Study on the current situation and influencing factors of unmet needs of patients after radical gastrectomy for gastric cancer based on mixed-methods approach / 中国实用护理杂志

Objective:To investigate the status quo and influencing factors of unsatisfied needs of patients after radical gastrectomy for gastric cancer through quantitative and qualitative mixed research methods, and to provide reference for the development of effective health management programs in the future.Methods:A total of 297 patients who were hospitalized in Tianjin Medical University Cancer Hospital from January to December 2021 after radical gastretomy were selected as subjects by convenient sampling method. The general data questionnaire and Short-Form Survivor Unmet Needs Survey (SF-SUNS) were used to investigate. Selected 12 patients with gastric cancer by objective sampling method for semi-structured in-depth interview and collate data by Colaizzi 7-step analysis method.Results:The total average score of 297 subjects who did not meet the requirements was (60.91 ± 16.00), which was in the middle level. The average score of each dimension from high to low was: continuous care unmet needs (2.37 ± 0.75) points, work economy unmet needs (2.22 ± 0.65) points, information unmet needs (2.20 ± 0.92) points, emotion unmet needs (1.72 ± 0.60) points. Educational background, main economic source of family and working state were the influencing factors of unmet demand ( t=5.32, -3.59, -3.28, all P<0.05). Qualitative research had extracted four themes: unmet needs for symptom network recognition and accurate symptom management, unmet needs for shared decision participation and disease perception trajectory, unmet needs for dignity maintenance and reconstruction of psychological stress mechanism, and unmet needs for "Internet plus" mobile medical continuous care. Conclusions:The problem of unmet needs of patients after radical gastritis is still prevalent and affected by a variety of factors. It is suggested that medical workers build an effective supportive care system based on the status quo of unmet needs of patients, promote the whole process of multidimensional health management services for patients with gastric cancer, and improve the quality of life.

Unmet Needs Among Breast Cancer Patients in a Developing Country and Supportive Care Needs Survey Validation

Background: Identifying and addressing breast cancer (BC) patients' unmet needs (UN) are crucial due to their possible contribution to higher levels of morbidity, particularly in vulnerable underserved populations, such as Latinas with BC. Objective: This study aimed to (1) identify and describe the most frequently reported items of moderate-high UN among Mexican women with BC covered by public healthcare insurance; (2) analyze the differences in UN domains according to participants' sociodemographic and clinical characteristics; and (3) validate the Supportive Care Needs Survey-Short Form-34 (SCNS-SF34). Methods: A cross-sectional study was conducted with 396 consecutive BC patients. A linguistically translated and culturally adapted version of the SCNS-SF34 for Mexican women with BC was completed by the participants. Results: The validation yielded a 32-item version of the SCNS with adequate psychometric properties. The Health System and Providers Information was the highest UN domain, followed by the psychological domain. "Fears about cancer spreading" (37.4%) and "Concerns about the worries of those close to you" (37.3%) were the most prevalent moderate-high UN. Sexuality was the only domain associated with clinical and sociodemographic characteristics. Conclusion: By defining the most urgent needs of this group of patients, our results will enable the development of targeted support services and patient-centered care.

Unmet needs for family planning and its socio-demographic correlates among women in the reproductive age group in central rural India

Background: Unmet need is the discrepancy between reproductive intentions and birth control practices. If the unmet needs remained neglected it leads to population explosion which is one of the greatest threats to India’s economic, social and political development. A community-based study was carried out in rural areas with the objective to find the prevalence of unmet need for family planning and its socio-demographic determinants among married women of reproductive age.Methods: A community based cross sectional study was conducted between January to June 2019. After calculation of sample size 670 participants were selected by simple random sampling method. Predesign and semi structured Performa was used for data collection. Data was collected and analyse using Epi Info 7.Results: Unmet needs of family planning among the study subject was 31.19% (57.58% for the spacer and 42.42% for limiter). It was significantly higher among the Muslim (66.67%) and Boudh (40.38) religion. It was higher among Illiterate (40.82%), women residing in joint families (72.16%). Unmet need of family planning was significantly associated with age of women, religion, educational status of women and their husbands, occupation, type of family, no of children the women have and age at marriage.Conclusions: Unmet needs among married women in the reproductive age group was still high and was significantly associated with age of women, religion, educational status of women as well as their husband, occupation, type of family, number of children the women had and age at marriage.

Unmet Needs and Services of Nursing Care for Adults with Extremely Severe and Severe Intellectual Disabilities Using Structural Equation Analysis / 中国康复理论与实践

Objective:To explore the characteristics and related factors of unmet needs of nursing care and service for adults with extremely severe and severe intellectual disabilities. Methods:A total of 127 547 adults with extremely severe and severe intellectual disabilities were sampled. Descriptive statistics and multiple response analysis were conducted, and a structural equation model of unmet needs of nursing care and received the services was developed. Results:A total of 26 038 adults with extremely severe and severe intellectual disabilities reported unmet needs of rehabilitation, including nursing care (52.50%), medicine (36.90%), assistive device (20.90%), functional training (19.70%) and surgery (0.80%) respectively. A total of 11 640 adults with extremely severe and severe intellectual disabilities reported received rehabilitation services, including nursing care (49.90%), medicine (36.80%), functional training (19.10%), assistive device (14.10%) and surgery (1.00%) respectively. The structural equation model showed that received nursing care service (main effect = 0.646) and received rehabilitation services (included nursing care) (main effect = 0.014), age (main effect = 0.031), household registration (main effect = 0.015) and educational level (main effect = -0.158) had effects on unmet needs of nursing care (P < 0.001). Conclusion:Adults with extremely severe and severe intellectual disabilities reported unmet needs mainly involved in field of nursing care, and their rehabilitation services mapped to their main needs. It proposed to develop rehabilitation services tailored to their rehabilitation experience, age, socioeconomic status, functional conditions and characteristic of unmet needs, to develop accessible services items and individualized nursing care programs, and to expand the nursing care service supply and coverage of nursing care.

Unmet Needs and Services of Rehabilitation for People with Intellectual Disabilities Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To analyze the characteristics of unmet needs and services of rehabilitation for people with intellectual disability (PIDs). Methods:A total of 250 654 PIDs had been sampled and administration data of unmet needs and services of rehabilitation at provincial level had been analyzed the characteristics of unmet needs and services of rehabilitation, and the related factors of needs and services were analyzed with Logistic Regression. Results:The rate of unmet needs reported by PIDs from high to low were nursing (47.8%), medicine (37.2%), functional training (26.1%), assistive devices (19.8%) and surgery (1.3%). The PIDs reported received service of rehabilitation, including nursing care (43.5%), medicine (29.3%), functional training (27.2%), assistive devices (19.6%) and surgery (0.8%). Logistic Regression Model showed that age and severity of disabilities significantly affect the reported the unmet needs and received services (P < 0.001). Conclusion:PIDs reported unmet needs mainly involved in the fields of nursing care, medicine and rehabilitation training and therapy. The unmet needs and received services had similar structure. It proposed to develop rehabilitation services tailored to PIDs' intellectual function and adaptive behaviors to develop services items and to deliver individualized and precise services.

Unmet Needs and Services Development of Rehabilitation for People with Hearing Disability Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To explore the characteristics of unmet needs and services of rehabilitation for people with hearing disability (PHD). Methods:A total of 219 473 PHDs administration data of unmet needs and services of rehabilitation at provincial level were sampled (2019) and analyzed the characteristics of needs and services of rehabilitation with multiple response analysis, and the related factors of needs and services with Logistic regression. Results:There were 47 657 (21.7%) PHDs reported their unmet needs of rehabilitation, from high to low were assistive devices (65.5%), medicine (22.7%), nursing care (19.1%), functional training (16.2%) and surgery (2.2%). There were 34 684 (18.8%) PHDs reported their received services, from high to low were assistive devices (59.8%), medicine (22.5%), functional training (19.7%), nursing care (19.4%) and surgery (1.8%). The logistic regression model showed that age, types of household registration and severities of disabilities related with the reported unmet needs and received services (P < 0.001). Conclusion:PHDs mainly reported unmet needs in the fields of assistive devices, medicine, and rehabilitation training. The reported unmet needs for PHDs had matched the received services structurally. It proposed to use modern science and technology to develop services delivery and to improve accessibility and quality of rehabilitation services.

Unmet Needs and Services of Rehabilitation for People with Visual Disability Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To analyze the characteristics of needs and development of rehabilitation services for people with visual disability (PVD). Methods:A total of 241 865 PVDs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:There were 50 882 (21.0%) PVDs reported their needs of rehabilitation, from high to low were assistive devices (56.5%), medicine (29.0%), nursing care (24.6%), functional training (15.5%), and surgery (4.2%). There were 43 492 (18.0%) PVDs reported their received services of rehabilitation, from high to low were assistive devices (55.0%), medicine (21.6 %), nursing care (20.8%), functional training (20.7%) and surgery (2.3%). The logistic regression model showed that severities of disabilities related with the reported unmet needs and received services (P < 0.001). Conclusion:PVDs reported unmet needs mainly in the fields of assistive devices, medicine, and nursing care. There is match structure of unmet needs and received services. It is important to provide accessible information environment. Information and communication technology (ICT) are proposed to assistive technology services for PVDs to enhance their capacity of information acquisition and to promote their participations.

Unmet Needs and Services of Rehabilitation for People with Physical Disabilities Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To explore the characteristics of unmet needs and services of rehabilitation for people with physical disabilities (PWPs). Methods:A total of 1 512 438 PWPs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:The reported unmet needs of PWPs from high to low were assistive devices assistive devices (55.9%), nursing care (27.0%), medicine (26.3%), functional training (23.9%) and surgery (2.3%). Received service of rehabilitation. The services of rehabilitation for PWPs arranged as assistive devices (48.2%), nursing caring (26.4%), functional training (24.3%), medicine (19.5%) and surgery (1.4%). The logistic regression model showed that age and severity of disabilities had significant effect on the reported unmet needs of rehabilitation and received services for PWPs (P < 0.001). Conclusion:PWPs reported unmet needs mainly in the fields of assistive devices, nursing care, medicine and rehabilitation training. They received primary services included assistive devices, nursing care and rehabilitation training and therapies. The services development will emphasize the accessibility and coverage. According to ICF model, it proposed to take measures to implement individualized and precise rehabilitation services to improve the quality of services.

Unmet Needs and Service of Rehabilitation for Children with Disabilities / 中国康复理论与实践

Objective:To explore the status of disability, and characteristics of unmet needs and services of rehabilitation for children with disabilities (CWDs). Methods:A total of 130 290 CWDs administration data of unmet needs and services of rehabilitation at provincial level had been sampled and analyzed. Results:CWDs accounted for 5.33% of the total population with disabilities, in which, 60.4% were boys and 39.6% were girls; 16.3% aged 0 to nine years and 83.7% were seven to 18 years old; 88.4% with agricultural household and 11.6% with non-agricultural household. The distribution of disability severity from severe to mild were 28.3%, 39.5%, 17.7% and 14.6%. The reported unmet needs included assistive devices (40.3%), functional training (37.4%), nursing care (32.2%), medicine (24.9%) and surgery (5.7%). The received services involved in assistive devices (37.9%), functional training (33.7%), nursing care (31.0%), medicine (19.7%) and surgery (2.9%). Logistic Regression model showed that severities of disabilities had significant effects on reported unmet needs and received services (P < 0.001). Conclusion:Implement rehabilitation programs would be tailored to the unmet needs of rehabilitation as CWDs had functioning oriented unmet needs. It proposed to develop individualized and structured rehabilitation services to improve the accessibility and quality of rehabilitation for CWDs.

Unmet Needs and Services of Rehabilitation for Adults with Disabilities / 中国康复理论与实践

Objective:To explore the status of disability, characteristics of unmet needs and services of rehabilitation and their related factors for adults with disabilities (AWDs). Methods:A total of 2 315 498 AWDs were sampled from the provincial level administration data (2019). Multiple response analysis was used to analysis the disability status of AWDs, characteristics of unmet needs and received services of rehabilitation, and related factors were explored with Logistic regression. Results:The distribution of disabilities for AWDs from high to low were physical disabilities (62.2%), visual disabilities (9.9%), intellectual disabilities (8.4%), mental disorders (7.3%), hearing disabilities (6.9%), multiple disabilities (2.8%) and speech disabilities (2.5%). The reporting rate of unmet needs of rehabilitation for AWDs from high to low were assistive devices (49.0%), medicine (33.3%), nursing care (27.7%), functional training (20.2%) and surgery (1.9%). The reporting rate of received service for AWDs from high to low were assistive devices (44.1%), nursing care (26.6%), medicine (25.9%), functional training (22.2%) and surgery (1.3%). The logistic regression model shown that types and severities of disabilities had significant effects on unmet needs and received services of rehabilitation for AWDs (P < 0.001). Conclusion:The reporting of unmet needs for AWDs had been influenced by their functioning and disability. There were gaps between unmet needs and received services. It proposed to develop precise and individualized reporting of unmet needs and service programs for AWDs.

Knowledge attitude and practice of contraception in Barabanki district of Uttar Pradesh: how far are we from meeting the unmet needs of contraception

Background: Barabanki one of the most populous districts of Uttar Pradesh with population growth rate being much higher than the national population growth rate. The objective of this study was to gain the knowledge about awareness and contraceptive practices in married women residing in Barabanki. To identify socio-demographic factors associated with unmet needs for contraceptionand also to ascertain the participation of husband in family planning.Methods: A cross sectional study was conducted in outpatient department of Obstetrics Gynecology and Department of Pediatrics in Medical college hospital in Barabanki. 144 females were enrolled in the study during the study period of one year. They were interviewed on the basis of a pre-structured proforma. Data obtained was then analyzed.Results: A total 144 women in the age group 18-45 years participated in the study of which 53% had knowledge of contraception. More than two thirds were not using any form of contraception. The most common method of contraception was barrier method followed by Depot medroxy progesterone acetate. Copper T was least used mode of contraception. The most common source of knowledge regarding contraception was from electronic media followed by friends and family. The most common reason behind the absence of contraception was lack of knowledge of contraception and husband disapproval.Conclusions: Poor knowledge of contraception led to decreased usage of contraceptive measures. Husband participation is virtually absent in family planning leading to high fertility. In order to make our family planning programs successful we must incorporate media for wider coverage to increase awareness and husbands for better implementation.

Access to pain management for cancer patients treated under the Brazilian private healthcare system / Acesso ao tratamento da dor de pacientes com câncer atendidos no sistema de saúde privado brasileiro

Objective: To reflect about current pain management in cancer patients treated under the Brazilian Private Healthcare System, considering legal boundaries, access to essential drugs and involved ethical issues. Panelists aimed to reach a consensus about recommendations to increase access to proper analgesia for patients with cancer secondary pain. Methods: Four Brazilian specialists, being a radiation oncologist (and bioethicist), an oncologist, a pain specialist and a CEO of a private healthcare plan, met after the 2019 American Society of Clinical Oncology (ASCO) meeting, held in Chicago, and discussed the aforementioned subjects. A consensus was reached and is described below. Results: Cancer pain is prevailing in our country, probably undertreated, and may be a prevalent cause of medical services overuse, which may increase healthcare costs. Thus, there may be an opportunity to improve patient's quality of life, with a positive budget impact for private healthcare plans, if this treatment becomes mandatorily reimbursed. There are several studies in the literature showing similar results, but this should be prospectively studied, preferable using real word evidence, at the Brazilian scenario. Cancer pain treatment protocols, designed by specialists, should be designed in agreement with all stakeholders. Conclusion: Panelists agreed that pain treatment, which must be considered a human right, is a clear priority in Brazil. All stakeholders should collaborate in designing protocols to improve patient's quality of life, consequently improving health insurance's budgets. If so, this would have clear consequences in access to innovative cancer treatments, as those discussed during the 2019 ASCO meeting.

Objetivo: Refletir sobre o manejo atual da dor em pacientes com câncer atendidos no sistema de saúde privado brasileiro, considerando limites legais, acesso a medicamentos essenciais e questões éticas envolvidas. Os participantes do painel procuraram chegar a um consenso sobre recomendações para aumentar o acesso à analgesia adequada para pacientes com dor secundária ao diagnóstico de câncer. Métodos: Quatro especialistas brasileiros reuniram-se após a reunião da Sociedade Americana de Oncologia Clínica (ASCO) de 2019, realizada em Chicago, e discutiram os mencionados assuntos. Um consenso foi alcançado e é descrito abaixo. Resultados: A dor oncológica prevalece em nosso país, provavelmente subtratada, e pode ser uma causa predominante de uso excessivo de serviços médicos, o que pode aumentar os custos com saúde. Assim, pode haver uma oportunidade de melhorar a qualidade de vida do paciente, com um impacto orçamentário positivo para planos de saúde privados, se esse tratamento for obrigatoriamente reembolsado. Existem vários estudos na literatura que mostram resultados semelhantes, mas isso deve ser estudado prospectivamente, preferencialmente usando evidências provenientes de dados de mundo real, no cenário brasileiro. Os protocolos de tratamento da dor do câncer, preparados por especialistas, devem ser elaborados de acordo com todas as partes interessadas. Conclusão: Os participantes do painel concordaram que o tratamento da dor, que deve ser considerado um direito humano, é uma clara prioridade no Brasil. Todas as partes interessadas devem colaborar na elaboração de protocolos para melhorar a qualidade de vida do paciente, consequentemente melhorando os orçamentos do seguro de saúde. Nesse caso, isso teria consequências claras no acesso a tratamentos inovadores contra o câncer, como os discutidos durante a reunião da ASCO em 2019.

Awareness and contraceptive practices among reproductive women in an urban area, Telangana, India: a cross-sectional study

Background: Current world population is 7.6 billions and India accounts 1.3 billions, India is the second most populous country in the world, by 2050 the world’s population is expected to reach 9 billion. Family Planning can have a positive impact on population growth, maternal mortality, and infant and new-born outcomes. Hence there is a need for considerable improvement in coverage and quality of family planning services. The objective of the study is to assess the awareness and contraceptive practices among womens.Methods: This cross-sectional study was conducted in an urban health-training center area of Rangareddy district, Telangana state. The study participants involved were women of reproductive age group 15–45 years. 200 women were selected by simple random sampling technique. Data entry was done in Microsoft excel and analyzed using SPSS version 20.Results: In this study 50% women belong to 26-35 year age group. 64% were literate, 41.4% belong to upper middle class, 74% women’s source of information regarding contraceptives is from medical professionals. 61% women are aware of contraception and 34% practice it.Conclusions: Based on our observation, 60% women were aware of contraception but only 34% practice at least one method. The common reasons for not practicing contraception are lack of knowledge, the desire for male child, pressure from husband. This study concludes that factors like age, education, socio-economic status have significant impact on awareness and practice of contraception.

Comparison of Factors Affecting Perceived and Objective Dental Needs / 치위생과학회지

BACKGROUND: With increased interest in oral health, several efforts have been made to improve oral health conditions. To achieve this, needs for oral health must be precisely determined and accurately measured. Therefore, factors influencing both objective unmet dental needs, which were determined by experts, and perceived unmet dental needs, which were determined by patients, were examined in this study. METHODS: Responses of 17,735 respondents aged greater than 19 years from the Korean National Health and Nutrition Survey collected using the fifth (2010~2012) rotation sample survey were analyzed. Based on the information collected from the survey and dental examination, we determined the associations between the independent (sex and socioeconomic level) and dependent variables using a chi-squared test. Moreover, ordinal logistic regression analyses on multiple categorical values were performed using perceived and objective dental needs as the dependent variables. RESULTS: Generally, factors influencing both perceived and objective dental needs were similar. These included sex, household income, educational level, private insurance, and subjective oral health status. However, the high-income groups had lesser perceived and objective dental needs compared to the low-income groups. Furthermore, factors such as sex, educational level, and marital status had different influence on both needs. CONCLUSION: Generally, factors that affect perceived and objective dental needs were similar. To minimize unmet dental needs, factors influencing both perceived and objective dental needs should be examined for a broad dental insurance coverage, and efforts to prevent oral diseases are also required.

Lupus among Filipinos: Unmet needs

@#Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of manifestations and potential to affect several organ systems. Complications arise from the disease itself as well as the medications especially glucocorticoids, significantly contributing to overall morbidity and mortality. SLE predominantly affects patients during prime productive years resulting in a substantial economic burden on the patient, caregivers, and society due to direct, indirect and intangible costs. The University of Santo Tomas (UST) lupus database established in 2008 and supported by Lupus Inspired Advocacy (LUISA), aims to bring recognition of SLE as an important disease among Filipinos, serving as the impetus to drive policy makers to include SLE in the national health agenda.

Factors and Determinants of Unmet Needs: Identifying Association Between Variables and Unmet Needs Among Married Women of Child Bearing Age in Lahore, Pakistan

Background: Unmet needs for family planning is an important method to evaluate family planning programs hence this study was conducted to assess the unmet needs of contraception and its associated factors and reasons. Objectives: 1) to determine the unmet needs, its determinants and reasons among fecund and sexually active married women 2) to identify association between variables and unmet needs among fecund and sexually active married women. Materials & Methods: It was a community based cross sectional study, conducted in the catchment area of Institute of Public Health Lahore. Sample size was 200 women of Child Bearing Age (CBA) who were fecund and sexually active, with no history of hysterectomy, and living with their husbands. Simple random sampling technique was applied to recruit the sample population. Data was collected upon a structured questionnaire. Dependent variable was unmet needs; and independent variables included socio demographic variables and factors related to reproductive health. Data entered and analyzed upon SPSS version 23. Descriptive statistics calculated; Bivariate analysis was applied to identify association of variables with met and unmet needs.  Results: About 19.38% women had unmet needs for family planning; 8.59% for limiting and 10.79% for spacing. Family Planning knowledge, discussion about family planning between spouses and Husband’s sole role as a decision maker were significantly associated with unmet needs. Reasons for unmet needs were fear of side effects 29.5%, experience of side effects 21.6% mainly menstrual cycle disturbance and weight gain, Lack of information 13.6%, disapproval from their husbands 20.5% and by their Mother in Laws 9.1%. Conclusion: Our study indicated unmet needs for contraception comparable to latest report by Pakistan Bureau of Statistics 2015-2016 (35.5%) but still there is a scope to improve health education system, plan a structured counselling for Family Planning, reduce the impact of obstacles and address current issues to meet contraception needs.

Survey on Sports Participation and Unmet Needs of Services for 6-12 Years Old Children with Intellectual Disabilities in the Areas of Minority Nationalities in Hubei Province / 中国康复理论与实践

@#Objective To investigate the situation of sports participation and the unmet needs of services for 6-12 years old children with intellectual disabilities. Methods 420 children with intellectual disabilities in areas of minority nationalities in Hubei province aged 6-12 years were surveyed with a questionnaire. Statistics had been conducted for situation and unmet needs of services. Results 72.6%respon-dents wanted to participate in sport, 70%respondents participated in sport at least once a week, maining for rehabilitation;the unmet needs of services mainly focused on the special education, medical rehabilitation, functional training and the non-barrier transformation for kitchen and toilets. Conclusion Comprehensive rehabilitation and services are needed in 6-12 years old children with intellectual disabilities in areas of minority nationalities in Hubei Province. The diversity of unmet needs needed to be attend.

Quality of life in young onset dementia: an updated systematic review / Qualidade de vida na demência de início precoce: uma revisão sistemática atualizada

Introduction Young onset dementia (YOD) develops before 65 years of age and has specific age-related adverse consequences for quality of life (QoL). We systematically examined factors related to the QoL of people with YOD and their caregivers. Method This systematic review used the PRISMA methodology. The literature search was undertaken on July 5, 2015, using Cochrane, PubMed, SciELO, PsycINFO, Scopus and Thomson Reuters Web of Science electronic databases. The search keywords included early onset and young onset combined with, dementia, Alzheimer, vascular dementia, mixed dementia, frontotemporal dementia, quality of life, well-being and unmet needs. Nine studies were included. We revised objectives, study design, sample, instruments and results related to QoL. Results People with YOD rated their own QoL significantly higher than their caregivers. Greater awareness of disease among people with YOD is associated with better QoL in caregivers. A relationship was found between unmet needs and daytime activities, lack of companionship and difficulties with memory. Issues associated with unmet needs were prolonged time to diagnosis, available health services and lack of caregiver's own future perspective. Conclusion Consideration should be given to conducting investigations with more homogeneous samples and use of a clear concept of QoL. The present study highlights the need for future research in a wider range of countries, using instruments specifically for YOD. It would be interesting if studies could trace parallels with late onset dementia groups.

Introdução A demência de início precoce se desenvolve antes dos 65 anos e possui consequências adversas específicas relacionadas à idade para a qualidade de vida (QV). Nós examinamos de forma sistemática fatores ligados à QV de pessoas com demência de início precoce e seus cuidadores. Método Foi utilizada a metodologia PRISMA, com busca nas bases de dados Cochrane, PubMed, SciELO, PsycINFO, Scopus e Thomson Reuters Web of Science electronic em 5 de julho de 2015. Foi utilizada a palavra-chave início precoce combinada com demência, Alzheimer, demência vascular, demência mista, demência frontotemporal, qualidade de vida, bem-estar e necessidades não atendidas. Nove estudos foram incluídos. Foram revisados os objetivos, desenho, amostra, instrumentos e resultados relacionados à QV. Resultados Pessoas com demência de início precoce pontuaram sua própria QV significantemente mais alta que seus cuidadores. A maior consciência da doença entre essas pessoas é associada com melhor QV dos cuidadores. Foi encontrada relação entre necessidades não atendidas e atividades diárias, falta de companhia e dificuldades com a memória. A demora na definição do diagnóstico, os serviços de saúde disponíveis e a falta de perspectivas futuras do cuidador foram fatores associados às necessidades não atendidas. Conclusão Deve-se considerar a possibilidade de conduzir investigações com amostras mais homogêneas e um conceito mais claro de QV. O presente estudo chama atenção para a necessidade de pesquisas em mais países, utilizando instrumentos específicos para pessoas com demência de início precoce. Seria interessante se estudos pudessem traçar paralelos com grupos de início tardio.

Prevalence and Predictors of Unmet Needs among the Elderly Residents of the Rural Field Practice Area of a Tertiary Care Centre from Northern India

Background: Surrogate markers simple enough to be used by primary care workers have not been closely investigated by the community experts in rural Uttar Pradesh. We assessed the physical disabilities in activities of daily living (ADL) and unmet need in physical disabilities among rural elderly. Predictors of unmet needs in physical disabilities among the elderly were also identified. Methods: A community based cross-sectional study was conducted among elderly residents of the rural field practice area of a tertiary care centre in rural Uttar Pradesh. Three hundred and thirty five (335) participants aged 60 years and above from 9 villages were selected using the Probability Proportional to Size (PPS) sampling technique. Study tools were the proforma regarding socio-demographic details, socio-economic status and Stanford Health Assessment Questionnaire. Multivariate logistic regression analysis was performed to identify predictors of unmet needs. Results: 185 (55.2%) had physical disability in one or more activity limitation. Gender wise elderly females had more physical disability in one or more ADL categories than elderly males (66.8% vs. 42.0%). Almost one third (32.5%) of subjects had unmet need for one or more physical disabilities. the predictors of unmet needs that were identified in the study were female gender (P = 0.046), elderly aged 70 years and above (P = 0.032), those living alone (P = 0.035), low monthly family income (P = 0.044), financially fully dependent elderly (P = 0.0002), and those having 3 or more physical disabilities (P = 0.033). Conclusions: The findings of the study highlight that large number of needs of the disabled are still unmet. Greater, targeted efforts are needed to identify at-risk elderly people living in the community. These predictors would act as surrogate markers and can be easily used by primary care workers to plan and provide services to the elderly people in rural communities.