Role of Social Support on Mental Health Among Resettled Bhutanese Refugees in Ohio.

More than 80% of Bhutanese refugees have resettled in the United States. Social support can lead to better resilience against poor mental health outcomes among this population. This study assessed the role of social support on mental health among the resettled Bhutanese adults in Central Ohio. This study used data collected by the Ohio Department of Mental Health and Addiction Services on 200 Bhutanese adults in Columbus. Social support was measured using a 12-item perceived social support scale. The 25-item Hopkins Symptoms Checklist was used to quantify depression and anxiety experienced in the past month. One-in-three participants reported mental health problems. Compared to participants with high social support, those with medium (OR 5.28, 95% CI 2.09-13.37) and low social support (OR 10.94, 95% CI 2.53-47.33) had more than 5- and 10-fold increased odds of mental health problems respectively. Future studies could further explore the role of social support on mental health during relocation, resettlement, and acculturation processes.

"Let Them Know That They're Appreciated": The Importance of Work Culture on Direct Care Worker Retention.

Retaining direct care workers (DCWs) in all areas of long-term services and supports (LTSS) remains an unending challenge. The current study purposively selected 12 high-performing LTSS communities (e.g., nursing homes, assisted living, home care agencies) in Ohio with high family satisfaction and staff retention. Qualitative interviews were conducted in 2022 with 21 personnel in leadership positions and 16 DCWs (e.g., certified nursing assistants, personal care aides). Interviews were audio recorded, transcribed, and a team of two coders conducted the thematic analysis. Three themes of work culture emerged as important for retention: (1) Family-Like Organizational Approach, (2) Supportive Working Conditions, and (3) Worker Empowerment. DCWs valued empathic relationships with their clients and supervisors. Favorable working conditions consisted of choice, participative leadership, and effective communication. DCWs experienced empowerment through appreciation, financial incentives, and career advancement opportunities. Findings suggest practical changes for person-centered care practitioners that are feasible across any organizational work culture setting. [Journal of Gerontological Nursing, 49(8), 7-13.].

Mental Health Status of Migrant Nepalese Workers Rescued By Government of Nepal During the Corona Virus disease -19 Pandemic.

BACKGROUND: The corona virus pandemic rapidly sweeps across the world; it is inducing a considerable degree of depression, stress and anxiety concern in the population at large and among certain groups in particular, such as migrant workers. The aim of the study is to find out mental health status of migrant workers rescued by Nepal Government from different countries during corona virus disease -19-19 pandemic. METHODS: Cross-sectional descriptive study involving 427 returned migrant workers was conducted using the depression, anxiety and stress scale -21(DASS-21). Association between socio-demographic variables to mental health status was performed using chi-square test and p-value <0.05 was considered as significant level. RESULTS: Out of 427 participants, 4 % of respondents found to have extremely severe level of stress followed by 1.9 % extremely severe level of depression and 2.3% extremely severe level of anxiety. The association between mental health status and covariates showed that depression, anxiety and stress were associated with the place of residence, educational status of the respondents, and their perception of corona virus disease -19 risk at workplace, and test for COVID-19 after arrival to Nepal. CONCLUSIONS: The study revealed that job loss, visa and employment contract expiry were the main reasons for migrant workers to return Nepal. Nearly one fourth of the respondents had suffered from depression, nearly one third from stress and 17% from anxiety. Necessary psychosocial interventions should be formulated and implemented for addressing the mental health problems of migrant workers during the corona virus disease -19-19 pandemic.

Prevalence of multimorbidity and its correlates among older adults in Eastern Nepal.

BACKGROUND: The number of people with multimorbidity is surging around the world. Although multimorbidity has been introduced in policy and practice in developed countries, developing countries like Nepal have not considered it as a matter of public health urgency due to the lack of enough epidemiological data. Multimorbidity profoundly affects older adults' wellbeing; therefore, it is crucial to estimate its prevalence and determinants. This study aimed to estimate the prevalence of multimorbidity among older adults in Eastern Nepal and identify its correlates. METHODOLOGY: A community-based cross-sectional survey was conducted in three districts of Eastern Nepal. Data were collected between July and September 2020, among 847 Nepali older adults, aged 60 and older, where study participants were recruited through a multi-stage cluster sampling technique. Semi-structured interviews were conducted at the community settings to collect data. Logistic regression assessed correlates of multimorbidity. SAS 9.4 was used to run all statistical tests and analyses. RESULTS: More than half (66.5%) of the participants had at least one of the five non-communicable chronic conditions; hypertension (31.6%), osteoarthritis (28.6%), chronic respiratory disease (18.0%), diabetes (13.5%), and heart disease (5.3%). The prevalence of multimorbidity was 22.8%. In the adjusted model, increased age (for 70-79 years, OR: 3.11, 95% CI: 1.87-5.18; for 80 + years, OR: 4.19, 95% CI: 2.32-7.57), those without a partner (OR: 1.52, 95% CI: 1.00-2.30), residing in urban areas (OR: 1.71, 95% CI: 1.16-2.51), and distant from health center (OR: 1.66, 95% CI: 1.04-2.64) were significantly associated with multimorbidity. CONCLUSIONS: This study found one in five study participants had multimorbidity. The findings will assist policymakers and stakeholders in understanding the burden of multimorbidity among the older population and identifying the groups in most need of health promotion intervention. Future interventions may include developing horizontal multimorbid approaches and multisectoral strategies specifically tailored to meet the needs of those populations.

Developmental delay and its associated factors among children under five years in urban slums of Nepal.

INTRODUCTION: Children from low-resource settings are more likely to encounter those factors that adversely influence their ability to acquire developmental potential. This study was conducted to assess the developmental status and its associated factors among children under five years of slum areas of Butwal Sub Metropolitan City, Rupandehi, Nepal. METHODS AND FINDINGS: We conducted a community-based cross-sectional descriptive study using Developmental Milestone Chart (DMC) among 165 children under five years. Ethical approval was obtained from Ethical Review Board of Nepal Health Research Council. R software was used for data analysis. The association between developmental status and associated factors were examined with Chi-square and followed by logistic regression. Notably, more than half of the children (56.4%) had delayed development across two or more domains of gross motor, fine motor, language/ speech, and social development. Age, sex, socio-economic status, availability of learning materials, the occurrence of infectious diseases, and height-for-age of children were found to be significantly associated with the developmental status of children under study (p<0.05). CONCLUSIONS: More than half of the children taken under the study had delayed development on different four domains. Findings from the study suggest that there should be similar studies conducted among children living in slum-like conditions. Additionally, programs should be designed as such which aims to mitigate the effect of socio-economic status on child development and has learning and nutritional aspects embedded central to its deliverance.

Health Services Utilization among Older Adults in Pokhara Metropolitan City.

The Government of Nepal provides a range of welfare schemes to senior citizens, but little is known about the use of public benefits by older adults. This community-based cross-sectional survey thus aims to assess the utilization and correlates of health services (through both private and public health facilities), free essential health services (provided by the government through public health facilities), and other welfare schemes - discounts in health treatment for certain diseases, monthly senior citizen allowance, reservation and concession in transportation, and the government-run health insurance program - among 201 Nepali older adults. Notably, a sizable proportion of the participants (22.4%) did not visit a health facility despite having a health problem. Females and those with higher co-morbidity had higher odds of health facility visits. Only 8% utilized the free essential health services, and 47% one or more of the other welfare schemes. Lack of awareness of free health services and welfare schemes were associated with lower odds of their utilization, respectively.

Quality of Life and Nutritional Status of the Geriatric Population of the South-Central Part of Nepal.

BACKGROUND: The main objective of the study was to assess the nutritional status and quality of life in the geriatric population of Lahan municipality of Siraha district. METHODS: A cross-sectional analytical study was conducted in Lahan municipality of Siraha district from June to December 2017. The Mini-Nutritional Assessment tool was used to investigate the nutritional status, and World Health Organization Quality of Life-OLD questionnaires were used to assess the quality of life among geriatric population. RESULT: Out of the total participants, one-third (45.7%) of the participants were at risk of malnutrition and 19.8% were malnourished while 34.5% had normal nutritional status. It was seen that 48.2% of participants had good quality of life whereas 51.8% of them had poor quality of life. There was a significant association between nutritional status and quality of life in the elderly population. CONCLUSION: The findings showed the need for active ageing interventions to improve the nutritional status and quality of life of elders at the community settings. Proper attention should be focused on elders' nutrition to reduce the observed prevalence of malnutrition, and focus should be given on the nutrition status that leads to improve the quality of life of elders.

Menopausal Symptoms among Postmenopausal Women of a Selected Municipality: A Cross-sectional Survey.

INTRODUCTION: Postmenopausal women experience various menopause-specific somatic, psychological, and urogenital symptoms which tend to affect their overall well-being. However, there is a scant focus on menopausal health problems of postmenopausal women in Nepal. The aim of the study was to find out the prevalence of menopausal symptoms among postmenopausal women of a Municipality. METHODS: A cross-sectional survey was conducted in selected wards of Tokha Municipality of Kathmandu district among postmenopausal women aged 45-60 years from September to October 2019. Ethical approval was taken from the Ethical Review Board, Nepal Health Research Council (reference number 694). Random sampling was used as the sampling technique. Face-to-face interview was used for data collection while a semi-structured interview schedule including the Nepali version of Menopause Rating Scale was used as a tool for measuring menopausal symptoms. EpiData version 3.1 was used for data entry while data analysis was performed using Statistical Packages for the Social Sciences version 20. RESULTS: Amongst the postmenopausal women, all 203 (100%) had menopausal symptoms with majority reporting milder symptoms as found in 143 (70.4%). The mean Menopause Rating Scale (MRS) score was obtained as 13.21±5.1. The most prevalent moderate and mild symptoms were vaginal dryness 94 (46.3%), and depressive mood 71 (35%) respectively while physical and mental exhaustion 175 (86.2%) was the most common in all forms. Over half 102 (50.2%) of the respondents were unaware of menopausal symptoms and almost three-fifth 121 (59.6%) reported menopause related symptoms affected their daily work activities. CONCLUSIONS: The majority of postmenopausal women in this study had milder menopausal symptoms, which parallels findings from other national studies.

Factors Associated with Postnatal Depression among Mothers Attending at Bharatpur Hospital, Chitwan.

Postnatal depression is linked with adverse outcomes for mothers, offspring, and her entire family, which stands as a significant public health problem and is often taken as a neglected issue of maternal and child health in the developing world. Postnatal depression is often falsely interpreted as common consequences related to the recent delivery. The main objective of this study is to find out the status of postnatal depression and the factors associated with it among the postnatal mothers attending at Bharatpur Hospital. Methodology. A total of 242 postnatal women were included in a hospital-based cross-sectional descriptive study. A systematic random sampling technique was done to get the sampling interval. Face to face interview technique was used for data collection, and depressive symptoms were measured by the Edinburgh Postnatal Depression Scale. Data was entered in Epi-Data and imported to SPSS for analysis. The data were summarized in terms of frequency (percentage), mean (SD), or median (IQR) as per necessity for descriptive analysis. The chi-square test and binary logistic regression were performed to find out the association between the covariates and depression status, assuming significance at p value <0.05. Results. The study revealed that the prevalence of postnatal depression was 16.9% by EPDS at cutoff point ≥12. It was found that postnatal depression was associated with current age, smoking, pressure to conceive a child, intent of pregnancy, and delivery-related complications. Conclusion. Postnatal depression within six months of delivery was found among nearly one-fifth of women, where 13.6% also had suicidal thoughts. More than half of the postnatal women had an early marriage. It is recommended that mothers with high risk should be routinely screened for postnatal depression followed by necessary interventions as well as safe motherhood counseling.

Prevalence of Risk Factors of Major Non-Communicable Diseases among Adolescents of Higher Secondary Schools of Kaski District.

BACKGROUND: The main aim of this study is to determine the prevalence of major non communicable disease risk factors among higher secondary school students. METHODS: A cross-sectional study was conducted among higher secondary students of grade 11 and 12 of Kaski district in Nepal. The study period was from July 2016 to June 2017. Total sample 640 higher secondary students were recruited through two-stage cluster sampling. Self-administrated questionnaire was used for the data collection tool along with other tools which were used such as UNICEF electronic weighing scale, stature meter and mechanical aneroid sphygmomanometer. Ethical approval was obtained from IRC, Pokhara University. Data were entered intoEpiData software and analysis was performed with the help of the Statistical Package for Social Science (SPSS). RESULTS: The prevalence of smoking was 6.1% which was high in male (11.9%) than female (0.6%). Alcohol consumption practice among the adolescents was 18.9%. Family history of hypertension was seen higher than family history of diabetes.The prevalence of hypertension was 11.7%. High prevalence of abnormal values of systolic and diastolic BP was found in male than female students. Overweight was seen in 6.1% students. Prevalence of obesity was almost equal in both groups. CONCLUSIONS: There is high prevalence of smoking, alcoholism among adolescents. Hypertension was more common than overwieght among adolescents.

Dietary Practice and Nutritional Status of Tuberculosis Patients in Pokhara: A Cross Sectional Study.

Background: Undernutrition increases the risk of progression from Tuberculosis (TB) infection to active TB disease and further leads to weight loss. Proper diet and nutrition play significant roles in treating TB patients. Active TB needs high energy requirement. The main aim of this study is to assess the dietary intake and nutritional status of TB patients in Pokhara city of Nepal. Methods: A cross-sectional descriptive study was carried out among 133 TB patients taking anti-tubercular drug. Data were collected using sequential sampling method. Data were collected from 4th October to 7th November, 2016. Results: This study revealed that about one-fifth of TB patients did not consume sufficient amount of calories as per RDA. More than one-third of patients were underweight during the time of registration and this is reduced to 21.8 percent in the present situation. Mean BMI was 20.99 kg/m2 (SD ± 5.81). Similarly, the mean BMI among Pulmonary TB (PTB) is 19.82 and 22.52 kg/m2 in Extra PTB. Working conditions and food intake frequency were significantly associated with calorie intake. This study found that the amount of calories, food frequency per day, types of TB, and nutritional status during registration were found to be associated with recent nutritional status. The statistical difference between mean BMI at registration and recent BMI and mean weight at registration and recent weight. Conclusion: Nutritional status has improved comparatively from the time of registration to the time of study. Proper nutritional counseling should be given to TB patients along with nutritional support to severely malnourished patients, and nutritional assessment of TB patients should be done periodically.

Life satisfaction among elderly patients in Nepal: associations with nutritional and mental well-being.

BACKGROUND: Nepal's demography is aging rapidly, yet few studies to date have examined how this has affected the health and well-being of the elderly, defined as those above 60 years in Nepal's Senior Citizen Act (2006). Our study, abbreviated NepEldQOLII, aims to assess perceived life satisfaction, and evaluate its relationship with nutritional health and mental well-being among the burgeoning Nepalese elderly population. METHODS: A cross-sectional survey among 289 Nepalese elderly, aged ≥60 years, attending an outpatient clinic of a hospital in Kathmandu, Nepal was conducted. Nutritional status, depression, and life satisfaction were assessed by a mini-nutritional assessment scale (range: 0-14), a geriatric depression scale (range: 0-15), and a satisfaction with life scale (range: 5-35), respectively. Mediation analyses, adjusted for age, sex, marital status, and family type, were used to assess mediating relationships between nutritional and mental wellbeing with life satisfaction as the outcome. RESULTS: Approximately 21% of the participants were dissatisfied with their life. Life satisfaction was positively associated with being married, high family income, involvement in active earning, and a high nutritional score. Conversely, life satisfaction was inversely associated with living in a nuclear (as opposed to joint) family, the perception of having worse health than peers, the perception of being ignored/hated due to old age, and a higher depression score. In mediation analyses, both nutrition (ß = 0.48, bias-corrected and accelerated (BCa) 95% CI: 0.27, 0.69) and depression (ß = - 0.87, BCa 95% CI: -1.01, - 0.74) had significant direct associations with life satisfaction. Furthermore, both nutrition (ß = 0.30, BCa 95% CI: 0.13, 0.49) and depression (ß = - 0.07, BCa 95% CI: -0.14, - 0.03) mediate each other's association with life satisfaction. Nutritional score mediated 7% of the total association between depression and life satisfaction; depression mediated 38% of the total association between nutrition and life satisfaction. CONCLUSIONS: Life satisfaction shows a pattern of decline as nutritional and mental health status decrease. Both depression and under-nutrition had a significant association with life satisfaction. The pathway by which nutrition affects life satisfaction is influenced by depression as a mediator. Moreover, nutritional status explained a small portion of the relationship between depression and life satisfaction. These observed preliminary findings should be confirmed in future longitudinal studies.