RESUMO
Background: The Worldwide Hospice Palliative Care Alliance has recommended integration of palliative care into primary health care. Diminished capacity to provide palliative care is a barrier for integration. The purpose of this study was to screen for palliative care needs in the community. Methods: A cross-sectional study was conducted in two rural communities of Udupi district. Supportive and Palliative Care Indicators Tool - 4ALL (SPICT-4ALL) was used to identify the palliative care needs. Purposive sampling was used to collect the individual information from the households for identifying the palliative care need. Conditions requiring palliative care and the sociodemographic factors associated with it were explored. Results: Out of 2041 participants, 51.49% were female, and 19.65% were elderly. Less than a quarter of them (23.08%) had at least one chronic illness. Hypertension, diabetes, and ischemic heart disease were commonly found. 4.31% had satisfied the requisite SPICT criteria, which indicated a need for palliative care. Diseases of cardiovascular system followed by dementia and frailty were the most common conditions requiring palliative care. Univariate analysis showed that age, marital status, years of education, occupation, and the presence of morbidities were significantly associated with the need for palliative care. Being unemployed and having one or more morbidities were factors independently associated with requirement of palliative care. Conclusions: The estimated palliative care need in the community survey exceeds the perceived need. Although palliative care is traditionally identified with cancer, the proportion of people with noncancer palliative care needs were significantly higher than cancer palliative care.
RESUMO
BACKGROUND: Stress is a major contributor to the physiology of hypertension (HTN) and is linked closely to mental well-being and overall quality of life (QoL). Health issues pertaining to women's health have usually focused on reproduction, while mental well-being has largely been neglected. OBJECTIVES: The objective of the study was to assess the perceived stress and QoL among homemakers with HTN. MATERIALS AND METHODS: A community-based cross-sectional study was carried out, among 426 homemakers with HTN residing in Udupi, Karnataka. The sociodemographic and disease characteristics, Cohen's Perceived Stress Scale-10, World Health Organization QoL Brief Questionnaire (WHOQOL-BREF), anthropometry, and vitals were measured. RESULTS: Of the study participants, 245 (57.5%) were aged ≤60 years and 317 (74.4%) had been diagnosed with HTN in the past decade. Low and high perceived stress was seen among 306 (71.8%) and 120 (28.2%) women, respectively. Among the four domains of WHOQOL-BREF, the physical domain had the highest mean (±standard deviation) score of 67.44 (±16.50), whereas the lowest score of 54.49 (±19.75) was observed in the social domain. The odds of high stress among single women and those with a pill burden of >2/day were 1.93 (P=0.004, 95% CI=1.228, 3.054) and 1.77 (P=0.038, 95% CI CI=0.962, 3.270) respectively. The QoL was significantly better among those aged <60 years, married, and literate women. CONCLUSIONS: Mental well-being among the hypertensive homemakers was good, with low perceived stress and high mean scores of QOL domains.
