10 research outputs found
Evaluation the Role of Interleukin-8 and Interleukin-10 in Myocardial Infarction Patients in Al- Najaf City
No full textThis study conducted to evaluate the interleukin-8 and interleukin- 10 level in hypertension and myocardial infarction patients in the period from March to December 2018 by using ELISA technique. A total of thirty three (33) patients from which (5 women and 8 men) with MI and (7 women and 4 men) with hypertension and a total of 19 (7 women and 12 men) healthy individuals were considered as control group. Resulting in, the mean of interleukin-8 level of hypertension and myocardial infarction patients (416.6 pg/ml) and (433.2pg/ml) respectively, with significant elevation comparing with non hypertension (292.03 pg/ml), non myocardial patients (378.9 pg/ml) and control (123.1 pg/ml), furthermore, mean of interleukin-10 level of hypertension and myocardial infarction patients (320.5pg/ml) and (102.9 pg/ml) respectively, with significantly different compared with non patients and control, where show significant increase mean of interleukin-10 level of hypertension compared with non hypertension patients (260.5 pg/ml) and control (129.4 pg/ml), also show a significant decline mean of interleukin-10 level for myocardial in comparison with non myocardial patients (146.3 pg/ml) and control (129.4 pg/ml). Concluded that interleukin-8 (pro and anti- inflammatory) significantly raised in hypertension and myocardial infarction in coronary artery patients, in contrast, this result observed decrease production of anti-inflammatory cytokines IL-10 in myocardial patients
Evaluation the Role of Interleukin-8 and Interleukin-10 in Myocardial Infarction Patients in Al- Najaf City
No full textThis study conducted to evaluate the interleukin-8 and interleukin- 10 level in hypertension and myocardial infarction patients in the period from March to December 2018 by using ELISA technique. A total of thirty three (33) patients from which (5 women and 8 men) with MI and (7 women and 4 men) with hypertension and a total of 19 (7 women and 12 men) healthy individuals were considered as control group. Resulting in, the mean of interleukin-8 level of hypertension and myocardial infarction patients (416.6 pg/ml) and (433.2pg/ml) respectively, with significant elevation comparing with non hypertension (292.03 pg/ml), non myocardial patients (378.9 pg/ml) and control (123.1 pg/ml), furthermore, mean of interleukin-10 level of hypertension and myocardial infarction patients (320.5pg/ml) and (102.9 pg/ml) respectively, with significantly different compared with non patients and control, where show significant increase mean of interleukin-10 level of hypertension compared with non hypertension patients (260.5 pg/ml) and control (129.4 pg/ml), also show a significant decline mean of interleukin-10 level for myocardial in comparison with non myocardial patients (146.3 pg/ml) and control (129.4 pg/ml). Concluded that interleukin-8 (pro and anti- inflammatory) significantly raised in hypertension and myocardial infarction in coronary artery patients, in contrast, this result observed decrease production of anti-inflammatory cytokines IL-10 in myocardial patients
Resilience as a protective factor against violent extremism: a systematic review of systematic reviews
No full textViolent extremism (VE) threatens global security. Efforts to counter VE have focused on identifying factors that pull and push toward extremism. However, identifying individual and community qualities that buffer against VE remains insufficient and needs improvement. This review aimed to identify links between resilience and VE. A systematic review of systematic reviews (SR-SR) using the Campbell Collaboration review methodology was conducted. A 5-stage search of 12 databases yielded 17 systematic reviews with more than 2800 records. After evaluation by two reviewers using the AMSTAR appraisal tool, only nine systematic reviews received a high rating and were analyzed. Seven reviews identified clear and direct protective resilience factors against VE. The protective resilience factors were categorized as (1) individual resilience factors, (2) family resilience factors, and (3) community resilience factors. Community resilience as a theme of resilience appeared more frequently within the reviewed literature encompasses community engagement, collective identity, social support networks, and emotional orientation. The study provided insights linking resilience as a buffer to VE. This evidence will enable policymakers and preventing violent extremism efforts to mobilize and strengthen community resilience
Resilience to Violent Extremism: Validation of the Arabic BRAVE Measure
No full textThis study translates the Building Resilience to Violent Extremism (BRAVE) measure to assess individual and community resilience levels to resist, counter, and buffer violent extremism. The Arabic BRAVE measure translated and validated the original Grossman (2020) five factors scale. The Arabic BRAVE measure provided scores across the same five factors contextualized using data from 604 youth Arabs from five countries. Following analyses of its structural validity, reliability, and measurement invariance, the 14-item Arabic BRAVE measure was found to have good internal reliability according to its composite reliability and Cronbach’s alpha, which varied between 0.73 and 0.93. The overall structure and measurement of the models were assessed through confirmatory factor analysis and multi-group invariance testing. Evidence for the configural and partial metric (but not scalar or residuals) invariance of the factor structure was observed when comparing the male and female subsamples. The Arabic BRAVE measure is a much-needed tool that can help identify young people’s protective capacities against and vulnerabilities to violent extremism, incorporating various capital factors to assist in designing a culturally sensitive public health approach to countering the threat of extremism.
AcknowledgementsThis research was funded by Naif Arab University for Security Sciences (Grant No. NAUSS-SRC-21-02)
Rancang Bangun Perangkat Lunak Penyediaan Tangan Palsu Berbasis Web Menggunakan Pendekatan Domain Driven Design dan Arsitektur Onion
No full textAmputasi bisa terjadi akibat kecelakaan atau prosedur pemotongan bagian tubuh tertentu untuk mengatasi suatu kondisi atau penyakit. Terjadinya amputasi bisa menyebabkan seseorang menjadi golongan penyandang disabilitas. Sehingga membutuhkan sebuah alat kesehatan yang didesain untuk menggantikan bagian tubuh tertentu untuk membantu pasien mendapatkan kembali fungsi tertentu setelah bagian tubuhnya atau disebut prosthesis. Salah satu bagian tubuh yang dapat dibuat prosthesis adalah tangan. Badan Perencanaan Pembangunan Nasional (BAPPENAS) mengatakan penyandang disabilitas menjadi salah satu kelompok penduduk yang sangat rentan tidak produktif dan miskin sehingga harus menjadi prioritas untuk mendapatkan bantuan. Oleh karena itu, diinisiasi sebuah inovasi pembentukan ekosistem masyarakat yang ramah terhadap penyandang disabilitas melalui Gerakan Seribu Tangan Palsu melalui Program Pengabdian kepada Masyarakat (ABMAS) Prioritas Institut Teknologi Sepuluh Nopember. Saat ini, gerakan sudah berjalan namun semua kegiatan yang terjadi di dalamnya masih tercatat manual belum menjadi sebuah sistem yang terintegrasi. Pada tugas akhir ini akan dirancang sebuah perangkat lunak berbasis web untuk mempermudah jalannya Gerakan Seribu Tangan Palsu, baik bagi administrator, pasien, maupun semua masyarakat yang ingin ikut andil dalam gerakan sosial ini. Dalam proses perancangan perangkat lunak, dilakukan dengan pendekatan Domain Driven Design untuk memecah tiap service pada modelnya menjadi lebih sederhana dan mudah dimengerti. Dan juga penulis mengimplementasikan arsitektur onion pada perancangannya sehingga untuk proses maintenance kedepannya dapat dilakukan dengan lebih efektif dan efisien.
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Amputation can occur as a result of an accident or a procedure whereby certain body parts are cut to treat a condition or disease. The occurrence of an amputation can cause a person to become a group of people with disabilities. So it requires a medical device that is designed to replace certain body parts to help patients regain certain functions after their body parts are called prostheses. One part of the body that can be made prosthesis is hand. Badan Perencanaan Pembangunan Nasional (Bappenas) said that persons with disabilities are a group of people who are very vulnerable to being unproductive and poor, so it must be a priority to get assistance. Therefore, an innovation was initiated to form a community ecosystem that is friendly to friends with disabilities through the Seribu Tangan Palsu Action through the Priority Community Service Program of the Sepuluh Nopember Institute of Technology. Currently, the Action is already running, but all the activities that occur in it are still recorded manually, not yet becoming an integrated system. In this final task, a web-based software will be designed to facilitate the operation of the Seribu Tangan Palsu Action, both for administrators, patients, and all members of the community who wish to take part in this social movement. In software design, a domain driven design approach is used to break down each service into a simpler and easier to understand model. And also the author implements the onion architecture in its design so that future maintenance processes can be carried out more effectively and efficiently
Desain dan Evaluasi Antarmuka Pengguna Aplikasi Web Responsif myITS Marketplace Berdasarkan Design Thinking
No full textInstitut Teknologi Sepuluh Nopember (ITS) memiliki banyak sekali layanan baik untuk sivitas akademik ITS maupun untuk kalangan umum. Layanan-layanan tersebut seperti diantaranya adalah Asrama Mahasiswa, Laboratorium, ITS Training Center, UPT Bahasa dan Budaya, Medical Center, Fasilitas Olahraga, Perpustakaan, dan ITS Press. Sayangnya, seluruh layanan tersebut belum terintegrasi satu sama lain dalam satu platform yang dapat diakses secara efektif oleh baik sivitas akademik ITS maupun kalahan umum. Hal ini menyebabkan adanya kesulitan bagi baik civitas akademika ITS maupun masyarakat umum untuk memesan atau menggunakan layanan karena tidak semua layanan terintegrasi satu sama lain. Melihat kebutuhan di atas, dibuatlah aplikasi web myITS Marketplace dengan fungsi sebagai platform terintegrasi untuk mengintegrasikan seluruh layanan yang ada di ITS. Namun, pada Pada tugas Tugas Akhir ini pengembangan aplikasi myITS Marketplace berfokus pada dua layanan ITS, yaitu asrama mahasiswa dan laboratorium ITS. Aplikasi sub yang akan mewadahi dua kebutuhan tersebut adalah myITS Dorm untuk asrama mahasiswa ITS, dan myITS Pro Lab untuk laboratorium-laboratorium ITS. Baik pengguna myITS Dorm maupun pengguna myITS Pro Lab mempunyai latar belakang dan kebiasaan yang sangat bervariasi. Variasi ini sering mengakibatkan terjadinya permasalahan terhadap pengalaman pengguna. Oleh karena itu,metode untuk mencegahnya pun diperlukan. Metode yang penulis gunakan dalam pengembangan desain antarmuka aplikasi website myITS Dorm dan myITS Pro Lab adalah Design Thinking yang berfokus pada pada pengguna. Metode tersebut diharapkan dapat mengidentifikasi dan lebih memahami pengguna dalam penggunaan aplikasi, menemukan masalah yang dihadapi pengguna, serta dapat mengeksplorasi ide-ide baru dalam kreasi fitur aplikasi yang tepat dan sesuai dengan kebutuhan pengguna.
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Institut Teknologi Sepuluh Nopember (ITS) has a lot of services
for both ITS academic community and public. These services
include Student Dormitory, Laboratories, Training Center,
Language and Culture Center, Medical Center, Sports Facilities,
Libraries, and Press. Unfortunately, all these services have not been
integrated with each other in a single platform that can be accessed
effectively by both ITS academics and public. This causes
difficulties for both academic community and public to use thes
services, because not all services are integrated with each other.
Seeing the needs above, myITS Marketplace web app was created
with a function as an integrated platform for all services in ITS.
In this Final Project, the development of the myITS Marketplace
app focuses on two ITS services, namely student dormitories and
ITS laboratories. The sub applications to accommodate these two
needs are myITS Dorm for ITS student dormitories, and myITS
Pro Lab for ITS laboratories. Both myITS Dorm users and myITS
Pro Lab users have very varied backgrounds and habits. These
variations often result in problems with the user experience.
Therefore, a method to prevent it is needed. The method that the
author uses in developing myITS Dorm and myITS Pro Lab
website application interface design is Design Thinking which
focuses on the user. This method is expected to identify and better
understand users in using the application, find problems faced by
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users, and can explore new ideas in the creation of appropriate
application features and according to user needs
The good teacher from the perspective of students and teachers
No full textفي كل سنة ينضم الكثير من المعلمين والمعلمات الى سلك التعليم ، وجميعنا نعلم بان اكثرهم ليسوا جيدين. بحسب رأينا فان هذه المهنة بالذات بحاجة الى التميز والى الدافعية الداخلية الكفيلة بصنع هذه الجودة والتميز.
المعلم هو صاحب رسالة مقدسة وشريفة ، وبدونه ليس هناك تعلم ولا تثقيف ، وان المهنة التي اختارها المعلم هي مهنة اساسية ومهمة هامة في تقدم ، تطور ونجاح المجتمع بأكمله. المعلم هو الأساس، فلا تربية جيدة بدون معلم جيد. فحتى لو لم تكن المناهج جيدة عليه ان يترك اثرا جيدا وجميلا في طلابه ، على المعلم ان يمتلك قدرات ومؤهلات تختلف عن قدرات ومؤهلات الاخرين. يجب على المعلم ان يتميز بالعديد من الصفات والخصائص والمهارات ونظرا لاهمية المعلم في العملية التربوية فانه يحتاج الى اعداد خاص والى برامج تاهيلية محددة ومدروسة بعناية ، تشرف عليها مؤسسات متميزة ومتخصصة . منذ بداية الحياة كان المعلم هو معلم الاجيال ومربيها ، ولكن التطورات والتغييرات السريعة التي جرب في المجتمع ادت ايضا الى تغيير بدورالمعلم فقد كان ناقلا للمعرفة والمعولمات واصبح وسيطا لها.
هناك العديد من الابحاث التي بحثت موضوع المعلم الجيد ولكن القليل منها بحث هذا الامر من وجهة نظر الطلاب والمعلمين معا . البحث الذي امامنا يسأل : من هو المعلم الجيد من وجهة نظر الطلاب؟ ومن هو المعلم الجيد من وجهة نظر المعلمين؟ اعتمد البحث على اسلوب البحث الكمي ، وتم استخدام استمارة اخذت من مقال باللغة العبرية ، وقد ترجمت للغة العربية (من قبل الباحثة الاولى في المقال). الاستبانة مكونه من 26 بند استعملت نفسها للطلاب والمعلمين . وشملت الابعاد : الابداع وطرق التفكير ، طرق التدريس والمادة التي يعلمها ، مبادئ وقيم تتعلق بالاهتمام والمساعدة والتقدير للطلاب ، القيادة ، المشاركة والاستكمال. تم توزيع الاستمارة على في 70 طالب في السابع في مدارس اعدادية في منطقة المثلث . وعلى 70 معلم مدارس اعدادية في منطقة المثلث. وجاءت نتائج البحث بحيث انها تدعم جزئيا فرضية البحث الاولى وتبين انه لا توجد فروق ذات دلالة احصائية في صفات المعلم الجيد حسب وجهة نظر الطلاب تعزى للجندر باستثاء الثفة " الابداع وطرق التفكير".
وكذلك فأنها تضحد فرضية البحث الثانية ، وتبين انه لا توجد فروق ذات دلالة احصائية في صفات المعلم الجيد حسب وجهة نظر المعلمين تعزى للجندر. فانها تدحض ايضا فرضية البحث الثالثة وتبين انه لا توجد فروق ذات دلالة احصائية في صفات المعلم الجيد حسب وجهة نظر المعلمين تعزى للجيل Many teachers join the education system every year, and as we know most ofthem are not good enough. However, the profession of teaching needs qualifiedpeople who have the internal motivation in order to reach the required qualityand excellence.Teachers have a sacred and honest message, and without them, there is neitherlearning nor education, so they are the basis of the whole process. The professionthey have chosen is fundamental and important in the progress of developmentand success of the entire society.Teachers are supposed to leave a good and beautiful impact on their studentsalthough the curriculum is not good enough. They must have abilities,qualifications, characteristics and skills that differentiate them from others.Because of the importance of teachers in the educational process, they needspecial preparation and specific rehabilitation programs that are carefully studiedand supervised by specialized institutions. Previously, teachers were responsibleof teaching the generations, but the rapid developments and changes that thesociety witnesses have also changed the role of the teacher. Therefore, teachershave become a mere mediator to transfer knowledge and information to theirstudents.However, there are several studies that have investigated the topic of the goodteacher; few of them have studied it from the perspective of both students andteachers. The research questions are: (a) who is the good teacher from thestudents' perspective? and (b) who is the good teacher from the teachers’perspective?The study has adopted the quantitative approach. It has used a questionnaire thathas been used in an article in the Hebrew language and it is translated into Arabic by the first author of the article. The questionnaire has 26 paragraphs that wereused for students and teachers. They focus on the aspects of creativity andthinking styles, methods of teaching and the subject they teach, principles andvalues related to the attention and assistance and appreciation of students,leadership, participation and completion. The questionnaire was answered by 70students in the seventh grade in junior schools in the triangle area and 70 teachersin junior schools in the same area.The results of the study partially supported the first hypothesis and indicated thatthere are no significant differences in the characteristics of the good teacher fromthe students’ perspective attributed to gender except the title of "creativity andthinking styles."There are no significant differences in the qualities of the good teacher from theteachers’ perspective attributed to gender, so the second hypothesis was notconfirmed. The third hypothesis was also not verified because the resultsindicated that there are no significant differences in the qualities of the goodteacher from the teachers’ perspective attributed to ag
Constructing and presenting the self through private sphere dress: an interpretive analysis of the experiences of Saudi Arabian women
No full text2014 Spring.Includes bibliographical references.The purpose of this interpretive study was to explore how married Saudi Arabian women construct and present the self through their choice of dress for the private sphere. Of particular interest was the marital dyad as a context for Saudi women's presentation of self through dress within the private sphere. The work was situated within the interactionist and dramaturgical traditions. Data were collected via in-depth interviews with fifteen married Saudi couples and were analyzed using constant comparison processes. Two manuscripts were developed through the analysis stage. The first manuscript focused upon three key themes related to Saudi women's use of private sphere dress to construct and present the self: (a) conceptualizing the desired self, (b) making sense of the marketplace: the role of traditional and Western dress in mobilizing desired selves, and (c) looking glasses: the role of others in mobilizing desired selves. Findings revealed that as they presented the self through dress within the private sphere, Saudi women engaged in a complex process of navigating Islamic teachings and Saudi cultural conventions, shifting cultural mores, and the diverse expectations of others. The second manuscript explored the marital dyad as a specific context for Saudi women's presentation of self through dress within the private sphere. Three themes were identified: (a) meanings that Saudi husbands and wives associated with traditional and Western dress for the private sphere, (b) "his place" and "her place" in shaping private sphere dress decisions, and (c) forging the private sphere self through lived interactions between Saudi husbands and wives. Findings revealed that there was some variation with regard to the roles assumed by husbands and wives in guiding wives' private sphere dress decisions and in the value wives accorded their husbands' appraisals of their appearances. The data did, however, provide evidence in support of the interactionist premise that the private sphere selves the wives constructed through dress were shaped, in part, through their interactions with their husbands
THE EFFECT OF PH ON THE RESISTANCE OF PROTEUS MIRABILIS BACTERIA TO ANTIBIOTICS
No full textTwenty-six bacterial isolates of Proteobacteria were isolated from patients with urinary tract infections from several hospitals in Babylon province. Urine samples were collected from patients with urinary tract infections, then these samples were grown on different culture media and identified by several biochemical tests. Also, their drug sensitivity was studied using nine types of antibiotics. The drug sensitivity of these samples was studied at acidic, neutral and basic pH using disk diffusion method. The study showed that ciprofloxacin and azithromycin had high activity against bacteria at both acidic and neutral pH, while amikacin, meropenem, imipenem and ciprofloxacin had high activity at basic pH against these bacteri
Quality of Life of Mothers Having Children with Chronic Renal Failure
No full textOriginal Research Paper
Quality of Life of Mothers Having Children with Chronic Renal Failure
Authors:
1Dr. Lamyaa Jumaa Jihad M.B.Ch.B. FIBMS /Family Medicine 2Professor, Dr. Wijdan Akram Hussein M.B.Ch.B. FICMS/CM, 3Ahmed Akram Hussein General surgeon (FICMS. CABMS)
1Ministry of Health, Baghdad, Iraq
2Al- Kindy College of Medicine /University of Baghdad, Iraq
3Al-Emamain Al-Kadhymain Medical City/ Ministry of Health/Iraq
Corresponding Author: Dr. Wijdan Akram Hussein M.B.Ch.B. FICMS/CM, Al- Kindy College of Medicine /University of Baghdad, Iraq
Article Received: 04-08-2022 Revised: 25-08-2022 Accepted: 15-09-2022
ABSTRACT:
Background: During the last several decades, significant improvements had been achieved in management of children suffering from end stage chronic kidney disease (ESCKD), with advancements in dialysis care whether in predialysis period or dialysis technology which lead to prolong long-term survival of affected children. But these medical achievements saddle families (especially mothers) of ESCKD children with significant psychosocial, social, environmental and physical burdens. Aims of study: To assess the overall Health Related QoL among mothers of ESCKD children in Child Protection Teaching Hospital in Baghdad. To find out the association of socio-demographic and socio-economic variables with physical, psychological, social and environmental domains of QoL. Methods: A descriptive cross sectional study was conducted on a sample of 108 mothers of less than 16 years old children diagnosed with ESCKD attending hemodialysis unite in Child Protection Teaching Hospital in Baghdad during the 1st half of 2019.Mothers` health-related quality of life was assessed using World Health Organization – Health Related QoL BREF questionnaire. Chi-square test was used to find out significance of associations between related variables where P. value ˂0.05was considered statistically significant. Results: Social relationships Health Related QoL is the most impaired domain in studied mothers (43.8/100), while the least affected domain is the physical health (52.2/100). Conclusion: physical health quality of life of Mothers who were caring for children with ESRD on hemodialysis was affected but to lesser extent than other QoL domains, while social relationships was the most affected domain followed by psychological wellbeing then environmental domains.
Key wards: Quality of life, end stage renal failure, Baghdad.
INTRODUCTION:
Regarding care in the management of various chronic illnesses in children and adolescents indicate that it is the mothers who are the main people involved in the care process (1). Important assertions depend on this fact, such as the burden of the mothers who are the caregivers, who in addition to domestic responsibilities undertake complex activities which are not part of their routine, arising from the care for their children with chronic illnesses. Caregiver burden can culminate in acute and chronic physical disorders, resulting in isolation and depression, as well as financial disequilibrium, reduction in libido and self-accusation (2). The caregiver's burden is defined as objective when it corresponds to the physical and/or mental effects arising from the act of caring; and as subjective when related to the negative sensation which the act of caring provokes in the caregiver (3). The conceptualization and measurement of quality of life (QoL) in the early days, followed later by health-related quality of life (HRQoL) has been of interest to researchers from the fields of sociology and healthcare for several decades now. Increasingly, HRQoL is seen as a measurable outcome of healthcare (4). Providing round-the-clock care for a kid is only part of being a parent. When it comes to a kid with a chronic illness who will be dependent for the rest of his or her life, the nature and significance of this care shift dramatically. Taking care of these kids has a ripple effect on the whole family, especially the parents, lowering their quality of life and affecting their physical and emotional health (QoL). When a parent's own physical or mental health prevents them from providing the care and support a kid needs, that youngster is more likely to fall short of his or her full potential in terms of functioning and independence. How parents manage stress, build resilience, and deal with novel circumstances all have a role in how well their children do in their care. It has been shown via research that a parent's mental health declines the more time they spend with their impaired kid, especially if that parent is the mother (5). Unlike in adult patients, Childhood Chronic Kidney Disease CKD presents clinical features that are specific and totally peculiar to the pediatric age, such as the impact of the disease on growth. This impact is often under-recognized but should not be neglected. Moreover, Chronic Kidney Disease (CKD) has a great psychosocial impact, both on the patient and his family. The parents not only have to fulfill the role of parents, but also take on many tasks we normally associate with nurses and doctors. Therefore, we must be aware that the increasing survival of pediatric patients with CKD, due to the improvement in the clinical and therapeutic management, will lead to a large number of effects on HRQoL mainly that of mothers. In Iraq, there is a strong emotional relationship between family members. Parents are directly affected by the whole family and have a special commitment towards their children. This traditional structure is an important source of support for the diseased children. Unfortunately, in the context of health care in Iraq, the needs and problems of family caregivers have not been addressed effectively and they don’t receive appropriate support. The concept of care is a process of taking care activities and its associated responsibilities (6). In addition to physical pressure, caring a chronically diseased child by his mother as a care giver bears all features for the chronic stress since it is associated with high levels of unpredictability and uncontrollability. These factors cause the secondary stress in different aspects of life, including work and family relationships. Stress-making factors to which caregivers are exposed result in mental stress and disorder in health behaviors, which in turn stimulate physiological responses, illness and even death (7). The term ‘caregiver’ refers to those who, during the treatment procedure, are mostly involved in looking after the patient and help the patient to handle and adopt with that chronic disease (8). Caregivers are vital and national source of health care and families (especially mothers) are often the first source of home health care.
Aims of study
To assess the overall HR QoL of mothers of children with chronic renal failure on hemodialysis
To find out the association between socio-demographic and socio-economic variables (e.g. age, gender, education, occupation, residency, marital status) and physical, psychological, social, and environmental domains.
METHODS:
Study design and duration of data collection
A descriptive cross-sectional study. Data collection was carried out during the period from 1st of April to 30th of June 2019; during the working hours of the hemodialysis unite Child Protection Teaching Hospital Medical City
Study Setting
The study was conducted in hemodialysis unit at Child Protection Teaching Hospital Medical City, Baghdad. This unite offers services to people lived everywhere in Baghdad, mainly in Al-Russafa district and the rural areas around.
Study population and sampling procedure
All mothers of children with ESCKD attending Child Protection Teaching Hospital Medical City for hemodialysis for their children were included.
Tools of data collection
Data was collected by using self-administered questionnaire consisted of two parts
Part one
This part ask about demographic information of patients: gender , age and duration of hemodialysis of ESCKD child, while each mother was asked to mention her age, educational level, her and her husband occupation, house and car property, Marital status, and residence.
Part Two
The researcher employed the Arabic version of WHOQOL-BREF, a shorter version of WHOQOL 100 survey tool, which was developed by the WHO to capture the broad aspects of HRQOL. There are a total of 24 satisfaction items in the WHOQOL-BREF questionnaire, split between four categories: physical health (DOM1), mental health (DOM2), social relationships (DOM3), and environmental health (DOM8). The questionnaire includes two items measuring both overall quality of life and general health (DOM4). This instrument emphasizes the subjective responses of person rather than their objective life conditions, with assessment made over the preceding two weeks. It was developed in a wide range of languages in different cultural settings and yields comparable scores across cultures (9). The scale includes 5-point Likert response ranging from 1 (very dissatisfied/very poor) to 5 (very satisfied/very good). The scores for each domain are scaled in a positive direction, that is, a higher score indicates a higher QOL rating (9). The scale was prepared so as to be filled by the individual. Scoring of domains was carried out according to WHOQOL user manual (10), where domain scores are scaled in a positive direction with 3 questions in negative direction. A score of mean ± SD on each domain is considered fair, a score of ˂ mean-1 SD is poor and a score of ˃ +1SD is good. (11,12) The dependent variable for this study was the quality of life of studied mothers, while the independent variables of this study included: child age, child gender duration of HD, mother age, residence and SES. The socioeconomic status (SES) was calculated using Wali Omer and Tariq Al-Hadithi method (13). SES= Education + Occupation + House ownership*1 + Car ownership0.5 + [(AGE-20)/100] - retired/unemployed
Ethical approval and permission
1. Permissions obtained from Ministry of Health by official letters directed to the authorities of Children Care Hospital.
2. Conduction of the study had been approved by the ethical committee at
Iraqi Council of Medical Specializations.
3. The mothers of patients gave informed consent to participate after the
objectives of the study were explained to them.
Statistical analysis
The data were entered into Microsoft Excel. Then they were loaded into Statistical Package for Social Sciences (SPSS) software (version 23). For descriptive analysis categorical variables were presented as frequencies and percentages. Continuous variables were presented as (Means ± SD). Pearson Chi square test has been used to examine the effects of socio-demographic data on the domains of parents’ QoL.
P-value level of < 0.05 was considered for significant association.
RESULTS:
One hundred and eight mothers of children with ESCKD met the criteria to be included in this study.Sixty-three (58.3%) of CKD children were males, the mean age of children was 10±1.5 years, 55(50.9%) aged less than 10 years, the duration of hemodialysis was equal or less than 1 year in 61(56.5%), 48(44.4%) of children had severe complicated form of ESCKD, Characteristics of diseased children , the mean age of mothers was 38±4.12 years, 63 (58.3%) of them aged less than 40 years, 80(74.1%) lived in urban areas. Regarding the socioeconomic status of studied mothers; 28(25.9%), 39(36.1%), 25(23.1%) and 16(14.8%) related to poor, fair, good and excellent socioeconomic state levels respectively,as in table 1.
Table 1 General characteristics of studied subjects
No.(total 108)
%
Child gender
Male
63
58.3
Female
45
41.7
Child age Mean ±SD 10±1.5 years
Child age
≤10 years
55
50.9
>10 years
53
49.1
Duration of HD
≤1 year
61
56.5
>1 year
47
43.5
Disease severity
Severs
48
44.4
less severe
60
55.6
Mother age Mean ±SD 38±5.12 years
Mother age
< 40 years
63
58.3
≥40 years
45
41.7
Residence
Urban
80
74.1
Rural
28
25.9
Socioeconomic status
Poor
28
25.9
Fair
39
36.1
Good
25
23.1
Excellent
16
14.8
Table 2 shows the QoL domain scores were lowest in social health (43.8±9.2) and the highest in physical health (52.2±11.4).
Table 2 distribution of studied mothers according to mean scores of QoL domains
Mean
Std. Deviation
Physical health
52.2
11.4
Psychological wellbeing
44.8
10.5
Social relationships
43.8
9.2
Environmental health
49.3
12.3
Regarding impression of study subjects about GQOL (general quality of life), 27% had poor, 45% fair and 28% had good impression. Gender was the only variable to be significantly associated with GQOL (Pv= 0.028). As in figure 1 and table 3
Figure1: Distribution of studied sample according to GQOL
Table 3 association between studied variables and patients` perception regarding their general QOL
Total
N= 108
Poor
N= 29
Fair
N= 49
Good
N=30
P value
N
C %
N
R%
N
R%
N
R%
Child gender
Male
63
58.3
23
36.5
25
39.7
15
23.8
0.028
Female
45
41.7
6
13.3
24
45
15
33.3
Child age groups
≤10 y
55
50.9
15
27.3
26
47.3
14
25.5
0.854
>10 y
53
49.1
14
26.4
23
43.4
16
30.2
Duration of HD
≤1 y
61
56.5
18
29.5
28
45.9
15
24.6
0.641
>1 y
47
43.5
11
23.4
21
44.7
15
31.9
Disease severity
Severs
48
44.4
10
20.8
22
45.8
16
33.3
0.345
Less sev.
60
55.6
19
31.7
27
45
14
23.3
Mother age
< 40 y
63
58.3
17
27
28
44.4
18
28.6
0.969
≥40 y
45
41.7
12
26.7
21
46.7
12
26.7
Residence
Urban
80
74.1
20
25
35
43.8
25
31.3
0.384
Rural
28
25.9
9
32.1
14
50
5
17.9
SES
Poor
28
25.9
9
32.1
13
46.4
6
21.4
0.758
Fair
39
36.1
10
25.6
15
38.5
14
35.9
Good
25
23.1
7
28
13
52
5
20
Excellent
16
14.8
3
18.8
8
50
5
31.3
In relation to GH, 25% of mothers had poor, 44% fair and 31% had got good perception. SES had been shown to have significant association with general health of the participating subjects (P value= 0.001). As in figure 2 and table 4.
Table 4 Association between studied variables and patients` perception regarding their general health
Total
N=108
Poor
N= 27
Fair
N=48
Good
N=33
P value
N
%
N
%
N
%
N
%
Child gender
Male
63
58.3
15
23.8
30
47.6
18
28.6
0.732
Female
45
41.7
12
26.7
18
40
15
33.3
Child age groups
≤10 y
55
50.9
14
25.5
29
52.7
12
21.8
0.103
>10 y
53
49.1
13
24.5
19
35.8
21
39.6
Duration of HD
≤1 y
61
56.5
15
24.6
28
45.9
18
29.5
0.939
>1 y
47
43.5
12
25.5
20
42.6
15
31.9
Disease severity
Severs
48
44.4
11
22.9
21
43.8
16
33.3
0.828
less sev.
60
55.6
16
26.7
27
45
17
28.3
Mother age
< 40 y
63
58.3
15
23.8
31
49.2
17
26.9
0.475
≥40 y
45
41.7
12
26.7
17
37.8
16
35.5
Residence
Urban
80
74.1
23
28.75
35
43.75
22
27.5
0.258
Rural
28
25.9
4
14.3
13
46.4
11
39.3
SES
Poor
28
25.9
11
39.3
15
53.6
2
7.1
0.001
Fair
39
36.1
8
20.5
21
53.8
10
25.6
Good
25
23.1
7
28
8
32
10
40
Excellent
16
14.8
1
6.3
4
25
11
68.8
Figure 2: Distribution of studied sample according to GH
Regarding physical health figure 3 showed that 34(32.5%), 27(25%) and 47(43.5%) mothers presented with poor, fair and good physical health respectively.
Figure 3: Distribution of studied subjects according to physical health
Regarding psychological wellbeing: figure 4 showed that 37(34.3%), 49(45.4%) and 22 (20.3%) patients presented with poor, fair and good psychological wellbeing respectively.
Figure 4 Distribution of studied subjects according to psychological wellbeing
Regarding social relationships figure 5 showed that 34(31.5%), 40 (37%) and 34 (31.5%) mothers presented with poor, fair and good social relationships respectively.
Figure 5: Distribution of studied subjects according to social relationships
Figure 6 showed that 30(27.8%), 43(39.8%) and 35 (32.4%) patients presented with poor, fair and good environmental health status respectively.
Figure 6 Distribution of studied subjects according to environmental health
DISCUSSION:
General health and QoL
The results of this study showed that studied mothers scored low general score according to both their personal rating and according to domains measured one where the score are less than 50/100 for both. These results agreed with results of other studies discussing association between low HRQL of parents and presence of chronically ill sons or daughters like that found by Benjak in Croatia during 2011 when the study concluded that parents of children with Autism reported a poor QoL and general health perception(14). Studies were done by Bih- Ching Shu 2009, Mugno 2007 and Yamada 2012 pointed similar results that poor QoL were recorded among parents of childr
