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Background: With advancing treatment of stroke patients, their mortality has decreased but morbidity and disability has increased. Hence, it becomes increasingly important to find the measures to improve these areas. The study aims to assess the quality of life (QOL) and disability in stroke survivors at least six months post stroke. Methods: Descriptive, cross sectional design was used to assess the QOL and disability in stroke patients attending Neuromedicine and Neurosurgery out-patient departments of Kathmandu Medical College. Data was collected purposively using interview from 155 respondents. QOL was assessed using Health Related Quality of Life in Stroke Patients (HRQOLISP-40) and disability was measured by using World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Analysis was done using Pearson’s correlation and Mann Whitney U test. Results: The QOL was found to be best in the ‘ecosocial’ and worst in the ‘soul’ domain. In disability, patients scored the best in ‘Getting along with people’ and ‘self-care’ domains and worst in the ‘life activities: school/ work’ domain. Respondents with hemorrhagic stroke, only one admission and those who did not exercise had better QOL. Patients with less than 10 years of formal education, those not earning and those with comorbidities had more disability. Correlation analysis showed better QOL with lesser age, higher monthly family income and higher Barthel index whereas higher disability was found in respondents with higher age and lower Barthel index. Conclusions: Disability in stroke patients needs to be addressed inorder to improve their QOL. The domains affected should be given attention during rehabilitation of stroke patients.

Background: Chronic diseases are in an increasing trend worldwide. Although, this rise may be due to a number of factors, one reason for the worldwide increase is due to better treatment protocols and higher awareness among patients. The management of chronic disease depends on the patient’s ability to alter the modifi able risk factors. The burden of disease can be decreased with better self- efficacy. Objectives: To assess the self-efficacy among patients with chronic diseases Methodology: In this descriptive, cross sectional study, data was collected purposively from 329 patients with chronic diseases presenting in the Medical outpatient department of Kathmandu Medical College. Face to face interview method was used to collect data using Chronic Disease Self-efficacy Scale and Patient Assessment Chronic Illness Care Questionnaire. Association with selected socio demographic variables were computed with Mann Whitney U and Kruskal Wallis H tests. Results: The mean age of the patients was 62±13 years. Males, those earning, those never admitted in the hospital for their disease and those who exercised were found to have better self-efficacy. There was significant difference in self-efficacy in terms of age, education, marital status, caregivers and body mass index. Self-efficacy showed significant positive correlation with monthly family income and health care provider score whereas significant negative correlation with age and monthly cost of treatment. Conclusion: Self-efficacy of patients with chronic disease can be improved with certain modifiable factors like daily exercise and appropriate body mass index. Younger patients, males, educated, employed and married patients were found to have better self-efficacy. Proper counselling by health care providers also improves self-efficacy.

High prevalence of behavioral risk factors for cardiovascular disease (CVD) warrants a life course approach for efficient prevention. Our previous HARDIC trial in semi-urban Nepal shows conventional CVD educational interventions for mothers improved knowledge, attitude, and practice (KAP). Digital cardiovascular health promotion provides opportunities to efficiently reach adolescents. Our aim was therefore to develop such digital health promotion through a serious game that is educational and entertaining, as an innovative way to reach adolescents. We conducted a mixed-method study to assess adolescents’ KAP and perception regarding CVD, explored opportunities for digital cardiovascular health promotion, and developed a concept for a serious game prototype. In total, 649 adolescents grades 8-10 in two government and seven private schools in a semi-urban community of Nepal were surveyed cross-sectionally following parental consent. A self-administered questionnaire assessed KAP of CVD, mobile phone use, internet availability at home and gaming behaviors. For deeper understanding of adolescents’ perception on CVD, we conducted eight focus group discussions (FGDs) separately among boys and girls (n=76). The health belief model and the technology acceptance model guided FGD development and analysis. Eighty percent of adolescents were aged 13-15 years, 49% were girls and 40.4% studied in government schools. The median (IQR) percent scores for KAP were 70.6 (10.59), 78.5 (8.46) and 69.5 (11.59), respectively. Good KAP (median percent scores >75%) was found in 27.7%, 69% and 27.8% adolescents, respectively. Knowledge ( p <0.001), attitude ( p =0.025) and practice ( p <0.001) was higher among adolescents in private than government schools. Girls had better attitude than boys (<0.001). Furthermore, 98% adolescents had smartphone access and 91.6% had internet access.Preliminary FGD analyses show that adolescents mentioned physical, nutritional, mental, environmental, and hereditary causes for CVD. Financial and work-related burdens, as well as psychological, mental and family-related issues were perceived to influence CVD severity. Temptations for junk food and physical inactivity were barriers to follow heart-healthy behavior. Adolescents perceived serious games as beneficial and easy to use for creating CVD awareness. The game should offer challenge and exhibit increased levels of difficulty to remain stimulating throughout its intended use.We conclude that the existing gaps in knowledge and practice, with good attitude and excellent mobile and internet prerequisites, provide great opportunity for serious games in Nepal. The prototype of “Happy Heart” is being pilot-tested among adolescents, suggesting a promising way forward for digital cardiovascular health promotion.

Besides providing baseline data about donors in Nepal, this study may guide health professionals in counselling potential donors and assisting patients and their families to make informed decisions regarding transplant. It can assist health care planners in making policies concerning transplant.