COVID-19 Vaccine Willingness and Related Factors Among Health Care Workers in 3 Southeast Asian Jurisdictions.

Importance: COVID-19 vaccine hesitancy is widespread and may lead to refusal or delay of vaccination, eventually reducing the overall vaccination coverage rate and vaccine effectiveness. Willingness to receive COVID-19 vaccination among health care workers (HCWs) is diverse across different jurisdictions. Objective: To assess the COVID-19 vaccine willingness among HCWs in 3 Southeast Asian jurisdictions in the context of pandemic severity and vaccination policy. Design, Setting, and Participants: A cross-sectional online survey was conducted among frontline HCWs in Hong Kong, Nepal, and Vietnam from May to November 2021. Eligible participants were nurses and doctors aged 18 and older, working in public or private health care settings on a full-time or part-time basis. Exposures: The COVID-19 pandemic and vaccination policy. Main Outcomes and Measures: COVID-19 vaccination willingness was defined as HCW willingness toward receiving the COVID-19 vaccine in full course or the first dose of the vaccine, and willingness to take the second dose. Information on sociodemographic characteristics, the history of seasonal influenza vaccination, attitudes toward vaccination, and opinions on strategies associated with vaccination uptake from the study participants. Results: Among the 3396 eligible doctors and nurses who participated in the survey, 2834 (83.4%) were from Hong Kong, 328 (9.7%) were from Nepal, and 234 (6.9%) were from Vietnam. Most respondents were female (76.2% [2589 ]), aged 30 to 39 years (31.2% [1058]), and nurse HCWs (77.6% [2636]); the response rates were 11% (2834 of 25 000) in Hong Kong, 36% (328 of 900) in Nepal, and 13% (234 of 1800) in Vietnam. Overall, the prevalence rate of willingness to take the COVID-19 vaccine was highest in Nepal (95.4% [313 of 328]), followed by Vietnam (90.6% [212 of 234]), and lowest in Hong Kong (54.4% [1542 of 2834]), relating to their different attitudes and opinions toward the COVID-19 vaccination, and the pandemic severity and vaccination policy in the 3 jurisdictions. Doctors were more willing to take COVID-19 vaccination than nurses (odds ratio, 5.28; 95% CI, 3.96-7.04). Older age (odds ratios, 1.39-3.70), male gender (odds ratio, 1.41; 95% CI, 1.11-1.75), higher educational level (odds ratio, 1.48; 95% CI, 1.17-1.87), and having seasonal influenza vaccination uptake history (odds ratio, 2.15; 95% CI, 1.82-2.54) were found to be associated with increased willingness. Choice of vaccination brand with adequate information, immunity passport, time off from work for vaccination and subsidy for travel to inconvenient vaccination centers were considered as strategies to enhance vaccine willingness. Conclusions and Relevance: In this survey study, vaccination unwillingness existed among HCWs in Southeast Asian regions, especially in Hong Kong. The findings of this study may have utility in the formulation of vaccination promotion strategies such as vaccination incentives. Attitudes toward vaccination in HCWs might be examples for the general population; however, changes over time should be further investigated.

Comparison of Resilience Among Healthcare Workers During the COVID-19 Pandemics: A Multinational Cross-Sectional Survey in Southeast Asian Jurisdictions.

Objectives: To examine the level of resilience among the frontline healthcare workers (HCWs) in four different Southeast Asian jurisdictions and identify the potential factors that may enhance healthcare workers resilience. Methods: An online cross-sectional survey was carried out among 3,048 eligible healthcare workers in Hong Kong, Nepal, Vietnam, and Taiwan from May 2021 to July 2022, and information on individual resilience, socio-demographic characteristics, organizational supports, and personal exposures were collected. A binary logistic regression model was used to identify the factors that were associated with a high resilience level. Results: The resilience score was the highest among healthcare workers of Vietnam, followed by Taiwan and Hong Kong, with Nepal scoring the lowest. Participants with old age, part-time work, higher education level, more satisfaction with workplace policy, better organizational supports, and fewer COVID-specific worries were associated with higher resilience. Healthcare workers who were satisfied with the overall organizational policy support had an OR of 1.48 (95% CI: 1.25-1.76) for a high resilience level. Conclusion: Implementing satisfying organizational policies and establishing supportive work environments for frontline healthcare workers can increase individual resilience and organizational stability.

Tuberculosis and Diabetes Mellitus Comorbidity among the Ageing Population: A Threat to the Public Health System of Nepal.

Ageing population is attributable to the growing trend of diabetes mellitus. Diabetic patients are three times greater risk of developing tuberculosis. The review aims to describe the state of tuberculosis and diabetes mellitus comorbidity, risk factors for the comorbidity from the perspective of the ageing in Nepal. It is a systematic narrative review of literature in Google Scholar and Pubmed. At first, title and abstract of an article was reviewed for relevance, and then full article was reviewed for validity. The secondary data was retrieved from the Central Bureau of Statistics of Nepal and WHO, and analysed in the Ms-Excel. In Nepal, the population is ageing. The risk factors associated with diabetes are escalating. On the other hand, tuberculosis is endemic and about 45% of the Nepalese people are infected with tuberculosis bacteria. These circumstances have laid the foundation that fosters tuberculosis and diabetes co-epidemic in the future. The clinical management of patients with the comorbid condition is a difficult task because diabetes and tuberculosis interact with each other, one worsening the other. The upsurge of the co-morbidity needs the provision of more health services threatening the public health system of Nepal. It is fundamental to create a mechanism to integrate diabetes and tuberculosis program such as screening, diagnosis and management of the both diseases at the all levels of health service delivery. Furthermore, increase awareness of healthy lifestyle and the prevention of the risk factors for tuberculosis and diabetes could reduce the occurrence of the comorbidity in the future.

Social support and its correlation with loneliness: a cross-cultural study of Nepalese older adults.

The aim of this study was to analyze the situation of social support exchange among elderly men and women and to study the cross-cultural validity of predictors of loneliness in two Nepalese castes/ethnicities of older adults. Data for this study were taken from a cross-sectional study of the elderly at least 60 years old living in one ward of Kathmandu City, conducted in 2005. Loneliness was measured using a three-item loneliness scale based on the University of California at Los Angeles (UCLA) Loneliness Scale. Sources of social support were classified as spouse, children living with their elders, children living apart, and friends/neighbors. Study findings indicate that the main social support exchange for the elderly was with adult children living together, spouse, and friends/neighbors. Results also show gender difference in social support. Significant variables of loneliness were social support received from spouse, social support provided to spouse, and children living together with both elderly parents. This finding shows there is a high degree of cross-cultural invariance in the predictor sources of social support on loneliness among two Nepalese castes/ethnicities older adults.

Correlates of loneliness among older Newar adults in Nepal.

OBJECTIVE: The purpose of this study was to identify significant factors for loneliness in older adults METHODS: The subjects (N = 195) were members of the Newar caste/ethnicity, aged 60 years and above (mean(+/- SD) 68.81 (+/- 7.69) years and 52% male) and living in Katmandu City. Data were collected by face-to-face interview using a three-item loneliness scale, developed based on the University of California at Los Angeles (UCLA) Loneliness Scale and prepared with a translation and back translation technique from English into Nepalese. The data were analyzed using logistic regression analyses. RESULTS: More than two-thirds of Newar elderly experience some type of loneliness. A statistically significant correlation was found between feelings of loneliness and age, sex, household status, total family size, network size, social participation, self-reported health, chronic health problems, working status, instrumental activities of daily living (IADL), and perceived economic satisfaction. Results of logistic regression analyses showed age, network size, and perceived economic satisfaction to be significant factors for loneliness. CONCLUSION: Loneliness is an important public health issue, predicting low quality of life among older adults. The present results indicate many elderly Nepalese experience some form of loneliness, with age, network size and perceived economic satisfaction as significant factors. However, this result may not be generalized to the greater population of Nepalese older adults and the external validity of the UCLA Loneliness Scale is an important criterion to examine in future research.

Relationship specialization amongst sources and receivers of social support and its correlations with loneliness and subjective well-being: a cross sectional study of Nepalese older adults.

Social support, subjective well-being (SWB), and loneliness are issues of central importance in research concerned with the quality of life (QOL) of elderly people in the 21st century. However, very little is known about the situation in low-income countries such as in Nepal. The purpose of this paper is to identify the relationships significant in social support (received (SSR) and provided (SSP)) and analyze their connections with loneliness and SWB. The subjects, not suffering from dementia, were 60 years and above living in Kathmandu city. The data was analyzed using logistic regression with some confounding variables controlled. The results indicate that loneliness is high and SWB is low amongst Nepalese older adults. SSR from children living together and SSP to spouse, children living together and friends and neighbors reduce loneliness. SSP to children living apart increases SWB-life satisfaction. SSR from children living together and SSP to children (living together and apart) increases SWB-life stability. However, SSP to relatives reduces SWB-life satisfaction and SSR from relatives reduces SWB-life stability in Nepalese older adult men.

Self-reported health: a study of older adults from a developing country--Nepal.

Self-reported health is an easy measure of overall health and is useful in identifying persons at risk of a decline in health and the risk of disability in older adults. The purpose of this paper is to identify the correlates of self-reported health for older adults in Nepal. The subjects (N = 137) were members of the Chhetri caste who were 60 years or older (mean age 69.1 +/- 7.2 years; 54% women) and living in Katmandu City. Data were collected by face-to face interviews using three self-reported health questions. A single scale was developed from the three self-reported questions. Bivariate analysis and multiple regression analysis were used to analyze the results. The findings show a correlation between self-reported health and sex, household status, living arrangements, social participation, chronic health problems, functional disability in activities of daily living (ADL), employment status, and economic satisfaction. Results of multiple regression analysis indicate that factors for self-reported health among older adults are chronic health problems, economic satisfaction, functional disability in ADLs, and social participation.