The accessibility and quality of health services for diabetes mellitus and chronic respiratory disease patients during Covid-19 in Northern Jordan: A mixed method study
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SUBMITTER: Al-Bataineh R
PROVIDER: S-EPMC10653463 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundHospital services in all parts of the world were severely affected by the crisis caused by the Coronavirus pandemic. This was particularly concerning for patients who suffer from chronic diseases.AimThis study aimed to: assess the level of quality and accessibility of chronic disease services from the perspectives of healthcare providers, assess the association between healthcare providers' socio-demographic factors and their perspectives on accessibility and quality level, and explore the providers' perspectives on the barriers and facilitators of quality and accessibility to chronic disease health services during the COVID -19 pandemic.MethodDesign: An explanatory mixed method design was employed in this study using a questionnaire and focus group discussion approach. The questionnaire consisted of three sections including, demographic, accessibility, and quality.SampleA convenience sampling approach was used to collect the quantitative from 412 healthcare providers working at public, private, and teaching hospitals. A purposive sample of 12 healthcare providers were interviewed to collect the qualitative data.AnalysisThe quantitative data were analyzed using SPSS Statistics Version 25. The qualitative data was analyzed using the thematic analysis approach.ResultsThis study found that the quality and accessibility of chronic disease services in northern Jordan were affected during COVID-19. Quantitative: The majority of the participants reported moderate level of accessibility and quality. Qualitative: Four main and six subthemes were identified: 1) Accessibility barriers including transportation and fear of infection; 2) Accessibility facilitators including availability of Personal Protective Equipment (PPE) and Covid-19 vaccination; 3) Quality barriers including staff shortage; 4) Quality facilitators including safety protocol.ConclusionThe quality and accessibility of chronic disease services were affected due to the healthcare system restating to address the Covid-19 pandemic. Different barriers and facilitators for chronic disease healthcare services accessibility and quality were identified. The findings of this study lay the ground for healthcare decision and policymakers to develop strategies and formulate polices to ensure these patients receive the needed healthcare services, and hence improve their health outcomes.
| S-EPMC10464245 | biostudies-literature
Project description:The global distribution of avian respiratory viruses highlights the need for effective surveillance programs and international collaboration to monitor viral circulation and implement timely control measures. In the current study, we aim to provide a comprehensive overview of avian respiratory viral infections in the poultry flocks in Jordan, focusing on the major viruses involved, their epidemiology, clinical manifestations, and evolution based on viroinformatics that will be helpful to improve the diagnostic methods, and control strategies including vaccines in the region. In this research, various poultry broiler groups in Jordan experiencing respiratory symptoms were tested for respiratory viral pathogens from January 2021 to February 2022. The mortality rates observed in the examined groups varied between 6% and 40%. The identified strains were authenticated using the RT-qPCR assay. Furthermore, they underwent in-depth characterisation through the sequencing of the complete spike (S1) gene for infectious bronchitis virus (IBV) and the haemagglutinin (HA) gene for avian influenza virus (AIV) subtype H9N2. Co-infection of IBV and AIV H9N2 viruses was detected through molecular analysis. The IBV strains showed affiliation with the variant groups GI-16 (3 strains) and GI-23 (9 strains) and exhibited numerous mutations. Meanwhile, H9N2 avian influenza viruses displayed various changes in amino acids within the HA gene, suggesting the influence of antibody-driven selection pressure. The phylogenetic analysis revealed that the H9N2 viruses identified in this investigation shared close genetic ties with EG3 (3 strains) and the Middle East group (ME1; 8 strains). These strains have been recently found in Jordan and nearby countries in the Middle East. Moreover, their HA genes exhibited similarities to viruses belonging to the G1-like lineage. In conclusion, avian respiratory viral infections remain a significant concern for the poultry industry, requiring constant vigilance and proactive measures to minimise their impact. Continued surveillance, robust diagnostic methods, effective vaccines, and international cooperation are essential components of a comprehensive approach to combat avian respiratory viral infections (AI, IBV, ND and ILT 'viruses) and safeguard avian health and global poultry production.
| S-EPMC10907842 | biostudies-literature
Project description:BackgroundQuality of life (QOL) is a good indicator of lifespan, especially for individuals who are suffering from a particular illness. QOL among patients with diabetes mellitus (DM) could be used for further implementations in addition to improving patient care and disease management, especially during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess QOL and identify factors associated with a good QOL among DM patients in northern Thailand.MethodsA cross-sectional study was conducted to gather information from DM patients attending six randomly selected hospitals in the Chiang Rai province, northern Thailand. A validated questionnaire and the 26-item quality of life brief version (WHOQOL-BREF) were used to collect socioeconomic factors and assess QOL, respectively. Chi-square tests and logistic regression were used to detect the associations between variables at a significance level of α = 0.05.ResultsA total of 967 participants were enrolled in the study: 58.8% were female, 52.3% were aged ≥ 60 years, 79.7% graduated primary school and had no additional education, 68.7% had an annual income ≤ 50,000 baht, and 29.3% were unemployed. The majority of patients had a poor-to-moderate overall QOL (49.4%); 90.1% reported a moderate QOL in the physical domain, 54.7% reported a moderate QOL in the mental domain, 63.4% reported a good QOL in the social relationship domain, and 50.6% reported a good QOL in the environmental domain. In multivariate analysis, seven variables were found to be associated with good QOL among the participants. Those aged ≤ 59 years had 1.90 times (95% CI 1.32-2.73) greater odds of having good QOL than those aged ≥ 60. Those who had annual income ≥ 100,001 baht had 2.16 times (95% CI 1.17-3.96) greater odds of having good QOL than those who had annual income ≤ 50,000 baht. Those who lived alone and with spouses had 3.38 times (95% CI 1.42-8.02) and 2.20 times (95% CI 1.20-4.02) greater odds of having good QOL, respectively, than those who lived with relatives. Those who exercised regularly had 4.72 times (95% CI 2.71-8.19) greater odds of having good QOL than those who never exercised. Those who had a high level of knowledge regarding prevention and care had 3.26 times (95% CI 1.22-5.55) greater odds of having good QOL than those who had low knowledge. Those who did not have diabetic nephropathy had 7.41 times (95% CI 4.99-11.01) greater odds of having good QOL than those who were diagnosed with diabetic nephropathy, and those whose medical fees were supported by the government under the universal scheme had 4.31 times (95% CI 1.15-16.7) greater odds of having good QOL than those who had to support themselves.ConclusionsAlmost a half of DM patients in northern Thailand reported having a low-to-moderate QOL, which can be improved by focusing on socioeconomic factors, family support as well as improving knowledge regarding DM prevention and care, including the support of medical fees.
| S-EPMC9122079 | biostudies-literature
Project description:We aimed to characterize the type 2 diabetes mellitus (T2DM) epidemic and the role of key risk factors in Jordan between 1990-2050, and to forecast the T2DM-related costs. A recently-developed population-level T2DM mathematical model was adapted and applied to Jordan. The model was fitted to six population-based survey data collected between 1990 and 2017. T2DM prevalence was 14.0% in 1990, and projected to be 16.0% in 2020, and 20.6% in 2050. The total predicted number of T2DM cases were 218,326 (12,313 were new cases) in 1990, 702,326 (36,941 were new cases) in 2020, and 1.9 million (79,419 were new cases) in 2050. Out of Jordan's total health expenditure, 19.0% in 1990, 21.1% in 2020, and 25.2% in 2050 was forecasted to be spent on T2DM. The proportion of T2DM incident cases attributed to obesity was 55.6% in 1990, 59.5% in 2020, and 62.6% in 2050. Meanwhile, the combined contribution of smoking and physical inactivity hovered around 5% between 1990 and 2050. Jordan's T2DM epidemic is predicted to grow sizably in the next three decades, driven by population ageing and high and increasing obesity levels. The national strategy to prevent T2DM needs to be strengthened by focusing it on preventive interventions targeting T2DM and key risk factors.
| S-EPMC7713435 | biostudies-literature
Project description:AimTo examine health-related quality of life trajectories among older adults with diabetes mellitus (DM).DesignA sequential explanatory mixed method study protocol.MethodsIn the quantitative phase, health-related quality of life trajectory over 5 years, from 2009 to 2013, of a national representative sample (N = 440) of older adults with DM was analysed using group-based modelling. Next, a qualitative multiple case study (N = 10) was conducted between November 2017 and April 2018. In the mixed phase, by linking the quantitative and qualitative data, similarities and differences among the four trajectories were identified.ResultsFour distinctive health-related quality of life trajectories could be distinguished: high then decrease, high stable, medium stable and low then increase. These differed in attitude towards DM, self-management of DM-related tasks, comorbidity-related health-related quality of life, coping with DM and financial concerns about medical needs.Relevance to clinical practiceOur results help illuminate the heterogeneity of health-related quality of life trajectories in older adults with DM. This research may help healthcare providers understand the need to assess the HR-QoL comprehensively and promote HR-QoL for older adults with DM.
| S-EPMC10495725 | biostudies-literature
Project description:Introduction Maternal morbidity and mortality are a global phenomenon with devastating effects on low-income and middle-income countries among which sub-Saharan Africa (SSA) is the hardest hit. Low utilisation of maternal health services has been recorded in recent times in the Nanton District of Ghana. This has raised concerns about the utilisation of antenatal care (ANC) and skilled delivery (SD) services in the district. However, we found no specific existing literature which has addressed these questions on ANC and SD utilisation in the study setting. Thus, this study seeks to explore the utilisation of ANC and SD services among mothers in the Nanton District of Northern Ghana. Methods and analysis This will be an observational study. It will use a mixed-method approach, particularly, convergent parallel design to implement the study. This will include quantitative and qualitative aspects using a questionnaire and focus group discussion guide. The planned sample size is 411 participants. The data will be collected at the communities. Before participation in the study, the research team will receive individual written consent from the participants. Descriptive and inferential data analysis will be performed after the data collection. The results will be presented as frequency tables, bar charts and line graphs to indicate the proportions of the outcome indicators. The strength of association among variables will be determined at 95% CI and a significance level of alpha (0.05) will be used. Ethics and dissemination Ethical clearance has been sought from the Ghana Health Service Ethics Review Board (GHS-ERC 027/03/22). The outcomes from this study may serve as a reference document for the District Health Directorate to use when developing strategies for ANC and SD services. The results will be published in open access and peer-reviewed journals.
| S-EPMC9756144 | biostudies-literature
Project description:AimsTo assess the knowledge and practices toward diabetes in the Jordanian community.MethodsThis study was conducted as a public based cross-sectional study in different cities in Jordan. A previously published validated questionnaire about knowledge, attitudes, and practices (KAP) toward diabetes mellitus (DM) was translated from the Arabic version and used in this study with very minor modification to be suitable for this study of the Jordanian population.ResultsA total of 1,702 participants were recruited in the present study. About half of the participants (53.3%) had good knowledge scores. The respondents' knowledge scores were significantly correlated with attitudes (p < 0.001). The education level (university or higher) and education related to a field were predictors for good knowledge and positive attitudes. About 46.3% of participants had positive attitudes toward the disease. As for practices, 37.7% of participants did not engage in regular exercise while more than half of the study subjects had never checked their blood glucose level on an annual basis. The factors influencing the practice of checking blood glucose level have been investigated.ConclusionThis study has highlighted the need for more educational interventions to address negative attitudes and promote healthy lifestyle practices and regular health checks especially in certain subgroups of patients, such as those not having a degree related to the medical field and not having a first-degree relative with DM.
| S-EPMC6440628 | biostudies-literature
Project description:ImportanceThe management of noncommunicable diseases in humanitarian crises has been slow to progress from episodic care. Understanding disease burden and access to care among crisis-affected populations can inform more comprehensive management.ObjectiveTo estimate the prevalence of hypertension and diabetes with biological measures and to evaluate access to care among Syrian refugees in northern Jordan.Design, setting, and participantsThis cross-sectional study was undertaken from March 25 to April 26, 2019, in the districts of Ramtha and Mafraq, Jordan. Seventy clusters of 15 households were randomly sampled, and chain referral was used to sample Syrian households, representative of 59 617 Syrian refugees. Adults were screened and interviewed about their access to care. Data analysis was performed from May to September 2019.ExposuresPrimary care delivered through a humanitarian organization since 2012.Main outcomes and measuresThe main outcomes were self-reported prevalence of hypertension and diabetes among adults aged 18 years or older and biologically based prevalence among adults aged 30 years or older. The secondary outcome was access to care during the past month among adults aged 18 years or older with a diagnosis of hypertension or diabetes.ResultsIn 1022 randomly sampled households, 2798 adults aged 18 years or older, including 275 with self-reported diagnoses (mean [SD] age, 56.5 [13.2] years; 174 women [63.3%]), and 915 adults aged 30 years or older (608 women [66.5%]; mean [SD] age, 46.0 [12.8] years) were screened for diabetes and hypertension. Among adults aged 18 years or older, the self-reported prevalence was 17.2% (95% CI, 15.9%-18.6%) for hypertension, 9.8% (95% CI, 8.6%-11.1%) for diabetes, and 7.3% (95% CI, 6.3%-8.5%) for both conditions. Among adults aged 30 years or older, the biologically based prevalence was 39.5% (95% CI, 36.4%-42.6%) for hypertension, 19.3% (95% CI, 16.7%-22.1%) for diabetes, and 13.5% (95% CI, 11.4%-15.9%) for both conditions. Adjusted for age and sex, prevalence for all conditions increased with age, and women had a higher prevalence of diabetes than men (adjusted prevalence ratio, 1.3%; 95% CI, 1.0%-1.7%), although the difference was not significant. Complications (57.4%; 95% CI, 51.5%-63.1%) and obese or overweight status (82.8%; 95% CI, 79.7%-85.5%) were highly prevalent. Among adults aged 30 years or older with known diagnoses, 94.1% (95% CI, 90.9%-96.2%) currently took medication. Among adults aged 18 years or older with known diagnoses, 26.8% (95% CI, 21.3%-33.1%) missed a medication dose in the past week, and 49.1% (95% CI, 43.3%-54.9%) sought care in the last month.Conclusions and relevanceDuring this protracted crisis, obtaining care for noncommunicable diseases was feasible, as demonstrated by biologically based prevalence that was only moderately higher than self-reported prevalence. The high prevalence of complications and obese or overweight status, however, suggest inadequate management. Programs should focus on reinforcing adherence and secondary prevention to minimize severe morbidity.
| S-EPMC7557515 | biostudies-literature
Project description:IntroductionExperiences and determinants connected with type 2 diabetes mellitus-associated erectile dysfunction (T2DMED) in health appointments are not well understood and infrequently reported. This systematic review was undertaken to synthesise evidence of the experiences, facilitators, and barriers around screening ED in men with T2DM during health service consultations.MethodsThe review report was based on the guidelines provided by the Joanna Briggs Institute for conducting mixed-method systematic reviews. Eight electronic databases were searched, including Web of Science, Embase via Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO, ProQuest, PubMed, PsychInfo via Ovid, MEDLINE via Ovid, Portal Garuda. Additionally, the review manually looked through the reference lists of the studies we included. Erectile dysfunction, type 2 diabetes mellitus, screening and barriers were initially used as keywords in the search strategy. All identified primary studies written in English and Bahasa Indonesia, and published between 2001 and 2022 were meticulously screened following an agreed set of inclusion criteria.FindingsOut of 3468 papers screened, only six were chosen for the review. These included three cross-sectional studies, two qualitative studies, and one mixed-method study. The study quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Based on the checklist criteria, the studies ranged between 5/10 to 9/10 in terms of quality. After synthesizing the findings, four main categories were identified including the willingness to discuss T2DMED, the barriers experienced and perceived, the limited understanding of T2DMED, and the support expected by men with T2DM.DiscussionMany men kept quiet about their struggles with T2DMED, hoping to bring it up as a topic of discussion during healthcare consultations. Barriers such as embarrassment, a sense of helplessness and reluctance to seek help, financial constraints, and dismissive healthcare professionals hindered them from addressing this issue. Both the participating men and healthcare professionals lacked a comprehensive understanding of T2DMED.RecommendationsIt is important to provide education tailored to men's specific needs and improve awareness about T2DM-associated ED. Creating a more T2DMED-friendly environment could be a potential solution to increase early screening and management. Future research should investigate potential barriers that prevent HCPs from identifying and addressing T2MED since their absence in the identified studies highlights this need.Systematic review registrationCRD42021292454.
| S-EPMC10416416 | biostudies-literature
Project description:BACKGROUND:Whilst alcohol misuse is decreasing amongst younger adults in many countries, it is increasing in older adults. Residential rehabilitation (rehab) is a vital component of the alcohol treatment system, particularly for those with relatively complex needs and entrenched alcohol problems. In this study, we sought to find out to what extent rehabs in England have upper age limits that exclude older adults, whether rehabs are responsive to older adults' age-related needs and how older adults experience these services. METHOD:This is a mixed method study. A search was carried out of Public Health England's online directory of rehabs to identify upper age thresholds. Semi-structured qualitative interviews were carried out with 16 individuals who had attended one of five residential rehabs in England and Wales since their 50th birthday. A researcher with experience of a later life alcohol problem conducted the interviews. RESULTS:Of the 118 services listed on Public Health England's online directory of rehabs, 75% stated that they had an upper age limit that would exclude older adults. Perceived differences in values, attitudes and behaviour between younger and older residents had an impact on older residents' experience of rehab. Activities organised by the rehabs were often based on physical activity that some older adults found it difficult to take part in and this could create a sense of isolation. Some older adults felt unsafe in rehab and were bullied, intimidated and subjected to ageist language and attitudes. CONCLUSION:This study identified direct and indirect age discrimination in rehabs contrary to the law. Further research is required to find out if age discrimination exists in rehabs in other countries. Rehabs should remove arbitrary age limits and ensure that they are responsive to the needs of older adults.
| S-EPMC6293575 | biostudies-other