Self-care and illness response behaviors in a frontier area

Evaluation of a Community-Run and General-Practitioner-Supervised Self-Care for Minor Illnesses (CGPSC) Program in a Remote Area in Taiwan

Although Taiwanese citizens benefit from affordable health care, residents in remote areas extensively rely on unsafe self-care practices because of a lack of easy access to medical services. To improve self-care safety, ten easy-access self-care medical spots (ESCMSs) managed by trained residents were established in two remote villages. This study aimed to assess the impact of ESCMSs on self-care and access to medical services. For a total of six commonly experienced minor illnesses, the average number of illnesses for which residents were confident to perform self-care increased from 2.78 in the pretest to 3.58 in the post-test. ESCMSs were also the first choice when experiencing minor illnesses for 31.25% residents who did not visit a doctor. Residents' personal experience with ESCMSs correlated with their perception of ESCMSs' function. Compared with residents who had no personal experience of using ESCMSs, those who used the ESCMS service were less likely to store medications for minor illnesses at home (51.02% vs. 76.67%). Furthermore, those who attribute the reduced needs for professional help to ESCMSs had used medications for minor illnesses at ESCMSs. These results suggest that establishing ESCMSs is a viable alternative to increase the self-care capacity of residents in remote areas and increase the access to medical resources. Moreover, because residents are less likely to store medication and travel for professional help, ESCMSs could indirectly reduce the risks of self-medication and traffic accidents, respectively. However, caution should be exercised when generalizing these results to more populated areas that also lack medical resources.

Factors contributing to the use of complementary and alternative medicine in rural older women with chronic pain in South Korea

AIM

The aim of this study was to assess the prevalence of complementary and alternative medicines (CAM) use for managing pain and to investigate the factors predictive of current CAM use among rural older women in South Korea.

BACKGROUND

Access to medical care among older adults in rural areas is poorer than in urban areas.

METHODS

A cross-sectional descriptive study with a stratified sample of 139 women aged over 65 with chronic pain residing in rural areas of Jeju Island, South Korea. A self-reported questionnaire was used to collect data.

RESULTS

Most subjects reported using at least one type of CAM for relieving pain within the past 12 months. Almost half of them reported currently using CAM. Herbs were the most commonly used CAM. Only 'severity of pain' was presently associated with an increased use of CAM.

CONCLUSION

It is imperative to take socio-geographic-cultural factors into consideration when planning health promotion programs and caring for clients.

Establishing a community-run GP-supervised self-care program for minor illnesses in remote areas in Taiwan: an observational study

BACKGROUND

We implemented a community-run and GP-supervised self-care for minor illnesses (CGPSC) program in a mountainous area where medical resources for caring for minor illnesses were scarce. In this paper, we reported the residents' experiences and evaluations of this program.

METHODS

The CGPSC program was implemented through easy-access self-care medical spots (ESCMSs) that were set up in the community with following services: non-prescription medications for minor illness (MMI) service, materials for caring for minor injuries, pamphlet on self-care for minor illnesses and minor injuries and medical consultation line. Ten selected residents were trained to run the ESCMSs. All services were supervised by the GP in charge. Nine months after the opening of the ESCMSs, a survey was conducted to evaluate residents' reactions to it.

RESULTS

Eighty per cent (n = 80) of the respondents were aware of the existence of the ESCMSs, and the MMI service was known to most residents and most utilized by them. Compared to respondents who had not used the MMI service (n = 30), those who had used the service (n = 50) considered the ESCMSs more helpful (90.00% versus 76.67%, P < 0.05) and had greater willingness to seek help from the ESCMS in the future (88.00% versus 56.67%, P < 0.01).

CONCLUSIONS

The collaborative efforts of the communities and the medical staff had made the ESCMS a safe, convenient and user-friendly resource to self-care for residents in a rural area. Under the supervision of the GP, trained community residents were able to run the ESCMS smoothly and efficiently.

Self medication for oral health problems in Cameroon

OBJECTIVE

To assess the use of self medication in oral health problems in Cameroon.

METHODS

This multi-regional cross-sectional survey was conducted in three towns; Bamenda, Yaounde and Buea over a 10 month period. The questionnaire elicited information on demography, oral problem for self medication, substance used for self medication, source of the substance, duration of self medication, reason for self medication, source of advice of the drugs or those products used, opinion about the substance, effect and duration.

RESULTS

The prevalence of self medication for oral health problems was 67.8% which was significantly associated with age, marital status and location. The most frequently self medicated oral health problem was toothache (54.7%). The majority (64.5%) of the respondents used pharmaceutical products while a minority (7.7%) used dangerous substances such as petrol and vinegar for self medication. Sources of substances of self medication included pharmacy (55.6%), road side vendors (26.1%), native healers (7.8%), mobile drug vendors in buses (5.3%), and others (5.3%). The choice of substances used for self medication was mostly guided by the advice from relatives.

CONCLUSION

The majority of the respondents self-medicated for oral health problems. Unmarried, urban residents, aged 21-30 years reported significantly increased self-medication for oral health problems. Evidently dangerous substances were utilised for self-medication in this study, necessitating awareness and other forms of intervention.

Predictors of Use of Complementary and Alternative Therapies Among Patients With Cancer

PURPOSE/OBJECTIVES

To determine predictors of use of complementary and alternative medicine (CAM) therapies among patients with cancer.

DESIGN

Secondary analysis of two federally funded panel studies.

SETTING

Urban and rural communities in the midwestern United States.

SAMPLE

Patients with lung, breast, colon, or prostate cancer (N = 968) were interviewed at two points in time. 97% received conventional cancer treatment, and 30% used CAM. The sample was divided evenly between men and women, who ranged in age from 28-98; the majority was older than 60.

METHODS

Data from a patient self-administered questionnaire were used to determine CAM users. Responses indicated use of herbs and vitamins, spiritual healing, relaxation, massage, acupuncture, energy healing, hypnosis, therapeutic spas, lifestyle diets, audio or videotapes, medication wraps, and osteopathic, homeopathic, and chiropractic treatment.

MAIN RESEARCH VARIABLES

Dependent variable for analysis was use or nonuse of any of the identified CAM therapies at time of interviews. Independent variables fell into the following categories: (a) predisposing (e.g., gender, age, race, education, marital status), (b) enabling (e.g., income, health insurance status, caregiver presence, geographic location), and (c) need (e.g., cancer stage, site, symptoms, treatment, perceived health need).

FINDINGS

Significant predictors of CAM use were gender, marital status, cancer stage, cancer treatment, and number of severe symptoms experienced.

CONCLUSIONS

Patients with cancer are using CAM while undergoing conventional cancer treatment.

IMPLICATIONS FOR NURSING

Nurses need to assess for CAM use, advocate for protocols and guidelines for routine assessment, increase knowledge of CAM, and examine coordination of services between conventional medicine and CAM to maximize positive patient outcomes.

Self-treatment of pain in a rural area

CONTEXT

In the United States, 42% of adults say they experience pain daily, the majority often relying on self-treatment. In addition, an increasing number of people are seeking complementary/alternative therapies, often without informing their health care providers.

PURPOSE

To explore the occurrence of pain and the modalities of self-treatment used by community members (N = 108) from a rural area of Michigan, the potential for interactions between pain self-treatment modalities and other medications currently being taken, and demographic variables that might affect self-treatment choice.

METHOD

This exploratory descriptive study was conducted using a survey method.

FINDINGS

Findings revealed that 66% were taking prescription medications, 75% over-the-counter medications, 20% herbal supplements, and 35% nonpharmacological treatments. Of the reported prescription and over-the-counter medications, 18% were opioids, 77% were nonopioids, and 18% were adjuvant medications. One-third of the subjects were taking more than 1 medication and/or herbal product or supplement, increasing their risk for potential drug-herb interactions, complicated by the fact that 20% did not inform their primary care practitioner of their self-treatment choices.

CONCLUSIONS

This study contributes to the knowledge of current self-treatment choices regarding pain management and potentially harmful interactions that might occur from using multiple medications and supplements.

Daily symptoms and responses in adults: a review

Healthy adults experience a variety of symptoms and health problems each day and the responses to these symptoms and problems vary significantly from doing nothing to consulting professional help. Patterns of daily symptoms for well adults, the symptom experience, and responses to daily symptoms are reviewed. Nurses and other health care professionals must be aware of the dynamic process of symptom identification, monitoring, lay and professional consultation, and decision making to facilitate client's health promotion and disease prevention efforts.

An ecological view of the rural environment: levels of influence on access to health care

Access to health care has diminished for rural Americans due in part to a record number of rural hospital closures. Hospitals have served as the infrastructure of rural health care. When hospitals close, other health services and providers are frequently lost. Adequate access to health care is one determinant of health. An ecological perspective on environment reveals multiple levels of influence that support or do not support access to rural health care. Implications for nursing science and practice involving all levels of environment are suggested by an ecological view.

Anticipated response to three common injuries by rural and remote area residents

Three progressively worsening injury scenarios were used to determine the influence of distance from medical services on the anticipated illness behaviour of rural and remote area residents. A total of 801 householders were interviewed in two rural areas of Queensland, Australia (320 in a coastal area and 481 in an inland area). There was a consistent trend with distance of decreasing willingness to seek immediate care at each injury stage. As the severity of each scenario increased, there was a convergence in anticipated action. Inland area respondents were less likely to seek medical care at each stage of the injuries than coastal area respondents. Distant respondents were more likely to telephone for medical advice before seeking care. When this was taken into account, there was less difference in anticipated action by distance, although those further from medical services still indicated a propensity to delay action in the less serious injuries.

When your client lives in a rural area. Part I: Rural health care delivery issues

In the past 2 years there has been increased emphasis on health care delivery concerns in rural environments. Research monies also target the health care needs of vulnerable populations living in areas with a shortage of health professionals; many of these populations are located in rural areas. There is, however, a paucity of information about populations and mental health nursing in rural environment. Part I of this two-part article summarizes pertinent definitions and characteristics of rural environments. The health care delivery system in rural settings is considered within a framework of availability, accessibility, and acceptability of services. Traditional belief systems are highlighted, and the impact of these on health care-seeking behaviors of rural people are discussed.