SACM - Australia

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    Heart disease, health outcomes, and healthcare utilisation among middle-aged and older Australians: a longitudinal study using HILDA survey data
    (The University of Queensland, 2024) Alkalabi, Meshal; Keramat, Syed Afroz
    STUDY 1 ABSTRACT Background Heart disease is a major public health concern globally, with substantial impacts on health outcomes among middle-aged and older adults. Understanding its influence on general health, mental health, self-assessed health, and health satisfaction is crucial for developing effective interventions tailored to this demographic in Australia. The study aims to investigate the longitudinal burden of heart disease on self-reported health outcomes among middle-aged and older Australians, focusing on general health, mental health, self-assessed health, and health satisfaction. Methods This study utilised longitudinal data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, focusing on individuals aged 40 years and older across four survey waves: 2009, 2013, 2017, and 2021. The study included 12,751 participants aged 40 and older, with 32,931 observations. Fixed-effects Generalised Least Squares (GLS) and fixed-effects ordered logistic regression models were applied to assess the association between heart disease and four health outcomes. Robustness checks were conducted using Generalised Estimating Equations (GEE) and random-effect GLS models. The analysis adjusted for sociodemographic, behavioural, and healthrelated variables. Results The results suggest that heart disease was negatively associated with general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. Specifically, participants with heart disease scored lower on general health (β = -4.67, 95% CI: -5.56 to -3.77, p < 0.001), mental health (β = -0.98, 95% CI: -1.84 to -0.12, p = 0.025), self-assessed health (β = -0.76, 95% CI: -0.94 to -0.58, p < 0.001), and health satisfaction (β = -0.50, 95% CI: -0.65 to - 0.35, p < 0.001) compared to those without heart disease. The heterogeneous analysis further revealed that gender differences influenced health outcomes, with females experiencing more pronounced declines across all health measures than males. Additionally, the marginal effects analysis indicated that heart disease reduced the likelihood of achieving the highest levels of self-assessed health and health satisfaction. Conclusion This study found that heart disease is linked to poorer health outcomes, including general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. To enhance the overall well-being of this population, communities, government and nongovernment organisations, and other stakeholders should prioritise routine healthcare prevention, targeted interventions, and treatment strategies, particularly for individuals affected by heart disease.. Keywords: Heart disease; general health; mental health; self-assessed health; health satisfaction STUDY 2 ABSTRACT Background Heart disease poses a significant burden on healthcare systems, particularly among middle-aged and older adults in Australia. Despite existing research on healthcare utilisation patterns, longitudinal studies focusing on how heart disease affects healthcare use over time among older Australians remain limited. The study aims to examine the longitudinal burden of heart disease on healthcare utilisation among middle-aged and older Australians, focusing on the number of doctor visits, hospital admissions, and nights spent in the hospital. Methods This longitudinal observational study utilised data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, covering the years 2009, 2013, 2017, and 2021. The study included 12,857 participants aged 40 and older, with 33,822 observations. The primary outcomes were the number of doctor visits, hospital admissions, and nights spent in the hospital. Heart disease status was the main exposure variable, and random-effects negative binomial regression models were used to examine associations, adjusting for socio-demographic, behavioural, and healthcare access factors. Results Participants with heart disease had significantly higher healthcare utilisation across all measures. The rate of doctor visits increased by 24% (IRR: 1.24, 95% CI: 1.20–1.28, p < 0.001), while hospital admissions nearly doubled (IRR: 1.91, 95% CI: 1.76–2.07, p < 0.001), and nights spent in the hospital were significantly longer (IRR: 1.89, 95% CI: 1.75–2.04, p < 0.001) compared to those without heart disease. Older age (≥ 70 years), female sex, multiple chronic conditions, and not being in the labour force were significant predictors of increased healthcare utilisation, indicating a compounded healthcare burden in these subgroups. Conclusion Heart This study shows that middle-aged and older Australians with heart disease have higher healthcare utilisation compared to those without the condition. Heart disease is a significant public health concern that necessitates comprehensive, long-term management strategies focused on prevention. Inadequate management of heart disease could lead to worsening health outcomes and place further strain on the healthcare system. Keywords: Heart disease, healthcare utilisation, longitudinal study, older adults, HILDA survey, doctor visits, hospital admissions, Australia.
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    Assessing Wellbeing and Student Achievement During COVID-19 Lockdown in Saudi Arabia
    (Flinders University, 2042-10) Alharthi, Shatha; Skrzypiec, Grace
    The COVID-19 pandemic during 2020-2021 resulted in unprecedented school closures and prolonged remote learning for Saudi Arabian students with unknown consequences at the time for perceived academic performance, mental health, and wellbeing. Prior research had suggested that reduced social interaction could negatively affect wellbeing and contribute to impaired mental health (e.g., depression and anxiety), while also resulting in lower academic performance. However, little was known about the direct impact of the pandemic on academic outcomes and mental health of middle school students in the Saudi Arabian context, particularly during extended periods of remote learning while facing social and educational challenges stemming from the worldwide crisis. A sequential explanatory mixed methods design was used to investigate this gap in knowledge by exploring the association between middle school students’ perceived academic achievement and their levels of wellbeing, depression, and anxiety during the COVID-19 lockdown. In the two-phase study design, an online survey was used to collect quantitative data from 401 Saudi male and female middle school students aged 11-18 in Mecca and Taif cities, KSA. The impact of COVID-19 lockdown on student wellbeing questionnaires, informed by procedures from a global study conducted by the Global Research Alliance (GRA), enquired about students’ self-perceived academic achievement, wellbeing levels, mental health status, and other essential factors such as demographic information, socioeconomic status, and frequency of activities during the lockdown. The qualitative phase involved semi-structured interviews with eight Saudi female students from the same population, to delve deeply into adolescents’ experiences, perceptions, and insights related to their experiences in lockdown. Structural Equation Modelling (SEM) using Mplus was the primary data analysis procedure used to test the relationships between the identified factors of self-perceived academic achievement. Results from the SEM revealed that variations in self-perceived academic achievement were significantly associated with wellbeing, gender, and socioeconomic status. Unexpectedly, depression, anxiety, the amount of schoolwork, and age did not exert a definitive impact on perceived academic achievement. Over half of the students perceived their performance during the lockdown as better than their peers, and they demonstrated adaptability, either maintaining or improving their academic performance amidst challenging circumstances. The study found that students’ mental health and wellbeing were largely protected, which was attributed to strong family support, religious practices, and adaptability within a supportive home environment. While most students did not show enduring signs of depression or anxiety, specific subgroups faced distress during the lockdown. Challenges related to remote learning, such as internet connectivity issues and online education platform quality, were evident; however, students exhibited coping in overcoming these obstacles to a significant extent. The study findings underscore the significance of promoting family support, religious involvement, and educational readiness within the Saudi education framework to enhance student wellbeing and academic achievement during school closures. The findings advocate for enhancing the preparedness of education systems for future disruptions to in-person, classroom learning. Recommendations include investing in high-quality online education platforms, enhancing teacher training for online instruction, and engaging families to support students in lockdown. Future research should focus on longitudinal studies to assess the lasting impacts of pandemic-driven disruptions on student wellbeing and academic performance, as well as on understanding students’ coping mechanisms during educational crises.
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    Experiences of Mental Health Recovery in the Kingdom of Saudi Arabia
    (University of Technology Sydney, 2024-07-11) Hawsawi, Tahani; Wilson, Amanda; Appleton, Jessica
    This thesis explores mental health recovery in Saudi Arabia from the perspectives of consumers, carers, and nurses. Using an exploratory descriptive qualitative design informed by social constructionism, the study involved semi-structured interviews with 16 consumers, 10 carers, and 8 nurses. Thematic analysis revealed that consumers view recovery as a transformative process, emphasising self-help and social support while facing barriers such as stigma and poor interpersonal skills. Carers highlighted the importance of the bond between carers and consumers, advocating for co-designed care planning. Nurses defined recovery primarily in terms of clinical improvements, recognising both biomedical and therapeutic approaches as facilitators. Common themes across all groups included the conceptualisation of recovery as a transformative journey requiring hope and determination, the significance of interpersonal skills, and the impact of stigma as a barrier. This study found that mental health recovery in Saudi Arabia is socially constructed and influenced by cultural norms and community interactions. The findings suggest that effective recovery-oriented practice in Saudi Arabia requires a shift from the dominant biomedical model towards a more holistic, culturally sensitive approach that integrates consumers' and carers' perspectives and emphasises consumer-centred, trauma-informed care.
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