Determinants of Vaccine Hesitancy among Home Health Care Service Recipients in Saudi Arabia.

BACKGROUND: Vaccine hesitancy has been identified by the World Health Organization (WHO) as a major worldwide health threat. Home Health Care (HHC) service recipients represent a vulnerable group and were prioritized to receive coronavirus disease (COVID-19) vaccination during the national vaccine campaigns in Saudi Arabia. We aimed to investigate the most frequent reasons for vaccine hesitancy among home health care recipients in Saudi Arabia. METHODS: This cross-sectional survey was conducted among home health care (HHC) service recipients in Saudi Arabia from February 2022 to September 2022. The behavioral and social drivers (BeSD) model developed by the WHO was used to understand the factors affecting vaccination decision making in our cohort. RESULTS: Of the 426 HHC service recipients enrolled in the study, a third were hesitant to complete the COVID-19 vaccination series. The most prevalent reported reason for COVID-19 vaccine refusal was concerns about the vaccine side effects (41.6%). Factors independently associated with COVID-19 vaccination hesitancy were: having chronic conditions (odds ratio [OR] = 2.59; 95% confidence interval [CI] = 1.33-5.05, p = 0.005), previous COVID-19 diagnosis (OR = 0.48; 95% CI: 0.28-0.82, p = 0.008), ease of getting the COVID-19 vaccine by themselves (OR = 0.49; 95% CI: 0.28-0.89, p = 0.018), belief in the importance of COVID-19 vaccine in protecting their health (OR = 0.60; 95% CI: 0.38-0.96, p = 0.032), and confidence in the safety of COVID-19 vaccination (OR = 0.38; 95% CI: 0.21-0.69, p = 0.001). CONCLUSION: Only one-third of the study participants were hesitant to complete the series of COVID-19 vaccination. Understanding the factors underpinning vaccine hesitancy among this group would help healthcare workers and policymakers in developing personalized health awareness campaigns aimed at improving vaccine acceptance levels.

Establishing the reliability and the validity of the Arabic translated versions of the Effort Assessment Scale and the Fatigue Assessment Scale.

OBJECTIVE: The aim was to establish the reliability and the validity of Arabic translated versions of the Fatigue Assessment Scale (FAS) and the Effort Assessment Scale (EAS). DESIGN: The FAS and the EAS were translated from the original English following a recommended six-step approach for translating hearing-related questionnaires for different languages. The reliability of the scales was investigated using Cronbach's alpha, item-total correlation, and inter-item correlation. Construct validity was investigated using factor analysis and the hypothesis testing method. STUDY SAMPLE: The translated scales were completed by 146 participants from Jordan and Saudi Arabia (age range 19-86 years old, 39% male). Participants' hearing level ranged from normal to profound. RESULTS: Item 3 in the translated FAS was removed to improve the scale's construct validity. The translated version of the EAS was found to be as reliable and valid as the original EAS. CONCLUSIONS: The availability of standardised versions of the FAS and the EAS provides a quick and easy method for improving hearing rehabilitation in Arabic-speaking countries where audiology services can often be costly and not necessarily accessible to all individuals.

Predictors of Mortality in Home Health Care Service: Data from Saudi Arabia.

Objective: This study aimed to 1) report the prevalence of chronic conditions among Saudi people receiving long-term home health care (HHC) services, 2) identify the predictors of mortality among individuals receiving long-term HHC services, and 3) study the association between frailty and poor health outcomes among HHC users. Design: Retrospective cross-sectional descriptive study. Setting and Participants: A total of 555 participants were recruited from HHC services at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. We collected the data from electronic health records (EHR), patient charts, and caregiver interviews for 555 participants included in HHC program from the year 2019 to 2022. Methods: Only individuals fulfilling the HHC program's eligibility criteria were included to the study. A total of 555 participants were included in the analysis. We assessed the functional performance by the Katz activity of daily living and Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). We calculated the means and frequency to describe the prevalence of chronic conditions and variables of interest. A Chi-square test or independent-samples t-test was run to determine if there were differences between the alive and deceased individuals. A binary logistic regression model was performed to predict mortality of HHC service recipients. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. We found that the strongest predictors for mortality were pressure ulcers with an odds ratio of 3.75 and p-value of <0.0001, and the Clinical Frailty Scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. Conclusions and Implications: In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services.

Is COVID-19 associated with self-reported audio-vestibular symptoms?

OBJECTIVE: To determine if a positive test for COVID-19 is associated with self-reported audio-vestibular symptoms. DESIGN: Self-reported changes in hearing, tinnitus, hyperacusis, and dizziness/rotatory vertigo were assessed in hospitalised and non-hospitalised COVID-19 patients during and after the acute phase of the disease and compared to non-COVID controls. STUDY SAMPLE: There were 150 severe cases of COVID-19 requiring hospital admission and 150 mild cases that were managed at home. Controls were 267 adults, 32 of whom had been hospitalised for a non-COVID-19 condition, and a further 85 who worked in hospital settings. RESULTS: Deterioration in hearing and/or tinnitus was reported in 8% of the COVID-19 cases (tinnitus had resolved in 2% after the acute phase), with no significant difference between severe and mild cases. Deterioration in hearing or tinnitus was not significantly different from controls. However, rotatory vertigo was reported by 5% in the COVID-19 groups and 1.1% in the controls, and this difference was statistically significant. CONCLUSIONS: There is no evidence that COVID-19 results in deterioration in hearing or tinnitus during the acute phase or after recovery in mild or severe cases. However, rotatory vertigo, which could be vestibular in origin, may be a clinical manifestation of COVID-19.

Subclinical Auditory Neural Deficits in Patients With Type 1 Diabetes Mellitus.

OBJECTIVES: Diabetes mellitus (DM) is associated with a variety of sensory complications. Very little attention has been given to auditory neuropathic complications in DM. The aim of this study was to determine whether type 1 DM (T1DM) affects neural coding of the rapid temporal fluctuations of sounds, and how any deficits may impact on behavioral performance. DESIGN: Participants were 30 young normal-hearing T1DM patients, and 30 age-, sex-, and audiogram-matched healthy controls. Measurements included electrophysiological measures of auditory nerve and brainstem function using the click-evoked auditory brainstem response, and of brainstem neural temporal coding using the sustained frequency-following response (FFR); behavioral tests of temporal coding (interaural phase difference discrimination and the frequency difference limen); tests of speech perception in noise; and self-report measures of auditory disability using the Speech, Spatial and Qualities of Hearing Scale. RESULTS: There were no significant differences between T1DM patients and controls in the auditory brainstem response. However, the T1DM group showed significantly reduced FFRs to both temporal envelope and temporal fine structure. The T1DM group also showed significantly higher interaural phase difference and frequency difference limen thresholds, worse speech-in-noise performance, as well as lower overall Speech, Spatial and Qualities scores than the control group. CONCLUSIONS: These findings suggest that T1DM is associated with degraded neural temporal coding in the brainstem in the absence of an elevation in audiometric threshold, and that the FFR may provide an early indicator of neural damage in T1DM, before any abnormalities can be identified using standard clinical tests. However, the relation between the neural deficits and the behavioral deficits is uncertain.

Place specificity measured in forward and interleaved masking in cochlear implants.

Interleaved masking in cochlear implants is analogous to acoustic simultaneous masking and is relevant to speech processing strategies that interleave pulses on concurrently activated electrodes. In this study, spatial decay of masking as the distance between masker and probe increases was compared between forward and interleaved masking in the same group of cochlear implant users. Spatial masking patterns and the measures of place specificity were similar between forward and interleaved masking. Unlike acoustic hearing where broader tuning curves are obtained in simultaneous masking, the type of masking experiment did not influence the measure of place specificity in cochlear implants.