Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, H...Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, Ho Chi Minh City from June to August 2022. Data were collected from 347 people living with HIV using structured questionnaires assessing sociodemographics, substance use, drug side effects, treatment beliefs, treatment satisfaction, and depression. ART adherence was evaluated using a multi-method tool, including self-report, pill count, the Provider Interview Tool, and the Visual Analog Scale. Participants were classified as having high adherence only if they met all four criteria across these methods. Multivariable logistic regression was used to identify factors influencing adherence, with significance set at P<0.05. Results: High ART adherence was observed in 69.5% of the participants. Adherence was significantly lower among tobacco users (OR 0.49, 95% CI 0.30-0.83, P=0.007), those with higher depression scores (per 1-point increase) (OR 0.89, 95% CI 0.84-0.95, P<0.001), frequent substance users (OR 0.50, 95% CI 0.30-0.83, P=0.007), and those experiencing more severe drug side effects (per level increase) (OR 0.64, 95% CI 0.45-0.92, P=0.016). Participants able to afford treatment had nearly three times higher odds of adherence than those unable to pay (OR 2.85, 95% CI 1.48-5.47, P=0.002). Conclusions: ART adherence among people living with HIV in Vietnam remains suboptimal. Interventions should target substance use, drug side effects, financial barriers, and depression screening to improve adherence.展开更多
Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely ...Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely follow prescriptions. Poor adherence to radiation therapy is associated with low survival and high mortality rates. This study therefore sought to investigate the levels of adherence and factors influencing adherence to radiation therapy among cervical cancer patients being treated at Cancer Diseases Hospital. Methods: A cross-sectional analytical study design was used, 142 patients were selected from the outpatient department using a fishbowl sampling method. A structured interview schedule was used to collect data. Data was entered and analyzed using SPSS, the binary logistic regression analysis was used to predict levels of adherence to treatment and to identify factors associated with adherence to RT among cervical cancer patients. Results: The findings showed that 93% of the participants adhered to radiation therapy while 7% did not adhere to treatment. Majority of the patients 77.1% had experienced side effects of radiation therapy. About 28% of patients had severe psychological distress. By using binary logistic regression, there was a statistically significant association between adherence and perceived quality of health care services (p = 0.001). The analysis showed that patients who perceived poor quality of health care services were 0.005 (99.5%) times less likely to adhere to radiation therapy. The other independent variables were not statistically significant despite being associated with adherence among cervical cancer patients. Conclusions and Recommendations: The findings showed that patients who perceived good quality of health care services had higher chances of adherence compared to those who perceived poor quality of health care services. There is therefore a need for quality service provision which could include good maintenance of radiation machines. Furthermore, there is a need to develop guidelines for follow-up in case of any disease outbreak to avoid interference with patients’ treatment schedules and appointments for reviews.展开更多
Liver transplant(LT)outcomes have markedly improved in the recent decades,even if long-term morbidity and mortality are still considerable.Most of late deaths are independent from graft function and different comorbid...Liver transplant(LT)outcomes have markedly improved in the recent decades,even if long-term morbidity and mortality are still considerable.Most of late deaths are independent from graft function and different comorbidities,including complications of metabolic syndrome and de novo neoplasms,seem to play a key role in determining long-term outcomes in LT recipients.This review discusses the main factors associated with late mortality and suggests possible strategies to improve long-term management and follow-up after liver transplantation.In particular,the reduction of drug toxicity,the use of tools to identify high-risk patients,and setting up a multidisciplinary team also for long-term management of LT recipients may further improve survival after liver transplantation.展开更多
The relational strategies in group are to improve patient’s BP （blood pressure） control and QoL （quality of life）. Methods： Twenty-one hypertensive patients were randomized into two groups： group A （10 patient...The relational strategies in group are to improve patient’s BP （blood pressure） control and QoL （quality of life）. Methods： Twenty-one hypertensive patients were randomized into two groups： group A （10 patients, age 67 ± 6 years, BMI （body mass index） 28.3 ± 6 kg/m2） was applied relational strategies, with meetings every 15 days 8 meetings; group B （11 patients, age 58 ± 13 years, BMI 28.2 ± 3 kg/m2） with meetings for group orientation every 40 days 3 meetings. The patients were monitored： at baseline （day 15） and at the end of the study （day 120）, the BP was measured by auscultatory method and the QoL questionnaire （WHOQOL-BREF） was applied, and was submitted to the examination with ABPM （ambulatory blood pressure monitoring）. Results： after 120 days there was a greater （p 〈 0.05） reduction in SBP （systolic blood pressure） in group A （37.8 ± 25 mmHg） than in group B （18 ± 9 mmHg）, but DBP （diastolic blood pressure） decreased similarly in both groups （A, 15 ± 21 vs B, 13 ± 14 mmHg）; the HR （heart rate） reduction was larger （p 〈 0.05） in group A （60.6 ± 8.9 bpm） than in group B （69.7 ± 10.7 bpm）. There was a more significant BMI decrease （p 〈 0.01） in group A （27.8 ± 5 kg/m2） than in group B （28.9 ± 4 kg/m2）. The observed correlations between physical domain and nightime DBP （at day 120） in ABPM were r = -0.712 （negative correlation, p = 0.003）; between psychological domain and SBP sleep time （at day 120） in ABPM were r = -0.527 （negative correlation, p = 0.044）; between environmental domain and daytime Δ HR in ABPM were r = -0.573 （negative correlation, p = 0.007）. Conclusion： the health education program conducted through interpersonal relationships within groups provided better control of SBP and greater reduction in BMI.展开更多
文摘Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, Ho Chi Minh City from June to August 2022. Data were collected from 347 people living with HIV using structured questionnaires assessing sociodemographics, substance use, drug side effects, treatment beliefs, treatment satisfaction, and depression. ART adherence was evaluated using a multi-method tool, including self-report, pill count, the Provider Interview Tool, and the Visual Analog Scale. Participants were classified as having high adherence only if they met all four criteria across these methods. Multivariable logistic regression was used to identify factors influencing adherence, with significance set at P<0.05. Results: High ART adherence was observed in 69.5% of the participants. Adherence was significantly lower among tobacco users (OR 0.49, 95% CI 0.30-0.83, P=0.007), those with higher depression scores (per 1-point increase) (OR 0.89, 95% CI 0.84-0.95, P<0.001), frequent substance users (OR 0.50, 95% CI 0.30-0.83, P=0.007), and those experiencing more severe drug side effects (per level increase) (OR 0.64, 95% CI 0.45-0.92, P=0.016). Participants able to afford treatment had nearly three times higher odds of adherence than those unable to pay (OR 2.85, 95% CI 1.48-5.47, P=0.002). Conclusions: ART adherence among people living with HIV in Vietnam remains suboptimal. Interventions should target substance use, drug side effects, financial barriers, and depression screening to improve adherence.
文摘Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely follow prescriptions. Poor adherence to radiation therapy is associated with low survival and high mortality rates. This study therefore sought to investigate the levels of adherence and factors influencing adherence to radiation therapy among cervical cancer patients being treated at Cancer Diseases Hospital. Methods: A cross-sectional analytical study design was used, 142 patients were selected from the outpatient department using a fishbowl sampling method. A structured interview schedule was used to collect data. Data was entered and analyzed using SPSS, the binary logistic regression analysis was used to predict levels of adherence to treatment and to identify factors associated with adherence to RT among cervical cancer patients. Results: The findings showed that 93% of the participants adhered to radiation therapy while 7% did not adhere to treatment. Majority of the patients 77.1% had experienced side effects of radiation therapy. About 28% of patients had severe psychological distress. By using binary logistic regression, there was a statistically significant association between adherence and perceived quality of health care services (p = 0.001). The analysis showed that patients who perceived poor quality of health care services were 0.005 (99.5%) times less likely to adhere to radiation therapy. The other independent variables were not statistically significant despite being associated with adherence among cervical cancer patients. Conclusions and Recommendations: The findings showed that patients who perceived good quality of health care services had higher chances of adherence compared to those who perceived poor quality of health care services. There is therefore a need for quality service provision which could include good maintenance of radiation machines. Furthermore, there is a need to develop guidelines for follow-up in case of any disease outbreak to avoid interference with patients’ treatment schedules and appointments for reviews.
文摘Liver transplant(LT)outcomes have markedly improved in the recent decades,even if long-term morbidity and mortality are still considerable.Most of late deaths are independent from graft function and different comorbidities,including complications of metabolic syndrome and de novo neoplasms,seem to play a key role in determining long-term outcomes in LT recipients.This review discusses the main factors associated with late mortality and suggests possible strategies to improve long-term management and follow-up after liver transplantation.In particular,the reduction of drug toxicity,the use of tools to identify high-risk patients,and setting up a multidisciplinary team also for long-term management of LT recipients may further improve survival after liver transplantation.
文摘The relational strategies in group are to improve patient’s BP （blood pressure） control and QoL （quality of life）. Methods： Twenty-one hypertensive patients were randomized into two groups： group A （10 patients, age 67 ± 6 years, BMI （body mass index） 28.3 ± 6 kg/m2） was applied relational strategies, with meetings every 15 days 8 meetings; group B （11 patients, age 58 ± 13 years, BMI 28.2 ± 3 kg/m2） with meetings for group orientation every 40 days 3 meetings. The patients were monitored： at baseline （day 15） and at the end of the study （day 120）, the BP was measured by auscultatory method and the QoL questionnaire （WHOQOL-BREF） was applied, and was submitted to the examination with ABPM （ambulatory blood pressure monitoring）. Results： after 120 days there was a greater （p 〈 0.05） reduction in SBP （systolic blood pressure） in group A （37.8 ± 25 mmHg） than in group B （18 ± 9 mmHg）, but DBP （diastolic blood pressure） decreased similarly in both groups （A, 15 ± 21 vs B, 13 ± 14 mmHg）; the HR （heart rate） reduction was larger （p 〈 0.05） in group A （60.6 ± 8.9 bpm） than in group B （69.7 ± 10.7 bpm）. There was a more significant BMI decrease （p 〈 0.01） in group A （27.8 ± 5 kg/m2） than in group B （28.9 ± 4 kg/m2）. The observed correlations between physical domain and nightime DBP （at day 120） in ABPM were r = -0.712 （negative correlation, p = 0.003）; between psychological domain and SBP sleep time （at day 120） in ABPM were r = -0.527 （negative correlation, p = 0.044）; between environmental domain and daytime Δ HR in ABPM were r = -0.573 （negative correlation, p = 0.007）. Conclusion： the health education program conducted through interpersonal relationships within groups provided better control of SBP and greater reduction in BMI.
