Factors associated with anxiety and depression among chronic obstructive pulmonary disease outpatients in Ho Chi Minh City, Vietnam.

This study investigates the prevalence of and associated factors with depression and anxiety among chronic obstructive pulmonary disease (COPD) outpatients at Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam. A cross-sectional study was conducted between March and May 2020 at the hospital's outpatient department. Those aged ≥18 years, diagnosed with COPD and undergoing COPD treatment, were eligible. The Hospital Anxiety and Depression Scale was used to measure depression and anxiety. Dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Among 392 patients, 381 (97%) participated in the study. The number of patients with depression and anxiety was 33.1% and 21.3%, respectively. Compared to men, women were more likely to experience depression (adjusted odds ratio [aOR] = 2.12, 95% confidence interval [CI] = 1.06-4.24) and anxiety (aOR = 4.11, 95% CI = 1.90-8.87). Those not having caregivers were more likely to experience depression (aOR = 3.03, 95% CI = 1.27-7.20) and anxiety (aOR = 3.47, 95% CI = 1.26-9.60). Having mMRC dyspnea scale ≥2 was associated with higher odds of experiencing depression (aOR = 5.94, 95% CI = 3.63-9.72) and anxiety (aOR = 6.78, 95% CI = 3.48-13.18). Those not adhering to medication treatment (aOR = 2.32, 95% CI = 1.15-4.70) and having comorbidity (aOR = 2.02, 95% CI = 1.10-3.73) were more likely to experience anxiety. Routine screening of COPD patients for depression and anxiety is necessary so that early interventions could be provided.

After-School Tutoring, Electronic Device Availability, and Obesity Among Fifth-Grade Students in Ho Chi Minh City, Vietnam.

This study investigates associations between after-school tutoring and availability of electronic devices with overweight/obesity among fifth-grade children in Ho Chi Minh City, Vietnam. A complex cross-sectional design was used to randomly select students and their parents in 8 public schools in Ho Chi Minh City in 2016. Students were categorized as overweight/obesity if their body mass index z score >+1 using the World Health Organization reference. Parents self-reported child's attendance in after-school tutoring and availability of electronic devices at home. Sampling weights were used to account for unequal selection probability and nonresponses in analyses. Students attending tutoring were more likely to be overweight/obesity (odds ratio = 1.59, P < .001). Overweight/obesity students spent on average about 1.5 hours/week more attending tutoring; most of these hours were during weekdays (P < .05). Students living in households with ≥2 types of devices were more likely to be overweight/obesity (odds ratio = 2.83, P < .001). Strategies to reduce study sitting time and the use of electronic devices may help with childhood overweight/obesity prevention.

Hand washing behavior and associated factors in Vietnam based on the Multiple Indicator Cluster Survey, 2010-2011.

BACKGROUND: Handwashing is a cost-effective way of preventing communicable diseases such as respiratory and food-borne illnesses. However, handwashing rates are low in developing countries. Target 7C of the seventh Millennium Development Goals was to increase by half the proportion of people with sustainable access to safe drinking water and basic sanitation by 2015. Studies have found that better access to improved water sources and sanitation is associated with higher rates of handwashing. OBJECTIVE: Our goal was to describe handwashing behaviour and identify the associated factors in Vietnamese households. DESIGN: Data from 12,000 households participating in the Vietnam Multiple Indicator Cluster Survey 2011 were used. The survey used a multistage sampling method to randomly select 100 clusters and 20 households per cluster. Self-administered questionnaires were used to collect data from a household representative. Demographic variables, the presence of a specific place for handwashing, soap and water, access to improved sanitation, and access to improved water sources were tested for association with handwashing behaviour in logistic regression. RESULTS: Almost 98% of households had a specific place for handwashing, and 85% had cleansing materials and water at such a place. The prevalence of handwashing in the sample was almost 85%. Educational level, ethnicity of the household head, and household wealth were factors associated with handwashing practice (p<0.05). Those having access to an improved sanitation facility were more likely to practise handwashing [odds ratio (OR)=1.69, 95% confidence interval (CI): 1.37-2.09, p<0.001], as were those with access to improved water sources (OR=1.74, 95% CI: 1.37-2.21, p<0.001). CONCLUSIONS: Households with low education, low wealth, belonging to ethnic minorities, and with low access to improved sanitation facilities and water sources should be targeted for interventions implementing handwashing practice. In addition, the availability of soap and water at handwashing sites should be increased and practical teaching programs should be deployed in order to increase handwashing rates.

Trends and determinants of infant and under-five childhood mortality in Vietnam, 1986-2011.

BACKGROUND: Although Vietnam has taken great efforts to reduce child mortality in recent years, a large number of children still die at early age. Only a few studies have been conducted to identify at-risk groups in order to provide baseline information for effective interventions. OBJECTIVE: The study estimated the overall trends in infant mortality rate (IMR) and under-five mortality rate (U5MR) during 1986-2011 and identified demographic and socioeconomic determinants of child mortality. DESIGN: Data from the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000 (MICS2), 2006 (MICS3) and 2011 (MICS4) were analysed. The IMR and U5MR were calculated using the indirect method developed by William Brass. Unadjusted and adjusted odds ratios were estimated to assess the association between child death and demographic and socioeconomic variables. Region-stratified stepwise logistic regression was conducted to test the sensitivity of the results. RESULTS: The IMR and U5MR significantly decreased for both male and female children between 1986 and 2010. Male children had higher IMR and U5MR compared with females in all 3 years. Women who were living in the Northern Midlands and Mountain areas were more likely to experience child deaths compared with women who were living in the Red River Delta. Women who were from minor ethnic groups, had low education, living in urban areas, and had multiple children were more likely to have experienced child deaths. CONCLUSION: Baby boys require more healthcare attention during the first year of their life. Comprehensive strategies are necessary for tackling child mortality problems in Vietnam. This study shows that child mortality is not just a problem of poverty but involves many other factors. Further studies are needed to investigate pathways underlying associations between demographic and socioeconomic conditions and childhood mortality.

Changes and socioeconomic factors associated with attitudes towards domestic violence among Vietnamese women aged 15-49: findings from the Multiple Indicator Cluster Surveys, 2006-2011.

BACKGROUND: Understanding factors associated with domestic violence-supportive attitudes among Vietnamese women is important for designing effective policies to prevent this behavior. Previous studies have largely overlooked risk factors associated with domestic violence-supportive attitudes by women in Vietnam. OBJECTIVE: This paper explores and identifies socioeconomic factors that contribute to domestic violence-supportive attitudes among Vietnamese women using data from the Multiple Indicator Cluster Surveys (MICS). DESIGN: Secondary data from two cross-sectional studies (MICS 3, 2006, and MICS 4, 2011) with representative samples (9,471 and 11,663 women, respectively) in Vietnam were analyzed. The prevalence of supportive attitudes toward domestic violence and associations with age, residence region, area, education level, household wealth index, ethnicity, and marital status were estimated using descriptive statistics and multivariate Poisson models, giving estimates of relative risk. RESULTS: Overall, the prevalence of acceptance of domestic violence declined between 2006 and 2011 in Vietnam (65.1% vs. 36.1%). Socioeconomic factors associated with women's condoning of domestic violence were age, wealth, education level, and living area. In particular, younger age and low educational attainment were key factors associated with violence-supportive attitudes, and these associations have become stronger over time. CONCLUSION: Higher educational attainment in women is an important predictor of women's attitudes toward domestic violence. To date, Doi Moi and the Vietnamese government's commitment to the Millennium Development Goals may have positively contributed to lowering the acceptance of domestic violence. Tailored interventions that focus on education will be important in further changing attitudes toward domestic violence.

A longitudinal cohort study of the impact of first- and both-eye cataract surgery on falls and other injuries in Vietnam.

AIM: Little information exists on the impact of cataract surgery on falls and other injuries in Vietnam. The aim of this study was to determine the impact of first and both eye cataract surgery on the number of falls and other injuries among bilateral cataract patients in Ho Chi Minh City, Vietnam. MATERIALS AND METHODS: A longitudinal cohort study was conducted involving 413 bilateral cataract patients aged 50+ years. Participants were assessed at three time points: 1 week before, 1-3 months after, and 1 year after first-eye cataract surgery. Visual measures (visual acuity, contrast sensitivity and stereopsis) were taken, and self-reported falls and injury data were collected. A multilevel longitudinal Poisson regression model was used to investigate change in the number of falls after surgery. RESULTS: The risk of falls decreased by 78% (incidence-rate ratio [IRR] 0.22, 95% confidence interval [CI] 0.06-0.77; P=0.018) in the year after cataract surgery for participants who had first-eye surgery only and 83% (IRR 0.17, 95% CI 0.04-0.69; P=0.012) for participants who had the second eye operated on compared to before surgery. The risk of falls was three times higher for females than males (IRR 3.13, 95% CI 1.53-6.40; P=0.002). Improved binocular contrast sensitivity was also associated with a decrease in falls (IRR 0.40, 95% CI 0.17-0.97; P=0.042). The prevalence of other injuries also decreased after cataract surgery. CONCLUSION: Cataract surgery reduced the number of falls and other injuries in Vietnam. Contrast sensitivity may be important for ophthalmologists to consider when prioritizing patients for surgery and assessing their fall risk.

Prevalence and visual risk factors for falls in bilateral cataract patients in Ho Chi Minh City, Vietnam.

PURPOSE: To determine the prevalence of falls in the 12 months prior to cataract surgery and examine the associations between visual and other risk factors and falls among older bilateral cataract patients in Vietnam. METHODS: Data collected from 413 patients in the week before scheduled cataract surgery included a questionnaire and three objective visual tests. RESULTS: The outcome of interest was self-reported falls in the previous 12 months. A total of 13% (n = 53) of bilateral cataract patients reported 60 falls within the previous 12 months. After adjusting for age, sex, race, employment status, comorbidities, medication usage, refractive management, living status and the three objective visual tests in the worse eye, women (odds ratio, OR, 4.64, 95% confidence interval, CI, 1.85-11.66), and those who lived alone (OR 4.51, 95% CI 1.44-14.14) were at increased risk of a fall. Those who reported a comorbidity were at decreased risk of a fall (OR 0.43, 95% CI 0.19-0.95). Contrast sensitivity (OR 0.31, 95% CI 0.10-0.95) was the only significant visual test associated with a fall. These results were similar for the better eye, except the presence of a comorbidity was not significant (OR 0.45, 95% CI 0.20-1.02). Again, contrast sensitivity was the only significant visual factor associated with a fall (OR 0.15, 95% CI 0.04-0.53). CONCLUSION: Bilateral cataract patients in Vietnam are potentially at high risk of falls and in need of falls prevention interventions. It may also be important for ophthalmologists and health professionals to consider contrast sensitivity measures when prioritizing cataract patients for surgery and assessing their risk of falls.

The impact of cataract surgery on vision-related quality of life for bilateral cataract patients in Ho Chi Minh City, Vietnam: a prospective study.

BACKGROUND: To determine the impact of cataract surgery on vision-related quality of life (VRQOL) and examine the association between objective visual measures and change in VRQOL after surgery among bilateral cataract patients in Ho Chi Minh City, Vietnam. METHODS: A cohort of older patients with bilateral cataract was assessed one week before and one to three months after first eye or both eye cataract surgery. Visual measures including visual acuity, contrast sensitivity and stereopsis were obtained. Vision-related quality of life was assessed using the NEI VFQ-25. Descriptive analyses and a generalized linear estimating equation (GEE) analysis were undertaken to measure change in VRQOL after surgery. RESULTS: Four hundred and thirteen patients were assessed before cataract surgery and 247 completed the follow-up assessment one to three months after first or both eye cataract surgery. Overall, VRQOL significantly improved after cataract surgery (p < 0.001) particularly after both eye surgeries. Binocular contrast sensitivity (p < 0.001) and stereopsis (p < 0.001) were also associated with change in VRQOL after cataract surgery. Visual acuity was not associated with VRQOL. CONCLUSIONS: Cataract surgery significantly improved VRQOL among bilateral cataract patients in Vietnam. Contrast sensitivity as well as stereopsis, rather than visual acuity significantly affected VRQOL after cataract surgery.

Assessing the test-retest repeatability of the Vietnamese version of the National Eye Institute 25-item Visual Function Questionnaire among bilateral cataract patients for a Vietnamese population.

AIM: To determine the test-retest repeatability of the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25) for use with older Vietnamese adults with bilateral cataract. METHODS: The questionnaire was translated into Vietnamese and back-translated into English by two independent translators. Patients with bilateral cataract aged 50 and older completed the questionnaire on two separate occasions, one to two weeks after first administration of the questionnaire. Test-retest repeatability was assessed using the Cronbach's α and intraclass correlation coefficients. RESULTS: The average age of participants was 67 ± 8 years and most participants were female (73%). Internal consistency was acceptable with the α coefficient above 0.7 for all subscales and intraclass correlation coefficients were 0.6 or greater in all subscales. CONCLUSION: The Vietnamese NEI VFQ-25 is reliable for use in studies assessing vision-related quality of life in older adults with bilateral cataract in Vietnam. We propose some modifications to the NEI-VFQ questions to reflect activities of older people in Vietnam.

The impact of cataract surgery on depressive symptoms for bilateral cataract patients in Ho Chi Minh City, Vietnam.

BACKGROUND: Depression is common among older populations with cataract. However, the impact of cataract surgery on depression in both developed and developing countries remains unclear. The aim of this study is to determine the impact of cataract surgery on depressive symptoms and to examine the association between objective visual measures and change in depressive symptoms after surgery among a Vietnamese population in Ho Chi Minh City. METHODS: A cohort of older patients with bilateral cataract were assessed the week before and one to three months after first eye surgery only or first- and second-eye cataract surgeries. Visual measures including visual acuity, contrast sensitivity, and stereopsis were obtained. Depressive symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression Scale (CES-D). Descriptive analyses and a generalized estimating equations (GEE) analysis were undertaken to determine the impact of cataract surgery on depressive symptoms. RESULTS: Four hundred and thirteen participants were recruited into the study before cataract surgery. Two hundred and forty-seven completed the follow-up assessment after surgery. There was a significant decrease (improvement) of one point in the depressive symptoms score (p = 0.04) after cataract surgery, after accounting for potential confounding factors. In addition, females reported a significantly greater decrease (improvement) of two points in depressive symptom scores (p = 0.01), compared to males. However, contrast sensitivity, visual acuity, and stereopsis were not significantly associated with change in depressive symptoms scores. First-eye cataract surgery or both-eye cataract surgery did not modify the change in depressive symptoms score. CONCLUSION: There was a small but significant improvement in depressive symptoms score after cataract surgery for an older population in Vietnam.