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Doran C, Duits A, Gerstenbluth I, Tami A, Bailey A. "What will the doctor give me, the same painkiller?": a qualitative study exploring health-care seeking and symptoms self-management among patients for the treatment of long-term chikungunya disease, in Curaçao. BMC Health Serv Res 2023; 23:1247. [PMID: 37957621 PMCID: PMC10641972 DOI: 10.1186/s12913-023-10254-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Long-term chikungunya disease, characterized by persistent disabling rheumatic symptoms, including poly-arthralgia/arthritis of severe pain intensity, can persist for years after infection with the re-emerging mosquito-borne chikungunya virus. Although persistent symptoms and pain severity are important determinants of health-care seeking and self-management of symptoms, research on these in relation to long-term chikungunya disease is scarce. This study aimed to explore the perceived benefits and perceived barriers concerning health-care seeking, based on the Health Belief Model, and the symptoms self-management strategies used for health outcome improvement among individuals affected by long-term chikungunya disease. METHODS An exploratory qualitative descriptive study was conducted with 20 purposively selected adults (17 females and 3 males) with persistent rheumatic symptoms, recruited from an ongoing longitudinal chikungunya cohort, in Curaçao. Semi-structured interviews were carried out, audio-recorded, and transcribed. An iterative coding process was used for themes identification through inductive thematic analyses. RESULTS No perceived benefits in health-care seeking were reported. Identified themes in relation to perceived barriers were: (1) health-care seeking at disease onset; (2) general practitioners (GPs) perceptions and awareness of persistent symptoms; (3) challenges for medical referrals and support; (4) no validation of symptoms and challenges accessing therapy; (5) health system restrictions; and (6) social stigmatization of psychological help. These perceived barriers have led participants to self-manage persistent symptoms. Over-the-counter pharmacological and/or non-pharmacological treatments were used without consulting GPs. Identified themes were: (1) self-medication of symptoms; and (2) self-management true non-pharmacological treatments. CONCLUSIONS To promote the benefits of long-term health-care seeking and subsequently reduce the possible harmful use of analgesics, a collaborative physician-patient therapeutic relationship need to be encouraged. To facilitate this, important shifts may be needed in chikungunya sequalae education of both patients and health-care professionals, and policy makers need to revise health systems for the long-term provision of multidisciplinary care to achieve beneficial health outcomes in long-term chikungunya disease.
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Affiliation(s)
- Churnalisa Doran
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, Netherlands.
| | - Ashley Duits
- Department of Immunology, Curaçao Biomedical and Health Research Institute, Pater Eeuwensweg 36, Willemstad, Curaçao, Curaçao
| | - Izzy Gerstenbluth
- Department of Epidemiology, Curaçao Biomedical and Health Research Institute, Pater Eeuwensweg 36, Willemstad, Curaçao, Curaçao
| | - Adriana Tami
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, Netherlands
| | - Ajay Bailey
- Department of Human Geography and Spatial Planning, University of Utrecht, Heidelberglaan 8, Utrecht, 3584 CS, Netherlands
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Willis E, Friedel K, Heisten M, Pickett M, Bhowmick A. Communicating Health Literacy on Prescription Medications on Social Media: In-depth Interviews With "Patient Influencers". J Med Internet Res 2023; 25:e41867. [PMID: 36912881 PMCID: PMC10131845 DOI: 10.2196/41867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/04/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Historically, pharmaceutical companies have struggled with trust and brand reputation among key stakeholders and have adopted innovative marketing strategies to reach patients directly and rebuild those relationships. Social media influencers are a popular strategy to influence younger demographics, including Generation Z and millennials. It is common for social media influencers to work in paid partnerships with brands; this is a multibillion-dollar industry. Long have patients been active in online health communities and social media platforms such as Twitter and Instagram, but in recent years, pharmaceutical marketers have noticed the power of patient persuasion and begun to leverage "patient influencers" in brand campaigns. OBJECTIVE This study aimed to explore how patient influencers communicate health literacy on pharmaceutical medications on social media to their communities of followers. METHODS A total of 26 in-depth interviews were conducted with patient influencers using a snowball sampling technique. This study is part of a larger project using an interview guide that included a range of topics such as social media practices, logistics of being an influencer, considerations for brand partnerships, and views on the ethical nature of patient influencers. The constructs of the Health Belief Model were used in this study's data analysis: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. This study was approved by the institutional review board of the University of Colorado and adhered to ethical standards in interview practice. RESULTS As patient influencers are a new phenomenon, it was our goal to identify how health literacy on prescription medications and pharmaceuticals is being communicated on social media. Using the constructs of the Health Belief Model to guide the analysis, 3 themes were identified: understanding disease through experience, staying informed on the science or field, and suggesting that physicians know best. CONCLUSIONS Patients are actively exchanging health information on social media channels and connecting with other patients who share similar diagnoses. Patient influencers share their knowledge and experience in efforts to help other patients learn about disease self-management and improve their quality of life. Similar to traditional direct-to-consumer advertising, the phenomenon of patient influencers raises ethical questions that need more investigation. In a way, patient influencers are health education agents who may also share prescription medication or pharmaceutical information. They can break down complex health information based on expertise and experience and mitigate the loneliness and isolation that other patients may feel without the support of a community.
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Affiliation(s)
- Erin Willis
- University of Colorado Boulder, Boulder, CO, United States
| | - Kate Friedel
- University of Colorado Boulder, Boulder, CO, United States
| | - Mark Heisten
- University of Colorado Boulder, Boulder, CO, United States
| | | | - Amrita Bhowmick
- Health Union, LLC, Philadelphia, PA, United States.,Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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The Relationship between Information Dissemination Channels, Health Belief, and COVID-19 Vaccination Intention: Evidence from China. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:6915125. [PMID: 36755775 PMCID: PMC9902139 DOI: 10.1155/2023/6915125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 01/31/2023]
Abstract
In the context of the ongoing global epidemic of COVID-19 and frequent virus mutations, the implementation of vaccine is the key to the prevention and control of the epidemic at this stage. In order to provide recommendations and evidence to support global epidemic prevention and control and vaccination efforts from the perspectives of health communication and individual psychological perceptions and to improve the vaccination rate of COVID-19 vaccine among appropriate populations, this study conducted a questionnaire survey in eight districts of Beijing and collected a total of 525 valid data points. A health belief model was used to examine the predictors of COVID-19 vaccination behavior, and the relationship between different COVID-19 vaccine information dissemination channels, residents' health beliefs, and propensity to vaccinate was analyzed. This study found the following: (1) among new media, interpersonal communication and traditional media communication channels, the new media channel had the largest number of audiences; (2) the personal health beliefs of audiences in the three information channels differed significantly, with the highest perceived benefits and lowest perceived barriers in the interpersonal communication channel and the highest perceived barriers in the new media communication channel; (3) the health belief model was a significant predictor, with perceived benefits and barriers being the most effective attitudinal variables for predicting vaccination intention. This study is valuable for advancing and improving vaccine communication diffusion research and promoting wider application of the health belief model and communication media in health communication topics.
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Gao R, Zhang H, Gong C, Wu Z. The role of farmers’ green values in creation of green innovative intention and green technology adoption behavior: Evidence from farmers grain green production. Front Psychol 2022; 13:980570. [PMID: 36312093 PMCID: PMC9614431 DOI: 10.3389/fpsyg.2022.980570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Grain for Green Project (GGP) is one of China’s important ecological restoration projects. The key rationale of this Program is to decrease soil erosion and develop ecological conditions. The agricultural sector is putting efforts to promote green innovation and production among farmers to achieve the targets of ecological restoration projects. However, farmers’ green values could play a constructive role in building green innovative intention and green technology adoption behaviors. Based on the unified theory of acceptance and use of technology (UTAUT), the present study investigates the association between farmers’ green values and green technology adoption behavior. For empirical investigation, the current study assumes that farmers’ green values positively correlate with green innovative intention and green technology adoption behavior, respectively. Further, this study proposes that green innovative intention positively impacts green technology adoption behavior. The present study also aims to determine the mediating role of green innovative intention in the relationship between farmer green values and green technology adoption behavior. This study also attempts to check the moderating role of health consciousness in the relationship between farmer green values and green innovative intention and the relationship between farmer green values and green technology adoption behavior, respectively. For empirical analyses, the present study gathered data from303 farmers in China through a structured questionnaire method using a convenient sampling technique. The present study applied partial least square structural equation modeling for empirically examining hypotheses using Smart PLS software. The findings confirmed that farmers’ green values have a positive association with green innovative intention and green technology adoption behavior, respectively. The results further verified that green innovative intention positively correlates with green technology adoption behavior. The finding also authenticated that green innovative intention positively mediates the relationship between farmers’ green values and green technology adoption behavior. The moderating role of health consciousness in the relationship between farmers’ green values and green innovative intention is also confirmed by the results of this study. However, the findings revealed that health consciousness does not moderate the relationship between farmers’ green values and green technology adoption behavior. This study’s findings serve the literature by providing empirical insight on the importance of farmers’ green values for green innovative intention and green technology adoption behavior. Moreover, the findings also have important theoretical and practical implications.
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Affiliation(s)
- Risheng Gao
- Jiangxi Regional Development Research Institute, Jiangxi University of Technology, Nanchang, China
| | - Haitao Zhang
- Jiangxi Regional Development Research Institute, Jiangxi University of Technology, Nanchang, China
| | - Chunming Gong
- Jiangxi Regional Development Research Institute, Jiangxi University of Technology, Nanchang, China
| | - Zhihua Wu
- School of Economics and Management, Jiangxi Agricultural University, Nanchang, China
- *Correspondence: Zhihua Wu,
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Lai KP, Chong SC, Lin B. How older adults’ health beliefs affect intention to perform COVID-19 self-examination: A reasoned action approach. HUMAN SYSTEMS MANAGEMENT 2022. [DOI: 10.3233/hsm-220134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: COVID-19 self-examination is a significant part of the national recovery plan against the virus. Although it is easier to perform COVID-19 self-examination (CSE), only a small percentage of people prefer it. There are no precise statistics on CSE in Malaysia, but informal data from news agencies imply low CSE. Lack of awareness and conflicting information about the reliability of CSE results may have raised concerns about CSE’s efficacy and effectiveness. OBJECTIVE: This study investigates how Malaysian older adults’ health beliefs influence their intention to perform CSE. The study developed a framework combining illness threats (ITH), perceived barriers (PBA), medical motivations (MMO), and control over illness (COI) from the Health Belief Model (HBM) with the Reasoned-Action Approach’s attitude (ATT), perceived control (PCO), and intention (INT). METHODS: Structural Equation Modelling (SEM) analyses were conducted with AMOS 26 software to determine the influence of HBM on older adults’ attitude, perceived control, and intention. The study collected 200 data for the pilot study and 400 data for hypotheses testing. RESULTS: ITH, MMO, and COI have positive effects, whilst PBA affects ATT negatively. ITH and COI positively impact PCO, and PCO has a greater significant effect on INT than ATT. CONCLUSION: Given the HBM’s role in influencing older adults’ intention to perform COVID-19 self-examination, providing different levels of care and emphasising the perception of knowledge of illness are especially beneficial. Several recommendations are made to ensure that CSE remains relevant for older adults’ well-being, although COVID-19’s impact has become more stabilised.
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Affiliation(s)
- Kim Piew Lai
- Faculty of Business, Multimedia University, Melaka, Malaysia
| | | | - Binshan Lin
- College of Business, Louisiana State University Shreveport, Shreveport, LA, USA
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Liu YL, Yan W, Hu B, Li Z, Lai YL. Effects of personalization and source expertise on users' health beliefs and usage intention toward health chatbots: Evidence from an online experiment. Digit Health 2022; 8:20552076221129718. [PMID: 36211799 PMCID: PMC9536110 DOI: 10.1177/20552076221129718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/13/2022] [Indexed: 11/05/2022] Open
Abstract
Objective Based on the heuristic–systematic model (HSM) and health belief model (HBM), this study aims to investigate how personalization and source expertise in responses from a health chatbot influence users’ health belief-related factors (i.e. perceived benefits, self-efficacy and privacy concerns) as well as usage intention. Methods A 2 (personalization vs. non-personalization) × 2 (source expertise vs. non-source expertise) online between-subject experiment was designed. Participants were recruited in China between April and May 2021. Data from 260 valid observations were used for the data analysis. Results Source expertise moderated the effects of personalization on health belief factors. Perceived benefits and self-efficacy mediated the relationship between personalization and usage intention when the source expertise cue was presented. However, the privacy concerns were not influenced by personalization and source expertise and did not significantly affect usage intention toward the health chatbot. Discussion This study verified that in the health chatbot context, source expertise as a heuristic cue may be a necessary condition for effects of the systematic cue (i.e. personalization), which supports the HSM's arguments. By introducing the HBM in the chatbot experiment, this study is expected to provide new insights into the acceptance of healthcare AI consulting services.
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Affiliation(s)
| | | | - Bo Hu
- Bo Hu, Department of Media and Communication, City University of Hong Kong, Run Run Shaw Creative Media Centre, 18 Tat Hong Avenue, Kowloon Tong, Hong Kong, China.
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Luo A, Yu Z, Liu F, Xie W. The Chain Mediating Effect of the Public's Online Health Information-Seeking Behavior on Doctor-Patient Interaction. Front Public Health 2022; 10:874495. [PMID: 35719674 PMCID: PMC9201044 DOI: 10.3389/fpubh.2022.874495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This paper aims to explore the influence mechanisms of online health information-seeking behavior (OHISB) on doctor-patient interactions from a psychological perspective, using theory as a guide, which can effectively guide the mode of doctor-patient interaction after search behavior in China. Methods We conducted a convenient web-based survey among members of the public who engage in searching behavior in China using a pretested structured questionnaire. Structural equation modeling was performed for path analysis and mediating effect testing. Results The findings of the study show that (1) 4 control variables (education level, occupation, income, and diagnosed disease) had significant differences in online health information-seeking behavior; 7 control variables (age, gender, living area, education level, occupation, income, medical insurance) were significantly different in doctor-patient interaction behaviors. (2) perceived disease severity (95% CI: 0.003, 0.04, P < 0.001), perceived action benefits (95% CI: 0.059, 0.138, P < 0.001), and e-health literacy (95% CI: 0.061, 0.155, P < 0.001) were positive predictors between OHISB and doctor-patient interactions. (2) E-health literacy and perceived disease severity (95% CI: 0.001, 0.013, P < 0.05), and e-health literacy and perceived action benefits (95% CI: 0.082, 0.166, P < 0.001) play chain mediating roles between OHISB and doctor-patient interactions. Conclusions E-health literacy, perceived disease severity, and perceived action benefits act as chain mediators between OHISB and doctor-patient interactions.
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Affiliation(s)
- Aijing Luo
- The Third Xiangya Hospital of Central South University, Changsha, China.,The Second Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research, College of Hunan Province, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Zhen Yu
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research, College of Hunan Province, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Fei Liu
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research, College of Hunan Province, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Wenzhao Xie
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research, College of Hunan Province, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
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8
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Jiang X, Hwang J, Su MH, Wagner MW, Shah D. Ideology and COVID-19 Vaccination Intention: Perceptual Mediators and Communication Moderators. JOURNAL OF HEALTH COMMUNICATION 2022; 27:416-426. [PMID: 36069353 DOI: 10.1080/10810730.2022.2117438] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Widespread COVID-19 vaccination is critical to slow the spread of the illness. This study investigates how political ideology is associated with COVID-19 vaccine intention via perceived effectiveness of the vaccine, perceived side effects, and perceived severity of the illness, three key aspects of the Health Belief Model (HBM). This study also examines how partisan information flow moderates the effects of ideology on these three HBM components. Using survey data collected from two battleground states in the 2020 election (N = 1849), regression, mediation and moderation analyses revealed that conservatives were less likely to intend to get vaccinated against COVID-19, and this association was significantly mediated by perceived effectiveness and perceived side effects of vaccination, as well as perceived severity of COVID-19. In addition, partisanship of news sources and discussion partners were significant moderators of ideology's association with perceived vaccine effectiveness, with conservatives viewing COVID-19 vaccination as less effective if they were frequently exposed to liberal news, and if they had frequent conversations with fellow conservatives. This suggests boomerang effects for cross-cutting mass media exposure, and reinforcement effect for interpersonal communication. Implications for efforts to promote COVID-19 vaccine uptake are discussed, including tailored and targeted campaign strategies.
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Affiliation(s)
- Xiaoya Jiang
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Juwon Hwang
- School of Media and Strategic Communications, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Min-Hsin Su
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michael W Wagner
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Dhavan Shah
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Willis E, Delbaere M. Patient Influencers: The Next Frontier in Direct-to-Consumer Pharmaceutical Marketing. J Med Internet Res 2022; 24:e29422. [PMID: 35230241 PMCID: PMC8924782 DOI: 10.2196/29422] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/22/2021] [Accepted: 12/16/2021] [Indexed: 01/26/2023] Open
Abstract
Social media influencers are becoming an increasingly popular strategic communication tactic used across industry verticals, including entertainment, fashion, and beauty, to engage directly with consumers. Pharmaceutical companies have also recently entered the social media marketing arena and—within the bounds of governmental regulations—have found ways to build relationships directly with patients using covert persuasion tactics like partnering with social media influencers. Due to consumers’ negative perceptions of pharmaceutical companies, it makes sense that new marketing tactics are being used to establish and improve relationships with consumers. Previous research well documents the ethical dilemmas of direct-to-consumer advertising, and there is recent burgeoning literature on online covert marketing tactics. The academic and medical literature, however, is behind in regard to social media influencers used in health and medicine. This paper highlights and defines terms used in industry practice, and also calls for more investigation and sets forward a research agenda. As consumers spend more time online and patients continue to consult social media for health information, it is important that this new marketing trend does not go unnoticed.
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Affiliation(s)
- Erin Willis
- Department of Advertising, Public Relations, and Media Design, University of Colorado Boulder, Boulder, CO, United States
| | - Marjorie Delbaere
- Edwards School of Business, University of Saskatchewan, Saskatoon, SK, Canada
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Chen H, Huang Q, Jiang M. Empowering Chinese College Students to Prevent Sexual Assault in Post-MeToo Era: An Empirical Study of the Bystander Intervention Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP449-NP472. [PMID: 32370581 DOI: 10.1177/0886260520917515] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
MeToo movement unveiled the high prevalence of sexual assault in Chinese colleges. To create a safer environment, many Chinese universities require students to engage in bystander intervention sessions, which encourages students to assess, identify, and interrupt the harmful situation. Drawing upon health belief model and theory of planned behavior, this study tests the effects of bystander intervention programs, exposure to news reports on MeToo movement, and institutional responses to sexual violence events on bystander intervention intention and behaviors. The results of an online survey (N = 814) indicated that bystander intervention programs were effective in changing attendees' perceived benefits, subjective norms, and bystander self-efficacy, which, in turn, led to increased bystander intervention intention and actual behaviors. Moreover, exposure to MeToo movement reports and institutional responses to sexual assault events were significant predictors of bystander intervention intention and behaviors via the mediation of perceived benefits, perceived costs, and subjective norms. The results provide valuable implications for developing effective bystander intervention programs in Chinese college communities.
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Palacios-Ceña D, Talavera B, Gómez-Mayordomo V, Garcia-Azorin D, Gallego-Gallego M, Cuadrado ML, Guerrero-Peral ÁL. Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain. BMJ Open 2021; 11:e048552. [PMID: 34404708 PMCID: PMC8372810 DOI: 10.1136/bmjopen-2020-048552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To explore the experiences of patients suffering from new daily persistent headache (NDPH) regarding the diagnostic process, treatment and medical care. DESIGN A qualitative phenomenological study was conducted. SETTING A specialised headache unit at two university hospitals in Spain between February 2017 and December 2018. PARTICIPANTS Patients diagnosed with NDPH according to the International Classification of Headache disorders (third beta edition). METHODS Purposeful sampling was performed. Data were collected using unstructured and semistructured interviews, researchers' field notes and patients' drawings. An inductive thematic analysis was used to identify significant emerging themes from interviews, field notes and descriptions of patients' drawings. Also, Guillemin's proposal was used to analyse the contents of drawings. RESULTS Nineteen patients with a mean age of 45.3 were recruited. Four main themes emerged: (1) Seeking a diagnosis, patients visit many doctors without receiving a clear answer and their diagnosis is delayed; (2) Self-medication-minimising pill intake, medication is ineffective, and therefore, some patients discontinue treatment, or are flexible with how they take medication; (3) Trying other non-pharmacological options, many patients turn to other therapies and complementary and/or alternative therapies as a second option, however these are ineffective and (4) Medical care, with two subthemes, referrals and lacking continuity of care, and building the doctor-patient relationship. Patients describe how the referral breaks the continuity of care, and how they identify the traits of a doctor who is approachable and which behaviours the doctor should avoid when caring for patients. CONCLUSIONS An in-depth knowledge of the beliefs and expectations of patients with NDPH will allow the professional to establish a relationship of trust, which will improve the patients' knowledge of which therapies are the most appropriate, and to establish expectations based on the relationship with the doctor, and not only on patients' beliefs.
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Affiliation(s)
- Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón/Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos, Alcorcón/ Madrid, Spain
| | - Blanca Talavera
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Víctor Gómez-Mayordomo
- Department of Neurology, Hospital Clínico San Carlos. Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - David Garcia-Azorin
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - María Luz Cuadrado
- Department of Neurology, Hospital Clínico San Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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De Las Cuevas C, Villasante-Tezanos AG, Motuca M, de Leon J. Effect of necessity-concern framework and polypharmacy on treatment adherence in psychiatric patients. Comparing an Argentinian with a Spanish sample. Hum Psychopharmacol 2021; 36:e2776. [PMID: 33508164 DOI: 10.1002/hup.2776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We aimed to replicate a prior Spanish study of medication adherence where logistic regression models provided highly significant odds ratios (ORs) for three continuous scores: necessity, concern and the necessity-concern differential, and a dichotomous variable: skeptical attitude. Adherence ORs in the necessity-concern framework were very strong in patients taking five or six medications. METHODS The sample comprised consecutive adult psychiatric outpatients in Mendoza, Argentina. The necessity-concerns framework was assessed using a subscale of the Beliefs about Medicines Questionnaire. Adherence (yes/no) to prescribed psychiatric medications was assessed by the Sidorkiewicz adherence tool. RESULTS When compared with the Spanish sample, the Argentinian group (508 patients with 875 medications) was characterized by: (1) significantly stronger adherence ORs with the necessity-concern framework, (2) significantly lower number of medications per patient and percentage of patients with marked psychiatric polypharmacy (≥4 medications), (3) though a higher number of medications still was significantly associated with poor adherence. CONCLUSIONS The Argentinian sample replicated the previous finding that patient beliefs regarding necessity and concern were associated with poor adherence to prescribed medications. Polypharmacy had an additive role decreasing adherence in both samples. In both samples, when prescribed ≥4 psychiatric medications, patients reported adherence to only two-third of the medications.
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Affiliation(s)
- Carlos De Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, San Cristóbal de La Laguna, Spain.,Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | | | - Mariano Motuca
- Center for Studies, Assistance and Research in Neurosciences, Instituto Vilapriño, Mendoza, Argentina
| | - Jose de Leon
- Mental Health Research Center at Eastern State Hospital, Lexington, Kentucky, USA.,Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apostol Hospital, University of the Basque Country, Vitoria, Spain
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13
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Fullerton MK, Rabb N, Mamidipaka S, Ungar L, Sloman SA. Evidence against risk as a motivating driver of COVID-19 preventive behaviors in the United States. J Health Psychol 2021; 27:2129-2146. [PMID: 34144644 DOI: 10.1177/13591053211024726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Does an individual's risk profile predict their social distancing and mask wearing in the U.S. during the COVID-19 pandemic? Common sense and some health behavior theories suggest that as a perceived threat increases, an individual should be more likely to take preventive measures. We explore this hypothesis using survey responses collected from 1114 U.S. adults during April and October 2020, and find that neither perceived nor actual risk predicted these preventive behaviors. Instead, being an essential worker, partisanship, and believing compliance was important were more reliable predictors. These results provide guidance for better pandemic response policies and challenge models of health behavior.
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Affiliation(s)
| | | | | | - Lyle Ungar
- University of Pennsylvania, Philadelphia, PA, USA
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Zhao Y, Zhang J, Wu M. Finding Users' Voice on Social Media: An Investigation of Online Support Groups for Autism-Affected Users on Facebook. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234804. [PMID: 31795451 PMCID: PMC6926495 DOI: 10.3390/ijerph16234804] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/24/2019] [Accepted: 11/27/2019] [Indexed: 11/16/2022]
Abstract
The trend towards the use of the Internet for health information purposes is rising. Utilization of various forms of social media has been a key interest in consumer health informatics (CHI). To reveal the information needs of autism-affected users, this study centers on the research of users' interactions and information sharing within autism communities on social media. It aims to understand how autism-affected users utilize support groups on Facebook by applying natural language process (NLP) techniques to unstructured health data in social media. An interactive visualization method (pyLDAvis) was employed to evaluate produced models and visualize the inter-topic distance maps. The revealed topics (e.g., parenting, education, behavior traits) identify issues that individuals with autism were concerned about on a daily basis and how they addressed such concerns in the form of group communication. In addition to general social support, disease-specific information, collective coping strategies, and emotional support were provided as well by group members based on similar personal experiences. This study concluded that Latent Dirichlet Allocation (LDA) is feasible and appropriated to derive topics (focus) from messages posted to the autism support groups on Facebook. The revealed topics help healthcare professionals (content providers) understand autism from users' perspectives and provide better patient communications.
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Affiliation(s)
- Yuehua Zhao
- School of Information Management, Jiangsu Key Laboratory of Data Engineering and Knowledge Service, Nanjing University, Nanjing 210023, China;
| | - Jin Zhang
- School of Information Studies, University of Wisconsin Milwaukee, Milwaukee, WI 53211, USA;
| | - Min Wu
- College of Health Sciences, University of Wisconsin Milwaukee, Milwaukee, WI 53211, USA
- Correspondence: ; Tel.: +1-414-229-4778
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