A pre-post evaluation of a digital intervention to improve psychosocial outcomes of caregivers of people living with cancer in Vietnam.

OBJECTIVES: To evaluate a co-designed intervention using digital resources "Vietnam Cancer Caring Coping" (V-CCC) on the health literacy, depression, and quality of life of caregivers supporting a cancer patient in oncology hospitals in Vietnam. METHODS: A pre-post quantitative evaluation with adult cancer caregivers across regional Oncology hospitals in Vietnam (Ho Chi Minh City, Da Nang, Can Tho, and Hue). Participants completed baseline and follow-up measures of health literacy (HLS-SF12) depression (PHQ-9) and Health-related Quality of Life (5Q-5D-5L). Participants accessed and reviewed V-CCC for a 2-week period. RESULTS: Two hundred and thirty-four caregivers completed pre and post-tests. Most participants were female (n = 143, 61%), married (n = 165, 70%), aged 18-44 (n = 155, 66%), lived rurally (n = 157, 67%). All health literacy scores of participants in post-intervention were significantly higher than that in pre-intervention across all domain's healthcare, disease prevention, and health promotion as well as the total score (p < 0.001). A significant reduction in the proportion of caregivers reporting PHQ-9 moderately severe/severe depression post-intervention was demonstrated (10.2 vs. 6.1%, respectively (p ≤ 0.001). No significant differences were observed pre and post-intervention across four 5Q-5D-5L health dimensions: mobility, self-care, usual activities, and pain/discomfort. Regarding anxiety/depression as measured by 5Q-5D-5L the proportion of participants who reported having moderate, severe, and extreme problems in pre- and post-intervention was statistically significant (32 vs. 24%), respectively (p = 0.0028). CONCLUSION: Co-designed digital resources can reduce health literacy inequities and improve psychological outcomes for cancer caregivers.

Understanding context: A qualitative analysis of the roles of family caregivers of people living with cancer in Vietnam and the implications for service development in low-income settings.

OBJECTIVES: Research on the needs of family caregivers of people living with cancer remains disproportionately focused in high income contexts. This research gap adds to the critical challenge on global equitable delivery of cancer care. This study describes the roles of family caregivers of people living with cancer in Vietnam and possible implications for intervention development. METHODS: Semi-structured interviews and focus groups with family caregivers (n = 20) and health care providers (n = 22) were conducted in two national oncology hospitals. Findings were verified via workshops with carers (n = 11) and health care professionals (n = 28) in five oncology hospitals representing different regions of Vietnam. Data was analyzed collaboratively by an international team of researchers according to thematic analysis. RESULTS: Family caregivers in Vietnam provide an integral role in the delivery of inpatient cancer care. In the hospital environment families are responsible for multiple roles including feeding, hydration, changing, washing, moving, wound care and security of personal belongings. Central to this role is primary decision making in terms of treatment and end-of-life care; relaying information, providing nutritional, emotional and financial support. Families are forced to manage severe complications and health care needs with minimal health literacy and limited health care professional input. CONCLUSIONS: Understanding context and the unique roles of family caregivers of people living with cancer is critical in the development of supportive services. As psycho-oncology develops in low and middle income contexts, it is essential that family caregiver roles are of significant importance.

Medical costs for the treatment of cervical cancer at central hospitals in Vietnam.

Cervical cancer remains the second most common cancer amongst female aged 15 to 44 years old in Vietnam. We estimated medical costs for the treatment of cervical cancer patients. We employed the standard costing approach and health care provider perspective. We first computed the unit cost of 22 medical services related to cervical cancer treatments and then, based on standard cervical cancer treatment protocols, we estimated the cost of nine treatment scenarios for cervical cancer patients. We found that the medical costs for treatment of cervical cancers at central hospitals in Vietnam increased as the cancer progresses into later stages.

Fractional epidermal grafting in combination with laser therapy as a novel approach in treating radiation dermatitis.

Radiation injury to the skin is a major source of dysfunction, disfigurement, and complications for thousands of patients undergoing adjunctive treatment for internal cancers. Despite the great potential for affecting quality of life, radiation injury has received little attention from dermatologists and is primarily being managed by radiation oncologists. During our volunteer work in Vietnam, we encountered numerous children with significant scarring and depigmentation of skin from the outdated use of radioactive phosphorus P32 in the treatment of hemangiomas. This dangerous practice has left thousands of children with significant fibrosis and disfigurement. Currently, there is no treatment for radiation dermatitis. Here, we report a case series using the combination of laser treatment, including pulsed-dye laser, fractional CO2 laser, and epidermal grafting to improve the appearance and function of the radiation scars in these young patients. We hope that by improving the appearance and function of these scars, we can improve the quality of life for these young patients and potentially open up a new avenue of treatment for cancer patients affected with chronic radiation dermatitis, potentially improving their range of motion, cosmesis, and reducing their risk of secondary skin malignancies.

Acquired cutis laxa associated with cutaneous mastocytosis.

Cutis laxa is characterized by dramatic wrinkling of skin that is lacking in elasticity due to inherent defects in dermal elastic fibers. Cutis laxa can be caused by genetic and metabolic disorders. It can also be acquired, possibly resulting from inflammatory processes with destruction of elastic fibers. This report describes a 26-year old woman who developed acquired cutis laxa and cutaneous mastocytosis leading to premature aging. She represents a unique co-occurrence of these two separate disease entities. To our knowledge, there has been only one published case report of acquired cutis laxa occurring in association with urticaria pigmentosa in a 4-year old girl. Our case would be a second case that exhibits the coexistence of these two disorders in an adult female.

An investigation into patterns of Alcohol drinking in Scotland after the introduction of minimum unit pricing.

BACKGROUND: In 2018, Scotland became the second country to implement minimum unit pricing (MUP) for all types of alcoholic beverages. The aim of this study was to examine the effect of the policy. METHOD: Three national household-level surveys were used: Scottish Health Surveys (2008-2021), Health Surveys in England (2011-2019), and Northern Ireland Continuous Household Survey (2011-2015). First, a generalized ordered logistic model examined patterns of drinking solely in Scotland from 2008-2021 covering current drinking, drinking categories and the weekly consumption (in alcohol units). Secondly, difference-in-difference (DID) analysis was employed to examine changes in "social drinking" behaviours in Scotland after the announcement in 2012 (2011-2015, Northern Ireland and England as comparators) and after the adoption of the policy in 2018 (England as a comparator, with two timeframes 2016-2019 and 2013-2019). RESULTS: Overall, drinking in Scotland began to decline prior to 2012 and dropped further with the enactment of MUP in 2018. In response to MUP, the likelihood of abstention increased along with a slight decrease in the prevalence of heavy drinking. The overall amount of drinking fell by about 8% after 2012 and 12% after 2018 (as compared to 2008-2011 level), with a significant decline seen in moderate drinkers but not of those who drank at hazardous or harmful levels. The DID analyses confirmed the reduction in current drinking in Scotland starting since 2012 and continued post-MUP in 2018. CONCLUSION: This study points to the impact of MUP in Scotland with a potential role for 'policy signalling' by the Scottish Government's with a multiple-buy discount ban and MUP's announcement since 2011-2012. Indications of impact include a clear decline in alcohol consumption levels and a small but noteworthy change in prevalence of overall drinking and heavy drinking.

A systematic review on the direct approach to elicit the demand-side cost-effectiveness threshold: Implications for low- and middle-income countries.

Several literature review studies have been conducted on cost-effectiveness threshold values. However, only a few are systematic literature reviews, and most did not investigate the different methods, especially in-depth reviews of directly eliciting WTP per QALY. Our study aimed to 1) describe the different direct approach methods to elicit WTP/QALY; 2) investigate factors that contribute the most to the level of WTP/QALY value; and 3) investigate the relation between the value of WTP/QALY and GDP per capita and give some recommendations on feasible methods for eliciting WTP/QALY in low- and middle-income countries (LMICs). A systematic review concerning select studies estimating WTP/QALY from a direct approach was carried out in seven databases, with a cut off date of 03/2022. The conversion of monetary values into 2021 international dollars (i$) was performed via CPI and PPP indexes. The influential factors were evaluated with Bayesian model averaging. Criteria for recommendation for feasible methods in LMICs are made based on empirical evidence from the systematic review and given the resource limitation in LMICs. A total of 12,196 records were identified; 64 articles were included for full-text review. The WTP/QALY method and values varied widely across countries with a median WTP/QALY value of i$16,647.6 and WTP/QALY per GDP per capita of 0.53. A total of 11 factors were most influential, in which the discrete-choice experiment method had a posterior probability of 100%. Methods for deriving WTP/QALY vary largely across studies. Eleven influential factors contribute most to the level of values of WTP/QALY, in which the discrete-choice experiment method was the greatest affected. We also found that in most countries, values for WTP/QALY were below 1 x GDP per capita. Some important principles are addressed related to what LMICs may be concerned with when conducting studies to estimate WTP/QALY.

Temporal Trends in Tobacco Smoking Prevalence During the Period 2010-2020 in Vietnam: A Repeated Cross-Sectional Study.

Objectives: This study used repeated cross-sectional data from three national surveys in Vietnam to determine tobacco smoking prevalence from 2010 to 2020 and disparities among demographic and socioeconomic groups. Methods: Tobacco smoking temporal trends were estimated for individuals aged 15 and over and stratified by demographic and socioeconomic status (SES). Prevalence estimates used survey weights and 95% confidence intervals. Logistic regression models adjusted for survey sample characteristics across time were used to examine trends. Results: Tobacco smoking prevalence dropped from 23.8% in 2010 to 22.5% in 2015 and 20.8% in 2020. The adjusted OR for 2015 compared to 2010 was 0.87, and for 2020 compared to 2010 was 0.69. Smoking decreased less for employed individuals than unemployed individuals in 2020 compared to 2010. Smoking was higher in the lower SES group in all 3 years. Higher-SES households have seen a decade-long drop in tobacco use. Conclusion: This prevalence remained constant in lower SES households. This highlights the need for targeted interventions to address the specific challenges faced by lower-SES smokers and emphasizes the importance of further research to inform effective policies.

Estimating the health impacts of sugar-sweetened beverage tax for informing policy decisions about the obesity burden in Vietnam.

BACKGROUND: Taxation on sugar-sweetened beverages (SSBs) has been adopted in more than 40 countries but remained under discussion in Vietnam. This study aimed to estimate the health impacts of different SSBs tax plans currently under discussion to provide an evidence base to inform decision-making about a SSBs tax policy in Vietnam. METHOD & FINDINGS: Five tax scenarios were modelled, representing three levels of price increase: 5%, 11% and 19-20%. Scenarios of the highest price increase were assessed across three different tax designs: ad valorem, volume-based specific tax & sugar-based specific tax. We modelled SSBs consumption in each tax scenario; how this reduction in consumption translates to a reduction in total energy intake and how this relationship in turn translates to an average change in body weight and obesity status among adults by applying the calorie-to weight conversion factor. Changes in type 2 diabetes burden were then calculated based on the change in average BMI of the modelled cohort. A Monte Carlo simulation approach was applied on the conversion factor of weight change and diabetes risk reduction for the sensitivity analysis. We found that the taxation that involved a 5% price increase gave relatively small impacts while increasing SSBs' price up to 20% appeared to impact substantially on overweight and obesity rates (reduction of 12.7% and 12.4% respectively) saving 27 million USD for direct medical cost. The greatest reduction was observed for overweight and obesity class I. The decline in overweight and obesity rates was slightly higher for women than men. CONCLUSION: This study supports the SSB tax policy in pursuit of public health benefits, especially where the tax increase involves around a 20% price increase. The health benefit and revenue gains were evident across all three tax designs with the specific tax based on sugar density achieving greatest effects.

Trend of metabolic risk factors among the population aged 25-64 years for non-communicable diseases over time in Vietnam: A time series analysis using national STEPs survey data.

Introduction: The study aims to examine the trends of 4 metabolic NCDs risk factors including raised blood pressure, increased blood glucose, elevated blood lipids and overweight/obesity over the last 10 years in Vietnam as well as examine these trends among different sub-population by geographical area, gender, and age groups. Methods: The study combined the national representative data from three rounds of STEPs survey in Vietnam conducted in 2010, 2015, and 2020 on people aged 25-64 years. The overall prevalence of each metabolic factor together with 95% CI for each time point as well as the stratified prevalence by rural/urban, male/female, and 4 separated age groups were calculated and considered the sampling weight. Cochran-Armitage test for trend was used to test for the differences in the prevalence over time. Results: The prevalence of hypertension, overweight/obesity, hyperglycemia, and hyperlipidemia among the population aged 25-64 years old was 28.3, 20.57, 6.96, and 15.63%, respectively in the year 2020. All NCD metabolic risk factors examined in this analysis show significantly increasing trends over time. For most age groups, the increasing burden of NCD metabolic risk factors was more significant during the period 2015-2020 compared to the period 2010-2015. Male population and population aged 55-64 experienced the most dramatic changes in the burden of all NCD metabolic risk factors. Conclusion: To reverse the increasing trend of NCD metabolic factors in Vietnam, intervention, and policy need to apply a comprehensive life course approach.

Trends in, projections of, and inequalities in non-communicable disease management indicators in Vietnam 2010-2030 and progress toward universal health coverage: A Bayesian analysis at national and sub-national levels.

Background: Movement towards Universal Health Coverage (UHC) can improve health services, risk factor management, and inequality in non-communicable diseases (NCD); conversely, prioritizing and monitoring NCD management can support pathways to UHC in resource-limited settings. We aimed to estimate trends in NCD management indicators in Vietnam from 2010, and projections to 2030 at national and sub-national levels; compute the probability of reaching UHC targets; and measure inequalities in NCD management indicators at demographic, geographic, and socio-economic levels. Methods: We included data of 37,595 households from four nationally representative surveys from 2010. We selected and estimated the coverage of NCD health service and risk management indicators nationally and by six sub-national groups. Using Bayesian models, we provided trends and projections and calculated the probability of reaching UHC targets of 80% coverage by 2030. We estimated multiple inequality indices including the relative index of inequality, slope index of inequality, and concentration index of inequality, and provided an assessment of improvement in inequalities over the study period. Findings: Nationally, all indicators showed a low probability of achieving 2030 targets except sufficient use of fruit and vegetables (SUFV) and non-use of tobacco (NUT). We observed declining trends in national coverage of non-harmful use of alcohol (NHUA), sufficient physical activity (SPA), non-overweight (NOW), and treatment of diabetes (TOD). Except for SPA, no indicator showed the likelihood of achieving 2030 targets at any regional level. Our model suggested a non-achievement of 2030 targets for all indicators in any wealth quintile and educational level, except for SUFV and NUT. There were diversities in tendency and magnitude of inequalities with widening gaps between genders (SPA, TOD), ethnic groups (SUFV), urban-rural areas (TOH), wealth quintiles, and educational levels (TOD, NUT, NHUA). Interpretation: Our study suggested slow progress in NCD management at the national level and among key sub-populations in Vietnam, together with existing and increasing inequalities between genders, ethnicities, geographic areas, and socioeconomic groups. We emphasised the necessity of continuously improving the healthcare system and facilities, distributing resources between geographic areas, and simultaneously integrating economic, education, and gender intervention and programs. Funding: None.

Evaluation of Inpatient Experience at Some Clinical Departments of Kien Giang General Hospital, Kien Giang Province, Vietnam, 2020: An Analytical Cross-Sectional Study.

Patient experience is being widely considered in evaluating the quality of health care services. This is a cross-sectional study with 860 inpatients hospitalized in 4 clinical departments (General Internal Medicine; Cardiology; General Surgery; Surgery, and Orthopedic Trauma) of the Kien Giang General Hospital, from April to June 2020. Data was collected through a two-part questionnaire used to evaluate the inpatient experience during hospital treatment, using the Likert scale 5 points. The patient's experience is classified into 3 aspects (environment-facilities, healthcare staff's care, treatment information). In total, 815 participants responded to the interview (94.8%). The rates of patients having a positive experience on the environment and facilities, the care of health workers, and treatment information are 31.7%, 85.9%, and 74.2%, respectively. The patient's positive overall experience rate is 65.5%. Factors related to the patient's overall experience are the department of treatment, residential area, age, and employment status (P < .05). Overall, the positive experience of inpatients at some clinical departments of Kien Giang General Hospital was a relatively low rate (65.5%). Specifically, healthcare staff's care is experienced at a high rate, this factor should be continuously promoted. Improving and upgrading factors in the aspects of the environment-facilities and the treatment information should be implemented if the hospital wants to improve its quality of healthcare services.

Attempt to Quit Tobacco Smoking among Male Smokers in Vietnam and Predictive Factors: Findings from Global Adult Tobacco Survey (GATS).

BACKGROUND: Vietnam is among countries with highest prevalence of tobacco smoking, attempt to quit is an important indicator to monitor the effectiveness of tobacco control efforts. This paper aims to describe smoking quit attempt and examine its association with some individual characteristics among male smokers. METHODS: Data from the Global Adult Tobacco Survey in Vietnam in 2015 was analyzed for a sample of 1,903 male smokers taking from the national representative sample of 8,996 adults aged 15 years and above. RESULTS: Proportion of quit attempt during 12 months prior to the interview among male smoker was 37.1%. Attempt to quit smoking was significantly associated with age (OR=2.84 and 95% CI: 1.43-5.66 for those aged 55 years and older vs. those aged 24 years and younger), with knowledge of harmful effects on health (OR=1.97 and 95% CI: 1.45-2.66 for those who could list 6 to 7 diseases vs. those who could list 3 or less diseases),  number of channels with anti smoking message (OR=1.72 and 95% CI: 1.21-2.45 for those who had exposure from 3 channels or more vs. those who did not expose any channels), number of years smoking (OR=0.59 and OR=0.40 for  those with less than 15 years smoking vs. those  with 25 to 34 years smoking and more than 35 years smoking, respectively). CONCLUSION: Intervention to improve knowledge of tobacco harmful effects, and access to multiple and modern antismoking communication channels would be effective to raise quit attempt among smokers. Research to promote effectiveness of quit advice by health staff should be paid more attention.

Health Service Utilization and Out-of-Pocket Expenditure Associated with the Continuum of Disability in Vietnam.

Reducing the burden of disability is key priority in many countries where the population is aging rapidly. The relationships between disability, health expenditure and economic burden are complex, particularly when disability is recognized as a continuum rather than a dichotomous phenomenon. However, these complex relationships are not adequately addressed in national health policy and management plans in Vietnam. This paper examines the economic consequences of disability across its continuum or levels of severity. Two-part regression models were applied to assess the relationships between disability, health service use and the out-of-pocket expenditure. We found that Vietnamese adults with disabilities had multiple characteristics of vulnerability, e.g., older, less likely to be employed, lower education, and poorer than adults without disabilities. These characteristics are associated with poorer health and higher need of healthcare utilization but, after controlling for these factors, disability still had an independent association with higher health expenditure and greater economic burden at their household (p < 0.05). Our study provides empirical evidence of the economic burden associated across the continuum of disability in Vietnam. Decisive action is critical for protecting persons with disability from medical impoverishment, and such targeted interventions should include those with moderate disability rather than the current focus on severe disability.

A qualitative study on the needs of cancer caregivers in Vietnam.

BACKGROUND: Vietnam has experienced a rapid increase in cancer incidence with many cancers (70%) being diagnosed at a late stage. The majority of physical and psychosocial care is provided by caregivers with minimal professional input. Due to limited resources in hospitals and social and cultural norms regarding caregiving in Vietnam, caregivers provide a range of supportive functions for family members diagnosed with cancer. OBJECTIVES: This study sought to provide empirical evidence on the self-identified unmet needs of caregivers of inpatients in national oncology hospitals in Vietnam. METHODS: Focus groups and in-depth interviews were conducted with caregivers (n = 20) and health care providers (n = 22) in national oncology hospitals in Hanoi and Ho Chi Minh City. Data was collaboratively analysed using thematic analysis. Findings were validated through key stakeholder group discussions with both caregivers and healthcare providers across multiple regions in Vietnam. RESULTS: Analysis demonstrated that the burden of informal care is high with many caregivers managing patient's severe and complex health needs with minimal support. Caregivers highlighted four main areas of critical need: (i) challenges in providing long term care, particularly in hospital and in-patient settings, such as accessing comfortable facilities, accommodation and finance; (ii) information needs about cancer, treatment, and nutrition; (iii) support for the emotional impact of cancer; and (iv) training about how to provide care to their family members during treatment and recovery phases. CONCLUSIONS: Caregivers provide invaluable support in supporting people with a cancer diagnosis, particularly given wider systemic challenges in delivering cancer services in Vietnam. Increasing visibility and formal support is likely to have both a positive impact upon the health and wellbeing of caregivers, as well as for cancer patients under their care. Given its absence, it is critical that comprehensive psychosocial care is developed for caregivers in Vietnam.

Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels.

BACKGROUND: To assess the reproductive, maternal, newborn and child health (RMNCH) service coverage in Vietnam with trends in 2000-2014, projections and probability of achieving targets in 2030 at national and sub-national levels; and to analyze the socioeconomic, regional and urban-rural inequalities in RMNCH service indicators. METHODS: We used national population-based datasets of 44,624 households in Vietnam from 2000 to 2014. We applied Bayesian regression models to estimate the trends in and projections of RMNCH indicators and the probabilities of achieving the 2030 targets. Using the relative index, slope index, and concentration index of inequality, we examined the patterns and trends in RMNCH coverage inequality. FINDINGS: We projected that 9 out of 17 health service indicators (53%) would likely achieve the 2030 targets at the national level, including at least one and four ANC visits, BCG immunization, access to improved water and adequate sanitation, institutional delivery, skilled birth attendance, care-seeking for pneumonia, and ARI treatment. We observed very low coverages and zero chance of achieving the 2030 targets at national and sub-national levels in early initiation and exclusive breastfeeding, family planning needs satisfied, and oral rehydration therapy. The most deprived households living in rural areas and the Northwest, Northeast, North Central, Central Highlands, and Mekong River Delta regions would not reach the 80% immunization coverage of DPT3, Polio3, Measles and full immunization. We found socioeconomic, regional, and urban-rural inequalities in all RMNCH indicators in 2014 and no change in inequalities over 15 years in the lowest-coverage indicators. INTERPRETATION: Vietnam has made substantial progress toward UHC. By improving the government's health system reform efforts, re-allocating resources focusing on people in the most impoverished rural regions, and restructuring and enhancing current health programs, Vietnam can achieve the UHC targets and other health-related SDGs. FUNDING: The authors did not receive any funds for conducting this study.

Cost-Effectiveness of Population-Based Tobacco Control Interventions on the Health Burden of Cardiovascular Diseases in Vietnam.

This study sought to assess the cost-effectiveness of population-based tobacco control interventions, which included health promotion and education, smoke-free models, cessation programs, warning on package, marketing bans, and raising tax. Standardized activity-based costing ingredient approach was applied with the provider perspective to calculate interventions cost from 2013 to 2017. The potential health impacts of the aforementioned interventions were calculated through a Microsoft Excel-based modeling adapted from Higashi et al and Ngalesoni et al. All six population-based tobacco control interventions were highly cost-effective with ranges from 1405 VND (Vietnamese Dong) to 135 560 VND per DALY (disability-adjusted life year) averted. It was identified that raising cigarette taxes and applying health warnings on tobacco packages are the most favorable, cost-effective interventions. The results from this study provide a robust message that calls for increased attention and efforts in developing an appropriate policy agenda, which jointly integrates both political and community-based interventions, to maximize intervention impact on tobacco use.

Health-related quality of life of the Vietnamese during the COVID-19 pandemic.

BACKGROUND: Vietnam applied strict quarantine measures to mitigate the rapid transmission of the SARS-COV-2 virus. Central questions were how the COVID-19 pandemic affected health-related quality of life (HRQOL) of the Vietnamese general population, and whether there is any difference in HRQOL among people under different quarantine conditions. METHODS: This cross-sectional study was conducted during 1 April- 30 May 2020 when the COVID-19 pandemic was at its peak in Vietnam. Data was collected via an online survey using Google survey tool. A convenient sampling approach was employed, with participants being sorted into three groups: people who were in government quarantine facilities; people who were under self-isolation at their own place; and the general population who did not need enforced quarantine. The Vietnamese EQ-5D-5L instrument was used to measure HRQOL. Differences in HRQOL among people of isolation groups and their socio-demographic characteristics were statistically tested. RESULTS: A final sample was made of 406 people, including 10 persons from government quarantine facilities, 57 persons under self-isolation at private places, and the rest were the general population. The mean EQ-VAS was reported the highest at 90.5 (SD: 7.98) among people in government quarantine facilities, followed by 88.54 (SD: 12.24) among general population and 86.54 (SD 13.69) among people in self-isolation group. The EQ-5D-5L value was reported the highest among general population at 0.95 (SD: 0.07), followed by 0.94 (SD: 0.12) among people in government quarantine facilities, and 0.93 (SD: 0.13) among people who did self-isolation. Overall, most people, at any level, reported having problems with anxiety and/or depression in all groups. CONCLUSION: While there have been some worries and debates on implementing strict quarantine measures can hinder people's quality of life, Vietnam showed an opposite tendency in people's HRQOL even under the highest level of enforcement in the prevention and control of COVID-19.

Healthcare Workers' Knowledge and Attitudes Regarding the World Health Organization's "My 5 Moments for Hand Hygiene": Evidence From a Vietnamese Central General Hospital.

OBJECTIVES: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. METHODS: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. RESULTS: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. CONCLUSIONS: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.

Willingness to pay for a quality-adjusted life year among advanced non-small cell lung cancer patients in Viet Nam, 2018.

To examine the willingness to pay (WTP) for a quality-adjusted life year (QALY) gained among advanced non-small cell lung cancer (NSCLC) patients in Viet Nam and to analyze the factors affecting an individual's WTP.A cross-sectional, contingent valuation study was conducted among 400 NSCLC patients across 6 national hospitals in Viet Nam. Self-reported information was recorded from patients regarding their socio-demographic status, EQ-5D (EuroQol-5 dimensions) utility, EQ-5D vas, and WTP for 1 QALY gained. To explore the factors related to the WTP, Gamma Generalized Linear Model and multiple logistic regression tools were applied to analyze data.The overall mean and median of WTP/QALY among the NSCLC patients were USD $11,301 and USD $8002, respectively. Strong association was recorded between WTP/QALY amount and the patient's education, economic status, comorbidity status, and health utility.Government and policymakers should consider providing financial supports to disadvantaged groups to improve their access to life saving cancer treatment.