- Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer
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Binh Thang Tran, Thanh Gia Nguyen, Dinh Duong Le, Minh Tu Nguyen, Nhan P. T. Nguyen, Minh Hanh Nguyen, The Due Ong
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J Prev Med Public Health. 2024;57(4):407-419. Published online June 24, 2024
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DOI: https://doi.org/10.3961/jpmph.24.090
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Abstract
Summary
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This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients.
Methods This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking.
Results The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT.
Conclusions FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.
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Summary
Key Message
- This first large-scale analysis looks into the financial toxicity faced by patients with cancer in Vietnam, as an example of low- and middle-income countries.
- Financial toxicity was remarkably high prevalent and strongly associated with patient- level factors.
- Patients experiencing financial toxicity tend to use various cost-coping strategies.
- These findings underscore the need for routine screening for financial toxicity risk and interventions.
- Validation of the Disaster Adaptation and Resilience Scale for Vulnerable Communities in Vietnam’s Coastal Regions
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Thanh Gia Nguyen, Binh Thang Tran, Minh Tu Nguyen, Dinh Duong Le
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J Prev Med Public Health. 2024;57(3):279-287. Published online April 25, 2024
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DOI: https://doi.org/10.3961/jpmph.24.110
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Abstract
Summary
PDFSupplementary Material
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This study validated the Vietnamese version of the Disaster Adaptation and Resilience Scale (DARS) for use in vulnerable communities in Vietnam.
Methods This was a cross-sectional study involving 595 adults from 2 identified communities. The original DARS assessment tool was translated, and the validity and reliability of the Vietnamese version of DARS (V-DARS) were assessed. The internal consistency of the overall scale and its subscales was evaluated using Cronbach’s alpha and McDonald’s omega reliability coefficients. Confirmatory factor analysis (CFA) was employed to evaluate its construct validity, building upon the factor structure identified in exploratory factor analysis (EFA). Construct validity was assessed based on convergent and discriminant validity.
Results Following the established criteria for EFA, 8 items were removed, resulting in a refined V-DARS structure comprising 35 items distributed across 5 distinct factors. Both alpha and omega reliability coefficients indicated strong internal consistency for the overall scale (α=0.963, ω=0.963) and for each of the 5 sub-scales (all>0.80). The CFA model also retained the 5-factor structure with 35 items. The model fit indices showed acceptable values (RMSEA: 0.072; CFI: 0.912; TLI: 0.904; chi-square test: <0.01). Additionally, the convergent and discriminant validity of the V-DARS were deemed appropriate and satisfactory for explaining the measurement structure.
Conclusions Our findings suggest that the V-DARS is a valid and reliable scale for use within vulnerable communities in Vietnam to assess adaptive responses to natural disasters. It may also be considered for use in other populations.
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Summary
Key Message
The current study is one of the few that addresses the need to develop valid and reliable tools for disaster adaptation and resilience, particularly in the poorest and most vulnerable communities affected by natural events. These findings provide evidence supporting the development of community-based interventions for disaster preparedness and response.
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Citations
Citations to this article as recorded by
- Enhancing gender-responsive resilience: The critical role of women in disaster risk reduction in Oman
Suliman Abdalla, Elnazir Ramadan, Wafa Al Mamari Progress in Disaster Science.2024; 24: 100376. CrossRef
- Sleep Quality and Poor Sleep-related Factors Among Healthcare Workers During the COVID-19 Pandemic in Vietnam
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Thang Phan, Ha Phan Ai Nguyen, Cao Khoa Dang, Minh Tri Phan, Vu Thanh Nguyen, Van Tuan Le, Binh Thang Tran, Chinh Van Dang, Tinh Huu Ho, Minh Tu Nguyen, Thang Van Dinh, Van Trong Phan, Binh Thai Dang, Huynh Ho Ngoc Quynh, Minh Tran Le, Nhan Phuc Thanh Nguyen
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J Prev Med Public Health. 2023;56(4):319-326. Published online May 31, 2023
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DOI: https://doi.org/10.3961/jpmph.22.528
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3,785
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Abstract
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The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic.
Methods In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher.
Results Participants’ mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95).
Conclusions The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.
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- A cross‐sectional study of sleep disturbance among middle‐aged cancer patients at Vietnam National Cancer Hospital
Anh Tuan Pham, Mai Tuyet Do, Huong Thi Thanh Tran Cancer Reports.2024;[Epub] CrossRef - Poor sleep quality and associated factors among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Winta Tesfaye, Ayechew Adera Getu, Baye Dagnew, Alemu Lemma, Yigizie Yeshaw Frontiers in Psychiatry.2024;[Epub] CrossRef
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