ABSTRACT
Purpose: Medication adherence is a crucial component in the management of elderly with co-morbid chronic conditions. Hence, this study aimed to investigate the determinants of medication non-adherence among rural elderly with co-morbid chronic conditions of hypertension (HTN) and type 2 diabetes mellitus (T2DM) in India. Patients and Methods: This cross-sectional study adopted the probability proportional to size (PPS) sampling technique to find the determinants of medication non-adherence among elderly residing in rural coverage areas of five randomly selected primary health centres (PHC) in Udupi district, Karnataka, India. A total of 360 elderly (72 samples from each cluster) who met the inclusion criteria and consented were interviewed using predesigned prevalidated and standardized or reliable tools. The data were coded and entered in SPSS version 16.0 and analyzed using both descriptive and inferential statistics. Results: The study found that 55.6% (n=200) of rural elderly with co-morbid conditions HTN and T2DM were non-adherent to their medications and established Spearman correlation coefficient rank (r) value between undesirable person-related factors (r=-0.444); good family support (including financial support) (r=0.185); poor accessibility to healthcare facility (r=-0.209); detrimental medication-related factors including high cost of medication (r=-0.237) were found to be significant at 0.05 level of confidence (p < 0.05). Further, the study depicted that the chi-square test (χ2) was identified to be significantly associated (p<0.05) with a variable such as education, knowledge, number of illnesses and impairments, vision, memory, and physical impairments. Conclusion: Medication adherence could be improved among rural elderly with co-morbid conditions by identifying and addressing the determinants at the earliest. Further, it is vital to identify the suitable intervention program to address these avoidable problems.
ABSTRACT
AIM: The aim of this study is to evaluate the effectiveness of music on anxiety and pain among patients following cardiac surgery. BACKGROUND: Cardiac surgery affects patients physically, psychologically and socially. Anxiety and pain are the usual problems among patients following cardiac surgery. DESIGN: The study design is a systematic review and meta-analysis. DATA SOURCES: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica database (EMBASE) and Web of Science databases were searched for randomized controlled trials from January 2000 to December 2017. REVIEW METHODS: The Cochrane collaboration guidelines were followed and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to summarize the quality of evidence. RESULTS: Fourteen studies were included in systematic review and 13 in meta-analysis. The meta-analysis revealed that there was a significant reduction in anxiety and pain among patients who received musical intervention compared with those who did not. CONCLUSION: Music has positive benefits on anxiety and pain. However, well-designed and high-quality trials are needed to generate higher quality evidence.
