National Journal of Community Medicine

Mental Health- An Emotional Roller Coaster Around Menopause

2024-09-28T06:44:23+00:00

Menopausal mental health is a critical yet often overlooked aspect of a woman’s overall well-being during the menopausal transition. Menopause, which typically occurs between the ages of 45 and 55, marks the end of a woman's reproductive years, characterized by a natural decline in estrogen and other hormones. This hormonal fluctuation can lead to various mental health challenges, including mood swings, anxiety, depression, and cognitive changes like memory lapses or difficulty concentrating.

Women may experience emotional turbulence during this period due to both biological and psychological factors. Physically, the drop in estrogen can influence the production of neurotransmitters like serotonin, which regulates mood. Psychologically, the changes associated with aging, such as shifts in identity, self-image, and social roles, may exacerbate feelings of stress or anxiety. Sleep disturbances, common during menopause, can also heighten mental health concerns, leading to fatigue and irritability.

Addressing menopausal mental health requires a comprehensive approach, including lifestyle modifications, counseling, and, in some cases, medical treatments like hormone replacement therapy (HRT). Mindfulness practices, physical activity, and a strong social support network can also help women navigate the emotional challenges of menopause. Raising awareness and reducing the stigma around mental health issues during menopause are essential to ensuring that women receive appropriate care and support during this significant life stage. By recognizing and addressing these challenges, women can maintain their mental health and overall quality of life during and after menopause.

Navigating NCDs’ Self-Management: A Comprehensive Review of Barriers & Facilitators in LMICs through Quantitative and Qualitative Lenses

2024-11-04T11:18:27+00:00

Introduction: Despite significant global and national investments in health, primarily aimed at primary and preventive measures, progress in alleviating toll of non-communicable diseases (NCDs) remains sluggish in low- and middle-income countries, hindering the achievement of Sustainable Development Goals by 2030. This review intends to elucidate the barriers and facilitators affecting self-management of NCDs and their determinants, with purpose of informing the development of more accessible and practical preventive strategies.

Methods: An extensive electronic literature search was conducted across PubMed, PsycINFO, CINAHL, and Scopus for studies published between 2013 to June 2024, resulting in total of 78 included studies: 56 quantitative, 20 qualitative, and 2 mixed-methods.

Findings: The synthesis of findings across these studies identified critical factors influencing NCDs’ self-management. The quantitative analysis highlighted 31 factors grouped into five main determinants: socio-demographic, psychosocial, behavioural, biological, resource-related, and health-system-related. Notably, increased age and educational attainment correlated positively with self-management compliance, while barriers such as forgetfulness and misconceptions negatively impacted adherence. The qualitative review identified 21 sub-themes under five broad themes, emphasizing personal challenges, financial limitations, environmental factors, social stigma, and issues with health providers.

Conclusion: Together, these insights reveal the multifaceted challenges of self-management and necessity for tailored interventions.

Prevalence and Associated Factors of Dysmenorrhea Among University Students in Tamil Nadu, India: A Cross-Sectional Study

2024-10-23T07:52:09+00:00

Introduction: Dysmenorrhea is a common gynaecological condition of uterine origin characterised by excruciating menstrual cramps. For more than 50% of menstruating women primary dysmenorrhea is both a clinical and a social problem. A cross-sectional study was conducted to estimate the prevalence and determine the factors associated with dysmenorrhoea among university students in Tamil Nadu.

Methods: With ethical approval from the Institutional Ethical Committee of SRMIST (Deemed University), 1076 students aged 18-25 were selected with simple random sampling. Data were collected using a structured questionnaire over June-Sept. 2023. The pain of dysmenorrhea was assessed using the Visual Analogue Scale (VAS).

Results: The estimated prevalence of dysmenorrhoea was 25.5% (274), and 92.47% (n=995) had menstrual pain. It was found that 45.45%, 28.90%, 17.01% and 8.64% of the university students experienced mild, moderate, severe, and worse pain, respectively, as measured using the VAS. There is a significant association between dysmenorrhea and clots during menstruation (AOR=1.40; 95% CI [1.032, 1.913]) and skipping of meals (AOR=1.7; 95% CI [1.172, 2.489]).

Conclusions: It is evident from the study that more than 25% of university students face dysmenorrhea, and most have pain with varied degrees and types. The students should seek help for dysmenorrhoea, not neglect it, and take care of their physical activities and nutrition. In addition, universities should promote education on nutrition and physical activities and empower students to seek help for dysmenorrhea.

Baseline Nutritional Status of Mother-Child Dyads in Urban Slums: Pre-Intervention Analysis for a Nutrition Informatics Intervention

2024-11-15T10:18:56+00:00

Background: Urban slums are critical for public health intervention due to high population density, poor living conditions, and limited healthcare access. This study examines baseline nutritional and lifestyle patterns among mother-child dyads in the urban slums of Uttar Pradesh. The dyads were recruited for Nutritional Assessment and Intervention Kiosk (NAIK), a Population Health Informatics platform to address double burden of malnutrition.

Methodology: This cross-sectional, pre-intervention study involved 406 mother-child dyads with children aged 2-5 years. Data on socio-demographic variables, anthropometric measurements, nutrient intake and lifestyle patterns were collected. Descriptive statistics summarized baseline characteristics.

Results: The demographic profile showed predominantly low-income mothers with 43.34% without primary education. The mean ages of mothers and children were 33.98 ± 5.9 years and 46.91 ± 10.89 months, respectively. The waist-to-hip ratio was 0.92 ± 0.76 indicating cardiovascular risk factors with significant maternal obesity (47.78%). Education of the mother was found to be significantly associated with Mid Upper Arm Circumference (MUAC) of the child. The findings highlight the overnutrition in mothers and nutrient inadequacy in children, influenced by inadequate dietary intake and unhealthy lifestyle.

Conclusions: This paper will comprehensively overview baseline population status, setting the stage for further analysis and evaluation of the intervention.

The Relationship Between Psychological Distress and Quality of Life Among Women Undergoing Mastectomy in Iraq: A Descriptive Correlational Study

2024-11-14T05:02:30+00:00

Background: A mastectomy, the surgical removal of one or both breasts, is a significant experience that affects a woman physically, emotionally, and psychologically. This study aimed to investigate the relationship between psychological aspects and quality of life among women with mastectomy.

Methods: A descriptive correlational study was conducted at an oncology center in Thi-Qar Province, Iraq from January 21^st to April 23^rd 2024. The study sample consists of 131 women who undergo mastectomy using a standardized questionnaire. Data were collected through the interviews and analyzed by applying descriptive and inferential statistical approach.

Results: The results indicate that the average age of the participants is 42 years, and most of them are in their forties and fifties. Most of them were married, had primary education, were unemployed, and did not have sufficient income. Nearly half of the women (48.9%) showed high psychological profiles, and a significant portion (84%) reported poor quality of life. Statistical analysis revealed a negative relationship between psychological aspects and quality of life (p=0.000).

Conclusions: The results of this study highlight the enormous psychological distress and high cost to life experienced by women after mastectomy, highlighting the urgent need for integrated psychological support for their care.

Impact of Screen Time and Sleep Duration on Adults’ Body Mass Index in A University in Chengalpattu District – A Cross-Sectional Study

2024-11-19T11:37:01+00:00

Background: The rapid technological advancements of the 21st century have led to significant changes in lifestyle behaviors, particularly among young adults in university settings. One of the most prominent shifts has been the increase in screen time due to widespread access to digital devices. Sleep is mainly being compromised by screen time which can be either for work or for leisure activities. Excessive screen time and short sleep duration has raised concerns regarding its potential negative impact on physical health, particularly on Body Mass Index (BMI). The aim was to estimate the prevalence of under-weight, normal weight, over-weight and obese and to assess the effect of sleep duration and screen time on body mass index of the adults in a university in Chengalpattu district.

Methodology: A descriptive cross-sectional study was conducted among staffs, students and workers from a Private university, Chengalpattu district, Tamil Nadu. Simple random sampling method was used and a sample size of 672 was calculated.

Results: Of 672 respondents, majority were males 364 (54.2%) and 308 (45.8%) were females. Almost more than half were in the age group of 31 - 60 years (392, 58.3%). It was found that almost two-third (470, 69.9%) of the participants had screen time for <4 hours / day. A statistically significant association was found between age of the participants, their screen time and sleep time.

Conclusions: The findings suggest that excessive screen time and insufficient sleep are significantly associated with higher BMI, highlighting the importance of addressing these modifiable behaviors to combat the growing prevalence of obesity among university students.

Analysing Low Back Pain Among University Students in Malaysia: A Public Health Perspective on Disability and Influencing Factors

2024-11-18T05:19:10+00:00

Purpose: Low back pain (LBP) and its association with disability has emerged as an area of concern. This study aimed to investigate the influence of demographic, low back pain on disability to provide insights for informed interventions enhancing students’ inclusive health and wellbeing.

Materials & Methods: A cross-sectional study was conducted among 351 students of all genders, aged 17 to 30. Nordic questionnaire was used to check the prevalence of low back pain. Oswestry disability index was employed to assess the back pain induced disability. Logistic regression analysis was used to analyse the association between risk factors and LBP.

Results: Among students, the total prevalence of LBP was 81.5%. Adjusted odds ratio and standardized coefficient, variables such as year of study (OR = 2.526, CI = 1.629–3.923), mode of study (OR = 4.725, CI = 1.767–12.630), and duration of electronic gadgets usage (OR = 2.912, CI = 1.544–5.490) were found to be independent risk factors and predictors for the occurrence of LBP among university students.

Conclusion: The study results demonstrate a substantial association between the use of computers, year of study, and use of electronic gadgets with prevalence of low back discomfort. Future investigations should focus on strategies to emphasize the significance of ergonomic guidance about computer usage and managing study workload throughout different academic years among university students.

Medication Adherence and Its Associated Factors Among Type II Diabetes Mellitus Patients Presenting to Health Centres in Tirupati, Andhra Pradesh, India

2024-11-26T08:45:42+00:00

Background: Diabetes is a swiftly expanding health issue. To avoid or postpone the development of complications, patients need to adherent to their antidiabetic drugs. The objective was to assess medication adherence and to determine the association between medication non-adherence and socio-demographic characteristics, co-morbidities, and self-care and medication practices among Type II Diabetes Mellitus patients.

Methods: An analytical cross-sectional study was conducted among 216 diabetic patients of more than 18 years of age with duration at least 6 months presenting to the 4 health centres in Tirupati. Medication adherence was assessed using the nine-item Hill-Bone Medication Adherence Scale (HBMAS).

Results: The study found that among the 216 participants, 82.9% were adherent while 17.1% were non-adherent to medications. On multivariate analysis, age group of >60 years (AOR=2.97(95% CI 1.158-7.662), belonging to rural areas (AOR=22.163 (95% CI:2.404-193.678), not following any dietary modifications (AOR= 2.976 (95% CI 0.935-9.479) and dependent on family member for medication intake remembrance (AOR=6.103(0.875-42.546) were found to be more at risk for non-adherence.

Conclusions: One-fifth of the study participants were non-adherent to medications. Increasing age, rural population, not following dietary modifications, and dependent on family members to remind them for medication intake were found to be associated with medication non-adherence.

Prevalence and Determinants of Functional Disability Among Elderly in Rural Goa, India

2024-11-22T05:22:18+00:00

Background: Functional disability in older adults, defined as the inability to perform essential daily activities, is categorized into Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Understanding these limitations is key for informing health policies and services. The aim was to estimate the prevalence and identify factors associated with functional disability among the elderly in rural Goa.

Methodology: A community-based cross-sectional study was conducted among the elderly residing in the field practice area of the Rural Health and Training Centre, Mandur, Goa. Data were collected from 300 elderly participants using the Katz ADL Index and Lawton Brody’s IADL Scale. Participants were selected through systematic random sampling.

Results: ADL disability prevalence was 13.7%, while IADL disability was 38.7%. ADL disability was associated with sex, education, financial dependence, co-morbidities, alcoholism, and sensory impairments. IADL disability was linked to age, sex, education, financial dependence, co-morbidities and visual impairment.

Conclusions: The study emphasizes the need for comprehensive geriatric assessments in rural communities, highlighting the importance of evaluating functional status at the primary healthcare level to improve elderly care policies.

Mental Health Outcomes and Their Correlates in The Post-COVID-19 Era Among University Students and Staff in Indonesia

2024-11-25T10:23:07+00:00

Background: The COVID-19 pandemic has profoundly affected global health, particularly mental health in academic communities. While its impact on mental health is well-documented, studies on the post-pandemic "new normal" remain scarce. This study examines the prevalence and factors linked to anxiety, depression, and QoL among Indonesian university students, lecturers, and staff post-pandemic.

Methods: This cross-sectional study examines the impact of risk factors on anxiety, quality of life, and depression among university students, staff, and faculty post-Covid-19 vaccination. An online website link was sent to the participants comprising instruments such as PHQ-2, WHOQOL-BREF and GDS. Chi-square tests were used for bivariate analysis, and multivariate logistic regression modelled associated factors.

Results: Poor QoL, depression, and anxiety were reported by 51.68%, 40.83%, and 44.19%, respectively. Unmarried individuals and those without a COVID-19 booster had higher odds of poor QoL (AOR: 3.32; 1.62). Unmarried individuals also faced greater depression risk (AOR: 2.56), while females and those with unvaccinated family members were more prone to anxiety (AOR: 2.42; 1.50).

Conclusion: This study highlights mental health challenges post-pandemic, especially for those with incomplete vaccination and limited social support. It emphasizes the need for targeted interventions and complete vaccination to boost resilience in academic settings.

Caregiver’s Perspective on Preventing Unintentional Childhood Injuries in South Karnataka, India – A Qualitative Study

2024-11-13T11:26:07+00:00

Background: Childhood unintentional injuries are the leading cause of death and disability among young children. Interventions to prevent unintentional injuries are multidimensional, and identifying key areas would facilitate a better understanding and implementation of preventive measures. The present research was conducted to explore and understand caregivers' perspectives on unintentional injuries, which might further contribute to developing injury prevention strategies.

Methods: The study adopted a qualitative approach. In-depth, open-ended, semi-structured, and individual interviews were conducted with caregivers of children between two and five-year-old age groups.

Results: The codes generated from the study are grouped under three major themes: ‘Child behaviour and development’, ‘Caregivers' knowledge and practices’, and ‘Safe environment’. The reasons for unintentional injuries and strategies to prevent them were reflected in the findings. Caregivers demonstrated awareness in a few of the areas by identifying the risk of injuries. Environmental determinants such as a lack of space or inadequate storage facilities were reported as barriers to injury prevention.

Conclusion: Understanding caregivers’ perspectives on injury prevention will enable them to change the behavior among caregivers. However, the barriers and facilitators to prevent injuries can be addressed during the development and implementation of the intervention package.

Predictors of Dependency in Instrumental Activities of Daily Living Among Community Dwelling Elderly in A Rural Field Practice Area of a Tertiary Care Hospital in Chengalpattu District, Tamilnadu, India- A Cross Sectional Study

2024-11-18T05:12:16+00:00

Background: Longer lifespans of elderly are associated with chronic illnesses that impair functioning, making it harder to carry out daily activities and making assistance necessary. The aim was to estimate the prevalence of dependence in Instrumental Activities of Daily Living (IADL) among elderly and to determine its sociodemographic and health related predictors.

Methodology: This cross-sectional study was conducted among elderly in Chengalpattu district from December 2023 to May 2024. Sample size was determined by multistage random sampling. A semi-structured questionnaire consisting of sociodemographic details and Lawton scale to assess dependence were used to collect data. Data was entered in Ms Excel and analysed using SPSS version 26.

Results: Mean age of participants was 67.4 ± 7.4 years. 131 (43.7%) of them were at risk of malnutrition and 83 (27.7%) were malnourished. Majority (n=178,59.3%) experienced increased IADL dependency. Binary logistic regression analysis showed increasing age, lower socioeconomic status, Divorced/Widowed/Unmarried, smoking and tobacco use, hospitalizations within previous year were significant predictors of IADL dependency.

Conclusions: The study concluded that a considerable proportion of our study population was suffering from IADL dependency (59.3%), with majority demonstrating mild to moderate degree of dependency. To prevent disease in its early stages, arrangements can be made for community-based extensive geriatric health assessments.

Pilot Study on The Nutritional Assessment and Intervention Kiosk: Utility and User-Centric Performance Evaluation in Combating Malnutrition

2024-11-18T05:12:10+00:00

Background: To combat double burden of malnutrition, Nutritional Assessment and Intervention Kiosk (NAIK) has been proposed as a potential solution. which provides personalized nutritional assessments and interventions, leveraging the latest digital health technologies. The present pilot study reports user-centric performance evaluation and utility of NAIK to determine its impact on managing malnutrition.

Methodology: The 406 samples were purposively selected to include children aged 2–5 years and their mothers living in urban slum areas of Gautam Budh Nagar District of Uttar Pradesh through the online-based NAIK. In order to evaluate the users' ability to utilize the developed system, the participants were tasked with completing a series of assigned usability tasks. The user-centric performance evaluation of the system was also evaluated.

Results: Out of total 406 sample, till the third visit 123 subjects (30.29%) were retained. A significant majority of respondents found NAIK platform easy to use but most users did feel the need for professional assistance. Overall, the assessments reveal that the NAIK platform is well-received by users. However, minor improvements could enhance clarity and reduce the learning curve for new users.

Conclusions: The positive user feedback on the usability of NAIK further supports its potential as a valuable tool for nutritional interventions in low-resource settings.

Prevalence of Dental Fluorosis among 6-18-Year-Olds in Vidarbha, Maharashtra, and Its Association with Geological and Geochemical Fluoride Levels: A Cross-Sectional Study

2024-11-26T05:57:29+00:00

Background: Endemic Fluorosis is a longstanding public health problem caused by excess fluoride intake through drinking water or food products grown in soil with high fluoride content. Many areas in Maharashtra state, particularly the Vidarbha region are affected by fluorosis. The aim was to determine the prevalence of Dental Fluorosis in children of the age group of 6-18 years and corelate it with the fluoride levels in water, soil and foodgrains.

Methods and Materials: A cross-sectional study will be conducted in randomly selected villages from Vidarbha region using multistage sampling. A total sample of 1230 children aged 6-18 years will be obtained. Dean`s index will be utilized for determining the prevalence of Dental Fluorosis. Fluoride levels of drinking water, soil and foodgrains will be analyzed.

Results: The salient feature of the study is the fluoride levels in the drinking water and locally grown staple foodgrains like rice, jowar and wheat etc. This will generate evidence that corroborates with the fluorosis levels observed in the selected study region.

Conclusion: The study will be a landmark in nearly a decade providing a comparative account of Dental Fluorosis in villages with high-to-moderate endemicity and co-relate clinical manifestations with fluoride levels in water, soil and foodgrains.