Hanan E. Badr

Foreign live-in domestic workers as caretakers of older Kuwaiti men and women: socio-demographic and health correlates

ABSTRACT Ageing of the population is posing new challenges for caretakers. This paper aims to examine: (a) age and gender differences in care provided by a domestic worker versus a family member in the performance of activities of daily living (ADL); (b) socio-demographic correlates of care during illness; and (c) self-reported physical, functional, and psychological health status in relation to care-giver. A cross-sectional household survey was conducted among 2,487 Kuwaiti nationals aged 50 years or older. This paper focuses on persons aged 70 or more. We found that domestic workers provided care to 28 per cent of men and 58 per cent of women who needed assistance with ADL; and to 14 per cent men and 51 per cent women during illness. These respondents ranked poorer on several health indicators and reported higher depressive symptoms score than those looked after by a family member. Logistic regression indicated that care by a domestic worker was approximately seven times more likely for women than men, about 10.8 times more likely for those without co-resident children compared with those who had three or more co-resident children, and 44 per cent less likely for the poorest compared with the richest persons. It appears that reliance on domestic workers is increasing and such reliance will remain necessary in the absence of culturally acceptable alternative institutional arrangements.

Obesity Among Kuwaitis Aged 50 Years or Older: Prevalence, Correlates, and Comorbidities

OBJECTIVES Obesity is a serious global health problem. Our objectives are to assess the prevalence of overweight and obesity among elderly Kuwaitis aged 50 or older, examine their sociodemographic correlates, and analyze the association between obesity and its comorbidities. METHODS A cross-sectional face-to-face interview survey using a structured questionnaire was conducted among 2,443 Kuwaiti men and women aged 50 or older. Height and weight were measured and body mass index (BMI) was calculated. RESULTS About 81% respondents were overweight of whom 46% were obese. Mean BMI was 30.0 (31.2 for women and 28.1 for men). Multinomial logistic regression analysis revealed that relatively young elderly Kuwaitis (50-59) were 1.7 and 2.2 times more likely to be overweight and obese, respectively, compared with those aged 70 or older. Married individuals had 2.3 times higher risk to be overweight or obese than non-married individuals. Women were 3.6 times more likely to suffer from obesity than men. Overweight and obesity were found to be independent risk factors for hypertension (OR = 1.3 and 1.9, respectively), diabetes (OR = 1.4), and osteoarthritis (OR = 1.8 and 1.6, respectively). CONCLUSIONS Prevalence of overweight and obesity is alarmingly high among elderly Kuwaitis. The associated disease burden is substantial. Stakeholders should address the problem and launch national extensive health-promoting campaigns targeting perceptible lifestyle changes.

Decline in co-residence of parents and children among older Kuwaiti men and women: what are the significant correlates?

A trend towards decline in co-residence with children is apparent in several countries while it is absent in others. The objectives of this paper are to address the patterns of co-residence with children among older Kuwaiti men and women aged 60+ and to assess the determinants of such patterns within the context of rapid socioeconomic changes occurring in the country (n = 1588). The data for this paper were collected as part of a household survey on the psychosocial health and disability among 2487 older Kuwaitis aged 50+. Forward step-wise logistic regression was run to assess the significant socio-demographic and health related correlates of living without any co-resident children. We found that the percentage living without any co-resident children increased from 5% in 1999 to 24% in 2005/6. About 13% women and 1% men were living alone in 2005/6. In the multivariate analysis, older age, female gender, non-Bedouin cultural background, a smaller number of children, higher educational level, and the presence of one or more domestic helpers were positively associated with the absence of co-resident children. On the other hand, those who were not married were less likely to reside without co-resident children, as were those with higher family incomes. Except for self-rated health none of the health related variables, such as chronic illnesses or depressive symptom experience, emerged as significant. Modernization forces seem to be at the core of the observed decline in co-residence with children.

The Role of Sociodemographic Factors and Chronic Illness in Functional Disability of Older Kuwaitis

A cross-sectional interview survey of 2,487 Kuwaiti individuals aged 50 and above was conducted to identify the background factors and chronic diseases that exacerbate functional disability among older Kuwaitis. Functional disability was measured as physical ability, ability for self-care, and ability to perform daily routine activities. Association of sociodemographic factors, lifestyle, depressive symptoms, and five chronic illnesses with disability was analyzed. A quarter of respondents (n = 607) reported to suffer from functional disability and 33% of them from severe disability. Logistic regression indicated that stroke, arthritis, and heart disease were positively associated with functional disability. Older age, unmarried status, non-Bedouin background, lower education, and lower income were significant positive correlates. Stroke was significantly associated with severe disability, as were older age, unmarried status, lower socioeconomic status (SES), higher depression level, and lack of coresident children. Thus, several sociodemographic factors, chronic illnesses, and depressive symptom experience are significant correlates of disability.

Towards promoting patient safety practices: Baseline assessment of patient safety culture in three private hospitals

ABSTRACT The study aimed to: assess patient safety culture in three private hospitals, define strengths and weaknesses in patient safety culture, and examine the socio-demographic determinants of patient safety culture. A cross-sectional study was conducted among 1193 healthcare providers and administrators with 68.4% response rate. A locally customized hospital version of the Patient Safety Culture Survey (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ) was used. The mean score of overall perception of safety and frequency of event reporting were 3.4/5.0 and 4.0/5.0, respectively. ‘Excellent’ and ‘very good’ overall grade on patient safety was reported by 28.9 and 55.3% of participants, respectively. About half of participants reported no events in the last 12 months, while 31.4% reported 1–2 events. The strength areas were teamwork within units, organizational learning, and continuous improvement composite dimensions. However, the areas that required improvement were supervisor expectations, actions promoting patient safety, and hospital handoffs and transitions. Higher level of education, nursing career, training on patient safety, having direct communication with patients and working in small hospitals were the determinants of better patient safety culture practice. Hospital managers and policy makers ought to heighten the performance and practices within a non-punitive reporting atmosphere.

Chronic Non-Cancer Pain Management Capacity in Karachi

Chronic non-cancer pain (CNCP) affects people everywhere in the world, but people in developing countries have far less access to therapies that provide relief. There are often missed opportunities to implement these therapies. Karachi shares many characteristics with megacities of the global south and represents Pakistan in the global city league. This review informs readers about the availability of health management and pain services for CNCP in Karachi, and their comparability to those found in other global cities. The literature about CNCP and its management in Karachi and Pakistan is scarce. Nevertheless, some conclusions can be made. In order to inform readers based in other global cities, a brief review of the current health system and pain services in Karachi and Pakistan are discussed together with barriers that impede pain service outputs. The present review employs vignettes to illustrate typical experiences of CNCP patients seeking pain management services in three sectors: public, charitable, and private institutions.

Can women make a difference in preventing schistosomiasis? The invisible power!

Schistosomiasis is a major occupational health problem in rural Egypt. This endemic parasitic infestation causes problems that range in severity from anaemia to renal failure and death. Women can make a difference in defeating this preventable endemic health problem through their specific feminine function as mothers and primary caregivers to the children and entire family or their non‐specific feminine function as teachers, doctors, nurses, etc. Through both functions, women can have a vital role in teaching healthy behaviours and changing the adverse ones that lead to schistosomiasis. The invisible power women have in sharing responsibility with men in health planning and decision‐making regarding a preventable health problem, schistosomiasis, should be visible.

Assessing the quality of life in patients with multiple sclerosis in Kuwait: a cross sectional study

Abstract The main objective of this paper was to assess the level and the determinants of quality of life (QOL) amongst patients with multiple sclerosis (MS). A cross-sectional study was conducted among a convenience sample of 200 adult MS patients. Inclusion criteria were: MS diagnosis for at least one year, and aged 21+ years. However, exclusion criteria were: having other neurological diseases, serious cardiovascular, orthopedic or other disability precluding participation. Self-administered questionnaire employed MSQOL-54 with two outcomes: Physical Health Composite (PHC) and mental health composite (MHC). Satisfaction with Daily Occupation scale was adopted through face to face interviews. The median of PHC and MHC scores were 48.9/100, and 53.4/100 respectively. Multivariate analysis revealed that unemployment was a determinant of poor PHC, while low monthly income was a predictor of poor MHC. Additionally, low endurance and sensory problems were associated with poor PHC, and MHC, while motor problems were allied with only poor PHC. Patient’s satisfaction level with performing activities of daily living was positively associated with PHC and MHC. Assessment of QOL is suggested to be comprised in medical settings.

MS People’s Performance and Satisfaction With Daily Occupations: Implications for Occupational Therapy:

People with multiple sclerosis (MS) face difficulties in performing daily occupations. The objectives of this study were to assess the performance of and level of satisfaction with daily occupations among people with MS, and to explore factors associated with their performance and satisfaction. A cross-sectional study was conducted among 200 MS individuals. The Arabic version of Satisfaction With Daily Occupations (SDO) scale was used. Mann-Whitney U, Kruskal-Wallis, Chi-square tests, and binary logistic regression were used for data analysis. SDO performance and satisfaction median scores were 10/14 and 51/70, respectively. Multivariate analysis revealed that unemployment and cognitive symptoms were associated with poor occupational performance. Furthermore, unemployment, being married, visual problems, and low endurance were significant correlates of poor satisfaction with performing daily occupations. Social and clinical factors contributed to dissatisfaction with the poor performance of daily occupations among people with MS. Intervention studies are needed to investigate the role of occupational therapy in improving the performance of daily occupations in people with MS.

Differences in physical activity, eating habits and risk of obesity among Kuwaiti adolescent boys and girls: a population-based study

Abstract The study aimed to assess gender differences among Kuwaiti adolescents in healthy living choices that impact the risk of obesity. A cross-sectional multistage cluster design was employed with a representative sample of 2672 students aged 13–15 years who completed a self-administered Global School-based Student Health (GSHS) survey. The study found that around 48.0% of adolescents were overweight and obese. More boys than girls were obese (28.2% vs. 22.3%, p < 0.0001). However, boys were more likely than girls to report healthy food choices regarding fruit (38.1% vs. 33.2%), and vegetables (21.8% vs. 16.7%). Only 20.7% of adolescents reported physical activity for more than 60 min/day, predominately by boys rather than girls (30.8% vs. 10.5%, respectively, p < 0.0001). Multivariate analysis revealed that male gender, skipping breakfast and physical inactivity were significantly correlated with the risk of overweight and obesity among adolescents. These results suggest that lifestyle education for promoting healthy body masses targeting adolescents should take gender into account.