Financial burden of survivors of medically-managed myocardial infarction and its association with selected social determinants and quality of life in a lower middle income country

Mahesh, Pasyodun Koralage Buddhika; Gunathunga, M. W.; Jayasinghe, Saroj; Arnold, Stephan; Mallawarachchi, D.S.V.; Perera, S. K.; Wijesinghe, U A D

doi:10.1186/s12872-017-0687-y

Cited by 13 publications

(11 citation statements)

References 41 publications

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“…The present study was done to explore the preand post-exacerbation QOL and their associated factors among patients with COPD. Findings of this study point towards low QOL of patients with COPD worsening following an exacerbation, compared to other chronic NCDs such as myocardial infarction and stroke (25,(26)(27). Older age, better health infrastructure, higher income and lower severity of the exacerbation are associated with a reduction of QOL compared to the baseline.…”

Section: Discussionmentioning

confidence: 70%

“…The questionnaire included the socio-demographic details, health infrastructure related details and the SF-Mahesh PKB et al JCCPSL 2018, 24 (2) Open Access 36 QOL measuring tool. A validated tool was used to quantify the health infrastructure based on availability, accessibility and affordability of health services with a maximum possible score of 5 (25)(26)(27). The SF-36 was administered to assess the baseline QOL (i.e.…”

Section: Methodsmentioning

confidence: 99%

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Quality of life and its associated factors among patients with COPD before and after an exacerbation in Sri Lanka

Mahesh¹,

Gunathunga

Jayasinghe

et al. 2018

J Coll Community Phys Sri Lanka

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Background: With demographic and epidemiological transitions, the burden of chronic non-communicable diseases (NCDs) is rising in Sri Lanka. Chronic obstructive pulmonary disease (COPD) is one main chronic NCD, the exacerbations of which are known to worsen the quality of life (QOL). Documented literature on the QOL of COPD patients is not commonly found in Sri Lanka and rarer on its exacerbations. Objective: To describe the QOL and its associated factors among patients with COPD before and after an exacerbation in Western Province of Sri Lanka Methods: A longitudinal study with two waves of data collection was done in 13 government hospitals among 289 participants in 2015. The study population included patients admitted to hospital with an exacerbation of COPD. Sample size was calculated to estimate the expected QOL in numerical scale with reference to documented global literature. The pre-exacerbation and post-discharge one month QOL was assessed using SF-36 generic QOL tool. Bivariate analysis was done followed by multivariate analysis. Results: In seven domains, there was a significant decline in QOL from pre-exacerbation to one month postdischarge (p<0.05). Further, pre-exacerbation QOL significantly correlated with post-discharge QOL in relation to five domains. Age (two domains), income (seven domains) and health infrastructure (seven domains) were significantly associated with their pre-exacerbation QOL. Younger age, higher income and better health-infrastructure are associated with relatively higher baseline. Older age, higher monthly income, better health infrastructure and less severity of the exacerbation were independent predictors of reduced QOL following an exacerbation. Conclusions: The QOL among COPD patients was relatively low compared to patients with other chronic NCDs such as myocardial infarction and stroke. The QOL in relation to several aspects worsened with exacerbations. Post-discharge QOL can be predicted with pre-exacerbation QOL for five domains of QOL.

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Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Quality of life and its associated factors among patients with COPD before and after an exacerbation in Sri Lanka

Mahesh¹,

Gunathunga

Jayasinghe

et al. 2018

J Coll Community Phys Sri Lanka

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“…It took in average 20 min for an interview with a participant. The median (Inter Quartile Range) age of the sample was 56 (46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65). The total respondents were 180 with the male to female ratio of the participants being approximately 2.8 to 1 (73 to 27%).…”

Section: Resultsmentioning

confidence: 99%

“… There will be a statistically significant difference of the financial domain scores between the groups with financial burden at family level and those who are not. The sixth was evaluated by a set of four judgmentally-validated questions composed by reviewing the literature on financial burden [ 58 ]. The questions were; whether the participant had to apply for a loan, whether the participant had to sell a property, whether the participant had a reduction of income and whether the participant had to restrict the expenses for other usual matters due to the impact of the disease condition.…”

Section: Methodsmentioning

confidence: 99%

Post-stroke Quality of Life Index: A quality of life tool for stroke survivors from Sri Lanka

Mahesh¹,

Gunathunga

Jayasinghe

et al. 2020

Health Qual Life Outcomes

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Background: Burden of stroke is rising due to the demographic and epidemiological transitions in Sri Lanka. Assessment of success of stroke-management requires tools to assess the quality of life (QOL) of stroke survivors. Most of currently used QOL tools are developed in high-income countries and may not reflect characteristics relevant to resource-constrained countries. The aim was to develop and validate a new QOL tool for stroke survivors in Sri Lanka. Methods: The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was referred. A conceptual framework was prepared. Item generation was done reviewing the existing QOL tools, inputs from experts and from stroke survivors. Non-statistical item reduction was done for the 36 generated items with modified-Delphi technique. Retained 21 items were included in the draft tool. A cross sectional study was done with 180 stroke survivors. Exploratory Factor Analysis was done and identified factors were subjected to varimax rotation. Further construct validity was tested with 6 a-priori hypothesis using already validated tools (SF-36, EQ-5D-3 L) and a formed construct. Internal consistency reliability was assessed with Cronbach alpha. Results: Four factors identified with principal-component-analysis explained 72.02% of the total variance. All 21 items loaded with a level > 0.4. The developed tool was named as the Post-stroke QOL Index (PQOLI). Four domains were named as "physical and social function", "environment", "financial-independence" and "pain and emotional-wellbeing". Four domain scores of PQOLI correlated as expected with the SF-36, EQ-5D Index and EQ-5D-VAS scores. Higher domain scores were obtained for ambulatory-group than the hospitalized-group. Higher scores for financial-independence domain were obtained for the group without financial-instability. Five a-priori hypothesis were completely proven to be true. Cronbach-alpha level ranged from 0.682 to 0.906 for the four domains. Conclusions: There is first evidence for sufficient construct validity of the PQOLI as a valid QOL tool for measuring the QOL of stroke survivors with satisfactory internal consistency reliability.

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“…The output can be described as a health profile, health status which is self-rated and as an index value [16]. It has been used to measure QOL among patients with myocardial infarctions in Sri Lanka [17].…”

Section: Introductionmentioning

confidence: 99%

Construct validity and reliability of EQ-5D-3L for stroke survivors in a lower middle income setting

et al. 2019

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Introduction Stroke is a leading disease accounting for burden of chronic NCDs especially in lower and lowermiddle income (LMI) settings. Quality of Life (QOL) is considered as an important facet of determination of success of patient management. EQ-5D-3L is a generic QOL tool. It provides an index score amalgamating responses for five descriptive questions and a visual analogue scale (VAS) value. Objectives To assess the validity and reliability of EQ-5D-3L for stroke patients in Sri Lanka, which is a LMI setting. Methods A descriptive cross sectional study was done among 100 stroke survivors among whom 50 each were managed at an ambulatory setting and an inward setting. A second wave of data collection was done for reliability analysis among one half of participants. The validity of EQ-5D-3L was assesses with five a-priori hypotheses. Reliability was assessed with test-retest method and with internal consistency. Non parametric Mann Whitney U test and Spearman correlation coefficients were used in the analysis. Results The EQ-5D index scores had significant positive correlation with SF-36 domain scores (p<0.001). The EQ-5D VAS scores had significant positive correlation with SF-36 domain scores (p<0.01). Index and VAS values of the EQ-5D were proved to be valid in known-group comparison (p<0.001). Participants reporting some kind of impairment for EQ-5D-3L dimensions had lower SF-36 domain scores. All the kappa values in the analysis of test-retest method were significant (p<0.001). For the VAS score, the Spearman correlation coefficient in testreter analysis was 0.993 (p<0.001). Cronbach's alpha value was 0.928. Conclusions and Recommendations EQ-5D-3L questionnaire demonstrates construct validity and is a reliable tool in measuring QOL among stoke survivors in Sri Lanka. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Financial burden of survivors of medically-managed myocardial infarction and its association with selected social determinants and quality of life in a lower middle income country

Cited by 13 publications

References 41 publications

Quality of life and its associated factors among patients with COPD before and after an exacerbation in Sri Lanka

Quality of life and its associated factors among patients with COPD before and after an exacerbation in Sri Lanka

Post-stroke Quality of Life Index: A quality of life tool for stroke survivors from Sri Lanka

Construct validity and reliability of EQ-5D-3L for stroke survivors in a lower middle income setting

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