Impact of behavioral health education interventions on knowledge, adherence to treatment, and quality of life of patients with heart failure: A randomized controlled trial

Original Research

Abstract

Introduction: Heart failure (HF) is a common chronic disease with high morbidity and mortality rates. Besides HF treatments aimed to improve patients’ quality of life and health status, health education interventions for behavioral changes ensuring their adherence to treatment are very important. Therefore, this study aimed to evaluate the effect of behavioral health education interventions on knowledge, treatment adherence, and quality of life of patients with HF.

Methods: This was a randomized controlled trial. A total of 330 patients were selected and randomly distributed into intervention and control groups (n = 165 per group). Data were collected at the time points before the intervention and three months after the intervention using the Dutch Heart Failure Knowledge Scale (DHFKS), Revised Heart Failure Compliance Scale (RHFCS), and quality of life (EQ-5D-5L v2.1, Vietnamese version).

Results: There were no significant differences between the two groups in HF knowledge or quality of life at baseline. After three months of health education intervention, intervention group significant increase to 1.68 times (95%CI: 1.05 – 2.69; p=0.03) in overall HF knowledge; 1.91 times (95%CI: 1.25 – 2.92; p=0.003) in general HF knowledge and 1.59 times (95%CI: 1.03 – 2.45; p=0.038) in behavior of exercise when compare to control group.  However, the quality of life did not change significantly after the intervention.

Conclusions: Although the health education intervention had no impact on the quality of life of patients with HF, it was effective in improving their HF knowledge and treatment adherence.

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Comparison of the long-term efficacy of Tenofovir monotherapy versus Tenofovir and Phyllanthus Amari combination therapy: a randomized controlled trial

Original Research

Abstract

Introduction: Hepatitis B infection has become a social burden in over the world due to its high prevalence, while the treatments still do not offer the desired effects. Literature showed that combining traditional medicine with modern drugs was able to inhibit the proliferation of the hepatitis B virus, thus making it an effective treatment. To compare the efficacy of Tenofovir monotherapy versus Tenofovir and Phyllanthus Amari combination therapy in chronic hepatitis B patients.

Materials and methods: Randomized controlled clinical trial on 200 chronic hepatitis B patients with HBeAg (+); divided into 2 groups: The combination therapy group used Phyllanthus Amari product and Tenofovir for treatment and the monotherapy group with Tenofovir.

Results: The serological, biological, and virological responses in the combination therapy group were earlier than those in the monotherapy group. Statistically significant differences in serological responses between the combination therapy versus monotherapy group were achieved from the 3rd (59% versus 33%, p=0.021) to the 18th month (99% versus 91%, p=0.029). Statistically significant differences in biochemical responses between the combination therapy versus monotherapy group were achieved from the 9th (12% versus 1%, p=0.003) to the 18th month (35% versus 21%, p=0.040). Statistically significant differences in virological response between the combination therapy versus monotherapy group were achieved from the 6th (23% versus 10%, p=0.021) to the 18th month (97% versus 88%, p=0.029).

Conclusion: The combination of Tenofovir and the Phyllanthus Amari product is more effective than using only Tenofovir for treatment in chronic hepatitis B patients with HBeAg-positive.

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Somatic Symptoms in Major Depressive Disorder: A Cross-sectional Study in a Mental Health Setting, Vietnam

Original Research

Abstract

Introduction: Major depressive disorder (MDD) presents a diverse clinical picture, especially with somatic symptoms, which can lead to negative impacts on the course and prognosis of the illness. This study aimed to (1) assess the prevalence of various somatic symptoms in MDD patients and (2) assess their association with demographic factors.

Methods: A total of 345 outpatients diagnosed with MDD according to DSM-5 criteria were enrolled in this cross-sectional study over 6 months. Participants completed a questionnaire that included clinical and demographic information as well as the PHQ-9.

Results: There were 99.7% of patients who had at least one somatic symptom. The common somatic symptoms were fatigue (89.9%), insomnia (87.8%), palpitations (77.7%), headache (69.6%) and dizziness (61.4%). Total PHQ-9 scores and total number of somatic symptoms were found to have a regression relationship with a regression coefficient of 0.14 (t = 6.001, p < 0.001). In multiple logistic regression analysis, female gender was found to be associated with dizziness (odd ratios [OR] = 2.54, 95% confidence interval [CI] 1.53-4.21, p < 0.01), headaches (OR = 1.94, 95% CI 1.16-3.32, p < 0.05), and bowel problems (OR = 0.59, 95% CI 0.37-0.96, p < 0.05); while headaches (OR = 1.73, 95% CI 1.05-2.85, p < 0.05), and stomach problems (OR = 0.56, 95% CI 0.36-0.88, p < 0.05) were associated with age 40 and below.

Conclusions: The study findings provide a resource for clinicians in mental health settings as well as primary care clinics in detecting inexplicable somatic symptoms associated with MDD.

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A cross-sectional study: the prevalence of mental disorders and associated factors in middle school students in Tuy Hoa City, Vietnam in 2021

Original Research

Abstract

Background: A mental disorder is a state of mental health deviance in a period and leads to the disruption of a body’s self-balance. Adolescence is a period of many psychophysiological changes, and several factors which are related to personal characteristic, family and school could adversely affect a child's mental well-being. The objectives of the study were to determine the prevalence of mental disorders and ascertain some associated factors in middle school students (ages 12-15) in Tuy Hoa city, Phu Yen province, Viet Nam 2021.

Materials and methods: A cross-sectional study was conducted from March to April on 539 students and parents at middle schools in Tuy Hoa city, Viet Nam in 2021. Parents were requested to complete the Strengths and Difficulties Questionnaire (SDQ).

Results: The prevalence of having mental disorders in middle school students was 22.7%. The difference between the prevalences of having mental disorders in male and female students was statistically significant (p=0.014), grade lever (p=0.020), conduct (p=0.040), concern from parents (p=0.046), family conflicts (p=0.029), being scolded for making mistakes by parents (p=0.004) and being bullied by classmates (p=0.045).

Conclusion: Experiencing mental disorders was relatively prevalent among middle school students. Some factors which were related to family and school environments were found associated with psychiatric disorders. Therefore, interventions and cooperation from parents and school officers are essential to mitigate students' sufferings caused by mental health problems, promote psychological well-being, or preclude psychoses from occurring. 

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How Vietnamese healthcare students think of nurses: Students stereotypes about Nursing at University of Medicine and Pharmacy at Ho Chi Minh City

Original Research

Abstract

Introduction: Vietnam’s health system increasingly recognizes the importance of interprofessional collaboration and education. Understanding stereotypes and interprofessional attitude could foster successful collaboration. This study aimed to assess stereotypes about nursing amongst healthcare students at University of Medicine and Pharmacy at Ho Chi Minh City.

Method: We invited nursing, medical, pharmacy and rehabilitation therapy students to complete an online survey before an interprofessional education course in September 2020. Student Stereotypes Rating Questionnaire was used to assess student stereotypes about nursing. Univariate regression was used to analyze the association between stereotypes score and other factors including interprofessional attitude as measured by Readiness for Interprofessional Learning Scale.

Results: With 102 students invited, 90 students completed the survey. Students were 20-21 years old, 57% were female, and 9% from minor ethnicity. The total attitude score was 80.2 ± 7.2, which meant favorable interprofessional learning. The total stereotype score was 37.1 ± 4.0, considered as high. Stereotype rated in descending order were: Practical skills (4.4), Interpersonal skills (4.3), Ability to be a team player (4.3), Professional competence (4.2), and Confidence (4.2), Ability to make decisions (3.9), Ability to work independently (3.8) and Leadership skills (3.5). There was an association between stereotype and interprofessional attitude total score (Coefficient 0.25, 95%CI: 0.15; 0.36, p-value < 0.01).

Conclusion: Vietnamese students highly regarded nursing profession, yet stereotypes about nursing existed and students viewed nurses as a capable team player, almost a follower. We need to study how interprofessional education courses could improve students’ attitude and stereotypes in future research. 

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Health service use and associated factors among old Khmer people: a cross-sectional survey in Tri Ton District, An Giang Province

Original Research

Abstract

Background: The health status of ethnic minorities of all ages lags far behind that of the general population, particularly in the old. The old minor ethnic population is more likely to have chronic diseases but less likely to access health services. This study assesses the rate of health services use and associated factors in the old Khmer population.

Method: A cross-sectional study was conducted on 400 Khmer people aged 60+ year-old from March to May 2020. Eligible participants were randomly recruited from households of five clusters out of nine communes of Tri Ton District, An Giang province, Vietnam. A structured questionnaire was designed to collect data on socio-demography, health status, health service use and accessibility to health services and quality of life. Quality of life was measured using EQ-5D-5L. All eligible participants were face-to-face interviewed by a bilingual researcher.

Result: The rate of health services use was 63.3%. The EQ-5D-5L utility index mean score was 0.46 (SD=0.28) and EQ-VAS mean score was 49.01 (SD=16.19). The odds of using health services were higher in those reported to have problems in mobility (OR=2.56, 95%CI 1.43-4.61, p<0.01), self-care (OR=2.05, 95%CI 1.30-3.24, p<0.01), activity (OR=2.35, 95%CI 1.44-3.82, p<0.01), pain/discomfort (OR=2.63, 95%CI 1.22-5.67, p=0.01), and anxiety/depression (OR=2.07, 95%CI 1.00-4.29, p=0.05) in univariate but not in multivariable analysis. The multivariable logistic regression showed that the odds of using health services were lower in those who were currently working (aOR=0.48, 95%CI 0.30-0.79, p<0.01), accessible to health information (aOR=0.47, 95%CI 0.27-0.80, p<0.01), but higher in those using health insurance (aOR=5.09, 95%CI 3.19-8.14, p<0.01), and in health facilities used Khmer language (aOR=2.04, 95%CI 1.15-3.62, p=0.01).

Conclusion: This study suggested that Khmer people should be involved in all stages of planning and implementing health programs and services for Khmer communities to improve the accessibility and health equity. 

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Emergence of telemedicine during COVID-19 pandemic: drawing upon an underrated modality in Vietnam

Review

Abstract

In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic. In Vietnam, the incidence rate started climbing in May 2021, reaching an all-time high of 9,000 cases per day, and is projected to increase even further. Direct patient contact, as has always been the case in conventional medical practice, now constitutes significant transmission risk during the height of COVID-19. Healthcare workers, while accounting for a minor proportion of the population, are two to three times more likely to contract COVID-19, especially those who provide outpatient care or home-based service. The pandemic has led to a significant increase in the adoption of telemedicine, as hospitals are overwhelmed with critically ill patients, demand for healthcare soars, and transmission risk remains serious. With appropriate attention and further advancement of Vietnam's telehealth infrastructure, telemedicine will become an indispensable weapon to combat COVID-19 and an important modality of medical care during and after the pandemic. 

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Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

Original Research

Abstract

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR.

Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included.

Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia.

Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

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Budget impact analysis of the HIV/AIDS treatment on a national scale: a study from the Vietnam Social Security perspective

Original Research

Abstract

Objectives: To analyze the budget impact of the HIV/AIDS treatment on a national scale, from the Vietnam Social Security (VSS) perspective.

Methods: A model with a 5-year time horizon was developed. The total first year direct medical cost (DMC) and its cost components were estimated for HIV-infected populations each year. Budget impact was described through the proportion of the DMC over the social health insurance (SHI) budget. A scenario analysis was conducted with four settings of different proportions of members and coverage levels of the SHI. All costs were converted to 2020 US dollars. 1-way sensitivity analyses were conducted with variations of mean values in a range of ±25%.

Results: The total DMC was estimated at $1.8M (10,000 cases) to treat all new infections and $27.7M (150,000 cases) to reach the treatment goal of the Ministry of Health (MOH) in 2020. The total DMC accounted for 0.6% of the SHI budget for the year 2020 to meet the treatment goal. The costs of CD4-count test and fully suppressive regimen containing Tenofovir Disoproxil Fumarate (TDF) were identified as key cost drivers. The proportion of the total DMC over the SHI budget among different scenarios did not vary significantly.

Conclusion: This is the first-ever study analyzing the budget impact of the HIV/AIDS treatment on a national scale, from the VSS perspective. The results showed that the cost of HIV/AIDS care was economical and the impact on the SHI budget was reasonable. Findings could be used to notify the MOH to allocate domestic resources and to optimize the current programs.

Graphical abstract

The difference in the timings of healthcare professionals’ shifts and sleep disturbances

Review

Abstract

Healthcare professionals (HCPs) bear a huge responsibility of taking care of patients 24 hours a day and for the whole week. Although HCPs help patients get over their sufferings, these workers endanger their lives and cause themselves health problems including sleep disturbances. Since most of these disturbances are related to the timing or the schedules of these workers, the aim of this mini-review is to shed the light on how these shift schedules are different and how they can affect the sleepness and/or wakefulness of the workers in the health sector.

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The Vietnamese Version of the Health-related Quality of Life Measure for Children with Epilepsy (CHEQOL-25): Reliability

Original Research

Abstract

Purpose: This study aimed to translate and culturally adapt the self-report and parent-proxy Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Vietnamese and to evaluate their reliability.

Methods: Both English versions of the self-report and parent-proxy CHEQOL-25 were translated and culturally adapted into Vietnamese by using the Principles of Good Practice for the Translation and Cultural Adaptation Process. The Vietnamese versions were scored by 77 epileptic patients, who aged 8–15 years, and their parents/caregivers at neurology outpatient clinic of Children Hospital No. 2 – Ho Chi Minh City. Reliability of the questionnaires was determined by using Cronbach’s coefficient α and intra-class correlation coefficient (ICC).

Results: Both Vietnamese versions of the self-report and parent-proxy CHEQOL-25 were shown to be consistent with the English ones, easy to understand for Vietnamese children and parents. Thus, no further modification was required. Cronbach’s α coefficient for each subscale of the Vietnamese version of the self-report and parent-proxy CHEQOL-25 was 0.65 to 0.86 and 0.83 to 0.86, respectively. The ICC for each subscale of the self-report and parent-proxy CHEQOL-25 was in the range of 0.61 to 0.86 and 0.77 to 0.98, respectively.

Conclusion: The Vietnamese version of the self-report and parent-proxy CHEQOL-25 were the first questionnaires about quality of life of epileptic children in Vietnam. This Vietnamese version was shown to be reliable to assess the quality of life of children with epilepsy aged 8–15 years.

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