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      Patient Preference and Adherence (submit here)

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      Is Open Access

      Health-related quality of life in elderly diabetic outpatients in Vietnam

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          Abstract

          Background

          Health-related quality of life (HRQoL) is an important indicator for designing care and treatment services for patients with diabetes. This is especially true given its rapid increase among the elderly population in Vietnam. HRQoL data in elderly diabetic Vietnamese are currently limited. This study aimed to 1) measure the HRQoL of elderly patients with type 2 diabetes (T2DM) in Vietnam and 2) identify related factors and their relationship with HRQoL.

          Patients and methods

          A cross-sectional study was conducted. We recruited 171 patients aged ≥60 years with T2DM at the Outpatient Department, National Geriatric Hospital from June to November 2015. Patients were asked to evaluate their health status using the EuroQol Five Dimensions Three Levels (EQ-5D-3L) and the Visual Analog Scale (VAS). Sociodemographic, diabetic treatment, and management characteristics were collected. Multivariate Tobit regression was used to determine which factors were associated with HRQoL, and the strength of this relationship.

          Results

          Patients reported some problems in all areas of the EQ-5D: pain/discomfort (50.9%), mobility (33.3%), anxiety/depression (24.0%), usual activities (21.1%), and self-care (10.5%). The mean EQ-5D index score was 0.80 (SD=0.20), and the mean EQ-VAS was 57.5 (SD=14.4). Patients who were male, lived in an urban area, could afford treatment, were taking fewer medications, and monitored blood pressure often (1–4 times a week) had a higher EQ-5D index when compared to other groups. Meanwhile, a longer duration of diabetes and older age were negatively associated with the EQ-5D index. Patients with any comorbidity had lower VAS scores than their counterparts.

          Conclusion

          The presence of diabetes and comorbidity were responsible for a significant decrease in HRQoL. Screening and identifying health problems, providing prompt treatment, and facilitating self-management among patients have the potential to increase diabetic patients’ HRQoL.

          Most cited references43

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          Understanding patients' experiences of treatment burden in chronic heart failure using normalization process theory.

          Our goal was to assess the burden associated with treatment among patients living with chronic heart failure and to determine whether Normalization Process Theory (NPT) is a useful framework to help describe the components of treatment burden in these patients. We performed a secondary analysis of qualitative interview data, using framework analysis, informed by NPT, to determine the components of patient "work." Participants were 47 patients with chronic heart failure managed in primary care in the United Kingdom who had participated in an earlier qualitative study about living with this condition. We identified and examined data that fell outside of the coding frame to determine if important concepts or ideas were being missed by using the chosen theoretical framework. We were able to identify and describe components of treatment burden as distinct from illness burden using the framework. Treatment burden in chronic heart failure includes the work of developing an understanding of treatments, interacting with others to organize care, attending appointments, taking medications, enacting lifestyle measures, and appraising treatments. Factors that patients reported as increasing treatment burden included too many medications and appointments, barriers to accessing services, fragmented and poorly organized care, lack of continuity, and inadequate communication between health professionals. Patient "work" that fell outside of the coding frame was exclusively emotional or spiritual in nature. We identified core components of treatment burden as reported by patients with chronic heart failure. The findings suggest that NPT is a theoretical framework that facilitates understanding of experiences of health care work at the individual, as well as the organizational, level. Although further exploration and patient endorsement are necessary, our findings lay the foundation for a new target for treatment and quality improvement efforts toward patient-centered care.
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            Assessing health system performance in developing countries: a review of the literature.

            With the setting of ambitious international health goals and an influx of additional development assistance for health, there is growing interest in assessing the performance of health systems in developing countries. This paper proposes a framework for the assessment of health system performance and reviews the literature on indicators currently in use to measure performance using online medical and public health databases. This was complemented by a review of relevant books and reports in the grey literature. The indicators were organized into three categories: effectiveness, equity, and efficiency. Measures of health system effectiveness were improvement in health status, access to and quality of care and, increasingly, patient satisfaction. Measures of equity included access and quality of care for disadvantaged groups together with fair financing, risk protection and accountability. Measures of efficiency were appropriate levels of funding, the cost-effectiveness of interventions, and effective administration. This framework and review of indicators may be helpful to health policy makers interested in assessing the effects of different policies, expenditures, and organizational structures on health outputs and outcomes in developing countries.
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              Burden of treatment for chronic illness: a concept analysis and review of the literature.

              Treatment burden, the burden associated with the treatment and management of chronic illness, has not yet been well articulated.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient Preference and Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2018
                27 July 2018
                : 12
                : 1347-1354
                Affiliations
                [1 ]Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam, thuhuonglk@ 123456hmu.edu.vn
                [2 ]National Geriatric Hospital, Hanoi, Vietnam, thuhuonglk@ 123456hmu.edu.vn
                [3 ]School of Public Health, University of Alberta, Edmonton, AB, Canada
                [4 ]Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
                [5 ]Hanoi Medical University, Hanoi, Vietnam
                [6 ]School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
                [7 ]Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
                [8 ]Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
                [9 ]Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
                [10 ]Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore
                [11 ]Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
                Author notes
                Correspondence: Huong Thi Thu Nguyen, Department of Gerontology, Hanoi Medical University, 01 Ton That Tung, Hanoi, 115000, Vietnam, Tel +84 9 7305 6334, Email thuhuonglk@ 123456hmu.edu.vn
                Article
                ppa-12-1347
                10.2147/PPA.S162892
                6067618
                30100711
                4608a1aa-dc0e-431f-9afd-8b40e28bd23e
                © 2018 Nguyen et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Medicine
                elder,quality of life,diabetes,vietnam
                Medicine
                elder, quality of life, diabetes, vietnam

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