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1.
BMC Gastroenterol ; 24(1): 193, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840079

RESUMO

BACKGROUND: Chronic liver disease (CLD) is one of the leading disease burdens in Pakistan. Until now, there has only been limited focus in the country on providing health services through tertiary services in urban cities, whereas there is almost no research in Pakistan on the mental health and quality of life of CLD patients. This study aimed to understand which predictors influence the mental health and quality of life of CLD patients in order to advise better policy protection. METHODS: Data was collected from CLD patients at the Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan. A total of 850 respondents were part of the final sample. The age of respondents ranged from 18 to 79 years and included the following diagnosis: (i) Chronic Viral Hepatitis (n = 271), (ii) Cirrhosis (n = 259), (iii) Hepatocellular Carcinoma (n = 193), and (iv) Non-viral Liver Disease (n = 127). RESULTS: Mean results reveal that females as well as illiterate patients need more support for mental health and communication with their physician; whereas men need more support to develop coping strategies. Structural equation modelling results reveal that the severity of symptoms (ß = 0.24, p < 0.001), coping strategies (ß=-0.51, p < 0.001), and doctor communication (ß=-0.35, p < 0.001) predict mental health. Quality of life is associated with the severity of symptoms (ß=-0.36, p < 0.001), coping strategies (ß = 0.26, p < 0.05), and doctor communication (ß = 0.09, p < 0.05). CONCLUSIONS: A 'bio-psycho-social-spiritual' model is recommended for Pakistan's CLD patients which includes the integration of social officers to provide support in four key areas to secure mental health and quality of life of patients.


Assuntos
Hepatopatias , Saúde Mental , Qualidade de Vida , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Paquistão/epidemiologia , Idoso , Adulto Jovem , Adolescente , Hepatopatias/psicologia , Doença Crônica , Adaptação Psicológica , Análise de Classes Latentes , Cirrose Hepática/psicologia , Neoplasias Hepáticas/psicologia , Carcinoma Hepatocelular/psicologia , Fatores Sexuais
2.
Healthcare (Basel) ; 11(15)2023 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-37570465

RESUMO

This study aimed to identify social determinants of maternal and child health (SDoH) in Pakistan. Using a qualitative study design, data were collected from community members in seven underserved areas of Lahore City, Pakistan. A total of 22 qualitative in-depth interviews and 10 focus group discussions (FGDs) were conducted. The participants included basic health unit healthcare staff, women of reproductive ages, male family members, mothers-in-law, and religious leaders. We found that maternal and child health is adversely affected by the following socioeconomic and environmental barriers: (i) poor housing quality and sanitation; (ii) inadequate food supply and safety; (iii) unsatisfactory public sector school services; (iv) a lack of safety and security; (v) scarce poverty alleviation efforts and loan schemes; (vi) unsatisfactory transport and internet services; and (vii) inadequate health services. The targets for maternal and child health in Pakistan cannot be met without close coordination between the primary health sector, local governance, and macro state structures, which collectively must monitor and improve housing adequacy, food security, public sector services (primary healthcare services, public schooling, public transport, and public internet access), overall safety, and poverty emergence.

3.
BMJ Open ; 11(1): e043544, 2021 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-33402411

RESUMO

OBJECTIVE: The purpose of this study is to assess the impact of microfinance health interventions (health insurance and health-awareness programmes) on health-related outcomes among female informal workers in Pakistan. DESIGN: We conducted a retrospective, quasi-experimental study among a total of 442 female borrowers from seven microfinance providers (MFPs) across four provinces of Pakistan in 2018. A standardised tool was used for data collection. Probit regression was used to identify the probability of female borrowers gaining improvements in health outcomes based on their sociodemographic characteristics. Propensity score matching (PSM) was used to assess the overall impact of health interventions. PRIMARY OUTCOME MEASURES: Four health-related outcomes reported by the women were used: perception of good health overall, ability to visit a general practitioner, ability to purchase prescribed medicine and intake of multivitamins. RESULTS: We found that women receiving health interventions had a greater probability of better health outcomes when they were from Punjab province, borrowing in groups and attending monthly meetings at MFPs. Even with a small loan amount, all four health-related outcomes were significantly associated with receiving health insurance and health-awareness programmes. PSM results show a greater likelihood of overall perceived good health (nearest neighbour matching (NNM) =17.4%; kernel matching (KM) =11.8%) when health insurance is provided and a significant improvement in the ability to purchase prescribed medicine when a health-awareness programme is provided (NNM=10.1%; KM=11.7%). CONCLUSION: Health and social policies are vital to secure health and well-being among poor women working in the informal sector. Targeting improved equity across female population groups for health interventions will in the long run improve poor women's health, income-earning abilities and capacity expansion for small businesses.


Assuntos
Promoção da Saúde , Renda , Criança , Feminino , Nível de Saúde , Humanos , Avaliação de Resultados em Cuidados de Saúde , Paquistão , Estudos Retrospectivos
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