ABSTRACT
Anxiety and depression are common psychological disorders in patients with type 2 diabetes mellitus (T2DM), which was upsurging worldwide amid the COVID-19 pandemic. This study aimed to explore factors associated with anxiety and depression among T2DM patients in Bangladesh during the COVID-19 pandemic. A cross-sectional study was conducted among T2DM patients using face-to-face interviews. Anxiety and depressive symptoms were measured using the CAS and PHQ-9 scales. Outcomes were assessed including sociodemographic, lifestyle, anthropometric, and challenges of getting routine medical and healthcare access-related questions. The prevalence of anxiety and depressive symptoms were 29.8% and 22.7%, respectively. Regression analysis reported that males older than 50 years, illiterate, unemployed or retired, urban residents, below the recommended level of moderate to vigorous physical activity (MVPA), low dietary diversity score (DDS) and obese respondents were associated with higher odds of anxiety and depressive symptoms. Moreover, respondents with transport difficulties, unaffordable medicine, medicine shortages, close friends or family members diagnosed with COVID-19 and financial problems during COVID-19 had higher odds of anxiety and depressive symptoms than their counterparts, respectively. Our study suggests providing psychological support, such as home-based psychological interventions, and highlighting policy implications to ensure the well-being of T2DM patients in Bangladesh during the pandemic.
ABSTRACT
BACKGROUND: The newly emerged COVID-19 has an unprecedented impact on all classes of people, particularly the elderly. The knowledge, attitudes, and practices (KAP) of older adults toward COVID-19 are currently unknown. This study aimed to investigate the KAP and its associated factors toward COVID-19 among older adults in Bangladesh. METHODS: A cross-sectional survey was conducted from April to May 2021 among Bangladeshi older adults. Face-to-face interviews were used to collect data from five selected divisions in Bangladesh using simple random sampling. The questionnaire consisted of socio-demographic characteristics, disease conditions, and KAP toward COVID-19. Descriptive statistics, t-tests, one-way analysis of variance (ANOVA), and logistic regression analyses were performed. RESULTS: Out of 900 respondents, the majority of older adults (82.9%) indicated that COVID-19 is a viral disease and the major clinical symptom of COVID-19 (86.5%). Only 22.1% of participants always washed their hands with soap or hand sanitizer, and 27.6% wore a mask to protect against the virus when going outside the home. Overall, 55.2% had adequate knowledge, 50.2% had positive attitudes toward COVID-19 and only 22.7% had good practices. Out of 30 scores, mean score values were 20.8±6.7 in the knowledge section, 21.2±4.3 in the attitude section, and 11.3±6.7 in the practice section out of 30. In binary logistic regression analysis, factors associated with poor knowledge, and practices were being male, aged >70 years, having a primary education, less income <5000BDT, and multimorbidity (p < 0.05). Participants having poor knowledge of COVID-19 had higher likelihood of negative attitudes (OR: 6.79, 95% CI = 4.87-9.47, p < 0.001) and poor practices (OR: 9.15, 95% CI = 6.94-13.16, p < 0.001). CONCLUSION: The findings highlight the need for immediate implementation of health education programs and adequate intervention programs for COVID-19 which integrates consideration of associated factors to improve the level of older adults' knowledge, attitudes, and practices.
