Health-related quality of life among Moroccan women after vaginal birth and cesarean section: Cross-sectional study.

Background: During the postpartum period, understanding women's well-being, specifically their Health-related Quality of Life (HRQoL), is vital for comprehensive healthcare. Objectives: Our study aims to explore the HRQoL and its associated factors in Moroccan women after vaginal birth (VB) and cesarean section (CS). Study design: In this cross-sectional study we assessed the HRQoL and its associated factors among Moroccan women who gave birth at the provincial hospital center of Settat. We gathered data from 566 women, using the EQ-5D-5L instrument alongside questionnaires about socioeconomic and obstetrical aspects. The assessment was conducted utilizing the improved Relative to an Identified Distribution (RIDIT) approach, and we employed a multiple linear regression model to pinpoint the associated factors. Results: A total of 566 women were included in our study. Our results revealed that the HRQoL in women who underwent CS was significantly lower than in VB women (EQ-5D index score = 0.30 ± 0.28 vs 0.61 ± 0.31; p < 0.0001). Similarly, the CS reduced the EQ-VAS score (mean difference = -10.73 ± 3.78; p < 0.0001). The CS was associated negatively with problems in mobility (ARI = 55 % [42-67], p < 0.0001), autonomy (ARI = 67 % [57-80], p < 0.0001), and usual activities (ARI = 56 % [42-69], p < 0.0001). Also, CS was associated with pain/discomfort (ARI = 47 % [34-60], p < 0.0001) and anxiety/depression (ARI = 3 % [-5.8-12.6], p = 0.31). The women who had birth complications had the worst HRQoL (EQ-5D index score = 0.32) compared to those who had no complications (EQ-5D index score = 0.56). Likewise, women who had postpartum complications had the worst HRQoL (EQ-5D index score = 0.39 vs EQ-5D index score = 0.54). Conclusion: The results highlighted that mode of birth, childbirth complications, and postpartum complications are strongly associated with women's HRQoL. The EQ-5D-5L dimensions were affected after delivery. Hence, there is a requirement to create specialized initiatives for overseeing postpartum HRQoL, aiming to enhance the quality of maternal healthcare.

Impact of Nutrition Education on Various Health-Related Components of Hemodialysis Patients: A Systematic Review.

This study aimed to identify the impact of nutrition education on various health-related components of hemodialysis patients. A systematic review was conducted according to the PRISMA guidelines. Relevant literature published between 2013 and 2023 was identified across two databases (PubMed and Science Direct). The protocol was registered in PROSPERO (CRD42023460681). Two independent reviewers retrieved the data, and 41 studies were selected. Nine components related to the impact of nutrition education in hemodialysis patients were identified. Each component was clarified by mentioning each study and its results. This study enabled us to characterize the various components of the impact of nutritional education in hemodialysis patients, namely biological markers, quality of life, cost of care, adherence to dietary recommendations, knowledge, malnutrition inflammation, dietary intake, weight change, and behavior change. This systematic review enables healthcare providers to assess the impact of nutritional education on hemodialysis patients. Also, it gives professionals an exact idea of the impact of nutrition education on hemodialysis patients, with knowledge of new methods using behavior change theories and innovative technological tools.

Lifestyle Habits Determinants of Health-Related Quality of Life in Moroccan College Students.

The transition to university is a critical period during which considerable life changes arise. Useful national data to design tailored interventions aimed at promoting health-related quality of life (HRQoL) among Moroccan students are lacking. The present study is aimed at filling this gap by investigating the levels and associated factors of HRQoL among a national sample of Moroccan university students. HRQoL was assessed using the EQ-5D-5L instrument. Data from 2759 university students were collected in a large, cross-sectional, web-based survey. All statistical analyses were conducted using the R software. The EQ-5D-5L findings showed that the majority of students rated level 1 (no problems) and level 2 (slight problems) for the "Mobility", "Self-Care", "Usual Activities", and "Pain/Discomfort" HRQoL dimensions. However, the "Anxiety/Depression" dimension was the exception; more than half (57.1%) of the students were slightly to extremely anxious or depressed. The levels of lifestyle habits were of concern among participants of this study. With respect to sedentary behaviors and physical activity, we found that approximately 80% of participants spent ≥2 h/day on different screen-based sedentary behaviors, and 60% were physically inactive. Lifestyle habits that were found to be associated with HRQoL are sleeping time, physical activity, leisure, hygiene, household activities, homework, and social media time. The multiple regression model explained 93% of the EQ-VAS score variance. The findings could be of great importance for researchers and policymakers interested in promoting health of university students.

Health-related quality of life during three trimesters of pregnancy in Morocco: cross-sectional pilot study.

Background: Pregnancy is universally considered a normal physiological process. However, it has a considerable impact on the quality of mothers' lives. This study piloted the use of the generic EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) descriptive system and the EuroQol Visual Analogue Scale (EQ-VAS) questionnaire, to assess the health-related quality of life (HRQoL) during pregnancy and its associated factors. Methods: In this cross-sectional pilot study carried out from August to December 2019 we assessed the HRQoL and its associated factors among Moroccan pregnant women who received prenatal care at Settat's health centers. The collected data from 270 pregnant women were compared to a dataset of 289 non-pregnant women using the EQ-5D-5L instrument and socioeconomic and obstetrical questionnaires. A multiple linear regression model was used to identify associated factors. The HRQoL comparison was made using the improved RIDIT approach, which allows estimating the Absolute Risk Increase (ARI) of problems related to mobility, usual activities, and self-care and the ARI of pain/discomfort and anxiety/depression (i.e. an ARI = 10% in mobility means that pregnancy increases problems in this health dimension by 10%). Findings: A total of 559 women were included in our study. Our results showed that the HRQoL in pregnant women was significantly lower than in non-pregnant women (EQ-5D index score = 0.71 ± 0.24 vs 0.79 ± 0.29; p < 0.0001). Similarly, the pregnancy reduced the EQ-VAS score (mean difference = -7.8 ± 17.21; p < 0.0001). The pregnancy increased the problems in mobility (ARI = 9.7% [1.7-17.6], p = 0.02), in self-care (ARI = 8% [2-14], p = 0.01), and in usual activities (ARI = 27.3% [18.9-35.7], p < 0.0001). Also, the pregnancy increased pain/discomfort (ARI = 26.5% [18-35.1], p < 0.0001) and anxiety/depression (ARI = 12% [3.2-20.9], p = 0.0112). The rural pregnant women had the worst HRQoL (EQ-5D index score = 0.57) compared to their urban peers (EQ-5D index score = 0.77). Likewise, women in the third trimester and nulliparous had the worst HRQoL (EQ-5D index score = 0.64 and 0.84 respectively). Interpretation: The results highlighted that place of residence, parity, and gestational age are strongly associated with pregnant's HRQoL. The five EQ-5D-5L dimensions were affected during pregnancy. Consequently, there is a need to develop specific programs to monitor the HRQoL during pregnancy in order to ensure better maternal health care. Funding: This study was funded by University Hassan First's own fund [grant number FP/01/2018].

Post-COVID-19 mental health and its associated factors at 3-months after discharge: A case-control study.

Background: Mental health disorders are among the most significant sequelae of the COVID-19 pandemic. Therefore, the aim of this study is to investigate the mental health status and associated risk factors of Moroccan COVID-19 survivors 3 months after hospital discharge. Methods: A case-control study was conducted from September 2021 to February 2022 on 824 participants. 213 were COVID-19 survivors and 611 were control group. Data were collected ether through an online anonymous survey. Anxiety and depression disorders were assessed using Hospital Anxiety and Depression Scale (HADS). Results: The average age of all participants was 55.17 ±â€¯16.44. Our findings highlighted higher prevalence of mental health disorders including anxiety and depression in COVID-19 survivors at 3 months after hospital discharge (HADS-A = 12.84; HADS-D = 10.91) compared to control group (HADS-A = 9.90; HADS-D = 8.27) (p < 0.001). Older patients, suffering from type 2 diabetes and kidney diseases, admitted to ICU, who stayed a long duration in the hospital, who had severe and longer duration of symptoms and who used Chloroquine, had higher levels of anxiety and depression after discharge. Conclusions: The present investigation highlights the need to develop a post-COVID-19 rehabilitation programs that can better manage the post COVID-19 impact and restore a good mental health for COVID-19 survivors. Also, to create preventative strategies to limit mental health disorders in COVID-19 survivors.

Health-Related Quality of Life of Moroccan COVID-19 Survivors: A Case-Control Study.

Background: Research on COVID-19 has mostly focused on transmission, mortality and morbidity associated with the virus. However, less attention has been given to its impact on health-related quality of life (HRQoL) of patients with COVID-19. Therefore, this study aimed to determine the demographic and clinical risk factors associated with COVID-19 and evaluate its impact on the HRQoL of COVID-19 survivors. Methods: A case-control study was carried out between September 2021 and March 2022 on 1105 participants. A total of 354 were COVID-19 survivors and 751 were the control group. The HRQoL was assessed using both EQ-5D-5L and SF-6D generic instruments. Results: The average age of all participants was 56.17 ± 15.46. Older age, urban area, tobacco use, presence of chronic diseases especially type 1 diabetes, kidney and cardiovascular diseases were significantly associated with COVID-19. The COVID-19 survivors had significantly lower HRQoL (EQ-VAS = 50.89) compared to the control group (EQ-VAS = 63.36) (p-value < 0.0001). Pain/ discomfort and anxiety/depression were the most negatively affected by COVID-19 (p-value < 0.0001). Conclusions: The findings from this study could help healthcare professionals and policy makers to better understand the HRQoL sequelae among the COVID-19 survivors and contribute to develop tailored interventions.

Health-related quality of life and behavior-related lifestyle changes due to the COVID-19 home confinement: Dataset from a Moroccan sample.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus initially appeared in Wuhan, Hubei Province, China has caused a novel coronavirus disease (COVID-19) [1]. The disease is rapidly spread around the world causing thousands of deaths and posing critical challenges for public health and clinical research in the world. The outbreak was declared by the World Health Organization (WHO) as a public health emergency of international concern. Nowadays, there are more than 18 millions of confirmed cases of coronavirus across the world with a total of 702,903 deaths [2]. In Morocco, there are 28,500 confirmed cases and 345 deaths. Forecasts for the cumulative number of confirmed, recovered, active and death cases were recently provided [3]. To manage the pandemic spread several countries adopted proactive and preventive measures including home confinement of the population. However, there is evidence that these measures, particularly home confinement, can cause unprecedented disruption in the well-being of the population. Being forced to stay at home and the daily activities' restrictions could impact the citizens' health-related quality of life (HRQoL) and behavior-related lifestyle. It has been reported that the COVID-19 pandemic has an impact on psychological behaviors [4], mental health [5] and anxiety/depression [6]. The Moroccan population was under home confinement from March 20, 2020. Assessing rapidly and simply the HRQoL during crisis such as the home confinement is a challenge of interest to provide speedy information to authorities which allow best management of damages yielding in crisis situation. The EQ-5D instrument is a generic questionnaire developed by the Euroqol group for measuring the HRQoL by combining five health dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) [7]. The EQ-5D instrument is translated into more than 300 languages and exhibit good reliability and validity in both patients and general population. Herein, we used the EQ-5D-5L instrument to assess for the first time the impact of the home confinement on the HRQoL. Also, we evaluated the changes in behaviors by asking some questions related to lifestyle before and during the home confinement. These data can help the Moroccan authorities and other countries to more understand the impact of this crisis on citizens and therefore to set up adequate protocols for managing the post-confinement or possible future crisis. We provided two datasets: (1) data we collected before confinement from a sample of 484 individuals describing their HRQoL [8] and (2) data we collected during the home confinement period from a sample of 537 individuals describing their HRQoL and behavior-related lifestyle.

The hidden Markov chain modelling of the COVID-19 spreading using Moroccan dataset.

The World Health Organization (WHO) declared in March 12, 2020 the COVID-19 disease as pandemic. In Morocco, the first local transmission case was detected in March 13. The number of confirmed cases has gradually increased to reach 15,194 on July 10, 2020. To predict the COVID-19 evolution, statistical and mathematical models such as generalized logistic growth model [1], exponential model [2], segmented Poisson model [3], Susceptible-Infected-Recovered derivative models [4] and ARIMA [5] have been proposed and used. Herein, we proposed the use of the Hidden Markov Chain, which is a statistical system modelling transitions from one state (confirmed cases, recovered, active or death) to another according to a transition probability matrix to forecast the evolution of COVID-19 in Morocco from March 14, to October 5, 2020. In our knowledge the Hidden Markov Chain was not yet applied to the COVID-19 spreading. Forecasts for the cumulative number of confirmed, recovered, active and death cases can help the Moroccan authorities to set up adequate protocols for managing the post-confinement due to COVID-19. We provided both the recorded and forecasted data matrices of the cumulative number of the confirmed, recovered and active cases through the range of the studied dates.