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Mkhailef Hawi Al-Tameemi M, Bahmanpour K, Mohamadi-Bolbanabad A, Moradi Y, Moradi G. Insights into determinants of health-seeking behavior: a cross-sectional investigation in the Iraqi context. Front Public Health 2024; 12:1367088. [PMID: 39005995 PMCID: PMC11242369 DOI: 10.3389/fpubh.2024.1367088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/11/2024] [Indexed: 07/16/2024] Open
Abstract
Background Health-seeking behavior (HSB) is a choice taken by an individual to maintain, achieve, or restore good health and prevent diseases. The purpose of this study is to examine the determinants of HSB among the Iraqi population. Methods This cross-sectional study in the Rusafa and Karkh districts of Baghdad investigated determinants of HSB from 2022 to 2023. With a sample size of 993 participants meeting inclusion criteria, data were collected through a self-reported questionnaire, utilizing four indicators to measure HSB. The study employed various statistical methods especially logistic regression models, facilitated by Stata 17 software. Results Results highlights that married individuals consistently have higher odds of having HSB compared to their single counterparts, with an odds ratio (OR) of 2.09 (95% confidence interval: 1.41-3.10). This relationship remains robust even after controlling for other variables. Furthermore, individuals with higher social class exhibit stronger connections to HSB, although the OR is 1.69 (95% CI: 0.47-6.13), indicating a wide confidence interval. Regarding underlying diseases and their duration, the results indicate that chronic diseases are associated with a higher likelihood of HSB, with an OR of 2.05 (95% CI: 1.35-3.11). Additionally, a longer duration of diseases in terms of years is also linked to a stronger association with HSB, with an OR of 2.86 (95% CI: 1.32-6.23). Conclusion In conclusion, this work provides important insights into HSB. Married people are continuously more likely to engage in HSB than single people, highlighting the importance of customized interventions. Furthermore, persons from higher social classes have stronger ties to HSB, highlighting the importance of socioeconomic considerations. The link between HSB and chronic diseases, combined with longer disease durations, emphasizes the importance of early detection and thorough healthcare management. These findings give critical guidance for healthcare providers, marketers, and politicians developing effective initiatives to promote HSB.
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Affiliation(s)
- Mohammed Mkhailef Hawi Al-Tameemi
- Department of Health Care Management, School of Medical Sciences and Technologies Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Kaveh Bahmanpour
- Department of Nursing, School of Medical Sciences, Islamic Azad University, Sanandaj, Iran
| | - Amjad Mohamadi-Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Agot K, Onyango J, Otieno G, Musingila P, Gachau S, Ochillo M, Grund J, Joseph R, Mboya E, Ohaga S, Omondi D, Odoyo-June E. Shifting reasons for older men remaining uncircumcised: Findings from a pre- and post-demand creation intervention among men aged 25-39 years in western Kenya. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003188. [PMID: 38820408 PMCID: PMC11142559 DOI: 10.1371/journal.pgph.0003188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 04/04/2024] [Indexed: 06/02/2024]
Abstract
Voluntary medical male circumcision (VMMC) reduces men's risk of acquiring Human immunodeficiency virus (HIV) through vaginal sex. However, VMMC uptake remains lowest among Kenyan men ages 25-39 years among whom the impact on reducing population-level HIV incidence was estimated to be greatest at the start of the study in 2014. We conducted a pre- and post-intervention survey as part of a cluster randomized controlled trial to determine the effect of two interventions (interpersonal communication (IPC) and dedicated service outlets (DSO), delivered individually or together) on improving VMMC uptake among men ages 25-39 years in western Kenya between 2014 and 2016. The study had three intervention arms and a control arm. In arm one, an IPC toolkit was used to address barriers to VMMC. In arm two, men were referred to DSO that were modified to address their preferences. Arm three combined the IPC and DSO. The control arm had standard of care. At baseline, uncircumcised men ranked the top three reasons for remaining uncircumcised. An IPC demand creation toolkit was used to address the identified barriers and men were referred for VMMC at study-designated facilities. At follow-up, those who remained uncircumcised were again asked to rank the top three reasons for not getting circumcised. There was inconsistency in ranking of reported barriers at pre- and post- intervention: 'time/venue not convenient' was ranked third at baseline and seventh at follow-up; 'too busy to go for circumcision' was tenth at baseline but second at follow-up, and concern about 'what I/family will eat' was ranked first at both baseline and follow-up, but the proportion reduced from 62% to 28%. Men ages 25-39 years cited a variety of logistical and psychosocial barriers to receiving VMMC. After exposure to IPC, most of these barriers shifted while some remained the same. Additional innovative interventions to address on-going and shifting barriers may help improve VMMC uptake among older men.
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Affiliation(s)
- Kawango Agot
- Impact Research and Development Organization, Kisumu, Kenya
| | - Jacob Onyango
- Impact Research and Development Organization, Kisumu, Kenya
| | - George Otieno
- Center for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Paul Musingila
- Division of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Susan Gachau
- Division of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya
| | | | - Jonathan Grund
- Division of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Rachael Joseph
- Division of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Edward Mboya
- Impact Research and Development Organization, Kisumu, Kenya
| | - Spala Ohaga
- Impact Research and Development Organization, Kisumu, Kenya
| | - Dickens Omondi
- Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Elijah Odoyo-June
- Division of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya
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Musonda E, Mumba P, Malungo JRS. Mortality from non-communicable diseases and associated risk factors in Zambia; analysis of the sample vital registration with verbal autopsy 2015/2016. BMC Public Health 2024; 24:666. [PMID: 38429671 PMCID: PMC10908156 DOI: 10.1186/s12889-024-18150-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are the world's growing cause of preventable illness, disability, morbidity, and mortality which account for 71% of deaths. The aim of this study was to determine the factors associated with mortality from NCDs among persons aged 15 years and above in Zambia. METHODOLOGY The study used data from Sample Vital Registration with Verbal Autopsy (SAVVY) 2015/16 (Zambia). A total of 3529 Verbal Autopsy were completed in the study, with only 2599 of death where among people aged 15 years and above. Three-level data analysis was applied; univariate analysis, bivariate analysis, and multivariate analysis (binary logistic regression). FINDINGS The overall number of deaths from NCDs was 28.81%. Stratified analysis by gender showed that deaths from NCDs were higher among women (32.60%) as compared to men (26.25%). Among all persons, dying from NCDs was associated with tobacco use, age, and education. Tobacco use was negatively associated with mortality from NCDs (adjusted odds ratio [aOR] = 0.68; 95% confidence interval [CI]: 0.48-0.98). Age was positively associated with the odds of dying from NCDs among persons aged 45-59 years (aOR = 3.87, 95% CI: 2.13-7.01), 60-74 years (aOR = 12.05, 95% CI: 6.44-22.55), and 75 + years (aOR = 15.16, 95% CI: 7.93-28.97). The likelihood of dying from NCDs was higher among persons with secondary education as compared to those with no education (aOR = 1.93, 95% CI: 1.11-3.33). CONCLUSION The findings from this study suggest that public health interventions targeting NCDs need to consider behavioural factors, especially tobacco use which exposes people to second-hand smoke. We also recommend large-scale national-level studies to further examine the contribution of each factor leading to mortality from NCDs.
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Affiliation(s)
- Emmanuel Musonda
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
| | - Peter Mumba
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Jacob R S Malungo
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Bryski MG, Azad CL, Etchill EW, Rhee DS. Global Disparities in Burn Outcomes: Does Gender Predict Mortality in the Global Burn Registry? J Surg Res 2023; 283:459-468. [PMID: 36434842 DOI: 10.1016/j.jss.2022.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/02/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Global burn injury burden disproportionately impacts low- and middle-income countries. Surgery is a mainstay of burn treatment, yet access to surgical care appears to be inequitably distributed for women. This study sought to identify gender disparities in mortality and access to surgery for burn patients in the World Health Organization Global Burn Registry (GBR). METHODS We queried the World Health Organization GBR for a retrospective cohort (2016-2021). Patients were stratified by sex. Outcomes of interest were in-hospital mortality and surgical treatment. Patient demographics, injury characteristics, outcomes, and health facility resources were compared between sexes with Wilcoxon rank sum test for nonparametric medians, and chi-squared or Fisher's exact test for nonparametric proportions. Multivariable logistic regressions were performed to assess the relationships between sex and mortality, and sex and surgery. RESULTS Of 8445 patients in the GBR from 20 countries (10 low resource), 40% of patients were female, with 51% of all patients receiving surgical treatment during their hospitalization. Female patients had a higher incidence of mortality (24% versus 15%, P < 0.001) and a higher median total body surface area (20% versus 15%, P < 0.001), yet a lower incidence of surgery (47% versus 53%, P < 0.001) following burn injury when compared to males. In multivariable analysis, female sex was independently associated with mortality after controlling for age, time to presentation, smoke injury, percent total body surface area, surgery, and country income status. Female sex was independently associated with surgical care (odds ratio 0.86, P = 0.001). CONCLUSIONS Female burn patients suffer higher mortality compared to males and are less likely to receive surgery. Further study into this gender disparity in burns is warranted.
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Affiliation(s)
| | - Chao Long Azad
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eric W Etchill
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel S Rhee
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Maximiano-Barreto MA, Alves LCDS, Monteiro DQ, Gratão ACM, Pavarini SCI, Luchesi BM, Chagas MHN. Cultural factors associated with burden in unpaid caregivers of older adults: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3629-e3642. [PMID: 36069278 DOI: 10.1111/hsc.14003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/21/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
The aim of the present systematic review was to investigate cultural factors associated with burden in unpaid caregivers of older adults. Searches were conducted in the Pubmed, Web of Science, PsycInfo, Scopus, Embase, LILACs and SciELO databases for relevant articles published in English, Portuguese and Spanish using the search terms 'Caregiver AND Culture AND (Burnout OR Caregiver Burden) AND Aged'. No restriction was imposed regarding year of publication. A total of 1234 articles were identified, 34 of which were selected for the present review. The following sociodemographic characteristics were associated with burden: being female, married, White caregivers, young and the spouse of the care recipient; having no siblings; having low schooling and low economic status. Cultural factors associated with burden were living with the care recipient, not professing a religion or having little spirituality, familism (i.e. less reciprocity) and an absence of social support. The present findings underscore the importance of developing intervention strategies that consider cultural factors to minimise the negative impacts of care on unpaid caregivers of older adults.
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Affiliation(s)
| | | | | | - Aline Cristina Martins Gratão
- Nursing Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Gerontology Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Sofia Cristina Iost Pavarini
- Nursing Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Gerontology Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bruna Moretti Luchesi
- Três Lagoas Campus, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | - Marcos Hortes Nisihara Chagas
- Psychology Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Bairral Institute of Psychiatry, Itapira, SP, Brazil
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Comparison of standard automotive industry injury predictors and actual injury sustained during significant whiplash events. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:3043-3058. [PMID: 33977348 DOI: 10.1007/s00586-021-06851-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE We present a unique opportunity to compare standard neck injury criteria (used by the automotive industry to predict injury) with real-life injuries. The injuries sustained during, and the overall kinematics of, a television demonstration of whiplash mechanics were used to inform and validate a vertebral level model of neck mechanics to examine the relevance of current injury criteria used by the automotive industry. METHODS Frontal and rear impact pulses, obtained from videos of sled motion, were used to drive a MADYMO human model to generate detailed segmental level biomechanics. The maximum amplitude of the frontal and rear crash pulses was 166 ms-2 and 196 ms-2, respectively, both with a duration of 0.137 s. The MADYMO model was used to predict standard automotive neck injury criteria as well as detailed mechanics of each cervical segment. RESULTS Whilst the subject suffered significant upper neck injuries, these were not predicted by conventional upper neck injury criteria (Nij and Nkm). However, the model did predict anterior accelerations of C1 and C2 of 40 g, which is 5 times higher than the threshold of the acceleration for alar ligament injury. Similarly, excessive anterior shear displacement (15 mm) of the skull relative to C2 was predicted. Predictions of NIC, an injury criterion relevant to the lower neck, as well as maximum flexion angles for the lower cervical segments (C3-T1) exceeded injury thresholds. CONCLUSION The criteria used by the automotive industry as standard surrogates for upper neck injury (Nij and Nkm) did not predict the significant cranio-cervical junction injury observed clinically.
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Readmission after epilepsy monitoring unit discharge in a nationally representative sample. Epilepsy Res 2021; 174:106670. [PMID: 34051574 DOI: 10.1016/j.eplepsyres.2021.106670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/22/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the 30-day readmission rate after Epilepsy Monitoring Unit (EMU) discharge in a nationally representative sample, as well as patient, clinical, and hospital characteristics associated with readmission. METHODS This is a retrospective cohort study of adults discharged from an elective hospitalization with continuous video electroencephalography (vEEG) monitoring, sampled from the Healthcare Cost and Utilization Project's 2014 Nationwide Readmissions Database. Descriptive statistics were used to quantify and characterize readmission within 30 days and logistic regression models were built to examine factors associated with readmission. RESULTS 6869 admissions met inclusion criteria, with 292 people (4.2 %) readmitted within 30 days. 79.5 % (n = 232/292) of all readmissions were non-elective. Patient characteristics associated with readmission included a higher Elixhauser comorbidity score [adjusted odds ratio (AOR) 1.03, 95 % confidence interval (CI) 1.02-1.04 per 1 point increase in Elixhauser score], a longer length of stay [AOR 1.05, 95 % CI 1.02-1.09 per one day increase in length], non-routine discharge [AOR 1.85, 95 %CI 102-3.38], and comorbid brain tumor diagnosis [AOR 2.55, 95 %CI 1.46-4.46]. Female sex was inversely associated with 30-day readmission [AOR 0.68, 95 % CI 0.54-0.85]. The most common reason for readmission was epilepsy or convulsion (27.6 %), followed by sepsis (5.8 %) and complications of surgical procedures or medical care (5.5 %). CONCLUSIONS Patients electively admitted for continuous vEEG monitoring are infrequently readmitted. These data provide a preliminary national readmission benchmark for patients with elective admissions for vEEG monitoring.
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Umoke PCI, Umoke M, Eyo N, Ugwu Mbbs A, Okeke E, Nwalieji CA, Agbaje SO, Onwe RN, Ekeh DO, Umoke UG, Agu MN, Okide CC. Delay in health-seeking behaviour: Implication to yellow fever outcome in the 2019 outbreak in Nigeria. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:703-711. [PMID: 33761167 DOI: 10.1111/hsc.13329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/26/2020] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
Yellow fever is a vaccine-preventable acute viral disease that can rapidly spread and cause serious public health impact. Delay in seeking health care from health facilities is a potential risk of prolonged disease spread. Therefore, this study assessed the delay in health-seeking behaviour and implications for yellow fever outcomes in the 2019 outbreak in Nigeria. Furthermore, the study examined the factors associated with delayed yellow fever vaccine uptake. A retrospective study was conducted from January to December 2019 using 137 cases recorded in the WHO database. The data were analysed using descriptive (frequency and percentages) and the Chi-square test. The results were significant at p < 0.05. Results showed a low uptake of yellow fever vaccine (24.1%) among patients and a median total health-seeking delay of 7 [IQR 7, 9] days. The delay was more among the older age ≥40 years (12 [IQR 12, 29]), females (8 [IQR 8, 11], and rural inhabitants 7 [IQR7, 9], particularly in Izzi LGA (9 [IQR 9, 16] than the other subgroups. Patients' location or place of residence was significantly associated with the yellow fever vaccine uptake (p < 0.000*), and delay (p = 0.003*). Conclusively, the low vaccine uptake was due to the delay in health-seeking behaviour. Thus, the healthcare system in Nigeria needs to intensify mass participation in immunisation programmes. Interventions that promote behavioural change towards immunisation are required. Also, health promotion campaigns to educate rural people on desirable health-seeking behaviour are needed.
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Affiliation(s)
- Prince C I Umoke
- Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Nigeria
| | - MaryJoy Umoke
- School Health Programme Unit, Department of Public Health, Ebonyi State Ministry of Health, Abakaliki, Nigeria
| | | | | | | | - Chioma A Nwalieji
- School Health Programme Unit, Department of Public Health, Ebonyi State Ministry of Health, Abakaliki, Nigeria
| | - Samson O Agbaje
- Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Nigeria
| | - Rosemary N Onwe
- Department of Economics, Ebonyi State University, Abakaliki, Nigeria
| | - David O Ekeh
- Education Foundation, Alex Ekwueme Federal University NdufuAlike, Ikwo, Nigeria
| | - Ugochi G Umoke
- University of Nigeria Teaching Hospital, Ituku Ozalla, Nigeria
| | - Martins N Agu
- Ananda Marga Universal Relief Team Foundation, Abakaliki, Nigeria
| | - Charity C Okide
- Department of Adult Education and Extramural Studies, University of Nigeria, Nsukka, Nigeria
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Oluseyi Akande K, Oke TO, Afuwape O, Adigun TA, Akere A, Aje A, Ola SO, Otegbayo JA. Spectrum and pattern of distribution of findings in patients with dyspepsia undergoing oesophago-gastro-duodenoscopy at a Tertiary Hospital in Ibadan, south west, Nigeria. ALEXANDRIA JOURNAL OF MEDICINE 2021. [DOI: 10.1080/20905068.2021.1913890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022] Open
Affiliation(s)
- Kolawole Oluseyi Akande
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
| | - Temitope Olufemi Oke
- Department of Medicine, Gastroenterology & Hepatology Unit, University College Hospital, Ibadan, Nigeria
| | - Oludolapo Afuwape
- Department of Surgery, College of Medicine, Division of Gastrointestinal Surgery, University of Ibadan, Ibadan, Nigeria
| | | | - Adegboyega Akere
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
| | - Ajibola Aje
- Department of Medicine, Gastroenterology & Hepatology Unit, University College Hospital, Ibadan, Nigeria
| | - Samuel Olawale Ola
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
| | - Jesse Abiodun Otegbayo
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
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Osman AF, Abdul Mutalib M, Tafran K, Tumin M, Chong CS. Demographic and Socioeconomic Variables Associated With Health Care-Seeking Behavior Among Foreign Workers in Malaysia. Asia Pac J Public Health 2020; 32:42-48. [PMID: 31924113 DOI: 10.1177/1010539519893801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Foreign workers in Malaysia face various barriers in accessing health care, which results in many of them being unable to obtain appropriate medical treatment in case of sickness. This study investigates the foreign workers' health care-seeking behavior and the demographic and socioeconomic variables that influence it. Data were collected from 502 foreign workers using a self-administered questionnaire. Multiple logistic regression was used to estimate the influence of demographic and socioeconomic variables on health care-seeking behavior among foreign workers. In cases of severe sickness, 20.5% of foreign workers stated that they will not go or are unlikely to go to a clinic or hospital. The multiple logistic regression revealed that foreign workers' tendency to avoid medical treatment is associated with gender, marital status, monthly income, preferred language of communication, and work classification. Nonetheless, in cases of mild sickness, demographic and socioeconomic variables do not influence foreign workers' health care-seeking behavior.
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Kouchakinejad-Eramsadati L, Khodadadi-Hassankiadeh N, Rad E, Hajizadeh M, Rezaei S, Heydari H. Explaining gender differences in transfer time to a trauma center in Northern Iran. ARCHIVES OF TRAUMA RESEARCH 2020. [DOI: 10.4103/atr.atr_2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Madhavan S, Bullis E, Myers R, Zhou CJ, Cai EM, Sharma A, Bhatia S, Orlando LA, Haga SB. Awareness of family health history in a predominantly young adult population. PLoS One 2019; 14:e0224283. [PMID: 31652289 PMCID: PMC6814221 DOI: 10.1371/journal.pone.0224283] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022] Open
Abstract
Family health history (FHH) is a key predictor of health risk and is universally important in preventive care. However, patients may not be aware of the importance of FHH, and thus, may fail to accurately or completely share FHH with health providers, thereby limiting its utility. In this study, we conducted an online survey of 294 young adults and employees based at a US university setting regarding their knowledge, sharing behaviors, and perceived importance of FHH, and use of electronic clinical tools to document and update FHH. We also evaluated two educational interventions (written and video) to promote knowledge about FHH and its importance to health. We found that 93% of respondents were highly aware of their FHH, though only 39% reported collecting it and 4% using an online FHH tool. Seventy-three percent of respondents, particularly women, had shared FHH with their doctor when prompted, and fewer had shared it with family members. Participants in the video group were significantly more likely to understand the benefits of FHH than those in the written group (p = 0.02). In summary, educational resources, either video or written, will be helpful to promote FHH collection, sharing, and use of online FHH tools.
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Affiliation(s)
- Sarina Madhavan
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Emily Bullis
- Duke University, Initiative for Society and Society, Durham, North Carolina, United States of America
| | - Rachel Myers
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Chris J. Zhou
- Duke University, Pratt School of Engineering, Durham, North Carolina, United States of America
| | - Elise M. Cai
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Anu Sharma
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Shreya Bhatia
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Lori A. Orlando
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Susanne B. Haga
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
- * E-mail:
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Tenenbaum A, Nordeman L, Sunnerhagen KS, Gunnarsson R. A risk stratification tool for prehospital triage of patients exposed to a whiplash trauma. PLoS One 2019; 14:e0216694. [PMID: 31086405 PMCID: PMC6516661 DOI: 10.1371/journal.pone.0216694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 04/26/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Our aim was to develop a risk stratification model to predict the presence of a potentially more sinister injury in patients exposed to a whiplash trauma. METHODS The study base comprised of 3,115 residents who first sought healthcare contact within one week after being exposed to a whiplash trauma between 1999-2008, from within a defined geographical area, Skaraborg County in south-western Sweden. Information about gender, age, time elapsed prior to seeking care, type of health care contact, and hospitalisation was retrieved. Seventeen potential risk factors were identified and evaluated using multivariable logistic regression. RESULTS Of 3,115 patients, 215 (6.9%) required hospital admission so theoretically 93% could have been initially assessed by primary health care. However, only 46% had their first contact in primary health care. All patients had symptoms resulting in a diagnosis of whiplash injury. Four risk factors were found to be associated with hospital admission: commotio cerebri (OR 31, 19-51), fracture / luxation (OR 11, 5.1-22), serious injury (OR 41, 8.0-210), and the patient sought care during the same day as the trauma (OR 5.9, 3.7-9.5). These four risk factors explained 27% of the variation for hospital admission and the area under curve (AUC) was 0.77 (0.74-0.80). Ninety-six percent of patients (2,985) had only a whiplash injury with no other injury. These could be split into those attending health care the same day as the trauma, 1,737 (56%) with a 7.1% risk for hospital admission, and those attending health care later, 1,248 (40%) with a 1.3% risk for hospital admission. CONCLUSION Patients with no signs of commotio cerebri, no fracture/luxation injury, no serious injury, comprising 96% of all patients exposed to a whiplash trauma can initially be referred to primary health care for initial assessment. However, those contacting the health care the same day as the trauma should be referred to a hospital for evaluation if they can't get an appointment with a general practitioner the same day.
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Affiliation(s)
- Artur Tenenbaum
- Hälsan & Arbetslivet, Occupational Health Care Unit, Region Västra Götaland, Alingsås, Sweden
- Department of Public Health and Community Medicine Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Nordeman
- Research and Development Center Södra Älvsborg, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg, Gothenburg, Sweden
| | - Katharina S. Sunnerhagen
- Institute of Clinical Neuroscience—Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ronny Gunnarsson
- Department of Public Health and Community Medicine Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Center Södra Älvsborg, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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Agyemang-Duah W, Peprah C, Arthur-Holmes F. Prevalence and Patterns of Health Care Use Among Poor Older People Under the Livelihood Empowerment Against Poverty Program in the Atwima Nwabiagya District of Ghana. Gerontol Geriatr Med 2019; 5:2333721419855455. [PMID: 31263740 PMCID: PMC6595647 DOI: 10.1177/2333721419855455] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/13/2019] [Accepted: 05/15/2019] [Indexed: 01/11/2023] Open
Abstract
In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations' health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 (N = 200). Chi-square and Fisher's exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.
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Affiliation(s)
| | - Charles Peprah
- Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | - Francis Arthur-Holmes
- Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
- Department of International Development, University of Oxford, Oxford, UK
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15
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Marczak J, Rembeck G, Petersson EL, Nordeman L. Patient experiences of living with chronic leg ulcers and making the decision to seek professional health-care. J Wound Care 2019; 28:S18-S25. [PMID: 30724122 DOI: 10.12968/jowc.2019.28.sup1.s18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE: The aim of the study was to elucidate how patients experience living with chronic leg ulcers before consulting a health professional, and to determine the reasons behind the decision to visit a health-care centre. METHOD: A qualitative interview study was carried out. There were 11 participants, five men and six women (age range: 27-83 years old). All participants in the study were patients visiting the public primary medical centre in western Sweden for the first time for a chronic leg ulcer. The data was obtained by recorded interviews. Systematic text condensation (STC) by Malterud was applied to the analysis. RESULTS: The analysis identified five main categories of the issues relating to ulcers to their ulcers: convictions, pain, emotions, strategies, and health-care treatment. At first, patients accepted the inconvenience of a leg ulcer. Gradually, they focused more on strategies dealing with the ulcer, and withdrew from their social context, while their fears increased. Many needed support in the decision to seek professional care. CONCLUSION: Despite pain, anxiety, emotional lability, and disappointment, they had strategies to cope with ulcers on their own. A social network seems crucial for the decision to seek professional health care and greater knowledge of leg ulcers, particularly in the elderly population, is needed.
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Affiliation(s)
| | - Gun Rembeck
- Midwife; Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Närhälsan Borås Youth Health Centre Region Västra Götaland, Sweden; and Research and Development Center Södra Älvsborg, Närhälsan Research and Development, Primary Health Care Region Västra Götaland, Sweden
| | - Eva-Lisa Petersson
- Occupational therapist; Närhälsan, Research and Development Primary Health Care Region Västra, Götaland Research, Development Center Gothenburg and South Bohuslän, Sweden; and Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Nordeman
- Physiotherapist; Research and Development Center Södra Älvsborg, Närhälsan Research and Development, Primary Health Care Region Västra Götaland, Sweden; and University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, Sweden
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16
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Giummarra MJ, Black O, Smith P, Collie A, Hassani-Mahmooei B, Arnold CA, Gong J, Gabbe BJ. A population-based study of treated mental health and persistent pain conditions after transport injury. Injury 2018; 49:1787-1795. [PMID: 30154021 DOI: 10.1016/j.injury.2018.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Persistent pain and mental health conditions often co-occur after injury, cause enormous disability, reduce social and economic participation, and increase long-term healthcare costs. This study aimed to characterise the incidence, profile and healthcare cost implications for people who have a treated mental health condition, persistent pain, or both conditions, after compensable transport injury. METHODS The study comprised a population cohort of people who sustained a transport injury (n = 74,217) between 2008 to 2013 and had an accepted claim in the no-fault transport compensation system in Victoria, Australia. Data included demographic and injury characteristics, and payments for treatment and income replacement from the Compensation Research Database. Treated conditions were identified from 3 to 24-months postinjury using payment-based criteria developed with clinical and compensation system experts. Criteria included medications for pain, anxiety, depression or psychosis, and services from physiotherapists, psychologists, psychiatrists, and pain specialists. The data were analysed with Cox Proportional Hazards regression to examine rates of treated conditions, and general linear regression to estimate 24 month healthcare costs. RESULTS Overall, the incidence of treated mental health conditions (n = 2459, 3.3%) and persistent pain (n = 4708, 6.3%) was low, but rates were higher in those who were female, middle aged (35-64 years), living in metropolitan areas or neighbourhoods with high socioeconomic disadvantage, and for people who had a more severe injury. Healthcare costs totalled more than $A707 M, and people with one or both conditions (7.7%) had healthcare costs up to 7-fold higher (adjusting for demographic and injury characteristics) in the first 24 months postinjury than those with neither condition. CONCLUSIONS The incidence of treated mental health and persistent pain conditions was low, but the total healthcare costs for people with treated conditions were markedly higher than for people without either treated condition. While linkage with other public records of treatment was not possible, the true incidence of treated conditions is likely to be even higher than that found in this study. The present findings can be used to prioritise the implementation of timely access to treatment to prevent or attenuate the severity of pain and mental health conditions after transport injury.
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Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia; Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia.
| | - Oliver Black
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Smith
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Institute for Work and Health, Toronto, Ontario, Canada
| | - Alex Collie
- Insurance, Work and Health Group, Monash University, Melbourne, Victoria, Australia
| | | | - Carolyn A Arnold
- Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia; Academic Board of Anaesthesia & Perioperative Medicine, School of Medicine Nursing & Health Sciences, Monash University, Clayton, VIC, Australia
| | - Jennifer Gong
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Belinda J Gabbe
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Farr Institute, Swansea University Medical School, Swansea University, Wales, UK
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17
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Das M, Angeli F, Krumeich AJSM, van Schayck OCP. The gendered experience with respect to health-seeking behaviour in an urban slum of Kolkata, India. Int J Equity Health 2018; 17:24. [PMID: 29444674 PMCID: PMC5813424 DOI: 10.1186/s12939-018-0738-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 02/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Empirical evidence shows that the relationship between health-seeking behaviour and diverse gender elements, such as gendered social status, social control, ideology, gender process, marital status and procreative status, changes across settings. Given the high relevance of social settings, this paper intends to explore how gender elements interact with health-seeking practices among men and women residing in an Indian urban slum, in consideration of the unique socio-cultural context that characterises India's slums. METHODS The study was conducted in Sahid Smriti Colony, a peri-urban slum of Kolkata, India. The referral technique was used for selecting participants, as people in the study area were not very comfortable in discussing their health issues and health-seeking behaviours. The final sample included 66 participants, 34 men and 32 women. Data was collected through individual face-to-face in-depth interviews with a semi-structured questionnaire. RESULTS The data analysis shows six categories of reasons underlying women's preferences for informal healers, which are presented in the form of the following themes: cultural competency of care, easy communication, gender-induced affordability, avoidance of social stigma and labelling, living with the burden of cultural expectations and geographical and cognitive distance of formal health care. In case of men ease of access, quality of treatment and expected outcome of therapies are the three themes that emerged as the reasons behind their preferences for formal care. CONCLUSION Our results suggest that both men and women utilise formal and informal care, but with different motives and expectations, leading to contrasting health-seeking outcomes. These gender-induced contrasts relate to a preference for socio-cultural (women) versus technological (men) therapies and long (women) versus fast (men) treatment, and are linked to their different societal and familial roles. The role of women in following and maintaining socio-cultural norms leads them to focus on care that involves long discussions mixed with socio-cultural traits that help avoid economic and social sanctions, while the role of men as bread earners requires them to look for care that ensures a fast and complete recovery so as to avoid financial pressures.
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Affiliation(s)
- Moumita Das
- School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. .,Centre for Study of Social Change and Development, Institute for Social and Economic Change (ISEC), Bangalore, India.
| | - Federica Angeli
- Department of Organization Studies, School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Anja J S M Krumeich
- Department of Health Ethics and Society, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of General Practice, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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