydney , Australia
| | - Robert C Heard
- Behavioural and Social Sciences in Health, Faculty of Health Sciences, University of Sydney , Sydney , Australia
| | - Hy-Han Thi Bui
- The South Center for Education & Training of Health Managers, Ho Chi Minh City Institute of Public Health , Ho Chi Minh City , Vietnam
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Thai TT, Jones MK, Harris LM, Heard RC. Prevalence and Correlates of Probable HIV-Associated Dementia in HIV Outpatients in Ho Chi Minh City, Vietnam. J Int Assoc Provid AIDS Care 2017; 16:366-375. [PMID: 28367733 DOI: 10.1177/2325957417701195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study identified prevalence and correlates of HIV-associated dementia (HAD) among people living with HIV (PLWHA) in Ho Chi Minh City, Vietnam. Four hundred PLWHA completed a self-report questionnaire and were interviewed by a trained researcher to assess HAD using the International HIV Dementia Scale (IHDS). Clinical information concerning HIV treatment was also extracted from medical records. The results indicate the prevalence of probable HAD based on IHDS score <10.5 was 39.8% (95% confidence interval [CI]: 35.0%-44.5%). Probable HAD was significantly higher among female, older PLWHA and among those with low education level (≤ primary school), moderate level of adherence to HIV medication and HIV stage 3. Those PLWHA with depressive symptoms also had higher odds of having probable HAD (odds ratio = 3.23, 95% CI: 2.05-5.11). These findings underscore the importance of early HAD screening and appropriate referral for further assessment and management of PLWHA especially those with higher risk of HAD.
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Affiliation(s)
- Thanh Truc Thai
- 1 Faculty of Public Health, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Mairwen K Jones
- 2 Behavioral and Social Sciences in Health, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Lynne M Harris
- 3 School of Psychological Sciences, Australian College of Applied Psychology, Sydney, Australia
| | - Robert C Heard
- 2 Behavioral and Social Sciences in Health, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Thai TT, Jones MK, Harris LM, Heard RC. The association between symptoms of mental disorders and health risk behaviours in Vietnamese HIV positive outpatients: a cross-sectional study. BMC Public Health 2017; 17:250. [PMID: 28288615 PMCID: PMC5348739 DOI: 10.1186/s12889-017-4162-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 03/02/2017] [Indexed: 11/11/2022] Open
Abstract
Background A high prevalence of symptoms of mental disorders (SOMD) has been found among people living with HIV/AIDS (PLHIV). Additionally, SOMD may impact on the prevalence of high-risk health behaviours (HRB). This study investigates the relationship between SOMD and HRB in a large sample of Vietnamese HIV positive outpatients. Methods A cross-sectional study was conducted with 400 outpatients at two HIV/AIDS clinics in Ho Chi Minh City, Vietnam, selected using a systematic sampling technique. Validated scales were used to measure SOMD, specifically symptoms of depression, anxiety, alcohol use disorder (AUD), substance use disorder (SUD) and HIV associated dementia (HAD). Participants completed a self-report questionnaire assessing HRB during the preceding 12 months including unsafe sexual practices and illicit drug use. Multivariable logistic regression models were used to evaluate associations between SOMD and HRB. Results The majority of participants (63.5%) were male and the median age was 34.0 years. Unsafe sexual practices and illicit drug use were reported by 13.8 and 5.5% of participants. The prevalences of HAD, depression, AUD, anxiety and SUD symptoms were 39.8, 36.5, 13.3 10.5, 3.3% respectively. There was no association between SOMD and HRB either with or without adjusting for correlates of HRB, except between symptoms of SUD and illicit drug use. PLHIV who had symptoms of SUD were more likely to use illicit drugs (adjusted Odds Ratio 81.14, 95% CI 12.55–524.47). Conclusions While the prevalence of SOMD among HIV positive outpatients was high, most SOMD were not associated with increased HRB. Only illicit drug use was predicted by symptoms of SUD. Screening PLHIV for symptoms of SUD may be useful for detecting people likely to be engaging in illicit drug use to reduce the risk of secondary disease transmission.
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Affiliation(s)
- Truc T Thai
- Faculty of Public Health, Ho Chi Minh City University of Medicine and Pharmacy, 159 Hung Phu Street, Ward 8, District 8, Ho Chi Minh City, Vietnam. .,Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 2141, Australia.
| | - Mairwen K Jones
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 2141, Australia
| | - Lynne M Harris
- School of Psychological Sciences, Australian College of Applied Psychology, Level 11, 255 Elizabeth Street, Sydney, NSW, 2000, Australia
| | - Robert C Heard
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 2141, Australia
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Thai TT, Jones MK, Harris LM, Heard RC. Screening value of the Center for epidemiologic studies - depression scale among people living with HIV/AIDS in Ho Chi Minh City, Vietnam: a validation study. BMC Psychiatry 2016; 16:145. [PMID: 27178070 PMCID: PMC4868017 DOI: 10.1186/s12888-016-0860-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 05/11/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Depression is believed to be under-diagnosed and under-treated in people living with HIV/AIDS (PLHIV). Early screening and referral to mental health services for treatment has been shown to enhance HIV patients' health during the course of HIV treatment. A lack of psychiatric specialist services for PLHIV at outpatient clinics (OPC) in Vietnam leads to insufficient identification of depression. However, alternative approaches are available such as the use of screening scales. This study investigated the psychometric properties of the Center for Epidemiologic Studies - Depression scale (CES-D) in Vietnamese HIV positive outpatients. METHODS A cross-sectional survey of 400 HIV positive outpatients was conducted in Ho Chi Minh City, Vietnam. Participants completed a self-reported questionnaire that included the CES-D. Participants were also interviewed independently by a psychiatrist who assessed for symptoms of major depressive disorder. CES-D reliability was measured by Cronbach's alpha. Criterion validity was evaluated by ROC analysis, Kappa index and the percentage of agreement between the CES-D and psychiatrists' interview. Construct validity was investigated by confirmatory factor analysis. RESULTS The reliability for the whole scale was good (Cronbach α = 0.81). The four sub-scales of the CES-D had lower levels of internal consistency with Cronbach alpha of 0.71, 0.73, 0.71 and 0.58 for somatic complaints, depressive affect, positive affect and interpersonal problems respectively. CES-D has adequate construct validity with CFI = 0.926, IFI = 0.927, GFI = 0.930 and RMSEA = 0.045 (90% CI = 0.037-0.053) in the final four-factor model. Area under curve was 0.88 indicating good criterion validity. At the cutoff of 16, the sensitivity and specificity were 79.8% and 83.0% respectively while the percentage of agreement between the CES-D and psychiatrists' interview was 82.0% with Kappa index at 0.60. CONCLUSIONS The CES-D was shown to be acceptable, reliable and valid for screening symptoms of depression in Vietnamese HIV outpatient clinic settings where mental health specialists are not always available. Routine use of the CES-D at HIV outpatient clinics, in combination with the availability of free-for-all national mental health services, is likely to be beneficial in improving the lives of PLHIV in Vietnam who have depression.
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Affiliation(s)
- Truc Thanh Thai
- Faculty of Public Health, Ho Chi Minh City University of Medicine and Pharmacy, 159 Hung Phu Street, District 8, Ho Chi Minh City, Vietnam. .,Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, Sydney, 2141, Australia.
| | - Mairwen K. Jones
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, Sydney, 2141 Australia
| | - Lynne M. Harris
- School of Psychological Sciences, Australian College of Applied Psychology, Level 6, 11 York Street, Sydney, 2000 Australia
| | - Robert C. Heard
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, Sydney, 2141 Australia
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Rawashdeh MA, Lee WB, Bourne RM, Ryan EA, Pietrzyk MW, Reed WM, Heard RC, Black DA, Brennan PC. Markers of Good Performance in Mammography Depend on Number of Annual Readings. Radiology 2013; 269:61-7. [DOI: 10.1148/radiol.13122581] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Naylor JM, Harmer AR, Heard RC, Harris IA. Patterns of recovery following knee and hip replacement in an Australian cohort. AUST HEALTH REV 2009; 33:124-35. [DOI: 10.1071/ah090124] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 04/10/2008] [Accepted: 10/28/2008] [Indexed: 11/23/2022]
Abstract
Most literature reporting the impressive results
from knee and hip replacement derives from
international data. Few Australian studies have
comprehensively compared outcomes after joint
replacement up to 1 year. This paper compares
the patterns of recovery across physical and
patient-centred outcomes following knee or hip
replacement in an Australian cohort. One hundred
and twenty-two consecutive patients undergoing
knee or hip replacement were prospectively followed.
Serial assessments were conducted (preoperatively,
and 2, 6, 12, 26 and 52 weeks postsurgery).
Joint pain, patient?s global improvement,
timed mobility, and complications were monitored.
English-proficient patients completed WOMAC
(Western Ontario and McMaster Universities
Osteoarthritis Index) and SF-36v2 (Medical Outcomes
Short-Form 36 version 2) questionnaires.
At 1 year, 81% (55 knee, 44 hip) were available for
follow-up. Significant, large improvements (up to
254%) were evident for most outcomes. Global
improvement was reported by 97%. Recovery for
both surgical groups was greatest within the first
26 weeks, but hip patients improved more quickly
in most outcomes. Wound disturbances were the
most common complication (23 in total, 23%) and
13 patients (13%) were readmitted for complications.
Recovery patterns were similar to that
observed elsewhere. The physical and patientcentred
outcomes provide a useful Australian
reference for clinicians of the temporal aspects of
recovery as well the differences between hip and
knee surgeries. Complication and readmission
rates appeared high, possibly partly explained by
the rigorous capture method.
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Naylor JM, Chow CM, McLean AS, Heard RC, Avolio A. Cardiovascular responses to short-term head-down positioning in healthy young and older adults. Physiother Res Int 2005; 10:32-47. [PMID: 15991485 DOI: 10.1002/pri.22] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND PURPOSE Isolated head-down postural drainage is assumed to acutely load the cardiovascular system. Consequently, it is considered a relative contraindication in the presence of severe cardiovascular disease. Evidence demonstrating that the head-down manoeuvre as used by physiotherapists does significantly load the cardiovascular system is lacking. The present study documents the cardiovascular responses t short-term 30 degrees head-down positioning in healthy subjects. The results are a point of reference for respiratory patients with and without cardiovascular disease. METHOD A quasi-experimental research design was used, with multiple measurements obtained at rest (long sitting and in the head-down position. Twenty-one young subjects (mean age 25 years (standard deviation, (SD) 3 years)) and 19 older subjects (mean age 66 years (SD 6 years)) were studied. Applanation tonometry and sphygmocardiography were used to measure temporal and pressure variables, and indices that estimate myocardial work and coronary blood flow. RESULTS Absolute differences existed between the two age groups for all variables at rest (p < 0.001). No age-time interaction was observed for any variable in the head-down position (p > 0.05). Serial measures in the head-down position did not vary across time (p > 0.05). Small (<9%) but significant (p < or = 0.02) decreases in heart rate, relative diastolic duration, mean arterial blood pressure and diastolic time indices, and small (<12%) but significant (p < or = 0.002) increases in cardiac cycle time, ejection duration (relative and absolute) and absolute diastolic duration were observed in the head-down position compared with rest. A small (9%) but significant (p < 0.001) fall in the sub-endocardial viability ratio occurred in the head down position. CONCLUSION The findings have little consequence in health, but they suggest that head-down postural drainage may be of concern for chest physiotherapy recipients with reduced cardiac reserve or impaired barorefilex function.
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Affiliation(s)
- Justine M Naylor
- School of Exercise and Sport Sciences, University of Sydney, NSW, Australia.
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Abstract
The aim of this study was to describe the type and frequency of hand use in healthy older adults. Observational studies were conducted involving structured observations at five-minute intervals on 15 healthy older adults as they went about their normal daily routine between 10.00 am and 2.00 pm. Overall, the dominant hand was used more frequently than the non-dominant hand. Subjects used their hands predominantly to hold and manipulate objects, and not for balance. There was no significant difference between the frequency of manipulating objects with the fingers and the frequency of use of the whole hand. Subjects used their hands significantly more often in bimanual activities than in unimanual activities or in no activity. Although subjects usually stood while they held or manipulated objects, they also sat or walked while manipulating them. The present study provides insights into how healthy older adults naturally use their hands in performing everyday activities. While the dominant hand is used more than the non-dominant hand, the hands are used predominantly together to perform bimanual tasks.
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Affiliation(s)
- Sharon L Kilbreath
- School of Physiotherapy, The University of Sydney, Lidcombe, NSW, 2141, Australia.
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